Equilibrium Research

Ncd is the founding member of the kinesin-14 family, which can move on microtubules toward the minus end in a nonprocessive manner by hydrolyzing ATP molecules. It was experimentally observed that while multiple anchored Ncd motors can drive the gliding of a microtubule with high efficiency, the full-length Ncd motors can drive the sliding of one microtubule relative to the antiparallel one with a much lower efficiency. However, a quantitative explanation of these experimental results is not available. The mechanism of how the microtubule sliding by the full-length Ncd motors has much lower efficiency than the microtubule gliding by the anchored Ncd motors is unclear. Here, we use both theoretical analysis and numerical simulation to study microtubule gliding and sliding by the Ncd motors, explaining quantitatively the available experimental data. The studies show that the competition between the motor's stalk rotation and its tail diffusion results in the much lower efficiency of the microtubule sliding than that of the microtubule gliding. This mechanism of the lower efficiency of microtubule sliding by the Ncd motors is different from the previously proposed mechanism of the nonefficient microtubule gliding by kinesin-1 motors anchored to the slippery surface.

Historically, there has been broad adoption of body mass index (BMI) as a gold-standard predictor of postoperative complications, yet the lack of consensus on clear BMI cutoffs suggests other factors involved. This study sought to evaluate how comorbidities modify the relationship between BMI and postoperative complications across different surgical locations and define a safe BMI threshold for those with and without comorbidities. The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was filtered for the most common plastic surgery procedures, which were organized by surgical site location. A multivariate logistic regression model was created, which incorporated comorbid status, BMI, and body location as predictors. Simple slopes analysis was performed to assess how the marginal effect of BMI on complication risk varied by comorbidity status within each body location. A total of 239,676 patients were identified, with 7.1% (n = 17,107) having at least 1 comorbidity and 0.8% (n = 1818) developing postoperative complications. Both BMI and comorbidity were significantly associated with complication development ( P < 0.01).We noted a significant interaction between the presence of comorbidities and increasing BMI. The combination of comorbidities and elevated BMI is particularly high risk in patients undergoing trunk, breast, and extremity procedures. For patients without comorbidities, BMI <35 kg/m 2 does not significantly increase the risk of complications. In contrast, in patients with comorbid disease, risk of complications begins to increase in patients with a BMI of 30 kg/m 2 . Through logistic regression analysis of the ACS-NSQIP database, this study demonstrates that elevated BMI alone may not lead to serious postoperative complications until reaching values above 35 or 40 kg/m 2 . Nevertheless, when a comorbidity is present, a BMI of 30 kg/m 2 may be associated with increased risk of complications. This study also shows that BMI-related risks varied by surgical site, with more pronounced complication risk in adipose-rich surgical sites such as the abdomen. It is essential to take a more individualized risk-stratified approach to preoperative patient evaluation with careful consideration of a patient's comorbidities and overall health status.

Introduction: Dementia with Lewy bodies (DLBs) is a distinct form of dementia characterized by the accumulation of alpha-synuclein in the brain. Early presentations are often heterogeneous, and the impact of this variability on disease progression remains poorly understood. This study explored the initial clinical presentation of DLB among Peruvian patients and its influence on the clinical course. Methods: We conducted a retrospective study of patients diagnosed with DLB and Alzheimer’s disease (AD) using standard clinical criteria. Cognitive function was assessed using Mini-Mental State Examination (MMSE), INECO Frontal Screening, and Uniform Data Set (UDS). We classified DLB patients based on their initial symptoms (hallucinations or parkinsonism) and compared their clinical and neuropsychological characteristics. Statistical analyses (ANOVA, chi-squared, Wilcoxon tests, and multivariate linear regression) were used to evaluate group differences and examine how initial symptoms influenced disease progression and cognitive decline. Results: Forty-six patients with probable DLB between June 2018 and May 2023 were included. The median time from symptom onset to diagnosis was 5 years. Cognitive symptoms were the most frequent initial presentation, followed by motor and behavioral signs. No significant clinical or neuropsychological differences were found between presentation subgroups at evaluation. Compared to AD patients, those with DLB scored higher on cognitive measures (MMSE, Rowland Universal Dementia Assessment Scale) and behavioral symptoms (Neuropsychiatric Inventory). Neuropsychological testing revealed DLB patients had more pronounced deficits in visuospatial and executive functions than those with AD. Conclusion: In our cohort, patients in the cognitive-onset group reached the threshold for dementia more rapidly. However, the initial presenting symptoms did not result in worse severity across specific cognitive or behavioral domains.

In the coming decades, the number of dementia cases is projected to increase worldwide. This public health issue will significantly impact low‐ and middle‐income countries, such as those in Latin America, due to their aging populations. Proper diagnosis and identification of these patients require a comprehensive assessment, including neuropsychiatric, laboratory, and imaging evaluations, supported by neuropsychological assessments.However, despite the necessity of neuropsychological evaluations to identify impairments in one or more higher cognitive functions—facilitating the differentiation between various types of dementia—the availability of trained personnel to administer these assessments correctly is limited. This shortage leads to undiagnosed cases or inaccurate results in clinical studies. Here, we describe and propose a structured virtual training model for future raters assessing dementia patients, based on the training conducted at the Instituto Peruano de Neurociencias as part of the GLASS‐AD (Global Latinos Sequencing Study for Alzheimer's Disease) study (Grant number: U01‐AG081817).The primary objective of this training was to ensure that raters could accurately administer neuropsychological tests, thereby guaranteeing the validity of results. The training was structured into several phases: (1) Virtual sessions provided a theoretical explanation of neuropsychological tests, organized by cognitive domains. (2) Participants submitted evidence of their practical application of the material, using cognitively healthy individuals simulating cognitive impairment symptoms. (3) Expert neuropsychologists reviewed the trainees' submitted videos, providing feedback and corrections. (4) Participants then resubmitted a video with the corrected test administration for approval and certification. (5) Finally, a follow‐up evaluation was scheduled six months later, requiring the submission of a new video to verify the quality and consistency of test administration.Standardizing training is essential to ensure that personnel are adequately prepared, improving the identification and diagnosis of dementia patients. This facilitates timely treatment and the development of strategies to mitigate the disease's impact on families and communities while also helping reduce the costs associated with patient care, especially in LMICs.

Summarising CBD target 3 to “30 × 30” emphasizes area coverage, but conservation success depends on MPA quality. Many existing MPAs are under-protected, and rapidly designating new areas risks creating ‘paper parks’ without ecological or social benefits. Prioritizing strictly or fully managed MPAs, supported by a clear and shared definition, is essential to achieve meaningful biodiversity outcomes. Quality-focused strategies ensure that global targets benefit both nature and people, rather than merely meeting numerical goals.

IntroductionMonitoring and addressing health inequalities is important. However, socioeconomic variables are usually unavailable within health datasets. Area deprivation measures provide access to open-source reliable socioeconomic data within low/middle-income countries and can contribute to the monitoring of the Sustainable Development Goals and assessing the growing burden of health inequalities.ObjectiveTo create a small-area deprivation measure for the whole of Brazil - the Brazilian Deprivation Index (Índice Brasileiro de Privação - IBP),MethodsUsing Census Sector data (mean population size=615) from the most recently available Brazilian Demographic Census (2010), variables measuring literacy, household income and housing conditions were standardised using z-scores and summed into a single measure. The IBP was validated using regional small-area measures of vulnerability: Belo Horizonte’s Health Vulnerability Index (IVS) and São Paulo’s Social Vulnerability Index (IPVS). Mortality data from Minas Gerais were used to estimate age-standardised mortality rates (ASMR) by ill-defined causes across IBP deprivation quintiles.ResultsThe IBP was created for 303,218 (97.8%) census sectors (99.7% population). Substantial regional variation in deprivation was found using the IBP measure, with higher deprivation in rural than urban areas. The IBP was correlated with the other indicators used for validation: the IVS (r = 0.96) and the IPVS (r = 0.68). We found gradients across the ill-defined causes ASMR, in Minas Gerais mortality was 2.6 higher in the most deprived quintile of IBP, compared with the least deprived. Main challenges in creating a deprivation measure for LMICs and possible solutions are demonstrated.ConclusionA small area deprivation index was created for Brazil, a large and highly diverse middle-income country. The IBP improves our understanding and monitoring of inequalities, serving as a valuable tool for informing targeted public policies. Although the index is based on Brazil’s specific context, the challenges faced, and the strategies implemented to tackle them are relevant for other low- and middle-income countries aiming to develop similar tools.

ObjectiveTo evaluate the discriminative capacity and psychometric properties of the Technology–Activities of Daily Living Questionnaire (T-ADLQ) in distinguishing cognitively unimpaired individuals from those with amnestic mild cognitive impairment (aMCI) and Alzheimer’s disease dementia (ADD) in a population with no formal education.MethodsThis cross-sectional study included individuals with no formal education over 50 years of age residing in Callao, Peru. Participants were classified into three cognitive groups: cognitively unimpaired (CU; n = 64), aMCI (n = 60), and early ADD (n = 63). Functional decline was assessed with the T-ADLQ. Group comparisons were conducted using the chi-square or ANOVA tests, as appropriate. Pearson correlations were used to assess concurrent validity. The reliability of the T-ADLQ was assessed using Cronbach’s alpha. Receiver operating characteristic (ROC) curve analyses and area under the curve (AUC) metrics were used to assess the discriminative validity of the measures across the three cognitive groups.ResultsIn a sample of 187 illiterate older adults, the T-ADLQ demonstrated excellent internal consistency (Cronbach’s α = 0.966) and strong inverse correlations with global and executive cognitive measures (MMSE, RUDAS, IFS). It also showed a moderate positive correlation with PFAQ. ROC analyses revealed excellent discriminative performance of the T-ADLQ. The total score and the instrumental (IADL) and advanced (AADL) domains achieved perfect accuracy in differentiating cognitively unimpaired individuals from those with aMCI or ADD. The basic activities of daily living (BADL) domain also showed high accuracy, particularly in distinguishing aMCI from ADD.ConclusionThe T-ADLQ and its subdomains exhibit strong psychometric properties and high discriminative capacity in detecting functional decline in individuals with aMCI and ADD. These findings support the T-ADLQ as a valid and reliable tool for assessing functional impairment in populations with no formal education.

The 2025 Sleep and Breathing Conference, co-hosted by the European Respiratory Society (ERS) and the European Sleep Research Society (ESRS), presented the latest advances in sleep disordered breathing and related fields. This comprehensive overview, written by Early Career Members of ERS Assembly 4, highlights the key scientific and clinical takeaways from the event. Symposia were dedicated to the pathophysiology of obstructive sleep apnoea (OSA), the role of intermittent hypoxia and autonomic dysregulation, diagnostic work-up, and treatment approaches for OSA, including the perspective of patients. Updates on central sleep apnoea, comorbid insomnia and sleep apnoea, obesity hypoventilation syndrome and sleep disordered breathing in neuromuscular disease were also presented. The event emphasised the importance of phenotyping, individualised treatment approaches and the integration of physiology into clinical decision-making in sleep disordered breathing.

Background and objectivesReducing sugar intake to prevent chronic diseases is recommended by the WHO. As an alternative, the use of artificial sweeteners has increased. Yet, the long-term impact of using artificial sweeteners on weight status or health is still debated, with experimental and epidemiological results showing adverse outcomes. Our objective was therefore to investigate associations between the consumption of artificial sweeteners and weight status.MethodsOur analyses included 101,182 adults from the French NutriNet-Santé prospective cohort study recruited between 2009 and 2023 (median follow-up: 6.5 years). Repeated 24-hour dietary records, including brands for industrial products, linked with data on qualitative and quantitative content in food additives, were used to assess intakes of artificial sweeteners from all dietary sources. Weight and height were collected every 6 months through a validated online questionnaire. Associations between intake of artificial sweeteners (total and most consumed: aspartame, acesulfame K, sucralose), BMI gain and risk of overweight and obesity were studied using multi-adjusted mixed and Cox models, respectively.ResultsCompared with non-consumption, a higher intake of artificial sweeteners (> sex-specific median) was associated with higher BMI gain (β higher consumers x time = 0.02, P < 0.001) and a higher risk of overweight (9641/367,549 person-years; HR = 1.30 [1.23-1.37], P-trend<0.001) and obesity (4062/531,650 person-years; HR = 1.40 [1.30-1.51], P-trend<0.001). Similar results were found for aspartame and acesulfame K, as well as in sensitivity analyses challenging reverse causality.ConclusionsIn this study, a higher consumption of intense sweeteners was associated with a higher risk of weight gain, overweight and obesity. These results suggest potential long-term adverse effects of intense sweeteners at doses below the admissible daily intake, and therefore provide important data for safety assessment.Key messages• Artificial sweeteners (total, aspartame, acesulfame K) are associated with gain weight and a higher risk of incidence of overweight and obesity.• If corroborated by further studies, our study underscores the necessity for stricter regulations on artificial sweeteners.

L’intimidation liée au poids s’observe fréquemment à l’école secondaire. L’objectif de la présente étude est d’explorer le point de vue d’adolescents sur ce phénomène et les stratégies visant à le contrer. Pour ce faire, des entrevues ont été réalisées auprès de 19 jeunes, âgés de 14 à 17 ans. Elles exploraient ce type d’intimidation, les facteurs explicatifs, les conséquences et l’efficacité des stratégies d’intervention. Les jeunes interrogés suggèrent que l’intimidation en lien avec le poids est subtile et qu’elle a d’importantes conséquences. Des stratégies visant à mobiliser les adultes et les pairs envers les jeunes qui subissent l’intimidation et à apporter un soutien émotionnel sont à préconiser, alors que les sanctions et la surveillance sont à éviter.