Browse Articles

Quantitative and temporal analysis of autophagy: Differential Response to amino acid and glucose starvation

Autophagy is a highly conserved, intracellular recycling process by which cytoplasmic contents are degraded in the lysosome. This process occurs at a low level constitutively; however, it is induced robustly in response to stressors, in particular, starvation of critical nutrients such as amino acids and glucose. That said, the relative contribution of these inputs is ambiguous, and many starvation medias are poorly defined or devoid of multiple nutrients. Here, we set out to create a quantitative dataset of autophagy across multiple stages in single, living cells, measured under normal growth conditions and during nutrient starvation of amino acids or glucose. We found that autophagy is induced by starvation of amino acids, but not glucose, in U2OS cells, and that MTORC1-mediated ULK1 regulation and autophagy are tightly linked to amino acid levels. While autophagy is engaged immediately during amino acid starvation, a heightened response occurs during a period marked by transcriptional upregulation of autophagy genes during sustained starvation. Finally, we demonstrated that cells immediately return to their initial, low-autophagy state when nutrients are restored, highlighting the dynamic relationship between autophagy and environmental conditions.

Threshold analysis of rainfall and groundwater recharge in mitigating drought risks in overexploited groundwater regions

This study examines how rainfall and groundwater recharge can help mitigate drought conditions, using the Standardized Precipitation Evapotranspiration Index (SPEI) as the drought indicator. It focuses on the top ten countries experiencing groundwater overexploitation and incorporates a global average perspective to provide deeper insights into these critical relationships. These insights are essential for informed policy-making and integrated decision-making, involving a range of stakeholders from local users to international policymakers on drought mitigation efforts from 1961 to 2022. The analysis employs the novel technique to estimate Dynamic Panel Threshold Regression (DPThR) model. The findings reveal that a 1-millimeter increase in rainfall improves the SPEI by 0.003 units, thereby reducing drought likelihood. The threshold for mitigating drought effects is identified at 614.41 millimeters of annual rainfall, with Pakistan, Iran, and Saudi Arabia being the most at-risk countries when rainfall falls below this level. Conversely, a one-standard-deviation increase in groundwater recharge enhances the SPEI by 5.06 units, indicating a substantial reduction in drought incidence. The threshold for mitigating drought effects is identified at –0.0039 standard deviations, with China, Iran, Mexico, Pakistan, Saudi Arabia, Turkey, and the United States being the most drought-prone when recharge falls below this level. Furthermore, it was found that temperature exerts a consistently negative and highly significant effect, indicating that warming intensifies drought through evapotranspiration and soil moisture depletion. While CO 2 emissions show no significant direct impact. Moreover, the study identifies unidirectional causality running from rainfall, groundwater recharge, temperature, and CO 2 emissions, reinforcing the dominance of hydro-climatic forces in driving drought variability. Policy recommendations include advancing artificial rainfall, enhancing groundwater recharge, and maintaining country-specific water use thresholds to reduce drought risk and strengthen water and climate resilience in overexploited regions.

A prospective evaluation of Johnson & Johnson COVID-19 vaccine on glycemic biomarkers in type 2 diabetes mellitus in Ethiopia

Background People living with Type 2 Diabetes Mellitus (T2DM) face a heightened risk of experiencing severe complications from COVID-19, underscoring the importance of vaccination. Nonetheless, the impact of COVID-19 vaccines—especially the Johnson & Johnson (Ad26.COV2.S) vaccine—on glucose regulation has not been fully elucidated. This study evaluates the impact of vaccination on glycemic parameters, including Random Blood Sugar (RBS) and Hemoglobin A1c (HbA1c), and identifies factors influencing glycemic variability. Methods Between May 2023 and June 2024, a prospective cohort study was carried out at Adama Hospital Medical College in Ethiopia. Adults diagnosed with Type 2 Diabetes Mellitus were divided into two cohorts based on vaccination status: those who received the vaccine and those who did not. Glycemic parameters were recorded at baseline and subsequently at three-month intervals—specifically at 3, 6, 9, and 12 months following vaccination. To evaluate trends over time and identify influencing factors, including demographic and clinical variables, longitudinal data were analyzed using Generalized Estimating Equations (GEE). Results Vaccinated individuals exhibited transient elevations in RBS, peaking at three months post-vaccination before stabilizing. In contrast, HbA1c levels demonstrated a gradual increase over time. Greater glycemic variability was observed in younger individuals and females. The primary determinants of variations in glycemic levels were vaccination status, duration following immunization, and demographic characteristics. In contrast, diabetes treatments and lifestyle-related factors showed only a limited influence. Conclusion The Johnson & Johnson COVID-19 vaccine was associated with short-term RBS fluctuations and a sustained increase in HbA1c levels in T2DM patients. These findings highlight the need for personalized glycemic monitoring post-vaccination. Despite these metabolic variations, the vaccine’s protective role against severe COVID-19 outweighs transient glycemic disturbances. Incorporating vaccination efforts into comprehensive diabetes management is crucial, and additional studies are warranted to investigate the underlying biological mechanisms.

Patient experience of advanced practice physiotherapy within low back pain care pathways in Canada and the United Kingdom: A multiple case-study protocol

Introduction Low back pain (LBP) is the leading cause of disability worldwide, with high prevalence in Canada and the United Kingdom. LBP care pathways offer high-quality, guideline concordant care, with advanced practice physiotherapy (APP) an integral component. APP is a higher level of practice providing care for individuals with complex healthcare needs. Patient experience is an important measure of healthcare service quality. Although patient experience has been explored in some APP settings, and in standard physiotherapy for people with LBP, no study has explored patient experience of APP in LBP care pathways. Aim & Objectives To explore and understand how patients experience APP within low back pain care pathways in the UK and Canada. To map APP integration within LBP care pathways in the UK and Canada. To explore advanced practice physiotherapists’ perspectives on the patient experience of APP. To explore patients’ experience of APP. To synthesise the physiotherapists’ perspectives on the patient experience and patients’ experience of APP. To compare patient experience of APP between the UK and Canada. Methods A qualitative, exploratory, multiple case-study using an embedded (nested) design situated within a constructivist paradigm will be conducted. Cases will be LBP care pathways in Ontario, Canada and England, United Kingdom. AP physiotherapist and patient participants from both cases will be recruited through non-probability sampling. LBP care pathways will undergo framework analysis, quantitative questionnaire data will be reported descriptively, and interview and open text questionnaire data will undergo thematic analysis. Both within-case and cross-case analyses will be conducted. Significance This study may improve patient-centred care in LBP care pathways, inform APP educational programs and curricula design, address a knowledge gap in the APP literature, and inform future research by offering theoretical propositions relevant to patient experience of APP within LBP care pathways.

Radical Electroprecipitation Prolongs “Electro”chemiluminescence of the Tris(2,2’-bipyridyl)ruthenium(II) and Tri- <i>n</i> -propylamine System by a Millionfold

Single-session radiofrequency ablation for the treatment of benign cystic thyroid nodules: A prospective study

Background Benign cystic thyroid nodules are commonly encountered in clinical practice and often require intervention due to compressive symptoms or cosmetic concerns. While ethanol ablation (EA) has been widely used, radiofrequency ablation (RFA) has emerged as a promising alternative, particularly for nodules with a significant solid component. This study aimed to evaluate the short-term efficacy and safety of single-session RFA in treating purely cystic and predominantly cystic thyroid nodules (PCTNs). Methods This prospective study included 38 patients with benign cystic thyroid nodules (10 purely cystic and 28 PCTNs) treated with single-session RFA. Pre- and post-treatment evaluations were performed using ultrasound imaging and thyroid function tests at 1, 6, and 12 months. The primary endpoint was volume reduction rate (VRR), and therapeutic success was defined as VRR &gt; 50%. Complications were assessed according to international image-guided tumor ablation criteria. This study was registered at ClinicalTrials.gov (identifier: NCT07115576). Results RFA resulted in significant volume reduction, with VRR improving from 65.97 ± 22.19% at 1 month to 83.29 ± 17.33% at 6 months and 82.49 ± 23.18% at 12 months (p = 0.004). Purely cystic nodules demonstrated higher VRR than PCTNs at all follow-up points (p &lt; 0.05). Thyroid function remained stable post-procedure. The therapeutic success rate was 83.3% at 1 month and 86.7% at 12 months, with no major complications reported. Purely cystic nodules showed a consistently higher and more durable response than PCTNs. Conclusion Single-session RFA appears to be a safe and effective minimally invasive treatment option for large benign thyroid nodules, although confirmation in comparative studies is needed. The technique is particularly advantageous for purely cystic nodules and offers a minimally invasive alternative to surgery or multiple EA sessions. Trial registration ClinicalTrials.gov NCT07115576

Intravenous iron for anaemia in pregnancy: A quantitative study of acceptability and feasibility of its integration into routine antenatal care practice in Nigeria

Background Anaemia in pregnancy (AIP), defined as a haemoglobin concentration of less than 11g/dl, is a significant global health issue, especially in resource-constrained settings. Of all the causes of AIP, iron deficiency anaemia is the commonest, accounting for approximately half of cases. While oral iron treatment is standard according to the WHO recommendation, poor adherence is a concern. Intravenous (IV) iron is an alternative treatment, especially in cases where oral iron is challenging to utilise. However, this intervention is yet to be integrated into routine antenatal care. This study aimed to assess skilled health personnels' (SHPs) perceptions of the acceptability and feasibility of IV iron in managing AIP in Lagos and Kano based on SHP characteristics and changes over time. Methods This was a repeated cross-sectional study embedded within a randomised controlled trial (RCT) conducted in 11 healthcare facilities in Lagos and Kano states, Nigeria. All SHPs trained in implementing IV iron were invited to participate in the study. Data were collected using the Acceptability and Feasibility of Intervention measure (AIM and FIM) survey tools between the RCT baseline in August 2021 and the endline in May 2023. Analysis was done using descriptive statistics, independent and Paired T-tests and Analysis of variance (ANOVA) in Stata. Results Of the 60 SHPs invited at baseline (pre-implementation), 53 (88%) completed the survey. At endline (post-implementation), 39 of the 46 SHPs involved in IV iron implementation responded (85%). When comparing groups, baseline AIM scores differed significantly by state ( p  = 0.001), though this was not sustained at endline. No other significant differences were seen by cadre or facility for AIM, and FIM did not differ significantly by state, cadre, or facility at either time point. Among the 20 SHPs who completed both surveys, the AIM score increased from baseline 16.8/20 (Standard deviation, SD = 2.0) to endline (18.5, SD = 2.0) ( p  = 0.002). FIM scores also increased over time, 17.1/20 (SD = 2.3) versus 18.2/20 (SD = 1.7) ( p  = 0.088). Conclusion Post-implementation, IV iron was perceived as highly acceptable and feasible with no differences across cadre, state, or facility levels. While acceptability significantly improved over time, feasibility also increased, though not statistically significantly at the 0.05 level.

Migration intentions and their impact on healthcare workers in a Lebanese public university hospital amid crises: A mixed-method study

Background The emigration of skilled healthcare workers (HCWs) seeking better opportunities poses major challenges to healthcare systems in low- and middle-income countries. Amidst ongoing economic and political crises, Lebanon is facing substantial healthcare workforce migration. This study explored the migration intentions of Lebanese HCWs, identifies key drivers, and proposes context-specific retention strategies. Methods A mixed-methods design was employed at Rafik Hariri University Hospital (RHUH) in Beirut, Lebanon. A structured survey assessed migration intentions and associated drivers among frontline healthcare workers, while semi-structured interviews with department chiefs explored organizational and systemic factors influencing workforce retention. Quantitative data were analyzed to identify predictors of migration intentions, and qualitative data were thematically analyzed using a combined deductive–inductive approach. Results Among 120 HCWs surveyed, 70% expressing intentions to migrate—primarily due to financial concerns (93%) and security issues (81%). Lower satisfaction with pay (adjusted OR= 0.85, 95% CI = 0.72–0.996) was significantly associated with migration intentions. Qualitative findings confirmed widespread staff migration since 2019, leading to critical shortages, heavier workloads, and department closures. Department chiefs emphasized the need for financial incentives, professional development opportunities, supportive management, and flexible scheduling to improve retention. Conclusions HCW migration from Lebanon reflects a complex interplay of financial, professional, and systemic factors. Immediate and sustainable policy interventions—combining financial stabilization with workforce development and improved working conditions—are urgently required to preserve healthcare system functionality and resilience.

Construction of a depression risk prediction model for hepatitis B patients based on machine learning strategy

Background Hepatitis B (HBV) is a chronic viral infection that can lead to cirrhosis, liver failure, and liver cancer, and has a profound impact on the patient’s mental health. However, current depression screening mainly relies on self-filled scales and clinical experience, lacking objective and efficient prediction tools. This study aims to construct a risk prediction model for depression in hepatitis B patients based on machine learning, and explore the key features that affect the occurrence of depression, so as to optimize mental health management strategies. Methods This study used the NHANES database to collect demographic, dietary, physical examination, laboratory test and questionnaire data. The data were standardized and SMOTE oversampling was used to solve the problem of class imbalance. Random Forest (RF) was used for feature screening to identify the top 20 most important predictive features, and five machine learning models (Gradient Boosting, Logistic Regression, AdaBoost, MLPClassifier, LDA) were used for prediction. The model performance was evaluated by AUC (area under the curve), accuracy, recall, precision and F1-score, and ROC curves, calibration curves, and decision curve analysis (DCA) were drawn to evaluate the clinical applicability of the model. Results All five machine learning models performed well in the task of predicting the risk of depression in hepatitis B patients, among which MLPClassifier (multi-layer perceptron) performed best, with an AUC of 0.935, a recall of 0.980, and an F1-score of 0.917, which was better than other models. In addition, feature analysis results showed that liver function damage (serum total bilirubin, alkaline phosphatase), electrolyte imbalance (serum potassium ions), chronic inflammation (red blood cell distribution width, lymphocyte count), and socioeconomic factors (poverty-income ratio, race) were important factors affecting the risk of depression in hepatitis B patients. Conclusion This study constructed an efficient and objective machine learning model that can be used to predict the risk of depression in patients with hepatitis B, providing a new tool for accurate screening and individualized management. The study revealed the potential mechanisms of physiological, biochemical and socioeconomic factors in the occurrence of depression in patients with hepatitis B, and provided a reference for future mental health intervention strategies.

Analysis of the current status and influencing factors of kinesiophobia in tumor patients with peripherally inserted central catheter: A cross-sectional study

Background Peripherally Inserted Central Catheters (PICCs) are widely utilized in tumor patients due to their lower risk of complications, extended indwelling duration, reduced local tissue trauma, and overall cost-effectiveness. Based on the Health Action Process Approach (HAPA) theory, this study aims to explore the current status and influencing factors of kinesiophobia in tumor patients with PICCs. The study provides reference for clarifying the mechanism of kinesiophobia and developing nursing intervention plans. Method Through convenience sampling, 162 tumor patients who underwent PICC maintenance in three hospitals in Jiangsu Province from December 4th, 2023, to December 31st, 2024 were selected. The patient general information questionnaire, Tampa scale of kinesiophobia, medical coping modes questionnaire, exercise self-efficacy scale, risk perception questionnaire, outcome expectation scale, exercise intention scale, and social support rating scale were used for evaluation. Result Tumor patients carrying PICC had a kinesiophobia score of 20.11 ± 6.94 points, and 42.59% of tumor patients with PICC had kinesiophobia. The results of multiple linear regression showed that the duration of catheter placement(t = −3.506,P = 0.001), pain(t = 2.652,P = 0.009), exercise self-efficacy(t = −3.891,P &lt; 0.001), and risk perception(t = 3.157,P = 0.002) are the main influencing factors of kinesiophobia in tumor patients with PICC. Conclusion The findings underscore a significant clinical concern regarding kinesiophobia among tumor patients with PICC. It is essential for nursing staff to implement systematic assessments and tailored interventions aimed at mitigating kinesiophobia. Addressing this issue can contribute to reducing associated adverse reactions and improving patient mobility and overall quality of life.

Implementation of guideline-directed medical treatment for ischemic heart disease management: A knowledge, attitude and practice based cross-sectional survey

Background Guideline-Directed Medical Therapy (GDMT) is central to managing ischemic heart disease (IHD), yet its implementation remains suboptimal in low- and middle-income countries (LMICs), including Pakistan. Aim This study assessed the knowledge, attitudes, and practices (KAP) of healthcare professionals (HCPs) toward GDMT and identified key barriers to its application. Methods A cross-sectional survey was conducted among HCPs including cardiologists and clinical pharmacists using a validated questionnaire. Data was collected from Punjab Institute of Cardiology, Lahore, Pakistan using convenience sampling. Descriptive statistics, t-tests, ANOVA, Mann–Whitney U, Kruskal–Wallis, and multiple linear regression analyses were used to evaluate KAP scores and their association with demographic and professional role. Statistical adjustment for multiple comparisons was done by Bonferroni correction. Results A total of 76 HCPs participated in the survey, comprising 42 cardiologists (55.3%) and 34 clinical pharmacists (44.7%). he overall mean knowledge score was 18.64 ± 2.02 out of 22 (84.7%). However, cardiologists (M = 19.54) scored significantly higher than clinical pharmacists (M = 17.52, p &lt; 0.001); thus rejecting the null hypothesis. Knowledge scores were significantly higher among older professionals, those with postgraduate education, and clinic-based practitioners (p &lt; 0.05). The average attitude score was 10.42 ± 2.06 out of 14 (74.4%), with younger professionals (aged 28–33), cardiologists, and postgraduates showing more favorable attitudes (p &lt; 0.05). The mean practice score was 9.51 ± 2.55 (67.9%), with no significant differences by gender, role, or setting. Regression models showed age and profession significantly predicted knowledge, while attitude was influenced by education, experience, gender, and profession. Practice behaviors were not predicted by any demographic variables. Key barriers to GDMT implementation included limited consultation time (47.4%) and poor patient adherence (25%). Conclusion Although GDMT knowledge and attitudes were generally high among Pakistani cardiologists and clinical pharmacists, reported practice remained moderate. The results underscore the need for targeted educational interventions and system-level strategies to support consistent GDMT implementation.

Investigating patient navigator impact on older adults’ transitions from acute care: A randomized controlled trial with embedded qualitative component

Background Fall-related injuries such as fractures are on the rise among older adults. Resulting transitions in care from hospital can be complex and place significant pressure on healthcare teams. This study sought to determine the impact of patient navigators in the orthogeriatric context. Methods A concurrent embedded mixed methods design was used, in which the quantitative, open label, randomized controlled trial, analysed using structural equation modelling, had an embedded reflexive thematic analysis qualitative component. Older adults (≥65 years) admitted to an orthopedic unit with any fracture were randomized into the standard of care or patient navigator group and followed until three months post-discharge. Main outcomes were, unplanned healthcare utilization post-discharge, patient satisfaction, and patient/caregiver experiences. Semi-structured interviews were conducted with patients ( n  = 60) and caregivers ( n  = 15) in both groups. Results The patient navigator group ( n  = 34) had fewer unplanned healthcare utilizations post-discharge at lower levels of frailty and more unplanned healthcare utilizations post-discharge as frailty increased compared to the standard of care group ( n  = 36). Patient satisfaction was not significantly different between groups. Comparisons between the standard of care and patient navigator patient and caregiver groups found the patient navigator groups had unique themes, detailing the positive impact of the patient navigator, particularly in relation to the provision of information and support. Conclusions Patient navigators play an important role in orthogeriatric rehabilitation by facilitating more appropriate use of healthcare resources. Patients and caregivers found patient navigators supportive and helpful with care. Patient navigators were shown particularly helpful for participants with higher care needs and would also be beneficial for patients with fewer family supports. Trial Registration: NCT06107699

Biodegradation of polyethylene terephthalate microplastics by Paenibacillus naphthalenovorans PETKKU2: Response surface optimization and genomic evidence for an alternative degradation mechanism

This study establishes Paenibacillus naphthalenovorans PETKKU2, isolated from landfill soil in Thailand, as the first reported member of this species capable of degrading polyethylene terephthalate microplastics (PET-MP). Initial screening identified PETKKU2 as the most efficient degrader among ten isolates, achieving 6.07 ± 0.18% weight loss after 35 days at 37°C. Response surface methodology optimization of pH, nitrogen concentration, and PET-MP loading enhanced degradation to 9.48 ± 0.21%, closely matching the predicted maximum of 11.15% and representing 96% improvement over baseline conditions. Integrated analytical characterization (FTIR, SEM, GC-MS) revealed an alternative degradation mechanism distinct from classical PETase-MHETase pathways. FTIR analysis confirmed extensive polymer oxidation with 41% reduction in ester carbonyl groups, while SEM demonstrated progressive surface erosion. Critically, the absence of mono(2-hydroxyethyl) terephthalate (MHET) intermediates, combined with whole-genome analysis revealing thermostable lipases, carboxylesterases, and dioxygenases, but no PETase/MHETase homologs, indicates novel enzymatic routes. Operating under mesophilic conditions (37 °C), PETKKU2 eliminates energy-intensive heating requirements while achieving performance comparable to established thermophilic degraders. These findings establish a promising platform for sustainable PET-MP bioremediation and advance understanding of alternative microbial plastic degradation mechanisms.

Transcriptomic analysis reveals the impact of concurrent, resistance, and endurance training on skeletal muscle

The shared and divergent molecular mechanisms underlying skeletal muscle adaptation to different exercise modalities are not fully understood. This study aimed to compare the physiological and transcriptomic responses to 12 weeks of concurrent (CET), resistance (RES), or endurance (END) training in healthy males. While all groups exhibited similar increases in lean body mass, RES and END elicited distinct functional improvements in maximal strength and aerobic capacity, respectively. Notably, CET preserved strength gains comparable to RES but showed a blunted improvement in anaerobic power. Transcriptomic analyses revealed both common and modality-specific signatures. Although the number of differentially expressed genes varied across groups (CET: 392; RES: 17; END: 49), enrichment analyses consistently identified the engagement of extracellular matrix (ECM) organization pathways. Gene set enrichment analysis further demonstrated a universal activation of ECM remodeling and an inhibition of translation initiation processes post-training. Weighted gene co-expression and protein-protein interaction network analyses pinpointed core genes associated with each modality, including COL1A1/COL1A2 for CET and END, and SPARC/ASPN for RES. Regulatory network predictions implicated the miR-29 family and JUN as potential co-regulators of collagen-related genes. In conclusion, this integrated analysis establishes ECM remodeling as a fundamental transcriptional response supporting exercise-induced hypertrophy common to diverse training modalities, while simultaneously identifying distinct gene regulatory networks that underlie their divergent functional outcomes.

Cortisol–CRP synchrony and mood recovery under clustered psychosocial stress in emerging adults

Psychosocial stress involving multiple life changes has well-documented effects on health, yet the physiological mechanisms linking stress exposure to emotional recovery remain incompletely understood. This simulation study examines how clustered life stress, quantified through the Holmes and Rahe Social Readjustment Rating Scale (SRRS) and Life Change Units (LCUs), influences synchrony between cortisol and C-reactive protein (CRP), and how this coupling predicts mood recovery in emerging adults. Using fully synthetic longitudinal data parameterized from published empirical ranges and established biometric patterns, we modeled cortisol–CRP coordination across varying LCU loads and buffering capacities. Results indicated that higher cumulative LCUs, particularly when stressors were temporally clustered, were associated with disrupted cortisol–CRP synchrony and delayed mood rebound. Conversely, stronger physiological coupling between endocrine and immune responses predicted more rapid emotional recovery, suggesting a potential biomarker of stress resilience. These findings identify a bi-axial pathway through which life stress may influence psychological outcomes and underscore the importance of multisystem coordination during vulnerable developmental periods. By integrating a validated stress inventory with biologically grounded simulation, this study contributes novel insights into stress responsivity and affective adaptation.

Association between triglyceride-cholesterol-body weight index and sarcopenia in the older adults from China: A cross-sectional study

Background The triglyceride-cholesterol-body weight index (TCBI) is a simple and reliable indicator of nutritional status. This investigation aimed to explore the association between TCBI and sarcopenia among older individuals in China. Methods The AWGS 2019 criteria were utilized to evaluate sarcopenia. TCBI was calculated as (TG × TC × BW)/1000. Logistic regression analysis explored the independent connection between TCBI and the occurrence of sarcopenia. RCS was employed to investigate both linear and nonlinear correlations, and threshold effects were scrutinized. Furthermore, subgroup and sensitivity analyses were also conducted. Results This study included 5293 participants. The TCBI was found to be negatively associated with sarcopenia in a fully corrected model, with a 66% decrease in the prevalence of sarcopenia for each 1-unit increase in LgTCBI (OR = 0.34; 95% CI: 0.28–0.41; p &lt; 0.001). The study showed that this association was further highlighted in those with normal BMI and remains consistent in sensitivity analyses. Furthermore, we found a nonlinear association between both TCBI and sarcopenia, with an inflection point of 7.05 by the RCS curve and threshold effect analysis. Conclusion This study revealed a nonlinear negative correlation between TCBI and sarcopenia, highlighting the implications of these findings for the early screening and timely intervention of sarcopenia.

Investigation of spillover effects of a sugar-sweetened beverage tax on beverage purchasing in a nearby, non-taxed area: A quasi-experimental, difference-in-differences analysis

Evidence suggests that sugar-sweetened beverage (SSB) taxes reduce SSB purchasing and improve health outcomes in the taxed area. The extent to which purchasing also changes in nearby communities due to tax signaling effects is unclear. The objective of this study was to assess whether the SSB tax in Seattle, Washington, USA, influenced SSB purchasing in nearby communities within the same media market. We used retail scanner data on weekly sales of 3,531 beverages from 127 retailers in King County excluding Seattle and its bordering area (KC), and 243 retailers in a matched comparison area outside the regional media market. Matching was done via Mahalanobis distance based on pre-tax, county-level demographic measures from the American Community Survey. We estimated linear difference-in-differences in mean volume sold of taxed and nontaxed beverages comparing two years before (2016−2017) and after tax implementation (2018−2019) adjusting for beverage-level fixed effects. We also estimated the difference-in-differences in Seattle versus a matched comparison to estimate the tax effect in Seattle as context for potential effects in KC. For taxed beverages, the mean difference-in-differences in volume sold in KC was 172 liters (95% CI: −1,396, 1,740; P = 0.83), reflecting a 1% change from pre-tax levels in KC for a given beverage. There was suggestive evidence of increased volume sold for taxed and nontaxed soda, and taxed multipack beverages in KC relative to the comparison area. In Seattle, the mean difference-in-differences in volume sold for taxed beverages was −3,628 liters (95% CI: −4,622, −2,634; P &lt; 0.001), reflecting a 20% decline for a given beverage in association with the tax. We did not find evidence of spillover effects in the form of reduced volume sold of SSB in communities near but not bordering the tax in Seattle. Studies in other contexts are needed to investigate spillover on purchasing as well as possible explanations for observed increases in purchases of taxed and nontaxed soda.

Zeolite-Encapsulated Ir Single Atom Catalysts Toward Efficient and Stable Propane Dehydrogenation

A Golden Fullerene Encapsulating Schmid Gold

Harary index of the zero divisor graph of upper triangular matrices