Last dental visit and severity of tooth loss: a machine learning approach

The aims of the present study were to investigate last dental visit as a mediator in the relationship between socioeconomic status and lack of functional dentition/severe tooth loss and use a machine learning approach to predict those adults and elderly at higher risk of tooth loss. We analyzed data from a representative sample of 88,531 Brazilian individuals aged 18 and over. Tooth loss was the outcome by; (1) functional dentition and (2) severe tooth loss. Structural Equation models were used to find the time of last dental visit associated with the outcomes. Moreover, machine learning was used to train and test predictions to target individuals at higher risk for tooth loss. For 65,803 adults, more than two years of last dental visit was associated with lack of functional dentition. Age was the main contributor in the machine learning approach, with an AUC of 90%, accuracy of 90%, specificity of 97% and sensitivity of 38%. For elders, the last dental visit was associated with higher severe loss. Conclusions. More than two years of last dental visit appears to be associated with a severe loss and lack of functional dentition. The machine learning approach had a good performance to predict those individuals.

A structural equation model of CFIR inner and outer setting constructs, organization characteristics, and national DPP enrollment

BACKGROUND

The National Diabetes Prevention Program (DPP) has made great strides in increasing accessibility to its year-long, evidence-based lifestyle change program, with around 3000 organizations having delivered the program. This large dissemination effort offers a unique opportunity to identify organization-level factors associated with program implementation and reach (enrollment) across diverse settings. The purpose of this study was to quantitatively examine the relationships among Consolidated Framework for Implementation Research (CFIR) Inner Setting and Outer Setting constructs and the implementation outcome of reach.

METHODS

This study analyzed data from a 2021 cross-sectional online survey with 586 National DPP Staff (lifestyle coaches, master trainers, program coordinators) with information about their organization, implementation outcomes, and responses to quantitative CFIR Inner Setting and Outer Setting construct items. Structural equation modeling was used to test a hypothesized path model with Inner and Outer Setting variables to explore direct and indirect pathways to enrollment.

RESULTS

The CFIR items had good internal consistency and indicated areas of implementation strength and weakness. Eight variables included as part of the CFIR structural characteristics and one organization characteristic variable had significant direct relationships with enrollment. The length of delivery, number of lifestyle coaches, number of full-time staff, large organization size, and organizations delivering in rural, suburban, and/or urban settings all had positive significant direct relationships with enrollment, while academic organizations and organizations with only non-White participants enrolled in their National DPP lifestyle change programs had a negative association with enrollment.

CONCLUSIONS

Participant reach is an important implementation outcome for the National DPP and vital to making population-level decreases in diabetes incidence in the USA. Our findings suggest that to facilitate enrollment, program implementers should focus on organizational structural characteristics such as staffing. Strengths of this study include the use of adapted and newly developed quantitative CFIR measures and structural equation modeling. Health prevention programs can use the methods and findings from this study to further understand and inform the impact of organization factors on implementation outcomes.

Examination of co-parenting support and parenting stress as mediators of the food insecurity-maternal depression/anxiety relationship

BACKGROUND

Identifying family environment factors related to food insecurity and maternal mental health could inform additional support for mothers who experience food insecurity. This study seeks to examine the mechanistic roles of co-parenting support and parenting stress on the food insecurity-maternal mental health relationship.

METHODS

Data from the Future of Families and Child Well-being Study, which recruited mothers post-delivery from 75 urban hospitals, was utilized. Analysis includes 1808 mothers followed for 15 years. Food insecurity was assessed at year 5, co-parenting support and parenting stress at year 9, and maternal depression and anxiety at year 15. Structural equation models evaluated the role of food insecurity on maternal depression (model 1) and anxiety (model 2) through co-parenting support and parenting stress simultaneously, adjusting for socio-demographics.

RESULTS

Co-parenting support did not mediate the relationships of food insecurity and maternal depression and anxiety, controlling for parenting stress. Controlling for co-parenting support, parenting stress did not mediate the food insecurity-maternal depression relationship, but partially mediated the food insecurity-maternal anxiety relationship (specific indirect: B = 0.026, CI:0.01, 0.05; specific direct: B = 0.131, CI:-0.04, 0.32).

LIMITATIONS

There was a significant period of time (10 years) between assessment of food insecurity and assessment of maternal mental health. Self-reported data on sensitive topics may be susceptible to bias. With observational research, it is possible that unobserved confounding variables impact the findings.

CONCLUSIONS

Cumulative support in the form of - parenting, economic (e.g., utilities), and food - may help reduce parenting stress and anxiety among mothers who experience food insecurity.

A study on urban household water consumption behavior under drought conditions

The increasing frequency of drought events has intensified the risk of water scarcity, posing significant challenges for urban domestic water supply. Reducing urban household water consumption is an important way to alleviate water stress during drought periods. However, due to various factors, it is difficult to determine a water-saving target that is within the residents' capacity. Here, taking Beijing, China as an example, we explored the socio-psychological factors behind urban household water use behaviors under drought conditions, and further quantified the compressible ratio of water quotas for flexible water use behaviors. Therefore, the present study was based on the theory of planned behavior (TPB) and extended TPB (ETPB) by adding drought risk perception as a variable to the theoretical framework. With the help of questionnaire method and structural equation modeling (SEM), the explanatory power of TPB and ETPB in predicting people's water saving intention and behavior was compared. Meanwhile, mathematical statistical analysis methods were employed to calculate the water quota for elastic water consumption behavior and the compressible proportion of urban residents' elastic water consumption under drought conditions. The results showed that drought risk perception has a significant positive correlation with subject norms and water reduction behavior under drought conditions. Furthermore, ETPB was more effective in analyzing water use intentions and behaviors. The predictive explanatory power of SEM for reducing water use increased from 44% to 50% after adding drought risk perception variable. In terms of quantification of elastic water use behavior, the average total water consumption in summer and winter were 71.3L/(p.d) and 52.9L/(p.d) under drought conditions, while it were 124.3 L/(p.d) and 108.9 L/(p.d) under normal conditions. And the compressible proportions of the total water quota for summer and winter elastic water use were 46.7% and 56.8%, respectively. The calculation results can provide a reference for the government to make emergency water supply decisions against drought.

Transfer of chromium from environment to fish in East Kolkata wetlands - evaluation by structural equation modeling

Chromium (Cr) is a significant pollutant in the effluents from leather industries and domestic city sewage. Cr was determined in water, sediment, and different tissues (gill, muscle, intestine, liver, and kidney) of Nile tilapia, Oreochromis niloticus harvested from wastewater-fed aquaculture (WFA) situated at Bamonghata, Bantala, Chowbaga and Chingrighata of East Kolkata Wetlands (EKW), a Ramsar site in West Bengal, India. The results showed that Cr concentration in surface water ranged between 0.05 to 0.15 mg/L, while Cr was detected at high concentration (100-300 mg/kg) in the sediment soil of the first three WFAs and in moderate concentration (50-110 mg/kg) in Chingrighata WFA. Average Cr concentrations in the tissues were ranked in the following sequence: kidney>liver>intestine>gill>muscle. However, the extent of accumulation of Cr in different tissues varied between the WFAs. We used Structural Equation Modeling (SEM) to determine the route of Cr transfer. The fitness of the model was evaluated by the performance measures. Cr accumulation pathways varied between the sites depending upon the level of Cr in water or sediment. Except for Bamonghata WFA, sediment was found as the principal source of accumulation of Cr in different tissues of O. niloticus. Cr refluxed from sediment into overlying water and accumulated in fish either through the food chain or through direct accumulation from water. In Bamonghata WFA, the role of sediment in the transfer of Cr could not be established due to the high water depth or biological non-availability of Cr in the sediment. It is concluded from this study that fish reared in the WFAs of EKW are still not hazardous in respect to Cr but require proper management to avoid the influx of Cr-containing effluents into the WFAs.

semPower: General power analysis for structural equation models

Structural equation modeling (SEM) is a widespread and commonly used approach to test substantive hypotheses in the social and behavioral sciences. When performing hypothesis tests, it is vital to rely on a sufficiently large sample size to achieve an adequate degree of statistical power to detect the hypothesized effect. However, applications of SEM rarely consider statistical power in informing sample size considerations or determine the statistical power for the focal hypothesis tests performed. One reason is the difficulty in translating substantive hypotheses into specific effect size values required to perform power analyses, as well as the lack of user-friendly software to automate this process. The present paper presents the second version of the R package semPower which includes comprehensive functionality for various types of power analyses in SEM. Specifically, semPower 2 allows one to perform both analytical and simulated a priori, post hoc, and compromise power analysis for structural equation models with or without latent variables, and also supports multigroup settings and provides user-friendly convenience functions for many common model types (e.g., standard confirmatory factor analysis [CFA] models, regression models, autoregressive moving average [ARMA] models, cross-lagged panel models) to simplify power analyses when a model-based definition of the effect in terms of model parameters is desired.

Risk perceptions of COVID-19, vocational identity, and employment aspirations of Chinese aviation students: a structural equation modeling approach

BACKGROUND

The COVID-19 pandemic has wreaked havoc on the aviation and education sectors in China. This study examined the relationships between risk perceptions of the pandemic, vocational identity, and employment aspirations of Chinese aviation students.

METHODS

The study used a convenience sampling approach to collect data (n = 276 respondents) from August 2 to 8, 2022. An online survey was sent via WeChat and QQ to Chinese students majoring in aviation service management who were under lockdown at six Chinese schools.

RESULTS

In spite of the strong support for the stringent COVID policies and full awareness of infection risk and protective measures, respondents were worried about the current unstable situation and felt fear for its severity and long-lasting symptoms. The casual path from career commitment to employment aspiration was supported, but high risk perceptions of the pandemic failed to have any psychological effect on the two constructs of vocational identity and employment aspirations.

CONCLUSIONS

The findings not only demonstrate the power of career commitment on employment aspirations but also reveal that a relatively high self-assessment of career proficiency may not necessarily lead to a clear career aspiration, possibly due to poor risk communication and insufficient career planning guidance. Thus, Chinese aviation students should improve their career proficiency and commitment, broaden their career options and adaptability, and have a clear career plan, in order to be well prepared for the fierce job market that will face the next wave of the ongoing pandemic.

Analysis of design-for-safety implementation factors in the Indonesian construction industry: A two-staged SEM-artificial neural network approach

Despite the rapid growth of infrastructure development in Indonesia, work safety remains a major concern in construction projects. Design-for-safety (DfS) is a critical strategy to prevent work accidents. The implementation of design-for-safety is one of the most important strategies for preventing work accidents. This study aimed to analyze multiple factors that influence the implementation of work safety design using two statistical approaches: structural equation modeling and an artificial neural network. Structural equation modeling analyzes the relationship pattern between variables and their indicators, and artificial neural network maps various similar patterns to predict variables that influence implementation. Designers, owners, policies, tools/equipment, knowledge, and contract documents positively affect design-for-safety implementation, with design and contract documents being the most significant variables. Accordingly, industry and government agencies are advised to prioritize contract documents and design factors, along with other variables as supporting factors in their programs to accelerate design-for-safety implementation in Indonesia.

Lessons learned from COVID-19 vaccination implementation: How psychological antecedents of vaccinations mediate the relationship between vaccine literacy and vaccine hesitancy

BACKGROUND

Enhancing the public's vaccine literacy is critical for curbing vaccine hesitancy and enhancing society's pandemic preparedness, particularly in an era of infodemic. Evidence on vaccine literacy as an influencing factor of hesitancy is scarce. Lessons could be learned from COVID-19 vaccination implementation. Taking the COVID-19 vaccines as an example, the current study aimed to examine the relationship between vaccine literacy and hesitancy and the mediating role of psychological antecedents of vaccination on the relationship.

METHODS

A baseline online questionnaire survey among the general public in China based on quota sampling was conducted in April 2021 to measure participants' vaccine literacy, psychological antecedents of vaccination, COVID-19 vaccination status, and vaccine hesitancy. A follow-up online survey tracked the updated COVID-19 vaccination status among those who hadn't taken COVID-19 vaccines at the baseline survey. Structural equation modeling has been applied to examine the direct and indirect effect of vaccine literacy on vaccine hesitancy. Time-to-event analysis was used to explore the effect of vaccine hesitancy on vaccination behavior.

RESULTS

Lower vaccine hesitancy was associated with higher vaccine literacy. The "3Cs" psychological antecedents were important mediators between vaccine literacy and vaccine hesitancy. The pathway between critical/interactive vaccine literacy and vaccine hesitancy through the "3Cs" psychological antecedents played a more important role. Time-to-event analysis showed participants with a higher vaccine hesitancy were prone to have a longer delay in vaccination.

CONCLUSIONS

Improving the public's ability to obtain and evaluate vaccination information can fix the public's psychological determinants of vaccination, reducing vaccine hesitancy and promoting vaccination. Governments need to put more effort into guiding and regulating the media to disseminate evidence-based information, rectifying misinformation, and improving the public's vaccine literacy through education, especially the public's capability to critically discern mixed information.

Effects of environmental factors on the river water quality on the Tibetan Plateau: a case study of the Xoirong River, China

Climate, topography, and landscape patterns affect river water quality through processes that influence non-point source pollution. However, little is known about the response of the water quality of rivers on China's Tibetan Plateau to these environmental factors. Based on the water quality parameters data of the Xoirong River on the Tibetan Plateau in western China, the redundancy analysis and variation partitioning analysis were adopted to determine the main influencing factors affecting river water quality and their spatial scale effects. The major water pollutants were further analyzed using the partial least square-structural equation modeling (PLS-SEM). Another mountainous river with a similar latitude, the same stream order, and low anthropogenic disturbance in central China, the Jinshui River, was also selected for comparative discussion. The results indicated that the overall river water quality on the Tibetan Plateau was superior to that of the Jinshui River. At the catchment scale, the cumulative explanatory powers of the influencing factors of both rivers were greatest. Landscape composition and configuration were the determinant factors for the overall water quality of the two rivers, while the river on the Tibetan Plateau was also significantly affected by climatic and topographical factors. Regarding the main water quality issue, i.e., total nitrogen, agricultural production activities might be the main cause of the river on the Tibetan Plateau. This study unveiled that the river water quality on the Tibetan Plateau is sensitive to climate and topography through comparative studies.

The association between workplace physical environment and nurses' safety compliance: A serial mediation of psychological and behavioral factors

Aim

This study describes Jordanian intensive care unit nurses' satisfaction with their physical environment and investigates the association between workplace physical environment and nurses' safety compliance. Additionally, the study offers serial mediation analyses of psychological and behavioral factors between satisfaction with the workplace physical environment and nurses' safety compliance.

Introduction

Compliance with safety measures is a vital indicator of safety performance, as less compliance directly reflects undesirable safety outcomes among nurses, like occupational accidents, injuries, and fatalities. Social cognitive theory and the safety triad model contribute to understanding safety compliance behaviors to safety procedures. Thus, enhancing safety compliance in healthcare organizations remains a challenge and concern.

Methods

A quantitative research method was used based on cross-sectional and descriptive data from eight governmental hospitals in Jordan. The population included all intensive care unit nurses in the Ministry of Health's hospitals (n = 1104). A cluster sampling technique selected 285 nurses to participate. Empirical results were obtained through structural equation modeling (i.e., Smart PLS-SEM), which has become popular in this kind of research.

Results

The mean of Jordanian ICU nurses' satisfaction with the workplace physical environment was 3.36, which is moderate. Although the Smart PLS findings did not support the direct association between the workplace physical environment and nurses' safety compliance, serial mediation of safety participation in the workplace physical environment and nurses' safety compliance and perceived safety management commitment confirm the indirect association in the study model.

Conclusion

This study fills a gap in available safety and nursing literature, especially when considering the scarce studies that investigated the physical elements in the workplace and both safety compliance and safety participation. The findings are valuable for academicians, health providers, and policymakers and may trigger creative ideas and interventional solutions to improve nurses' safety compliance in healthcare organizations.

Spatio-temporal characterization of dissolved organic matter in karst rivers disturbed by acid mine drainage and its correlation with metal ions

Dissolved organic matter (DOM) is widely present in surface water environments and plays a critical role in the biogeochemical cycling of metal ions. Metal ions in acid mine drainage (AMD) have seriously polluted karst surface water environments, but few studies have explored interactions between DOM and metal ions in AMD-disturbed karst rivers. Here, the composition and sources of DOM in AMD-disturbed karst rivers were investigated by fluorescence excitation-emission spectroscopy combined with parallel factor analysis. In addition, correlations between metal ions and other factors (DOM components, total dissolved carbon (TDC) and pH) were determined using structural equation modeling (SEM). Results showed that there were evident differences in the seasonal distribution of TDC and metal ion concentrations in AMD-disturbed karst rivers. The concentrations of DOC, dissolved inorganic carbon (DIC), and metal ions were generally higher in the dry season than in the wet season, with Fe and Mn pollution being the most pronounced. The DOM in AMD contained two types of protein-like substances that were mainly from autochthonous inputs, while DOM in AMD-disturbed karst rivers contained two additional types of humic-like substances from both autochthonous and allochthonous inputs. The SEM results showed that the influence of DOM components on the distribution of metal ions was greater than that of TDC and pH. Among the DOM components, the influence of humic-like substances was greater than that of protein-like substances. Additionally, DOM and TDC had direct positive effects on metal ions, while pH had a direct negative effect on these. These results further elucidated the geochemical interactions between DOM and metal ions in AMD-disturbed karst rivers, which will assist in the pollution prevention of metal ions in AMD.

What is the relationship between alexithymia and experiential avoidance? A latent analysis using three alexithymia questionnaires

Alexithymia is a clinically relevant personality trait characterized by poor emotional awareness and associated with several psychological and physical health concerns. Individuals with high alexithymia tend to engage in experiential avoidance and this may mediate psychological distress. However, little is known about what specific processes of experiential avoidance are involved, and the nature of the relation between alexithymia, experiential avoidance, and psychological distress remains unclear at a latent construct level. To examine this relationship at the latent construct level, a representative sample of 693 U.S. adults completed alexithymia (TAS-20, BVAQ, PAQ), general distress (DASS-21), multi-dimensional experiential avoidance (MEAQ), and general health (PROMIS-G-10) questionnaires. Structural equation modeling revealed that alexithymia significantly predicted experiential avoidance (β = 0.966, t = 82.383, p < .01), experiential avoidance significantly predicted general distress (β = 0.810, t = 2.017, p < .05), and experiential avoidance fully mediated the relationship between alexithymia and general distress (βindirect = -0.159, t = -0.398, p > .05). Correlations between alexithymia and experiential avoidance subfactors revealed a strong relationship to the repression and denial subfactor. Experiential avoidance is a promising target for clinical interventions, though longitudinal research is necessary to elucidate how the relationship between alexithymia and experiential avoidance unfolds over time.

Examining supporting and constraining factors of physicians' acceptance of telemedical online consultations: a survey study

As healthcare demands exceed outpatient physicians' capacities, telemedicine holds far-reaching potential for both physicians and patients. It is crucial to holistically analyze physicians' acceptance of telemedical applications, such as online consultations. This study seeks to identify supporting and constraining factors that influence outpatient physicians' acceptance of telemedicine.We develop a model based on the unified theory of acceptance and use of technology (UTAUT). To empirically examine our research model, we conducted a survey among German physicians (n = 127) in 2018-2019. We used the partial least squares (PLS) modeling approach to test our model, including a mediation analysis. The results indicate that performance expectancy (β = .397, P < .001), effort expectancy (β = .134, P = .03), and social influence (β = .337, P < .001) strongly impact the intention to conduct online consultations and explain 55% of its variance. Structural conditions regarding data security comprise a key antecedent, associating with performance expectancy (β = .193, P < .001) and effort expectancy (β = .295, P < .001). Regarding potential barriers to usage intentions, we find that IT anxiety predicts performance (β = -.342, P < .001) and effort expectancy (β = -.364, P < .001), while performance expectancy fully mediates (βdirect = .022, P = .71; βindirect = -.138, P < .001) the direct relationship between IT anxiety and the intention to use telemedical applications.This research provides explanations for physicians' behavioral intention to use online consultations, underlining UTAUT's applicability in healthcare contexts. To boost acceptance, social influences, such as personal connections and networking are vital, as colleagues can serve as multipliers to reach convergence on online consultations among peers. To overcome physicians' IT anxiety, training, demonstrations, knowledge sharing, and management incentives are recommended. Furthermore, regulations and standards to build trust in the compliance of online consultations with data protection guidelines need reinforcement from policymakers and hospital management alike.

The relation of depressive symptoms to theory of mind in adults

BACKGROUND

Theory of mind (ToM) is the ability to understand thoughts and feelings of others. Significant heterogeneity exists for the strength of the association between depression and ToM performance.

METHODS

To clarify these relations, two studies of depressed and nondepressed adults investigate cross-sectional associations of four latent depression factors (i.e., somatic symptoms, depressed affect, positive affect, and interpersonal problems) to two aspects of ToM (reasoning vs. decoding). Study 1 investigated associations between depression factors and reasoning ToM (N = 258), and Study 2 investigated associations between depression factors and decoding ToM (N = 219).

RESULTS

In Study 1, the interpersonal problems factor was negatively related to reasoning ToM, though in Study 2, no consistent associations emerged between depression and decoding ToM. Study 2 also replicated a novel approach to assessing valence with the Reading the Mind in the Eyes Test.

LIMITATIONS

This investigation was primarily limited by cross-sectional designs, self-report, and online delivery of measures.

CONCLUSIONS

Findings emphasize the heterogeneity of ToM as a construct and identify targets for clinical intervention, with specific focus on bolstering reasoning ToM skills.

Mechanistic insights into the response of electroactive biofilms to Cd2+ shock: bacterial viability and electron transfer behavior at the cellular and community levels

Electroactive biofilms (EABs) play a crucial role in environmental bioremediation due to their excellent extracellular electron transfer (EET) capabilities. However, Cd2+ can have toxic effects on the electrochemical performance of EABs, and the comprehensive inhibition mechanism of EABs in response to Cd2+ shock remains elusive. This study indicated that Cd2+ shock significantly reduced biomass and increased oxidative stress in EABs at the cellular level. The bacterial viability of EABs in phase III under 0.5 mM Cd2+ shock (EABCd2+-III0.5) decreased by 16.31% compared to EABCK-III. Moreover, intracellular NADH, c-Cyts, and the abundance of electroactive species were essential indicators to evaluate EET behavior of EABs. In EABCd2+-III0.5, these indicators decreased by 26.32%, 33.40%, and 20.65%, respectively. Structural equation modeling analysis established quantitative correlations between core components and electrochemical activity at cellular and community levels. The correlation analysis revealed that the growth and electron transfer functions of EABs were predictive indicators for their electrochemical performance, with standardized path coefficients of 0.407 and 0.358, respectively. These findings enhance our understanding of EABs' response to Cd2+ shock and provide insights for improving their performance in heavy metal wastewater.

manymome: An R package for computing the indirect effects, conditional effects, and conditional indirect effects, standardized or unstandardized, and their bootstrap confidence intervals, in many (though not all) models

Mediation, moderation, and moderated mediation are common in behavioral research models. Several tools are available for estimating indirect effects, conditional effects, and conditional indirect effects and forming their confidence intervals. However, there are no simple-to-use tools that can appropriately form the bootstrapping confidence interval for standardized conditional indirect effects. Moreover, some tools are restricted to a limited type of models. We developed an R package, manymome, which can be used to estimate and form confidence intervals for indirect effects, conditional effects, and conditional indirect effects, standardized or not, using a two-step approach: model parameters are estimated either by structural equation modeling using lavaan or by a set of linear regression models using lm, and then the coefficients are used to compute the requested effects and form confidence intervals. It can be used when there are missing data if the model is fitted by structural equation modeling. There are only a few limitations on some aspects of a model, and no inherent limitations on the number of predictors, the number of independent variables, or the number of moderators and mediators. The goal is to have a tool that allows researchers to focus on model fitting first and worry about estimating the effects later. The use of the model is illustrated using a few numerical examples, and the limitations of the package are discussed.

Understanding health outcome drivers among adherence club patients in clinics of Gauteng, South Africa: a structural equation modelling (SEM) approach

BACKGROUND

There has been growing interest in understanding the drivers of health outcomes, both in developed and developing countries. The drivers of health outcomes, on the other hand, are the factors that influence the likelihood of experiencing positive or negative health outcomes. Human Immunodeficiency Virus (HIV) continues to be a significant global public health challenge, with an estimated 38 million people living with the aim of this study was therefore to develop and empirically test a conceptual research model using SEM, aimed at explaining the magnitude of various factors influencing HIV and other health outcomes among patients attending Adherence Clubs.

METHOD

This was a cross sectional survey study design conducted in 16 health facilities in the City of Ekurhuleni in Gauteng Province, South Africa. A total of 730 adherence club patients were systematically sampled to participate in a closed ended questionnaire survey. The questionnaire was assessed by Cronbach's alpha coefficient for internal consistency. The proposed model was tested using structural equation modelling (AMOS software: ADC, Chicago, IL, USA).

RESULTS

A total of 730 adherence club members participated in the study. Of these, 425 (58.2%) were female and 305 (41.8%) were male. The overall results indicated a good reliability of all the scale involved in this study as Cronbach alphas ranged from 0.706 to 0.874, and composite reliability from 0.735 to 0.874. The structural model showed that the constructs health seeking behavior (β = 0.267, p = 0.000), health care services (β = 0.416, p = 0.000), stigma and discrimination (β = 0.135, p = 0.022) significantly predicted health outcomes and explained 45% of its variance. The construct healthcare service was the highest predictor of health outcomes among patients in adherence clubs.

CONCLUSION

Patient health seeking behaviour, healthcare services, stigma and discrimination were associated with perceived health outcomes. Since adherence clubs have been found to have a significant impact in improving patient outcomes and quality of life, there is a need to ensure replication of this model.

Multivariate GWAS of Alzheimer's disease CSF biomarker profiles implies GRIN2D in synaptic functioning

BACKGROUND

Genome-wide association studies (GWAS) of Alzheimer's disease (AD) have identified several risk loci, but many remain unknown. Cerebrospinal fluid (CSF) biomarkers may aid in gene discovery and we previously demonstrated that six CSF biomarkers (β-amyloid, total/phosphorylated tau, NfL, YKL-40, and neurogranin) cluster into five principal components (PC), each representing statistically independent biological processes. Here, we aimed to (1) identify common genetic variants associated with these CSF profiles, (2) assess the role of associated variants in AD pathophysiology, and (3) explore potential sex differences.

METHODS

We performed GWAS for each of the five biomarker PCs in two multi-center studies (EMIF-AD and ADNI). In total, 973 participants (n = 205 controls, n = 546 mild cognitive impairment, n = 222 AD) were analyzed for 7,433,949 common SNPs and 19,511 protein-coding genes. Structural equation models tested whether biomarker PCs mediate genetic risk effects on AD, and stratified and interaction models probed for sex-specific effects.

RESULTS

Five loci showed genome-wide significant association with CSF profiles, two were novel (rs145791381 [inflammation] and GRIN2D [synaptic functioning]) and three were previously described (APOE, TMEM106B, and CHI3L1). Follow-up analyses of the two novel signals in independent datasets only supported the GRIN2D locus, which contains several functionally interesting candidate genes. Mediation tests indicated that variants in APOE are associated with AD status via processes related to amyloid and tau pathology, while markers in TMEM106B and CHI3L1 are associated with AD only via neuronal injury/inflammation. Additionally, seven loci showed sex-specific associations with AD biomarkers.

CONCLUSIONS

These results suggest that pathway and sex-specific analyses can improve our understanding of AD genetics and may contribute to precision medicine.

Beyond generalized anxiety: the association of anxiety sensitivity with disordered eating

BACKGROUND

Anxiety and eating disorders (EDs) are rising at alarming rates. These mental health disorders are often comorbid, yet the factors associated with their comorbidity are not well understood. The present study examined a theoretical model of the pathways and relative associations of anxiety sensitivity (AS) with different dimensions of ED risk, controlling for generalized anxiety.

METHODS

Participants (N = 795) were undergraduate students with an average age of 21 (SD = 4.02), predominantly female (71%), and Hispanic (71.8%). Participants completed an online survey with established measures of AS (i.e., Anxiety Sensitivity Index-3; ASI-3), general anxiety (i.e., Beck Anxiety Inventory; BAI), and eating behaviors (i.e., Eating Attitudes Test-26; EAT-26).

RESULTS

The results of our structural equation models indicated that AS subscales were significantly associated with dimensions of the EAT-26, even when controlling for generalized anxiety. Specifically, the ASI-3 factors reflecting cognitive and social concerns provided the most consistent significant associations with EDs. Whereas reporting higher cognitive concerns was associated with higher ED symptoms (e.g., reporting the urge to vomit after a meal), reporting higher social concerns was associated with fewer ED symptoms. These differential results may suggest risk and resilience pathways and potential protective or buffering effects of social concerns on ED risk.

DISCUSSION

Findings advance understanding of the role of AS in the comorbidity of anxiety and EDs, demonstrating the strong association of AS with ED pathology. These findings provide cognitive indicators for transdiagnostic therapeutic intervention in order to reduce the risk of EDs.

The relationship between self-concept clarity, athletic identity, athlete engagement and the mediating roles of quality of life and smartphone use in Chinese youth athletes

Background

Youth athletes represent the future of competitive sports, so examining their commitment to sport is critical. This study investigated the impacts of self-concept clarity and athletic identity on athlete engagement among Chinese youth athletes, and the mediating roles of quality of life and smartphone use.

Methods

410 youth athletes from sports schools completed an online cross-sectional survey measuring self-concept clarity, athletic identity, quality of life, smartphone use, and athlete engagement. We used convenience sampling. Instruments included validated scales like the Self-Concept Clarity Scale.

Results

The direct effect of self-concept clarity and athlete engagement in youth athletes was not significant (β = 0.04, p = 0.344), but there was a direct effect of athletic identity and athlete engagement (β = 0.61, p < 0.05). Quality of life mediated the relationships between self-concept clarity(indirect effect = -0.054, 95 % CI = -0.114, -0.019), athletic identity(indirect effect = 0.202, 95 % CI = 0.114, 0.349) and athlete engagement.

Conclusions

This study helps address gaps in understanding athlete engagement in youth athletes. The mediation model provides insights to improve self-concept clarity, athletic identity and quality of life to motivate greater engagement in youth athletes.

Gun carrying among US adolescents: the mutual impact of violence experiences, safety concerns, and substance use behaviors

OBJECTIVES

Youth firearm carriage significantly contributes to firearm-related injuries and deaths in the United States (US). This study examined the sex-specific patterns and cumulative effects of violence experiences, safety concerns, and substance use behaviors on youth firearm carriage.

STUDY DESIGN

Cross-sectional study.

METHODS

Based on a nationally representative sample (N = 13,526), the multigroup structural equation modeling (SEM) was used to examine the interplay of violence experiences (weapon threats, physical fights, and sexual violence), safety concerns, and substance use behaviors (cigarette, electronic vapor, alcohol, marijuana, and prescription opioid), and their direct, indirect, and total effects on youth gun carrying behavior.

RESULTS

About one in 50 females and one in 15 males reported firearm carriage in the past year. Sex-specific patterns existed. Among female adolescents, gun carrying was strongly correlated with violence experiences (standardized coefficient (β) = 0.77, P < 0.001), but no direct connection was observed with substance use behaviors. Among males, both violence experiences (β = 0.56, P < 0.001) and substance use behaviors (β = 0.26, P < 0.001) were significantly correlated with gun carrying. Although safety concerns did not show a direct effect on gun carrying, a significant indirect effect was observed via the pathway of violence experiences. Collectively, the three clusters of predictors explained about 59.9% of variance in gun carrying among females and 54.6% of variance among males.

CONCLUSIONS

Violence experiences have a robust impact on gun carrying behavior in both female and male adolescents. Effective violence prevention programs and sex-specific strategies (e.g., substance use intervention for males) are needed to reduce youth firearm carriage.

From liquid to solid: A novel approach for utilizing sulfate reduction effluent through phase transition - Effluent-induced nanoscale zerovalent iron sulfidation

This study investigated the use of sulfate reduction effluent (SR-effluent) to induce sulfidation on nanoscale zerovalent iron (nZVI). SR-effluent-modified nZVI achieved a 100% improvement in Cr(VI) removal from simulated groundwater, a result comparable to cases where other, more typical sulfur precursors (Na2S2O4, Na2S2O3, Na2S, K2S6, and S0) were used. Through a structural equation model analysis, amendment of nanoparticles' agglomeration (standardized path coefficient (std. path coeff.) = -0.449, p < 0.05) and hydrophobicity (std. path coeff. = 0.100, p < 0.05) and direct reaction between iron-sulfur compounds and Cr(VI) (std. path coeff. ranged from -0.195 to 0.322, p < 0.05) were primarily contributing to sulfidation-induced Cr(VI) removal enhancement. Regarding the property improvement of nZVI, the SR-effluent's corrosion radius played a crucial role in tuning the content and distribution of the iron-sulfur compounds based on the core-shell structure of the nZVI and the redox processes at the aqueous-solid interface.

The Effects of Social Rank and Neighborhood and School Environment on Adolescent Depression and Suicidal Ideation: A Structural Equation Modeling Approach

Depression and suicide constitute major public health problems, and their prevalence has been increasing among adolescents in the United States. More research is needed to understand the association between multilevel risk factors and depression and suicidal ideation in adolescents, particularly factors related to perceived social rank and environmental stress. The present study examined relationships among family mental history of mental illness, in-utero and perinatal complications, social rank factors, environmental factors, and depression and suicidal ideation in the past month in a clinical population of adolescents. A cross-sectional survey was administered in outpatient clinics to 197 adolescents ages 12-18 who were primarily Black and female. Findings from structural equation modeling showed the largest effects for the social rank factor on depression and suicidal ideation in the past month. These findings highlight the importance of preventive interventions for coping with social hierarchies to prevent depression and suicidal ideation.

Sustainable development through corporate social responsibility adoption and its drivers: evidence from corporate industrial sector

Corporate social responsibility (CSR) is a vital strategy for promoting firms' sustainable development goals, encompassing social, environmental, and economic factors. In emerging economies, manufacturing firms face mounting challenges in ensuring their sustainability. This study aims to identify the key drivers of CSR and examine their impact on CSR adoption in the manufacturing industry of Pakistan. The study employs the survey method to collect data, utilizing a one-to-one interview approach with a matrix-style questionnaire administered to a panel of experts selected through purposive sampling technique. Interpretive structural modeling (ISM) combined with Matrices' Impacts Cruise's Multiplication Appliquée a UN Classement (MICMAC) and structural equation model (SEM) are used for data assessment, modeling, and analysis. The findings indicate that compliance with government regulations and stakeholders' pressure are the essential drivers of CSR adoption and positively influence CSR adoption. Consequently, firms should consider adopting CSR strategies to enhance their sustainability based on the outcomes of this analysis.

Green HRM practices for encouraging pro-environmental behavior among employees: the mediating influence of job satisfaction

This study aims to investigate the relationship between green human resource management (HRM) practices and pro-environmental behavior among employees with mediating role of job satisfaction in this relationship. A questionnaire was used to collect data from the employees working in the pharmaceutical industry of Pakistan. Structural equation modeling (SEM) was employed to examine study hypotheses. The study's findings indicate that green HRM practices favorably effect employees' job satisfaction, with the exception of green recruiting and selection, which leads to a greater degree of pro-environmental activity among employees. Additionally, it was discovered that job satisfaction, with the exception of green recruitment and selection, partially mediates the association between green HRM practices and pro-environmental behavior. The study also advances the field of analyzing firms' green activities from a psychological and sociological perspective, testing employee job satisfaction as a psychological condition that supports the link between green HRM and pro-environmental behavior. The study highlights the importance of green HRM practices in promoting pro-environmental behavior among employees. By aligning HRM procedures with environmental objectives, implementing environmental training, and involving employees in sustainability initiatives, organizations can build a culture of environmental responsibility and encourage sustainable behavior.

Health status, resources, and job demands in geriatric nursing staff: A cross-sectional study on determinants and relationships

BACKGROUND

According to current estimates, the number of people needing care will double in the next 40 years. It is expected that between 130,000 and 190,000 additional nurses will be needed by 2030 in Germany. Physical and psychological burdens associated with nursing in long-term care facilities can develop into serious health risk factors and significantly impact occupational factors such as absenteeism, especially when linked to difficult working conditions. However, demands and resources specific to the nursing profession have not been analyzed extensively to preserve and promote nurses' workability and health adequately.

OBJECTIVE

Our study aimed to examine the extent to which perceived health among geriatric nursing staff in Germany is predicted by personal resources, job demands, and job resources. In addition, we analyzed the impact of different behavior and experience patterns on these relationships.

DESIGN, SETTING, AND PARTICIPANTS

An observational study was conducted between August 2018 and February 2020 in 48 nursing home facilities with 854 staff members in Germany as part of the project 'PROCARE - Prevention and occupational health in long-term care'.

METHODS

The survey contained instruments that measure workplace exposure, musculoskeletal complaints, physical and mental well-being, chronic stress, and work-related behavior and experience patterns. In addition, health-related information on physical activity and nutrition was collected. Data were analyzed using structural equation modeling.

RESULTS

The combined physical and mental workload for geriatric nurses is very high, with 75 % showing chronic stress. In the overall model, job and personal resources have a stronger association with mental health than physical health, while job demands have an equal impact on mental and physical health. Coping behavior also plays an important key role that should be assessed and considered. A behavior and experience risk pattern (health-endangering) is more strongly associated with a lower health status than a health-promoting behavior pattern. Results of the multigroup test showed that work-related behavior and experience patterns significantly moderate the relationship between physical health and mental health (χ2 = 392/p ≤ .001/df = 256/RMSEA = 0.028/CFI = 0.958/TLI = 0.931). Only 43 % show a health-friendly coping pattern.

CONCLUSIONS

Our findings underline the importance of holistic health promotion, which not only aims at changes at the behavioral level and the development of coping strategies but also takes on the task of reducing the workload and including measures to improve the working climate.

TRIAL REGISTRATION NUMBER

DRKS.de (DRKS00015241); August 9, 2018.

TWEETABLE ABSTRACT

Healthier coping patterns can benefit geriatric nurses' health. However, this is not a substitute for improving working conditions.

An empirical study on English preservice teachers' digital competence regarding ICT self-efficacy, collegial collaboration and infrastructural support

This study aims to investigate English preservice teachers' digital competence regarding their self-efficacy in information and communication technologies (ICT), their collaboration with colleagues, and the support they received from the infrastructure. A questionnaire based on the "Digital competence of educators (DigCompEdu)" was used in this research. Structural equation modeling (SEM) was applied to verify the hypothesized model using data obtained from 425 graduate students majoring in English pedagogy. This study produced significant findings: (1) English preservice teachers' ICT self-efficacy has strong or moderate positive associations with their perceptions of collegial collaboration, infrastructural support and digital competence; (2) the association between participants' perspectives on collegial collaboration and digital competence is statistically equivalent to the association between their ICT self-efficacy and digital competence; (3) although English preservice teachers' perceptions of infrastructural support have a positive association with their views on digital competence, it is not as significant as the former ones; and (4) further study is needed, as the dependent variables in this study explained only 66% of the variation in collegial collaboration, 44% in infrastructural support, and 78% in digital competence.

Predicting factors influencing perceived online learning experience among primary students utilizing structural equation modeling Forest Classifier approach

Introduction

Amid the COVID-19 pandemic, the temporary closure of educational institutions led to the adoption of remote or online learning delivery. Challenges, especially for grade schools were evident.

Objective

This study aimed to identify factors affecting the perceived online discussion experience of Filipino primary students through distance learning in the National Capital Region, Philippines.

Method

Variables such as cognitive presence, teaching presence, social presence, and online discussion experience were investigated simultaneously by utilizing the structural equation modeling (SEM) and random forest classifier (RFC) approach. A total of 385 currently enrolled Filipino grade school student participants were surveyed.

Results

Results show that cognitive presence has the most significant impact on the perceived online discussion experience, followed by teaching presence, and social presence. This study is the first study that analyzed the online discussion experience among grade school students in online education in the Philippines considering SEM and RFC. It was seen that highly significant factors such as teaching presence, cognitive presence, social presence, triggering events, and exploration will lead to high and very high learning experience with grade school students.

Conclusion

The findings of this study would be significant for teachers, educational institutions, and government agencies to improve the online delivery of primary education in the country. In addition, this study presents a reliable model and results which can be extended and applied for academicians, educational institutions, and the education sector to develop ways in enhancing the online delivery of primary education worldwide.

Cognitive and socioeconomic factors that influence the mathematical problem-solving skills of students

Mathematical problem-solving is necessary to encounter professional, 21st-century, and everyday challenges. The relevant context of mathematical problem-solving is related to science, which is presented using natural language. Mathematical problem-solving requires both mathematical skills and nonmathematical skills, e.g., science knowledge and text comprehension skills. Thus, several internal and external factors affect success in mathematical problem-solving. In this study, we investigated the cognitive (i.e., mathematics domain-specific prior knowledge (DSPK), science background knowledge, and text comprehension skills) and socioeconomic status (SES) (i.e., parents' educational level and family income) factors that affect students' mathematical problem-solving skills. The data considered in this study included tests, documents, and a questionnaire from grade seven to nine students (n = 1067). In addition, a theoretical model was constructed using structural equation modeling. We found that this model was close to satisfying the critical values of fit indices. The model was then modified by deleting the nonsignificant paths, and the modified model exhibited a better fit. We found that most of the exploratory variables directly affected mathematical problem-solving skills, with the exception of the parents' educational levels. The strongest factor was mathematics DSPK. Both the father's and mother's educational levels indirectly influenced mathematical problem-solving skills through family income. In addition, text comprehension skills indirectly impacted mathematical problem-solving skills with science background knowledge acting as a mediator.

Factors Influencing Non-Fungible Tokens (NFT) Game Engagement during the COVID-19 pandemic: The Theory of Planned Behavior (TPB) and Hedonic Motivation System Adoption Model (HMSAM) Approach

The prominent form of Non-Fungible Token (NFT) is found in the gaming industry. NFT games received immense attention during the COVID-19 pandemic because of their play-to-earn model. NFT gamers can enjoy and increase their finances in their spare time. Hence, the researchers utilized Structural Equation Modeling (SEM) to investigate the intention and immersive behaviors of 1082 respondents. The modified framework from the Theory of Planned Behavior (TPB) and Hedonic Motivation System Adoption Model (HMSAM) underwent SEM tests. These theories and methods were used to analyze relationships among hypotheses and assess factors influencing NFT game engagement. The results showed that hedonic motivation produced positive and significant influences on perceived usefulness, curiosity, joy, attitude, subjective norms, and perceived behavioral control. Subjective norms significantly influenced perceived ease of use. In due course, perceived ease of use yielded positive and significant effects on perceived usefulness, joy, attitude, and perceived behavioral control. Moreover, perceived usefulness, curiosity, joy, attitude, and perceived behavioral control had significant positive effects on behavioral intention. In addition, perceived usefulness, curiosity, joy, and attitude significantly and positively affected immersion. Meanwhile, only four hypotheses were not supported by the study. These findings were translated into theoretical and managerial implications to contribute to the academe given the strong the change of behavior of users towards NFT games during the pandemic; gaming industry since they will be able to develop, improve and create a new ecosystem in the gaming space, and NFT stakeholders since they will benefit from the development that will influence this study.

Why we need to abandon fixed cutoffs for goodness-of-fit indices: An extensive simulation and possible solutions

To evaluate model fit in confirmatory factor analysis, researchers compare goodness-of-fit indices (GOFs) against fixed cutoff values (e.g., CFI > .950) derived from simulation studies. Methodologists have cautioned that cutoffs for GOFs are only valid for settings similar to the simulation scenarios from which cutoffs originated. Despite these warnings, fixed cutoffs for popular GOFs (i.e., χ2, χ2/df, CFI, RMSEA, SRMR) continue to be widely used in applied research. We (1) argue that the practice of using fixed cutoffs needs to be abandoned and (2) review time-honored and emerging alternatives to fixed cutoffs. We first present the most in-depth simulation study to date on the sensitivity of GOFs to model misspecification (i.e., misspecified factor dimensionality and unmodeled cross-loadings) and their susceptibility to further data and analysis characteristics (i.e., estimator, number of indicators, number and distribution of response options, loading magnitude, sample size, and factor correlation). We included all characteristics identified as influential in previous studies. Our simulation enabled us to replicate well-known influences on GOFs and establish hitherto unknown or underappreciated ones. In particular, the magnitude of the factor correlation turned out to moderate the effects of several characteristics on GOFs. Second, to address these problems, we discuss several strategies for assessing model fit that take the dependency of GOFs on the modeling context into account. We highlight tailored (or "dynamic") cutoffs as a way forward. We provide convenient tables with scenario-specific cutoffs as well as regression formulae to predict cutoffs tailored to the empirical setting of interest.

Implementing traumatic brain injury screening in behavioral health treatment settings: results of an explanatory sequential mixed-methods investigation

BACKGROUND

Traumatic brain injury (TBI) is a complex condition common among individuals treated in behavioral healthcare, but TBI screening has not been adopted in these settings which can affect optimal clinical decision-making. Integrating evidence-based practices that address complex health comorbidities into behavioral healthcare settings remains understudied in implementation science, limited by few studies using theory-driven hypotheses to disentangle relationships between proximal and medial indicators on distal implementation outcomes. Grounded in the Theory of Planned Behavior, we examined providers' attitudes, perceived behavioral control (PBC), subjective norms, and intentions to adopt The Ohio State University TBI Identification Method (OSU TBI-ID) in behavioral healthcare settings.

METHODS

We used an explanatory sequential mixed-methods design. In Phase I, 215 providers from 25 organizations in the USA completed training introducing the OSU TBI-ID, followed by a survey assessing attitudes, PBC, norms, and intentions to screen for TBI. After 1 month, providers completed another survey assessing the number of TBI screens conducted. Data were analyzed using structural equation modeling (SEM) with logistic regressions. In Phase II, 20 providers were purposively selected for semi-structured interviews to expand on SEM results. Qualitative data were analyzed using thematic analysis, integrated with quantitative results, and combined into joint displays.

RESULTS

Only 25% (55/215) of providers adopted TBI screening, which was driven by motivations to trial the intervention. Providers who reported more favorable attitudes (OR: 0.67, p < .001) and greater subjective norms (OR: 0.12, p < .001) toward TBI screening demonstrated increased odds of intention to screen, which resulted in greater TBI screening adoption (OR: 0.30; p < .01). PBC did not affect intentions or adoption. Providers explained that although TBI screening can improve diagnostic and clinical decision-making, they discussed that additional training, leadership engagement, and state-level mandates are needed to increase the widespread, systematic uptake of TBI screening.

CONCLUSIONS

This study advances implementation science by using theory-driven hypothesis testing to disentangle proximal and medial indicators at the provider level on TBI screening adoption. Our mixed-methods approach added in-depth contextualization and illuminated additional multilevel determinants affecting intervention adoption, which guides a more precise selection of implementation strategies.

Psychometric evaluation of the Japanese version of the fear of pain questionnaire-III and its association with dental anxiety: a cross-sectional study

BACKGROUND

Fear of pain is a significant concern related to chronic pain and its impact on daily functioning. It is also associated with dental anxiety, highlighting its relevance in dental practice. This study aimed to validate the Japanese version of the Fear of Pain Questionnaire-III (FPQ-III) and explore its relationship with dental anxiety.

METHODS

400 participants completed the Japanese version of the FPQ-III, with 100 participants re-evaluated after one month. Convergent validity was tested against dental anxiety and pain catastrophizing, while discriminant validity was assessed by examining general anxiety and depression correlations. Confirmatory factor analysis was used to examine the factorial validity of the FPQ-III and a shortened version of the FPQ-III (FPQ-9). Item response theory was applied for each subscale to estimate the discriminative power of each item and draw a test information curve. Structural equation modeling (SEM) was used to investigate the relationship between fear of pain and dental anxiety.

RESULTS

Data from 400 participants (200 women, 44.9 ± 14.5 years) were analyzed. The FPQ-III showed good internal validity, intra-examiner reliability, discriminant validity, and convergent validity. Confirmatory factor analysis results supported a three-factor structure, and the FPQ-9 showed a good fit. Test information curves demonstrated that the FPQ-9 maintained high accuracy over a similarly wide range as the FPQ-III. SEM revealed that fear of minor pain was associated with dental anxiety via fear of medical pain even in individuals without painful medical or dental experiences (indirect effect 0.48 [95% CI: 0.32-0.81]). Fear of severe pain tended to be higher in individuals with chronic pain compared to those without (latent mean values 0 vs. 0.27, p = 0.002) and was also associated with dental anxiety via fear of medical pain in women (indirect effect 0.15 [95% CI: 0.01-0.34]).

CONCLUSION

The Japanese version of the FPQ-9 demonstrated high reliability and validity, making it a valuable tool in dental clinical and research settings. It provides insights into the fear of pain among individuals with chronic pain and dental anxiety, informing potential intervention strategies.

The pathways from disadvantaged socioeconomic status in childhood to edentulism in mid-to-late adulthood over the life-course

BACKGROUND

This study aimed to examine the direct and indirect pathways from childhood socioeconomic status (SES) to the prevalence of edentulism in mid-to-late age Chinese individuals using structural equation modeling (SEM).

METHODS

This study analyzed data from 17,032 mid- to-late age Chinese individuals in the 2014 and 2015 China Health and Retirement Longitudinal Study (CHARLS). Childhood SES was determined based on the parents' education and occupation, financial situation of the family, primary residence, food availability, and medical convenience. Adulthood SES was established according to educational achievements of the individuals. Edentulism is defined as the loss of all natural teeth. SEM was used to examine the statistical significance of the association between childhood SES and edentulism, mediated by childhood health, adulthood SES, and adult health.

RESULTS

Childhood SES had significant indirect (β = -0.026, p < 0.01), and total (β = -0.040, p < 0.01) effects on edentulism. It was determined that 65% of the total effect of childhood SES on edentulism was indirect, and mainly mediated by adult SES. Also, the goodness-of-fit indices of the best-fitting model were acceptable.

CONCLUSION

This study revealed that childhood health, adult health and adult SES are mediators that explain the relationship between childhood SES and edentulism. The global attention to alleviate the inequality in edentulism should focus on exploring recommendations and intervention strategies from childhood to adulthood, by considering adult SES, childhood and adult health.

Exploring factors that influence the behavioural intention of medical students to use 3D gastroscopic model to learn how to operate gastroscope using UTAUT Model

BACKGROUND

The application of virtual reality (VR) in gastroscopic operation teaching can be safe and effective, but the advantages can be realized only when students accept and use it. This study aims to identify the factors influencing Chinese clinical medical postgraduates on their intention to use the 3D gastroscopic model constructed based on VR technology using Unified Theory of Acceptance and Use of Technology (UTAUT) model. Students' demographic factors are also taken into consideration.

METHODS

All methods were carried out in accordance with relevant guidelines. Data were collected from clinical medical postgraduates students in China using stratified sampling. A total of 292 questionnaires including valid responses were used in this study. Data were processed using Amos 24.0 and SPSS 26.0 software and the statistical analysis technique was based on structural equation modeling (SEM).

RESULTS

The results showed that different from the mediator of home location and year of clinical learning, mediator of gender, university kind and graduate degree did not affect the behavioral intention. In addition, performance expectancy, facilitating condition, and social influence directly and indirectly have effect on behavioral intention. Also, the significance between social influence and performance expectancy, social influence and effort expectancy were verified.

CONCLUSIONS

This study manifested that the proposed framework based on the UTAUT had explanatory power to identify the factors influencing the students' behavioral intention to use the 3D gastroscopic model constructed based on VR technology. Whereas, an important variable of effort expectancy in the frame of the SEM were not certified, thereby indicating that particular attention should be paid to this variable by universities and teachers before applying 3D gastroscopic model constructed based on VR technology in teaching. Added preparatory work is required such as explaining the basic knowledge of the operating steps of VR model and make students adequately understand its accessibility, which can probably improve the intentions of them to use it. The positive effects of social influence on performance expectancy and effort expectancy we proposed was also verified in this study, which provided a direction for future research.

The impact of containment policy and mobility on COVID-19 cases through structural equation model in Chile, Singapore, South Korea and Israel

Objectives

The study aims to understand the impact of containment policy and mobility on COVID-19 cases in Chile, Singapore, South Korea and Israel. To provide experience in epidemic prevention and control.

Methods

Structural equation modeling (SEM) of containment policies, mobility, and COVID-19 cases were used to test and analyze the proposed hypotheses.

Results

Chile, Israel and Singapore adopted containment strategies, focusing on closure measures. South Korea adopted a mitigation strategy with fewer closure measures, focusing on vaccination and severe case management. There was a significant negative relationship among containment policies, mobility, and COVID-19 cases.

Conclusion

To control the COVID-19 and slow down the increase of COVID-19 cases, countries can increase the stringency of containment policies when COVID-19 epidemic is more severe. Thus, countries can take measures from the following three aspects: strengthen the risk monitoring, and keep abreast of the COVID-19 risk; adjust closure measures in time and reduce mobility; and strengthen public education on COVID-19 prevention to motivate citizen to consciously adhere to preventive measures.

Processing Speed is Related to the General Psychopathology Factor in Youth

The relationship between the p factor and cognition in youth has largely focused on general cognition (IQ) and executive functions (EF). Another cognitive construct, processing speed (PS), is dissociable from IQ and EF, but has received less research attention despite being related to many different mental health symptoms. The present sample included 795 youth, ages 11-16 from the Colorado Learning Disabilities Research Center (CLDRC) sample. Confirmatory factor analyses tested multiple p factor models, with the primary model being a second-order, multi-reporter p factor. We then tested the correlation between the p factor and a latent PS factor. There was a significant, negative correlation between the p factor and PS (r(87) = -0.42, p < .001), indicating that slower processing speed is associated with higher general mental health symptoms. This association is stronger than previously reported associations with IQ or EF. This finding was robust across models that used different raters (youth and caregiver) and modeling approaches (second-order vs. bifactor). Our findings indicate that PS is related to general psychopathology symptoms. This research points to processing speed as an important transdiagnostic construct that warrants further exploration across development.

Climate plays a dominant role over land management in governing soil carbon dynamics in North Western Himalayas

The soil carbon (C) dynamics is strongly influenced by climate and land-use patterns in the Himalayas. Therefore, soils under five prominent land use [e.g., maize (Zea mays), horticulture, natural forest, grassland, and wasteland] were sampled down up to 30 cm depth under two climatic conditions viz., temperate and subtropical to assess the impacts of climate and landuse on soil C dynamics. Results demonstrated that irrespective of land use, temperate soil contains 30.66% higher C than subtropical soils. Temperate soils under natural forests had the higher total organic carbon (TOC, 21.90 g kg^-1), Walkley-Black carbon (WBC, 16.42 g kg^-1), contents, and stocks (TOC, 66.92 Mg ha^-1 and WBC, 50.24 Mg ha^-1), and total soil organic matter (TSOM, 3.78%) concentration as compared to other land uses like maize, horticulture, grassland, and wasteland. Under both climatic conditions, maize land use had the lowest TOC 9.63, 6.55 g kg^-1 and WBC 7.22, 4.91 g kg^-1 at 0-15 and 15-30 cm soil depth, respectively. Horticulture land use had 62.58 and 62.61% higher TOC and WBC over maize-based land use under subtropical and temperate climatic conditions at 0-30 cm soil depth, respectively. However, soils of maize land use under temperate conditions had ∼2 times more TOC than in subtropical conditions. The study inferred that the C-losses is more in the subtropical soil than in temperate soils. Hence, the subtropical region needs more rigorous adoption of C conservation farming practices than the temperate climatic setting. Although, the adoption of C storing and conserving practices is crucial under both climatic settings to arrest land degradation. Horticultural land uses along with conservation effective soil management practices may be encouraged to restore more soil C and to improve the livelihood security of the hill populace in the North Western Himalayas.

Development of the non-occupational post-exposure prophylaxis (NPEP) knowledge scale among Chinese men who have sex with men

BACKGROUND

Nonoccupational post-exposure prophylaxis (NPEP) is a short course of medication taken to reduce the likelihood of acquiring human immunodeficiency virus (HIV) infection upon exposure. A review of the literature demonstrates an urgent need for an empirically validated instrument that measures detailed knowledge of NPEP among the key population of men who have sex with men (MSM).

METHODS

Semi-structured interviews, focus groups, and a cross-sectional survey with a sample of 419 MSM was conducted in 2018 in China to develop and psychometrically evaluate the new instrument, the NPEP Knowledge Scale. Exploratory and confirmatory factor analyses, differential item functioning analyses, and structural equation modeling were conducted using Mplus 7.4.

RESULTS

The NPEP Knowledge Scale demonstrated excellent reliability and validity. Cronbach's alpha was 0.903. The range of item R² were 0.527-0.969, p's < 0.001. Model estimated inter-item correlations ranged between 0.534 and 0.968. In addition, HIV knowledge, NPEP use, and NPEP knowledge were all significantly correlated.

CONCLUSIONS

The NPEP Knowledge Scale is suitable for research, program evaluation, and clinical and community services that require using NPEP to minimize the ever-present risk of new HIV infections.

Effect of soil water-phosphorus coupling on the photosynthetic capacity of Robinia pseudoacacia L. seedlings in semi-arid areas of the Loess Plateau, China

Afforestation can improve soil erosion in the ecologically fragile areas of the Loess Plateau; however, the amount of water and phosphorus fertilizer that can promote vegetation survival is unclear, which hinders the improvement of the local ecological environment and the waste of water and fertilizer. In this study, based on field surveys, water and fertilizer control tests on Robinia pseudoacacia L. seedlings in experimental fields, and fitting CO2 response curves to R. pseudoacacia seedlings using a Li-6400 portable photosynthesizer, we measured their leaf nutrient contents and calculated resource use efficiency. The results showed that (1) under the same moisture gradient, except for photosynthetic phosphorus utilization efficiency (PPUE), light use efficiency (LUE), water use efficiency (WUE), carbon utilization efficiency (CUE), and photosynthetic nitrogen use efficiency (PNUE) all increased with increasing phosphorus fertilizer application. Under the same phosphorus fertilizer gradient, WUE increased with decreasing water application, and LUE, CUE, PNUE, and PPUE all reached the maximum at 55-60% of field water holding capacity. (2) Net photosynthetic rate (Pn) of R. pseudoacacia seedlings increased with increasing intercellular carbon dioxide concentration (Ci), and as Ci continued to increase, the increase in Pn became slower, but no maximal electron transport rate (TPU) occurred. Under the same CO2 concentration, Pn reached a maximum at 55-60% of field water holding capacity and phosphorus fertilizer at 30 gPm-2·a-1. (3) Leaf maximum carboxylation rate (Vcmax), maximum electron transport rate (Jmax), daily respiration (Rd), stomatal conductance (Gs), and mesophyll conductance (Gm) reached their maximum at 30 gPm-2·a-1 of phosphorus fertilizer. Vcmax, Jmax, and Rd reached their maximum at 55-60% of field water holding capacity; Gs and Gm reached their maximum at 75-80% of field water holding capacity. (4) The higher the soil phosphorus content, the lower the biochemical (lb), stomatal (ls), and mesophyll (lm). With the increase of soil moisture, lb and ls are higher, and lm is lower. (5) Structural equation modeling showed that water-phosphorus coupling had a less direct effect on Rd and a more direct impact on Gs and Gm. Relative photosynthetic limitation directly affected the photosynthetic rate, indicating that water and phosphorus affected the photosynthetic rate through relative plant limitation. It was concluded that the resource use efficiency and photosynthetic capacity reached the maximum when 55-60% of field water holding capacity was maintained, and phosphorus fertilization was at 30 gP m-2·a-1. Therefore, maintaining suitable soil moisture and phosphorus fertilizer levels in the semi-arid zone of the Loess Plateau can improve the photosynthetic capacity of R. pseudoacacia seedlings.

Time for a Measurement Check-Up: Testing the Couple's Satisfaction Index and the Global Measure of Sexual Satisfaction Using Structural Equation Modeling and Item Response Theory

Relationship and sexual satisfaction are two central outcomes in the study of relationships and are commonly used in both academia and applied practice. However, relationship and sexual satisfaction measures infrequently undergo specific psychometric investigation. Ensuring that measures display strong psychometric performance is an important but under-tested element of replication that has come under more scrutiny lately, and adequate measurement of constructs is an important auxiliary assumption underpinning theory-testing empirical work. A measurement check-up was conducted, including Confirmatory Factor Analysis (CFA) to test factorial validity, measurement invariance to test for group comparability, and Item Response Theory (IRT) to assess the relationship between latent traits and their items/indicators. This format was used to evaluate the psychometric properties of the Couple's Satisfaction Index (CSI) and the Global Measure of Sexual Satisfaction (GMSEX), two commonly used scales of relationship and sexual satisfaction with a sample of 640 midlife (40-59 years old) married Canadians who were recruited by Qualtrics Panels. Results of CFA suggested that both models were satisfactory. Invariance testing provided robust support for intercept invariance across all the groupings tested. IRT analysis supported the CSI and GMSEX, however, there was evidence that the GMSEX provided somewhat less information for those high on sexual satisfaction. This measurement check-up found that the CSI and GMSEX were reasonably healthy with some caveats. Implications are discussed in terms of replicability and meaning for scholars and practitioners.

Effects of successional sulfadiazine exposure on biofilm in moving bed biofilm reactor: Secretion of extracellular polymeric substances, community activity and functional gene expression

The effects of sulfadiazine (SDZ) on responses of biofilm in a moving bed biofilm reactor were explored with emphasis on the changes in extracellular polymeric substances (EPS) and functional genes. It was found that 3 to 10 mg/L SDZ reduced the protein (PN) and polysaccharide (PS) contents of EPS by 28.7%-55.1% and 33.3%-61.4%, respectively. The EPS maintained high ratio of PN to PS (10.3-15.1), and the major functional groups within EPS remained unaffected to SDZ. Bioinformatics analysis showed that SDZ significantly altered the community activity such as increased expression of s_Alcaligenes faecali. Totally, the biofilm held high SDZ removal rates, which were ascribed to the self-protection by secreted EPS, and genes levels upregulation of antibiotic resistance and transporter protein. Collectively, this study provides more details on the biofilm community exposure to an antibiotic and highlights the role of EPS and functional genes in antibiotic removal.

A comparative study on the taste quality of Mytilus coruscus under different shucking treatments

Shucking is an indispensable step in the preparation of cooked mussel products, as it facilitates the detachment of meat from the shell. In this study, we comprehensively investigated the effects of boiling, steaming, and microwaving on taste constituents in half-cooked mussel meat. Two-dimensional correlation spectroscopy revealed the key differential taste components of the different shucking groups. Structural equation modeling (SEM) indicated the positive effects of saltiness and bitterness on umami taste, while sweetness and sourness had negative effects on umami taste in half-cooked mussel meat. Furthermore, Glu, Asp, Ala, Arg, betaine, malic acid, succinic acid, glycogen, Cl^-, Na⁺, K⁺, and PO3- 4 were quantitatively determined as the main taste compounds. The steaming shelling group had the most enriched taste components, with the highest equivalent umami concentration compared to the other shelling groups. Hence, steaming shucking may be favored due to abundant tastes and nutrients.

Locomotor effects of a fibrosis-based immune response in stickleback fish

The vertebrate immune system provides an impressively effective defense against parasites and pathogens. However, these benefits must be balanced against a range of costly side-effects including energy loss and risks of auto-immunity. These costs might include biomechanical impairment of movement, but little is known about the intersection between immunity and biomechanics. Here, we show that a fibrosis immune response in threespine stickleback (Gasterosteus aculeatus) has collateral effects on their locomotion. When freshwater stickleback are infected with the tapeworm parasite Schistocephalus solidus, they face an array of fitness consequences ranging from impaired body condition and fertility to an increased risk of mortality. To fight the infection, some stickleback will initiate a fibrosis immune response in which they produce excess collagenous tissue in their coelom. Although fibrosis is effective at reducing infection, some populations of stickleback actively suppress this immune response, possibly because the costs of fibrosis outweigh the benefits. Here we quantify the locomotor effects of the fibrosis immune response in the absence of parasites to investigate whether there are collateral costs of fibrosis that could help explain why some fish forego this effective defense. To do this, we induce fibrosis in stickleback and then test their C-start escape performance. Additionally, we measure the severity of fibrosis, body stiffness, and body curvature during the escape response. We were able to estimate performance costs of fibrosis by including these variables as intermediates in a structural equation model. This model reveals that among control fish without fibrosis, there is a performance cost associated with increased body stiffness. However, fish with fibrosis did not experience this cost but rather displayed increased performance with higher fibrosis severity. This result demonstrates that the adaptive landscape of immune responses can be complex with the potential for wide reaching and unexpected fitness consequences.

Developing a model for predicting safety performance of nurses based on psychosocial safety climate and role of job demands and resources, job satisfaction, and emotional exhaustion as mediators

BACKGROUND

The present study aimed to develop a model for predicting the safety performance of nurses based on psychosocial safety climate (PSC) and the role of job demands and resources, job satisfaction, and emotional exhaustion as mediators.

METHODS

A cross-sectional study using structural equation modeling (SEM) was carried out among nurses in Iran. Data were collected using the Psychosocial Safety Climate questionnaire, Neal and Griffin's Safety Performance Scale, the Management Standards Indicator Tool, the Effort-Reward Imbalance questionnaire, the Michigan Organizational Assessment Job Satisfaction subscale and the Maslach Burnout Inventory.

RESULTS

Surveys were distributed to 340 nurses provided informed consent. After removing incplete surveys, data from 280 partipants were analysed. The completion rate was 82.35%. The SEM results indicated that PSC can directly and indirectly predict nurses' safety performance. The final model showed an acceptable goodness of fit (p = 0.023). It indicated that PSC, job demands, and job satisfaction were directly related to safety performance, and also that PSC, emotional exhaustion, job resources, and job demands were all indirectly related to safety performance. Also, PSC had a significant relationship with all mediator variables, and job demands had direct effect on emotional exhaustion.

CONCLUSIONS

The current study presented a new model for predicting safety performance in nurses in which PSC, both directly and indirectly, plays an important role. In addition to paying attention to the physical aspects of the workplace, healthcare organizations should also take into account PSC to improve safety. Next steps in reducing safety issues in nursing is to develop intervention studies using this new evidence-based model as a framework.

Ranking the risks of eighty pharmaceuticals in surface water of a megacity: A multilevel optimization strategy

Pharmaceuticals in freshwater posed ecological risks to aquatic ecosystem, however, most risk assessments of pharmaceuticals were conducted at screening level, which were limited by the availability of the toxicity data. In this study, risks of 80 pharmaceuticals including 35 antibiotics, 13 antiviral drugs, 13 illicit drugs, and 19 antidepressants in surface water of Beijing were assessed with a proposed multilevel environmental risk optimization strategy. Target pharmaceuticals were detected in surface water samples with the detection frequency from 1.7 % to 100 % and the total concentrations from 31.1 ng/L to 2708 ng/L. Antiviral drugs were the dominant pharmaceuticals. Preliminary screening-level risk assessment indicated that 20 pharmaceuticals posed low to high risks with risk quotient from 0.14 (chloroquine diphosphate) to 27.8 (clarithromycin). Thirteen pharmaceuticals were recognized with low to high risks by an optimized risk assessment method. Of them, the refined probabilistic risk assessment of joint probability curves coupling with a quantitative structure activity relationship-interspecies correlation estimation (QSAR-ICE) model was applied. Clarithromycin, erythromycin and ofloxacin were identified to pose low risks with maximum risk products (RP) of 1.23 %, 0.41 % and 0.35 %, respectively, while 10 pharmaceuticals posed de minimis risks. Structural equation modeling disclosed that human land use and climate conditions influenced the risks of pharmaceuticals by indirectly influencing the concentrations of pharmaceuticals. The results indicated that the multilevel strategy coupling with QSAR-ICE model was appropriate and effective for screening priority pollutants, and the strategy can be used to prioritize pharmaceuticals and other emerging contaminants in the aquatic environment.

Controlled and driving mechanism of the SPM variation of shallow Brackish Lakes in arid regions

Suspended particulate matter (SPM) in the brackish Ebinur Lake of arid northwest China profoundly affect its water quality and watershed habitat quality. However, the actual driving mechanisms of the Lake's SPM changes remain unclear. Therefore, the purpose of this study is to explore the controlling factors driving the variability of SPM in the Ebinur Lake. This study constructed month-by-month SPM maps of Ebinur Lake based on time-series remote-sensing imageries and SPM inversion model. Thirty-four factors that might influence SPM changes were extracted, and the Partial Least Squares Structural Equation Modeling (PLS-SEM), suitable for complex relationships and factor interactions, was applied to identify the relative influence of each factor quantitatively. The results showed: (1) a clear increasing trend of SPM concentration in Ebinur Lake from 2011 to 2020; (2) that SPM changes were influenced by external and internal factors, explaining 48.2 % and 46.9 % of the changes, respectively; (3) that, to the external factors, meteorological factors exerted the greatest influence on SPM (relative contribution of 38.9 %); that, to the internal factors, water salinity imposed the greatest influence on SPM (relative contribution of 43.3 %); (4) that, among the meteorological factors, the measured variable Alashankou wind speed expressed the most significant positive effect on SPM (weighting coefficient of 0.894), and sulfate generated the strongest positive effect on SPM (weighting coefficient of 0.791) among the water salinity factors. Hence, the quantitative identification of drivers of SPM changes in Ebinur Lake could provide a new perspective to investigate the driving mechanisms of lake water quality in arid areas and inform their sustainable restoration and management.

Exploring the role of ICT in pharmaceutical supply chain practices and operational performance in Ethiopia: a structural equation modeling approach

BACKGROUND

A well-coordinated supply chain ensures the sustainable availability of life-saving medicines that improve public health outcomes. Information Communication Technology (ICT) is one of the strategies for optimizing supply chain coordination. However, there is a paucity of data on how it affects supply chain practice and performance at the Ethiopian Pharmaceutical Supply Agency (EPSA).

OBJECTIVE

This study aimed to explore the relationships between information and communication technology, supply chain practice, and pharmaceutical supply chain operational performance using a structural equation modeling approach.

METHODS

We conducted an analytical cross-sectional study between April and June 2021. Three hundred twenty EPSA employees participated in the survey. We used a pretested, self-administered five-point Likert scale questionnaire to collect the intended data. A structural equation modeling confirmed the relationship between the constructs (information communication technology, supply chain practices, and performance). Thus, the measurement models were first validated using exploratory and confirmatory factor analysis in SPSS/AMOS software. A p-value of less than 5% indicated statistical significance.

RESULTS

Of the 320 questionnaires distributed, 300 participants (202 males and 98 females) duly responded. In this survey, supply chain practices (mainly customer relationship management and information sharing) and ICT had significant positive direct effects on operational performance with standardized regression weights (β) of 0.65 (p < .001) and 0.29 (p < .001), respectively. On the other hand, 73% of the variations in operational performance were explained by ICT and supply chain practices, wherein ICT played moderate mediation effects between supply chain practice and performance (VAF = 0.24, p < .001). Despite the significant positive influence of ICT, the agency still faced data visibility problems with customers and other supply chain partners.

CONCLUSION

The findings revealed that supply chain practices and ICT implementation impacted the agency's supply chain performance positively and significantly. The ICT implementation practice in the agency posited a significant positive partial mediating role between supply chain practice and operational performance. Thus, if the agency focuses on the automation and integration of customer relationship management and the practice of information exchange, the essential supply chain practices, it can further improve operational performance.

Inferential implications of normalizing binomial proportions in a structural equation model: A simulation study motivated by feedlot data

Most commercial software for implementation of structural equation models (SEM) cannot explicitly accommodate outcome variables of binomial nature. As a result, SEM modeling strategies of binomial outcomes are often based on normal approximations of empirical proportions. Inferential implications of these approximations are particularly relevant to health-related outcomes. The objective of this study was to assess the inferential implications of specifying a binomial variable as an empirical proportion (%) in predictor and outcome roles in a SEM. We addressed this objective first by a simulation study, and second by a proof-of-concept data application on beef feedlot morbidity to bovine respiratory disease (BRD). We simulated data on body weight at feedlot arrival (AW), morbidity count for BRD (Mb), and average daily gain (ADG). Alternative SEMs were fitted to the simulated data. Model 1 specified a directed acyclic causal diagram with morbidity fitted as a binomial outcome (Mb) and as a proportion (Mb_p) predictor. Model 2 specified a similar causal diagram with morbidity fitted as a proportion for both outcome and predictor roles within the network. Structural parameters for Model 1 were accurately estimated based on the nominal coverage probability of 95 % confidence intervals. In turn, there was poor coverage for most morbidity-related parameters under Model 2. Both SEM models showed adequate empirical power (>80 %) to detect parameters not equal to zero. Model 1 and Model 2 produced predictions that were reasonable from a management standpoint, as determined by calculating the root mean squared error (RMSE) through cross-validation. However, interpretability of parameter estimates in Model 2 was impaired due to the model misspecification relative to the data generation. The data application fitted SEM extensions, Model 1 * and Model 2 * , to a dataset from a group of feedlots in the Midwestern US. Models 1 * and 2 * included explanatory covariates, specifically percent shrink (PS), backgrounding type (BG), and season (SEA). Lastly, we tested if AW exerted both direct and BRD-mediated indirect effects on ADG using Model 2 * . In Model 1 * , mediation was not testable due to the incomplete path from morbidity as a binomial outcome through Mb_p as a predictor to ADG. Model 2 * supported a minor morbidity-mediated mechanism between AW and ADG, though parameter estimates were not directly interpretable. Our results indicate normal approximation to a binomial disease outcome in a SEM may be a viable option for inference on mediation hypotheses and for predictive purposes, despite limitations in interpretability due to inherent model misspecification.