Search Results (12,766)

Background/Objectives: Eleocharis ussuriensis Zinserl. is a perennial riparian sedge widely distributed in Northeast Asia and a dominant component of freshwater vegetation in South Korea. However, the intraspecific genetic structure of this species across contrasting hydrological habitats remains insufficiently understood. This study aimed to develop novel SSR markers from whole-genome data and investigate genetic variation and population structure among E. ussuriensis populations in South Korea. Methods: Twenty-one novel simple sequence repeat (SSR) markers were developed from whole-genome sequence data and applied to analyze genetic variation in 120 individuals from 6 populations. Genetic diversity, differentiation, and gene flow were estimated using allele-frequency-based metrics, and population genetic structure was further evaluated using spatial information derived from geographic coordinates. Results: A total of 201 alleles were detected, with a mean polymorphism information content (PIC) of 0.759, indicating high marker informativeness. Mean genetic diversity across populations showed observed heterozygosity (Ho = 0.360) and expected heterozygosity (He = 0.281), while multilocus genotype ratios (G/N) ranged from 0.30 to 1.00 among populations. Genetic differentiation was substantial (F_ST = 0.373–0.669; Jost’s D = 0.540–0.997). Mantel tests revealed that genetic differentiation was significantly correlated with geographic distance (r = 0.67, p < 0.001). Both allele-frequency-based and spatially explicit approaches suggested genetic structuring among populations. Conclusions: The results suggest spatial tendencies in genetic structure among populations, reflecting patterns of allele distribution across regions. These findings provide baseline information on genetic variation in E. ussuriensis and may contribute to a better understanding of its ecological dynamics. Full article

Background: Dyspnea is a common reason for emergency medical service (EMS) interventions and is associated with a substantial risk of severe clinical course, complications, and hospital admission. Its differential diagnosis in the prehospital setting remains challenging due to the limited availability of imaging modalities. Point-of-care ultrasound (POCUS), including lung ultrasound (LUS), is a rapid, field-applicable technique recommended in numerous acute respiratory diagnostic scenarios. Objective: To evaluate the use of lung ultrasound in the prehospital setting and its association with the precision of diagnoses related to respiratory failure, the frequency of transport to the emergency department (ED) among patients presenting with dyspnea/respiratory failure, and to characterize the profile of sonographic findings with their correlation to clinical diagnostic categories. Additionally, transport rates in the study population were compared with aggregated regional data for the Masovian Voivodeship (excluding the analyzed county). Methods: A retrospective observational study was conducted on EMS interventions performed between 01 January 2025 and 30 June 2025 in Legionowo County (N = 353). The analysis included ICD-10 codes assigned in prehospital documentation (one primary code and up to two additional codes) in patients presenting with dyspnea and/or respiratory failure, the performance of ultrasound examination, and resulting LUS findings (absence of pleural sliding and/or lung point; B-lines; consolidations; C-lines; pleural effusion). Descriptive analyses, frequency comparison tests (χ²/Fisher), estimation of relative risk (RR) with 95% confidence intervals (CI), and agreement analysis using Cohen’s kappa coefficient (κ) between etiological categories derived from ICD-10 codes and those inferred from LUS profiles were performed (κ with 95% CI estimated using bootstrap resampling). The study was reported in accordance with the STROBE guidelines for observational studies. Additionally, the distribution of ICD-10 coding and the proportion of hospital transports across the entire Masovian Voivodeship were compared with those observed in the analyzed area. Results: Ultrasound examination was performed in 72/353 (20.4%) EMS interventions; transport to the emergency department occurred in 239/353 (67.7%) cases. The most frequent clinical categories based on ICD-10 codes were: general/symptom-based 182/353 (51.6%), inflammatory 77/353 (21.8%), obstructive 66/353 (18.7%), and cardiological 20/353 (5.7%). Among abnormal LUS findings, the most common were B-lines (43/72; 61.4%) and consolidations (29/72; 41.4%). Consolidations were strongly associated with the inflammatory category (OR 9.72; p < 0.001), whereas B-lines were associated with the cardiological category (OR 23.41; p = 0.0011) among cases in which LUS was performed. Ultrasound use was associated with a higher frequency of assigning at least one targeted (non-symptom-based) diagnosis within ICD coding: 53/72 (73.6%) vs. 111/278 (39.9%), RR 1.84 (95% CI 1.51–2.25; p < 0.001). Agreement between the ICD-10 etiological category (inflammatory/cardiological/obstructive/other) and the category inferred from the LUS profile was moderate: κ = 0.36 (95% CI 0.21–0.51), with an observed agreement of 54.2%. Compared with aggregated regional data (Masovian Voivodeship excluding the analyzed county), the overall transport rate for comparable ICD-10 codes was lower in the study unit: 279/409 (68.2%) vs. 11,351/13,785 (82.3%), RR 0.83 (95% CI 0.78–0.89; p < 0.001). The largest differences were observed for dyspnea (R06.0: 72.9% vs. 88.2%; RR 0.83) and obstructive codes (J44/J45/J46 combined: 43.1% vs. 67.0%; RR 0.64). Conclusions: In this retrospective analysis, an EMS unit with systematically implemented ultrasound demonstrated a lower frequency of hospital transport for selected dyspnea/respiratory failure codes compared with regional data and greater precision in ICD-10 diagnostic coding in cases where ultrasound was performed. The profile of LUS findings correlated with clinical categories in a manner consistent with existing literature. Full article

Achieving sustainable development requires moving beyond pollution metrics to holistic measures, such as the load capacity factor (LCF), which balances ecological demand and supply. While recent studies have provided important insights into the determinants of LCF in OECD countries, further research is needed to incorporate additional determinants and updated estimation approaches. This study addresses this gap by examining the impacts of financial innovation, forestry, urbanization, population, and economic growth on the LCF in Organization for Economic Cooperation and Development (OECD) economies from 1990 to 2023. Using second-generation panel econometric methods, including tests for cross-sectional dependence, slope heterogeneity, second-generation unit roots, and cointegration techniques, this paper confirms a stable long-run relationship among the variables. The core analysis applies the method of moments quantile regression to uncover the heterogeneous effects across the LCF distribution. The results indicate that financial innovation consistently enhances the ratio of biocapacity to ecological footprint. In contrast, economic growth and urbanization exert significant negative pressure on the LCF, whereas population size shows a uniformly detrimental effect. Forestry has a positive but less pronounced influence. Robustness checks using fully modified ordinary least squares, dynamic ordinary least squares, and panel-corrected standard errors confirm these results. The present study concludes that targeted financial innovation and stringent urban demographic policies support OECD nations in improving ecological balance and reducing ecological deficits. Full article

Background and Objectives: Stroke remains a major contributor to global morbidity and mortality, with substantial geographic variation in incidence and outcomes. Although declining trends in stroke incidence and mortality have been documented in several Western European populations, countries in Eastern Europe have historically experienced a disproportionately high cardiovascular disease burden. Comprehensive long-term evaluations assessing simultaneous trends in stroke attack rates, mortality, and case-fatality in Lithuania are limited. This study aimed to investigate 24-year trends (2000–2023) in stroke epidemiology among working-age residents of Kaunas city. Materials and Methods: Data were derived from the Kaunas population-based stroke registry and included individuals aged 25–64 years. Age-standardized attack rates, mortality rates, and case-fatality rates per 100,000 population were calculated using the World Health Organization standard population. Temporal trends were assessed using Joinpoint regression analysis to estimate annual percentage changes (APCs) with corresponding 95% confidence intervals (CIs). Analyses were stratified by sex, age group (25–54 and 55–64 years), and stroke subtype (ischemic and hemorrhagic). Results: During 2000–2023, overall stroke attack rates declined significantly in both sexes, with a more pronounced reduction observed among females. Stroke mortality decreased significantly among females over the entire study period, whereas no significant overall change was observed among males, largely due to increases during 2010–2021 that attenuated earlier and subsequent improvements. Case-fatality rates demonstrated no significant overall long-term trend in either sex but exhibited marked temporal variability, including significant increases during 2010–2021 followed by substantial declines after 2021. Age-stratified analyses confirmed significant reductions in attack rates across both age groups. Ischemic stroke incidence declined significantly in both sexes, while hemorrhagic stroke mortality decreased significantly among males and females. The period 2021–2023 was characterized by pronounced reductions in mortality and case-fatality across multiple subgroups. Conclusions: Over the past two decades, the stroke burden among working-age residents of Kaunas has declined substantially, particularly among females. Despite period-specific deteriorations, recent improvements underscore the impact of advances in stroke prevention and acute care. Sustained risk factor control and continued healthcare system development remain essential to maintain favourable trends. Full article

This study aimed to estimate life expectancy at birth and survival patterns within a multigenerational family from Romania (102 individuals), whose members lived across the period 1900–2024. Life expectancy was estimated using abridged synthetic cohort life tables, and the results were interpreted through survival curve analysis. Life expectancy at birth was estimated at approximately 84 years for females and 80 years for males, while the overall life expectancy for the total family population was 81 years, representing a weighted estimate derived from sex-specific life tables, with weights corresponding to the proportion of females and males in the studied population, rather than a simple arithmetic mean, following standard demographic practice. The resulting survival curves exhibited a clear Type I survival pattern, characterized by low mortality at younger ages and an increasing concentration of deaths at older ages. When contextualized using recent Eurostat data, the life expectancy estimated for the analyzed family exceeds current national-level values reported for Romania and is close to the European Union average, particularly for females. These findings indicate a favorable survival profile at the familial level and illustrate the usefulness of life tables for investigating longevity patterns in small populations. Full article

In urban areas, green spaces have become the main refuge for biodiversity, providing essential habitat and resources for urban-adapted species. However, scientific evidence on the fitness consequences of urban green space management for urban populations remains scarce, limiting our ability to design successful conservation and management strategies. Here, we assess the fitness consequences of different levels of management practices in green spaces (i.e., high for areas with continuous intervention such as regular mowing and irrigation, and low for areas with minimal, sporadic maintenance) based on a 19-year long-term monitoring of the Eurasian Tree Sparrow (Passer montanus), a species with high behavioural plasticity in response to human-altered habitats. We formulated a unistate capture–mark–recapture model to estimate age-dependent survival while accounting for uncertainty in recapture probability. Furthermore, by means of GLMMs, we tested if the level of management influences reproductive parameters (i.e., breeding failure, number of eggs, nestlings, fledglings, brood number from the same year, breeding success). We found that high urban green space management caused a decline in adult survival, but we found no effect on juvenile survival. We also found lower breeding failure, a greater number of eggs, and larger brood numbers in the low management areas, but no differences were found in the number of nestlings and fledglings. Consequently, we found no differences in overall breeding success. Our results highlight the reduction in survival in a near-threatened passerine species due to routine green urban space management, in addition to differences in reproductive parameters depending on the degree of green urban space management. Overall, we confirm that the same species show several reproductive strategies with different breeding effort to reach similar breeding success, whatever the human context is. However, birds pay the cost in adult survival, and probably in shortening life span. Therefore, the management of urban green spaces has a negative impact on biodiversity in cities. It is necessary to review the management practices of these urban areas and promote practices that are friendly to biodiversity. Full article

Objectives: To investigate the association between adherence to national nutritional guidelines (Dutch Healthy Diet Index [DHD-index]) and glaucoma prevalence and to explore whether this association changed after accounting for measured intraocular pressure (IOP). Methods: This cross-sectional study used baseline data 2010–2013 from The Maastricht Study, a population-based cohort in The Netherlands. Adults aged 40–75 years with implausible dietary intake were excluded. Dietary intake was evaluated using a validated food frequency questionnaire, and adherence was quantified by the DHD-index. All participants underwent ophthalmic examination including perimetry and IOP measurement. Logistic and linear regression models examined associations of DHD adherence with glaucoma prevalence and IOP. Additional exploratory analyses assessed whether the association with glaucoma was attenuated after accounting for measured IOP. Results: Among 5729 participants (mean age: 59.5 ± 8.7 years; 50.1% female), glaucoma prevalence was 9.7% (n = 558). Each 10-point increase in DHD-index score was associated with 12.5% lower odds of glaucoma prevalence (odds ratio [OR]: 0.88; 95% confidence interval [CI], 0.83 to 0.93) and lower IOP (β: −0.17; 95% CI, −0.25 to −0.09 mmHg). Individuals in the highest DHD adherence tertile had 38% lower odds of glaucoma than those in the lowest tertile (OR 0.62; 95% CI, 0.50 to 0.76). Additional adjustment for measured IOP yielded similar estimates. Conclusions: Higher adherence to the Dutch Healthy Diet was associated with a lower glaucoma prevalence. The association was only minimally attenuated after accounting for measured IOP. Longitudinal studies should examine whether adherence to national dietary guidelines is associated with glaucoma onset and progression. Full article

Objectives: This study examines how different benefit payment modes under China’s long-term care insurance (LTCI) program influence healthcare utilization and medical expenditures among middle-aged and older adults. Specifically, it compares the effects of in-kind benefits and mixed benefits on healthcare service use and financial burden. Methods: This study uses data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018, focusing on middle-aged and older adults with functional limitations. Exploiting the staggered implementation of LTCI pilot programs across 14 cities, a difference-in-differences (DID) approach is employed to estimate the causal effects of different benefit payment modes on healthcare utilization and expenditures. Heterogeneity analyses are conducted to explore differences between rural and urban populations. Results: The results indicate that the in-kind benefit mode significantly reduces inpatient visits, total medical costs, and out-of-pocket expenditures. By contrast, the mixed benefit mode shows only a modest reduction observed mainly in outpatient visits. Heterogeneity analysis further reveals that in-kind benefits are particularly effective in reducing healthcare utilization and medical expenditures among rural residents, while urban residents experience higher reductions in out-of-pocket spending. Conclusions: These findings highlight the importance of benefit design in shaping the effectiveness of LTCI policies. Prioritizing service-based benefits may improve healthcare system efficiency and reduce financial burdens among older adults. The results provide policy-relevant insights for optimizing LTCI benefit design in China and other aging societies. Full article

The zero-inflated two-parameter Rayleigh (ZITR) distribution provides a flexible framework for modeling data with excess zeros and positive observations following a two-parameter Rayleigh distribution. It is particularly suitable for right-skewed data and has applications in areas such as road traffic mortality and survival analysis. This study develops and compares several methods for constructing confidence intervals for the difference and ratio of variances from two independent ZITR populations. The considered methods include Bayesian approaches based on Markov Chain Monte Carlo (MCMC) and highest posterior density (HPD) intervals, as well as the generalized confidence interval (GCI), method of variance estimates recovery (MOVER), approximate normal (AN), percentile bootstrap (PB), and bootstrap with standard error (BS). The performance of these methods is evaluated via Monte Carlo simulations under various parameter settings and sample sizes, using coverage probability and expected interval length as performance criteria. The results indicate that the Bayesian HPD method generally performs well across a wide range of scenarios. A real-data application using road traffic mortality data from January 2025 in Chanthaburi and Narathiwat provinces is also presented, demonstrating the practical usefulness of the proposed approaches for comparing the variance structure between the two regions. Full article

Background/Objectives: Sosnowsky’s hogweed Heracleum sosnowskyi, which originated in the Greater Caucasus region and spread rapidly across Central and Eastern Europe after being introduced as cattle fodder in the 1950s, is an example of an extremely dangerous invasive species listed by the European Union. This study aimed to estimate the genetic diversity of 6 native populations of Sosnowsky’s hogweed from the Caucasus region of Russia and Georgia, as well as 15 invasive populations from Lithuania and Poland, and to assess the adaptability of hogweed in new environments. Methods: Genetic analyses of plant material were conducted, including DNA extraction, ISSR genotyping, PCR product separation, and subsequent molecular data mining and analysis. Results: A pairwise Mantel test revealed a positive correlation between geographical distance and the genetic diversity of the hogweed populations. The presence of three distinct allele pools was confirmed in the populations under study, with genotypes from Poland dominated by the first allele pool, which had the largest number of polymorphic and private loci. Analysis of molecular variance by origin showed that 99% of the variation was within the analysed hogweed populations, with only 1% being between them. Native populations from Russia were genetically distinct from those in Poland and Lithuania. Some of the Georgian population shows genetic similarities to Russians, while the rest shows similarities to the secondary invasive Lithuanians. Conclusions: Introduced populations of H. sosnowskyi are characterised by considerable genetic variation, likely resulting from multiple introductions and subsequent evolutionary processes, which may facilitate local adaptation and invasiveness, although overall large-scale genetic differentiation remains low. Full article

Background: Heart failure with reduced ejection fraction (HFrEF) and chronic kidney disease (CKD) are common in the growing population of elderly patients, yet little evidence specifically targeting this population exists. The purpose of this study is to analyze the effect of SGLT2 inhibition in this cohort. Methods: A single-center, real-world observational study was performed. Patients aged >75 with HFrEF and CKD and theoretical indication for sodium–glucose cotransporter 2 (SGLT2) inhibitors were enrolled. Results: A total of 173 patients were included, with a mean age of 84.7 years, mean left ventricle ejection fraction of 29.5% and estimated glomerular filtration rate of 45.9 mL/min/1.73 m². During a median follow-up of 39 months, 73 (42.2%) deaths from any cause and 95 (53.3%) major clinical events (composite of mortality and heart failure admission) were recorded. Multivariate Cox proportional hazards regression analyses were performed to identify associated variables, and SGLT2 inhibition showed to be a protective factor for the mortality endpoint (hazard ratio 0.324 [0.117–0.894]). Male sex was shown to be a risk factor for both endpoints, diabetes mellitus for the mortality endpoint and diuretic use for the major clinical event endpoints. Conclusions: In a real-world study, treatment with SGLT2 inhibitors in elderly patients with HFrEF and CKD was associated with a lower rate of all-cause mortality. Full article

China’s rapid economic growth is partly due to the productivity gains from agglomeration, whereby firms and workers in larger and denser cities benefit from proximity through knowledge spillovers, thicker labor markets, and shared infrastructure. This study examines the changing nature and location of agglomeration economies in China using resident-based measures of urban scale from the 2000, 2010, and 2020 population censuses. Chinese “cities” are administrative jurisdictions that contain both dense urban districts and lower-density counties, so the agglomeration elasticities are estimated separately for districts and counties for a balanced panel of 298 prefectural jurisdictions. Agglomeration economies occur only in urban districts, while coefficients on urban scale for counties and county-level cities are close to zero or significantly negative. Moreover, district-level elasticities decline over time, from 0.24 in 2000 to 0.15 in 2020, assuming no feedback from productivity to urban scale. Allowing for such feedback, the temporal decline is even greater, from 0.24 in 2000 to 0.08 in 2020. However, urban growth is shifting increasingly toward counties rather than districts, foregoing the potential agglomeration effects. Changes in location of construction workers also shows this dispersed urban growth. Hence, recent urban growth is increasingly in locations without agglomeration benefits. Full article

In the context of the transition of the European energy sector and economy towards sustainable systems, this study aims to investigate the influence of digital enablers on affordable and clean energy in the European Union, using an econometric approach based on panel data regression. In accordance with the literature review and the main programmatic documents that mark the sustainable transition of the energy system, as well as the role of digitalization in this process, 4 research hypotheses and 16 sub-hypotheses were developed regarding the influence of digital enablers specific to the digitalization of the population and enterprises on clean and affordable energy. To confirm the hypotheses, a panel data regression was used for the period 2016–2024 in the European Union states. From a methodological perspective, the panel data regression was carried out using estimation of fixed effects and random effects models, Hausman tests for model selection, diagnostic testing, and correction of standard errors using Driscoll–Kraay estimators. The panel data regression analysis was carried out using R software, version 4.5.1. The results obtained showed that not all independent variables that express the digitalization of the population have the same influence on the share of renewable energy. The performed analysis shows the influence of the level of digitalization of enterprises on the share of renewable energy in the final energy consumption value, but also of the digitalization of the population on the price of energy, as a synthetic expression of affordable energy. Therefore, an essential contribution of the research is represented by highlighting the differentiated impact of digital enablers on clean and affordable energy, using a dual perspective of digitalization, at both the population and enterprise levels. Full article

Background/Objective: Accurate resting energy expenditure (REE) estimation is paramount for the nutritional management of older Asian adults with multimorbidity. However, standard predictive equations (PEs) lack precision for this cohort. This study aimed to recalibrate PEs using BMI-stratified, slope-only regression to enhance bedside accuracy. Methods: REE was measured via indirect calorimetry in 400 hospitalized patients (age ≥ 65). Sensitivity analyses identified significant proportional bias in existing models. Models were recalibrated and validated using 1000-iteration bootstrap resampling. Results: Standard PEs exhibited significant bias, particularly underpredicting requirements for 68% of underweight patients. The new Singapore Older Adults Resting energy expenditure (SOAR) PE 1 (963.67 + 8.56 × weight − 5.6 × age) eliminated weight-dependent systematic errors. The recalibrated models utilizing actual body weight achieved accuracy rates of up to 64% in obese cohorts, comparable to complex adjusted-weight protocols. Conclusions: Population-specific recalibration is essential to mitigate the bidirectional risks of malnutrition and overfeeding in geriatric rehabilitation. The BMI-stratified multipliers provided offer a robust, clinically efficient framework for individualized nutritional care. Full article

Introduction: Accurately meeting the energy requirements of patients in intensive care units (ICUs) is crucial to prevent catabolism, muscle loss, and complications. We assessed their energy needs in this study using indirect calorimetry (IC) and predictive formulas, comparing the results with delivered energy intake and evaluating agreement. Materials and Methods: A total of 38 mechanically ventilated patients in seven ICUs at Kayseri City Hospital were included; eligible patients were ≥18 years old and mechanically ventilated for at least 24 h. Disease severity and nutritional risk were evaluated using validated indices (prognostic nutritional index (PNI) and Modified Nutrition Risk in the Critically Ill (mNUTRIC)), and basal energy expenditure (BEE) was measured by IC and calculated using the Harris–Benedict (HB) and ESPEN formulas. IC measurements lasted 15 min under resting conditions in conscious patients and, according to acute phase criteria, in unconscious patients in a quiet, temperature-controlled environment. Nutrition was provided enterally or parenterally based on patient condition and disease severity. Agreement between IC and predictive formulas was assessed using Bland–Altman analysis, a statistical method that evaluates agreement between two measurement techniques. Results: Estimated energy requirements differed significantly from delivered energy intake (p < 0.001). IC-derived values were significantly lower than those estimated by the HB equation and ESPEN recommendations (p < 0.001), suggesting that predictive equations may overestimate energy requirements in this population. By contrast, delivered energy intake was lower than IC-measured values, with a mean difference of approximately 503 kcal, indicating a potential risk of underfeeding in clinical practice. Weak correlations were observed between methods (IC vs. HB: r = 0.35, p = 0.003; IC vs. ESPEN: r = −0.21, p = 0.02), indicating limited agreement between predictive equations and IC measurements, and Passing–Bablok regression analysis further supported this lack of agreement between methods. Conclusions: The energy intake delivered to patients was lower than the calculated values. Indirect calorimetry is important for accurately monitoring and determining energy requirements based on delivered energy intake, and further research in this area is needed. These findings highlight the importance of individualized monitoring of energy expenditure in critically ill patients and suggest that reliance solely on predictive equations may lead to clinically relevant discrepancies in energy delivery. Full article