We conducted an analysis of a nationwide survey of US physician offices between 2016 and 2019 and calculated annualized prevalence rates of urinary tract infections (UTIs). During the 3-year study period, UTI was the most common infection in US physician offices, accounting for approximately 10 million annualized encounters.

Hand, foot, and mouth disease (HFMD) shows spatiotemporal heterogeneity in China. A spatiotemporal filtering model was constructed and applied to HFMD data to explore the underlying spatiotemporal structure of the disease and determine the impact of different spatiotemporal weight matrices on the results. HFMD cases and covariate data in East China were collected between 2009 and 2015. The different spatiotemporal weight matrices formed by Rook, K-nearest neighbour (KNN; K = 1), distance, and second-order spatial weight matrices (SO-SWM) with first-order temporal weight matrices in contemporaneous and lagged forms were decomposed, and spatiotemporal filtering model was constructed by selecting eigenvectors according to MC and the AIC. We used MI, standard deviation of the regression coefficients, and five indices (AIC, BIC, DIC, R2, and MSE) to compare the spatiotemporal filtering model with a Bayesian spatiotemporal model. The eigenvectors effectively removed spatial correlation in the model residuals (Moran’s I < 0.2, p > 0.05). The Bayesian spatiotemporal model’s Rook weight matrix outperformed others. The spatiotemporal filtering model with SO-SWM was superior, as shown by lower AIC (92,029.60), BIC (92,681.20), and MSE (418,022.7) values, and higher R2 (0.56) value. All spatiotemporal contemporaneous structures outperformed the lagged structures. Additionally, eigenvector maps from the Rook and SO-SWM closely resembled incidence patterns of HFMD.

Objectives/Goals: Sexual minority populations (SMPs), including lesbian, gay, and bisexual groups, disproportionately encounter discriminatory experiences due to bi/homonegativity and systemic inequities across various social domains. We aim to understand how the neighborhood-level stressors and resilience sources differed across specific groups in SMPs. Methods/Study Population: Utilizing the NIH All of Us’ cloud-based platform, we selected cohorts self-identifying as gay (n  =  9,454), bisexual (n  =  15,284), lesbian (n = 5267), or straight (n  =  349,748). We explored multiple key measures of neighborhood-level stressors (e.g., neighborhood disorder, neighborhood cohesion, and environment index) and resilience sources (e.g., neighbor cohesion, social support), and other factors (e.g., food insecurity, housing insecurity, and housing instability) by their sexual orientations using analysis of variance or Chi-square analyses. Results/Anticipated Results: Our sample comprised 60.8% females and 37.5% males identifying as non-binary or transgender, with an average age of 55.6 years (SD  =  17.1). The racial composition was 56.0% White, 19.4% Black, 18.7% Hispanic, and 5.9% others (e.g., Asian, multiracial). Compared to straight individuals, SMPs reported high neighborhood stressors (e.g., disorder, worse environment) but lower neighborhood-level resilience sources (e.g., social support, cohesion). In addition, bisexual groups reported highest prevalence of housing insecurity (6.7% vs. 2.3%), housing instability (36.0% vs. 19.6%), and food insecurity (26.57% vs. 12.21%). Discussion/Significance of Impact: SMPs, particularly bisexual individuals, face greater neighborhood stressors and fewer resilience sources than their straight counterparts. These findings call for targeted interventions to address these disparities and promote health equity, using large-scale datasets to inform community-based solutions.

Objectives/Goals: Discriminatory experiences within healthcare settings significantly hinder equitable health access for sexual minority groups (SMPs) in the USA. These discriminatory experiences can manifest in various forms (e.g., refusal of care). We aimed to explore different types of discrimination encountered by SMPs in the healthcare settings. Methods/Study Population: This study utilized secondary data from the NIH All of Us Research Program. For this analysis, we selected cohorts self-identifying as gay (n  =  9,454), bisexual (n  =  15,284), lesbian (n  =  5,267), and straight (n  =  349,748), enabling robust comparisons across SMPs and straight individuals. We employed analysis of variance and Chi-square analyses to assess group differences in healthcare discrimination, using key indicators from the Discrimination in Medical Settings Scale. These indicators captured experiences such as being treated with less respect or courtesy and feeling ignored by healthcare providers, providing a comprehensive view of discriminatory encounters in healthcare settings for SMPs. Results/Anticipated Results: Our analyses revealed that bisexual individuals reported the highest levels of healthcare discrimination (mean  =  3.64, SD  =  2.45), followed by lesbians (mean  =  3.37, SD  =  2.47), other SMPs (mean  =  3.36, SD  =  2.53), gay (mean  =  2.69, SD  =  2.47), and straight participants (mean  =  2.60, SD  =  2.42). Among the seven discrimination indicators, the most reported experience was feeling like a doctor or nurse was not listening, with 76.8% of bisexual participants, 72.3% of lesbians, 68.8% of other SMPs, and 56.9% of gay participants reporting this experience. This was followed by reports of being treated with less respect and being treated with less courtesy in healthcare settings. These findings highlight the pervasive nature of healthcare discrimination among SMPs, particularly bisexual individuals. Discussion/Significance of Impact: SMPs experience higher levels of discrimination in healthcare settings compared to their straight counterparts. Our results underscore the urgent need to foster respectful, inclusive healthcare environments and ensure that healthcare providers are adequately trained to address the unique health needs and experiences of SMPs.

Objectives/Goals: Sexual minority populations report a disproportionately high prevalence of alcohol use, often attributed to coping with bi/homonegativity and systemic inequities across various social domains. This study aims to explore alcohol use patterns and associated neighborhood and individual factors among sexual minority populations (SMPs) using data from the NIH All of US dataset. Methods/Study Population: Alcohol use was assessed using the AUDIT-C (Alcohol Use Disorders Identification Test—Consumption) scale across a sample of 9,454 gay, 15,284 bisexual, 5,267 lesbian, and 349,748 straight participants. The AUDIT-C measured hazardous alcohol use, and logistic regression models were employed to examine its association with neighborhood-level factors (e.g., socioeconomic status, alcohol outlet density) and individual-level factors (e.g., age, race/ethnicity, income, and education) among SMPs. Interaction terms assessed how these relationships varied by sexual orientation. Sensitivity analyses were conducted to assess the robustness of the findings, including stratified analyses by gender identity and the exclusion of extreme outliers in alcohol use reporting. Results/Anticipated Results: Our analyses revealed that gay participants had the highest AUDIT-C scores (mean  =  3.60, SD  =  2.27), followed by bisexual (mean  =  3.35, SD  =  2.21), other SMPs (mean  =  3.18, SD  =  2.19), lesbian (mean  =  3.04, SD  =  2.08), and straight individuals (mean  =  3.05, SD  =  2.06). Alcohol use was positively associated with neighborhood disorder (β  =  0.12, 95% CI  =  0.07, 0.17), housing insecurity (β  =  0.14, 95% CI  =  0.03, 0.25), and male gender (β  =  0.98, 95% CI  =  0.96, 1.00). In contrast, neighborhood density (β  =  -0.11, 95% CI  =  -0.15, -0.07), food insecurity (β  =  -0.14, 95% CI  =  -0.20, -0.08), being Black, and identifying as bisexual were negatively associated with alcohol use. Sensitivity analyses determined no significant differences among specfic supgroups. Discussion/Significance of Impact: This study highlights important differences in alcohol use across SMPs and emphasizes the influence of neighborhood-level stressors (e.g., disorder and housing insecurity). These findings underscore the need for addressing social and environmental determinants of alcohol use in SMPs to mitigate the negative impacts of alcohol consumption.

Accurate characterization of high-power laser parameters, especially the near-field and far-field distributions, is crucial for inertial confinement fusion experiments. In this paper, we propose a method for computationally reconstructing the complex amplitude of high-power laser beams using modified coherent modulation imaging. This method has the advantage of being able to simultaneously calculate both the near-field (intensity and wavefront/phase) and far-field (focal-spot) distributions using the reconstructed complex amplitude. More importantly, the focal-spot distributions at different focal planes can also be calculated. To verify the feasibility, the complex amplitude optical field of the high-power pulsed laser was measured after static aberrations calibration. Experimental results also indicate that the near-field wavefront resolution of this method is higher than that of the Hartmann measurement. In addition, the far-field focal spot exhibits a higher dynamic range (176 dB) than that of traditional direct imaging (62 dB).

Let $\{\omega _n\}_{n\geq 1}$ be a sequence of independent and identically distributed random variables on a probability space $(\Omega , \mathcal {F}, \mathbb {P})$, each uniformly distributed on the unit circle $\mathbb {T}$, and let $\ell _n=cn^{-\tau }$ for some $c>0$ and $0<\tau <1$. Let $I_{n}=(\omega _n,\omega _n+\ell _n)$ be the random interval with left endpoint $\omega _n$ and length $\ell _n$. We study the asymptotic property of the covering time $N_n(x)=\sharp \{1\leq k\leq n: x\in I_k\}$ for each $x\in \mathbb {T}$. We prove the quenched central limit theorem for the covering time, that is, $\mathbb {P}$-almost surely,

$$ \begin{align*}\frac{N_n(x)-\mathbb{E}_{\mathbb{P}}(N_n(x))}{\sqrt{\sum_{k=1}^n \ell_k(1-\ell_k)}}\end{align*} $$

converges in law to the standard normal distribution.

One species-general life history (LH) principle posits that challenging childhood environments are coupled with a fast or faster LH strategy and associated behaviors, while secure and stable childhood environments foster behaviors conducive to a slow or slower LH strategy. This coupling between environments and LH strategies is based on the assumption that individuals’ internal traits and states are independent of their external surroundings. In reality, individuals respond to external environmental conditions in alignment with their intrinsic vitality, encompassing both physical and mental states. The present study investigated attachment as an internal mental state, examining its role in mediating and moderating the association between external environmental adversity and fast LH strategies. A sample of 1169 adolescents (51% girls) from 9 countries was tracked over 10 years, starting from age 8. The results confirm both mediation and moderation and, for moderation, secure attachment nullified and insecure attachment maintained the environment-LH coupling. These findings suggest that attachment could act as an internal regulator, disrupting the contingent coupling between environmental adversity and a faster pace of life, consequently decelerating human LH.

Nontuberculous mycobacteria (NTM) is a large group of mycobacteria other than the Mycobacterium tuberculosis complex and Mycobacterium leprae. Epidemiological investigations have found that the incidence of NTM infections is increasing in China, and it is naturally resistant to many antibiotics. Therefore, studies of NTM species in clinical isolates are useful for understanding the epidemiology of NTM infections. The present study aimed to investigate the incidence of NTM infections and types of NTM species. Of the 420 samples collected, 285 were positive for M. tuberculosis, 62 samples were negative, and the remaining 73 samples contained NTM, including 35 (8.3%) only NTM and 38 (9%) mixed (M. tuberculosis and NTM). The most prevalent NTM species were Mycobacterium intracellulare (30.1%), followed by Mycobacterium abscessus (15%) and M. triviale (12%). M. gordonae infection was detected in 9.5% of total NTM-positive cases. Moreover, this study reports the presence of Mycobacterium nonchromogenicum infection and a high prevalence of M. triviale for the first time in Henan. M. intracellulare is the most prevalent, accompanied by some emerging NTM species, including M. nonchromogenicum and a high prevalence of M. triviale in Henan Province. Monitoring NTM transmission and epidemiology could enhance mycobacteriosis management in future.

It is unclear how much adolescents’ lives were disrupted throughout the COVID-19 pandemic or what risk factors predicted such disruption. To answer these questions, 1,080 adolescents in 9 nations were surveyed 5 times from March 2020 to July 2022. Rates of adolescent COVID-19 life disruption were stable and high. Adolescents who, compared to their peers, lived in nations with higher national COVID-19 death rates, lived in nations with less stringent COVID-19 mitigation strategies, had less confidence in their government’s response to COVID-19, complied at higher rates with COVID-19 control measures, experienced the death of someone they knew due to COVID-19, or experienced more internalizing, externalizing, and smoking problems reported more life disruption due to COVID-19 during part or all of the pandemic. Additionally, when, compared to their typical levels of functioning, adolescents experienced spikes in national death rates, experienced less stringent COVID-19 mitigation measures, experienced less confidence in government response to the COVID-19 pandemic, complied at higher rates with COVID-19 control measures, experienced more internalizing problems, or smoked more at various periods during the pandemic, they also experienced more COVID-19 life disruption. Collectively, these findings provide new insights that policymakers can use to prevent the disruption of adolescents’ lives in future pandemics.

This work studies two-dimensional fixed-flux Rayleigh–Bénard convection with periodic boundary conditions in both horizontal and vertical directions and analyses its dynamics using numerical continuation, secondary instability analysis and direct numerical simulation. The fixed-flux constraint leads to time-independent elevator modes with a well-defined amplitude. Secondary instability of these modes leads to tilted elevator modes accompanied by horizontal shear flow. For $Pr=1$, where $Pr$ is the Prandtl number, a subsequent subcritical Hopf bifurcation leads to hysteresis behaviour between this state and a time-dependent direction-reversing state, followed by a global bifurcation leading to modulated travelling waves without flow reversal. Single-mode equations reproduce this moderate Rayleigh number behaviour well. At high Rayleigh numbers, chaotic behaviour dominated by modulated travelling waves appears. These transitions are characteristic of high wavenumber elevator modes since the vertical wavenumber of the secondary instability is linearly proportional to the horizontal wavenumber of the elevator mode. At a low $Pr$, relaxation oscillations between the conduction state and the elevator mode appear, followed by quasi-periodic and chaotic behaviour as the Rayleigh number increases. In the high $Pr$ regime, the large-scale shear weakens, and the flow shows bursting behaviour that can lead to significantly increased heat transport or even intermittent stable stratification.

Dysmenorrhea is associated with epilepsy. Existing evidence is mostly limited to observational studies, which are liable to confounding and bias. This study investigated the causal relevance of dysmenorrhea on epilepsy using Mendelian randomization (MR). We extracted instrumental variants for dysmenorrhea and epilepsy from published genomewide association study data, focusing on individuals of East Asian descent. A comprehensive suite of MR estimations and sensitivity analyses was performed to ensure the robustness of the findings. Each outcome database was analyzed separately in both directions. For dysmenorrhea and epilepsy, 7 and 3 genetic variants respectively were selectively extracted as instrumental variants. The results suggest that dysmenorrhea is causally associated with an elevated risk of epilepsy (inverse variance weighted [IVW]: OR = 1.26; 95% CI [1.07, 1.47]; p = 4.42 × 10−3); conversely, no strong evidence was found to corroborate that epilepsy exerts a causal effect on the incidence of dysmenorrhea (IVW: OR = 1.04; 95% CI [0.82, 1.33]; p = .72). These findings provide novel insights into the causal relationship between dysmenorrhea and epilepsy, which may have implications for clinical decision-making in patients with epilepsy and dysmenorrhea.