UNASSIGNED: The towering peaks of the Himalayas lie in troves of captivating hill destinations, especially in India. Each destination aims to provide tourists with unique experiences and breath-taking landscapes. Understanding the tapestry of factors that weave the allure of these destinations and draw visitors from diverse backgrounds remains intriguing.
UNASSIGNED: This study delves into the socio-demographic tapestry of Himalayan hill destination selection, unraveling the complex interplay of demographic characteristics, social influences, and individual motivations that shape tourists\' choices.
UNASSIGNED: This study aims to answer why different tourists have different travel choices and what factors are the drivers behind such choices. The results show that destination selection factors are similar irrespective of respondents\' socio-demographic variabilities; however, for a few factors, the results are reversed.
UNASSIGNED: The study has implications for policymakers and the limitations of the research discussed at the end.

This report presents the latest statistics on the stroke population in South Korea, sourced from the Clinical Research Collaborations for Stroke in Korea-National Institute for Health (CRCS-K-NIH), a comprehensive, nationwide, multicenter stroke registry. The Korean cohort, unlike western populations, shows a male-to-female ratio of 1.5, attributed to lower risk factors in Korean women. The average ages for men and women are 67 and 73 years, respectively. Hypertension is the most common risk factor (67%), consistent with global trends, but there is a higher prevalence of diabetes (35%) and smoking (21%). The prevalence of atrial fibrillation (19%) is lower than in western populations, suggesting effective prevention strategies in the general population. A high incidence of large artery atherosclerosis (38%) is observed, likely due to prevalent intracranial arterial disease in East Asians and advanced imaging techniques. There has been a decrease in intravenous thrombolysis rates, from 12% in 2017-2019 to 10% in 2021, with no improvements in door-to-needle and door-to-puncture times, worsened by the coronavirus disease 2019 pandemic. While the use of aspirin plus clopidogrel for non-cardioembolic stroke and direct oral anticoagulants for atrial fibrillation is well-established, the application of direct oral anticoagulants for non-atrial fibrillation cardioembolic strokes in the acute phase requires further research. The incidence of early neurological deterioration (13%) and the cumulative incidence of recurrent stroke at 3 months (3%) align with global figures. Favorable outcomes at 3 months (63%) are comparable internationally, yet the lack of improvement in dependency at 3 months highlights the need for advancements in acute stroke care.

OBJECTIVE: Homophily represents the extent to which people feel others are like them and encourages the uptake of activities they feel people like them do. Currently, there are no data on blood donor homophily with respect to (i) people\'s representation of the average prototypical UK blood donor and (ii) the degree of homophily with this prototype for current donors, non-donors, groups blood services wish to encourage (ethnic minorities), those who are now eligible following policy changes (e.g., men-who-have-sex-with-men: MSM) and recipients. We aim to fill these gaps in knowledge.
METHODS: We surveyed the UK general population MSM, long-term blood recipients, current donors, non-donors and ethnic minorities (n = 785) to assess perceptions of the prototypical donor in terms of ethnicity, age, gender, social class, educational level and political ideology. Homophily was indexed with respect to age, gender and ethnicity.
RESULTS: The prototypical UK blood donor is perceived as White, middle-aged, middle-class, college-level educated and left-wing. Current donors and MSM are more homophilous with this prototype, whereas recipients and ethnic minorities have the lowest homophily. Higher levels of homophily are associated with an increased likelihood of committing to donate.
CONCLUSIONS: The prototype of the UK donor defined this as a White activity. This, in part, may explain why ethnic minorities are less likely to be donors. As well as traditional recruitment strategies, blood services need to consider broader structural changes such as the ethnic diversity of staff and co-designing donor spaces with local communities.

Life history trade-offs are one of the central tenets of evolutionary demography. Trade-offs, depicting negative covariances between individuals\' life history traits, can arise from genetic constraints, or from a finite amount of resources that each individual has to allocate in a zero-sum game between somatic and reproductive functions. While theory predicts that trade-offs are ubiquitous, empirical studies have often failed to detect such negative covariances in wild populations. One way to improve the detection of trade-offs is by accounting for the environmental context, as trade-off expression may depend on environmental conditions. However, current methodologies usually search for fixed covariances between traits, thereby ignoring their context dependence. Here, we present a hierarchical multivariate \'covariance reaction norm\' model, adapted from Martin (2023), to help detect context dependence in the expression of life-history trade-offs using demographic data. The method allows continuous variation in the phenotypic correlation between traits. We validate the model on simulated data for both intraindividual and intergenerational trade-offs. We then apply it to empirical datasets of yellow-bellied marmots (Marmota flaviventer) and Soay sheep (Ovis aries) as a proof-of-concept showing that new insights can be gained by applying our methodology, such as detecting trade-offs only in specific environments. We discuss its potential for application to many of the existing long-term demographic datasets and how it could improve our understanding of trade-off expression in particular, and life history theory in general.

UNASSIGNED: The coronavirus pandemic impacted health-seeking behaviour and access to primary care in Australia. We investigated factors associated with intention-to-attend and attendance of cervical screening during the pandemic, mainly in Victoria, Australia.
UNASSIGNED: We used questionnaire and attendance data (Aug 2020-Nov 2022) from Compass-PLUS, a sub-study of the Compass randomized-controlled trial of Human Papillomavirus-based vs cytology-based screening. Data was restricted to the HPV-screening arm for comparability to the national program. We investigated associations overall and for younger (25-39 years) and older (≥40 years) cohorts, between intention-to-attend/attendance, and socio-demographics, anxiety-related scores, and agreement with beliefs about screening during the pandemic (e.g. importance of screening, increased workload, working from home, risk of infection).
UNASSIGNED: Among 2,226 participants, positive intention to attend screening was more likely among those with a family history of cancer (p = 0.030) or living outside major cities (p = 0.024). Increased attendance was associated with increasing age (p < 0.001), prior regular cervical screening history [adjusted relative risk (aRR) for 2 screens in 6 years vs none: 1.23 (95 %CI 1.09,1.40); p < 0.001], and part-time employment or retirement compared to full-time employment [aRR:1.08 (1.02,1.14); aRR:1.12 (1.03, 1.22); respectively]. Lower attendance was related to increased agreement with statements indicating screening de-prioritisation (p-trend < 0.05) and higher recent anxiety, specifically in the older cohort (p-trend = 0.002).
UNASSIGNED: Reduced priority of screening and heightened recent anxiety may partly explain indications of lower-than-expected cervical screening rates during the pandemic. It is important that catch-up of missed HPV screens is performed to prevent a possible increase in cancer diagnoses in the long term.

Levels of fertility and the shape of the age-specific fertility schedule vary substantially across U.S. regions with some states having peak fertility relatively early and others relatively late. Structural institutions or economic factors partly explain these heterogeneous patterns, but regional differences in personality might also contribute to regional differences in fertility. Here, we evaluated whether variation in extraversion, agreeableness, conscientiousness, neuroticism, and openness to experience measured at the U.S. state-level was associated with the level, timing, and context of fertility across states above and beyond sociodemographics, voting behavior, and religiosity. Generally, states with higher levels of agreeableness and conscientiousness had more traditional fertility patterns, and states with higher levels of neuroticism and openness had more nontraditional fertility patterns, even after controlling for established correlates of fertility (r ~ |.50|). Personality is an overlooked correlate that can be leveraged to understand the existence and persistence of fertility differentials.

OBJECTIVE: To analyze the fertility rate trends in the GCC countries and their association with socioeconomic factors so that policymakers may use the study findings for future healthcare plans.
METHODS: Total population, crude death rate, life expectancy, literacy rate, human development index (HDI), female employment, unemployment rate, urbanisation, gross domestic product (GDP) per capita and inflation were chosen as possible predictors of TFR trends. The data were collected for the Global Burden of Disease 2021 study and other official databases such as the World Bank, the United Nations Development Program and Our World in Data for the 6 Gulf Cooperation Council (GCC) countries. Mean with standard deviation and percentage change was calculated to assess trends of TFR and all other variables from 1980-2021.
RESULTS: The fertility rate declined in all 6 countries in 2021 compared to 1980. The highest decline was found in the United Arab Emirates (75.5%), while the lowest was in Kuwait (60.9%). From 1980-2021, total population, life expectancy, HDI, literacy rate, GDP, urbanisation, and female labor force increased in all GCC countries. The total population, life expectancy, urbanisation, female labor force, GDP and HDI were negatively and significantly correlated with TFR (p<0.01). The literacy rate showed a negative and significant correlation with TFR in Bahrain, Kuwait, Saudi Arabia, and Qatar.
CONCLUSIONS: The TFR is declining in GCC countries. The plausible causes include the inclination towards postponement of marriages and excessive costs of living. These trends and associations need to be evaluated by policymakers so that they identify priority areas for interventions, allocate resources and formulate developmental plans accordingly to ensure strategic progress of the region.

OBJECTIVE: To (i) assess the prevalence, incidence, and burden of severe periodontitis and edentulism in 2021, and (ii) forecast their rates in 2050.
METHODS: Prevalence, incidence, and Years Lived with Disability (YLDs) for severe periodontitis and edentulism in 2021 were gathered globally, covering 204 countries, seven super regions, and 21 regions from the Global Burden of Disease (GBD) 2021 study. Prevalence, incidence, and YLDs due to periodontitis and edentulism to 2050 were projected using mixed-effects models with the socio-demographic index as the main covariate.
RESULTS: In 2021, over 1 billion people were affected by severe periodontitis (1066.95 million; 95% UI: 896.55-1234.84), with a global age-standardized prevalence of 12.50% (10.53-14.49). South Asia had the highest prevalence rate, at 17.57% (14.73; 20.14). Edentulism affected 353 million people globally (300.60-416.20), resulting in an age-standardized prevalence of 4.11% (3.50; 4.83). The highest edentulism prevalence was found in Latin America and the Caribbean, at 7.39% (6.44; 8.39). By 2050, more than 1.5 billion people (+44.32%) are projected to have severe periodontitis, and over 660 million (+84.40%) to be edentulous. In the same year, 19.67% (130.23 million) of the edentulous people worldwide will be located in China. Severe periodontitis is expected to move up one position, and edentulism nine positions, among the most impactful Level 4 diseases/conditions affecting YLDs worldwide by 2050.
CONCLUSIONS: Severe periodontitis and edentulism remain major public health challenges in 2021, with the number of affected individuals projected to rise significantly in the coming decades.

The incidence of dengue virus disease has increased globally across the past half-century, with highest number of cases ever reported in 2019 and again in 2023. We analyzed climatological, epidemiological, and phylogenomic data to investigate drivers of two decades of dengue in Cambodia, an understudied endemic setting. Using epidemiological models fit to a 19-y dataset, we first demonstrate that climate-driven transmission alone is insufficient to explain three epidemics across the time series. We then use wavelet decomposition to highlight enhanced annual and multiannual synchronicity in dengue cycles between provinces in epidemic years, suggesting a role for climate in homogenizing dynamics across space and time. Assuming reported cases correspond to symptomatic secondary infections, we next use an age-structured catalytic model to estimate a declining force of infection for dengue through time, which elevates the mean age of reported cases in Cambodia. Reported cases in >70-y-old individuals in the 2019 epidemic are best explained when also allowing for waning multitypic immunity and repeat symptomatic infections in older patients. We support this work with phylogenetic analysis of 192 dengue virus (DENV) genomes that we sequenced between 2019 and 2022, which document emergence of DENV-2 Cosmopolitan Genotype-II into Cambodia. This lineage demonstrates phylogenetic homogeneity across wide geographic areas, consistent with invasion behavior and in contrast to high phylogenetic diversity exhibited by endemic DENV-1. Finally, we simulate an age-structured, mechanistic model of dengue dynamics to demonstrate how expansion of an antigenically distinct lineage that evades preexisting multitypic immunity effectively reproduces the older-age infections witnessed in our data.

Seabirds have been touted as excellent bioindicators of mercury pollution. We utilised grey-faced petrel (Pterodroma gouldi) feathers to assess interannual differences in total mercury (THg) concentrations in adults (2020-2021) and chicks (2019-2021) breeding in the Auckland region of New Zealand. For adults, we also correlated feather THg with bird age (3-37+ years) and breeding outcome (i.e., Non breeder, Egg failed, Chick reared) recorded for that season i.e., 2020 and 2021. Interannual differences in chick feather THg were matched with bulk stable isotopes (δ13C, δ15N) to map the influence of adult foraging behaviour on chick feather THg values. Adult feather THg levels were similar across the years investigated i.e., mean ± S.D. 38.2 ± 12.8 (2020), and 39.5 ± 14.7 (2021) ug g-1 (some of the highest THg values recorded for seabirds). A slight, but significant decrease in THg accumulation was evident as age increased but feather THg had no significant influence on breeding outcome. Interannual differences in chick feather THg concentrations were 7.78 ± 1.6 (2019), 4.23 ± 1.45 (2020) and 6.97 ± 4.41 (2021) μg g-1, (p < 0.01); and correlated with a significantly lower δ13C value i.e., -17.2 ± 0.4 ‰ (2019), -17.8 ± 0.3 ‰ (2020) and -17.6 ± 0.2 ‰ (2021). This suggests that the lower feather THg values in 2020 chicks resulted from more oceanic, rather than shelf-edge, prey being consumed by chicks that year. Values of δ15N in chick feathers remained consistent among years i.e., 15.2 ± 1.2 ‰ (2019), 15.2 ± 0.2 ‰ (2020) and 15.3 ‰ (± 0.4). Due to these interannual differences, we recommend using grey-faced petrel chicks to monitor Hg pollution over adults. Chicks are also subject to cultural harvests by Māori communities, offering partnership opportunities to generate mutually beneficial information streams for Māori communities and scientists alike.