The effect of education based on health belief model on promoting preventive behaviors of hypertensive disease in staff of the Iran University of Medical Sciences

Formulation of precise exercise intervention strategy for adolescent depression

The high incidence of adolescent depression has become the focus of social and academic attention. Exercise is an important method to improve adolescent depression, but its intervention effect is still controversial. This study first compares and analyzes the relevant studies at home and abroad and finds that exercise prescription in adolescent depression intervention is not accurate enough. A meta-analysis was conducted to develop a precise exercise intervention strategy for adolescent depression. Firstly, this thesis identified how to optimize five elements (exercise intensity, exercise frequency, exercise time, exercise cycle, and exercise type) of exercise prescription to improve depression in adolescents. This is the problem. Furthermore, the concept of "precision exercise" was proposed, and a precision exercise intervention strategy (moderate-intensity aerobic exercise for 8-10 weeks, 3 times/week, 45-50 min/time) was constructed to improve adolescent depression. This paper also presents research that strengthens the cross-sectional research and empirical research on adolescent depression and establishes a precision exercise prescription database for adolescent depression in China. In conclusion, this study not only puts forward the concept of "precision exercise" but also constructs a precision exercise intervention strategy for adolescent depression, which has important theoretical and practical significance for improving the high incidence of adolescent depression.

Elucidating Cyathula Officinals' mechanism in osteoarthritis treatment: Network pharmacology and empirical evidence on anti-inflammatory actions

In this study, we explored the therapeutic potential of Cyathula Officinals (CNX) in Knee Osteoarthritis (KOA) treatment. Utilizing network pharmacology and in vitro experiments, we identified active ingredients, action targets and pathways in CNX. Our analysis, integrating databases like TCMSP, SwissTarget Prediction, Genecards, CTD, STRING, and DAVID, highlighted 396 action targets and 283 disease targets, pinpointing 64 intersection genes linked to KOA. The significant involvement of the MAPK and NF-κB pathways in CNX's anti-inflammatory action was validated through qPCR, which might underlie CNX's efficacy in inhibiting chondrocyte apoptosis and IL-6 expression. These findings suggest CNX's potential in KOA management, offering insights for its clinical application.

Ecotoxicological effects of cypermethrin on indigenous climbing perch (Anabas testudineus)

Pesticides including cypermethrin (10% EC) are commonly used pesticide in tea gardens of Bangladesh possess distinct harmful effects on an aquatic community. The experiment was carried out to assess the ecotoxicological effects of cypermethrin (10%) concentrate on indigenous Climbing Perch (Anabas testudineus). A total of 120 A. testudineus (mean length 16 ± 2.67 cm and mean weight 31.6 ± 3.56 g) were exposed to the acute toxicity test when the lethal concentration 50 value (LC50) for 96 h was maintained at 1.00 ppm. Three different sub-lethal concentrations of 0.05 ppm (5%), 0.10 ppm (10%), and 0.20 ppm (20%) were used respectively as three treatments and a control of 0 ppm with three replicates each. Restlessness, erratic movement, increased opercular activities, loss of equilibrium, and irregular response to feeding were observed in all the treatments compared to control one. Concerning histopathological alterations, all the analyzed organs showed highest changes in the T3 (cypermethrin conc. 20%) compared to other treatments while T0 (0 ppm) had normal structure. The major changes in the gill were epithelial cell hyperplasia, necrosis, severe lamellar fusion and epithelial lifting; while necrotic proximal tubules, glomerular shrinkage, disrupted renal corpuscle of the kidney and nuclear pyknosis, degenerated hepatic cells and vacuolation were observed in the liver. Severe melanomacrophage centre (MMC), haemosiderosis and vacuolation were found in spleen. The effect of cypermethrin on the hematological parameters of experimental fish was also studied. Red blood cells, hemoglobin and hematocrit were decreased in the experimental groups and lowest value was in T3 while values of white blood cells were increased in the experimental groups compared to control one. Hence, the present observation revealed that pesticides even at low concentrations can cause harmful effects on A. testudineus.

Computer vision based deep learning approach for toxic and harmful substances detection in fruits

Formaldehyde (CH₂O) is one of the significant chemicals mixed with different perishable fruits in Bangladesh. The fruits are artificially preserved for extended periods by dishonest vendors using this dangerous chemical. Such substances are complicated to detect in appearance. Hence, a reliable and robust detection technique is required. To overcome this challenge and address the issue, we introduce comprehensive deep learning-based techniques for detecting toxic substances. Four different types of fruits, both in fresh and chemically mixed conditions, are used in this experiment. We have applied diverse data augmentation techniques to enlarge the dataset. The performance of four different pre-trained deep learning models was then assessed, and a brand-new model named "DurbeenNet," created especially for this task, was presented. The primary objective was to gauge the efficacy of our proposed model compared to well-established deep learning architectures. Our assessment centered on the models' accuracy in detecting toxic substances. According to our research, GoogleNet detected toxic substances with an accuracy rate of 85.53 %, VGG-16 with an accuracy rate of 87.44 %, DenseNet with an impressive accuracy rate of 90.37 %, and ResNet50 with an accuracy rate of 91.66 %. Notably, the proposed model, DurbeenNet, outshone all other models, boasting an impressive accuracy rate of 96.71 % in detecting toxic substances among the sample fruits.

Effectiveness of massage and range of motion exercises on muscle strength and intensive care unit-acquired weakness in Iranian patients with COVID-19: a randomized parallel-controlled trial

BACKGROUND

Muscle weakness is prevalent in intensive care patients. This study focused on comparing the effects of massage and range of motion (ROM) exercises on muscle strength and intensive care unit-acquired weakness (ICU-AW) among patients with coronavirus disease 2019 (COVID-19).

METHODS

This study was a randomized clinical trial that recruited patients (n=45) with COVID-19 admitted to the ICU and divided them into three groups (ROM exercises, massage, and control). We evaluated muscle strength and ICU-AW in the arms and legs using a hand dynamometer. The Medical Research Council sum score was determined before and after the intervention.

RESULTS

The study findings were that 0%, 20%, and 100% of the participants in the ROM exercises, massage, and control groups had ICU-AW on the 7th day of ICU admission. The ROM exercise group had greater muscle strength in the hands and legs than the massage and control groups, and the massage group had greater muscle strength than the control group.

CONCLUSIONS

Massage and ROM exercises could improve muscle strength and reduce ICU-AW in COVID-19 patients admitted to the ICU.

Bioinformatics reveals diagnostic potential of cuproptosis-related genes in the pathogenesis of sepsis

Background

Multiple modes of cell death occur during the development of sepsis. Among these patterns, cuproptosis has recently been identified as a regulated form of cell death. However, its impact on the onset and progression of sepsis remains unclear.

Method

We screened a dataset of gene expression profiles from patients with sepsis using the GEO database. Survival analysis was performed to analyze the relationship between cuproptosis-related genes (CRGs) and prognosis. Hub genes were identified through univariate Cox regression analysis. The diagnostic value of hub genes in sepsis was tested in both training sets (GSE65682) and validation sets (GSE134347). To examine the association between hub genes and immune cells, single-sample gene set enrichment analysis (ssGSEA) and Pearson correlation analysis were employed. Additionally, the CRGs were validated in a septic mouse model using real-time quantitative PCR (qRT-PCR) and immunohistochemistry (IHC).

Results

In sepsis, most CRGs were upregulated, with only DLD and MTF1 downregulated. High expression of three genes (GLE, LIAS, and PDHB) was associated with better prognosis, but only two hub genes (LIAS, PDHB) reached statistical significance. The receiver operating characteristic (ROC) analysis for diagnosing sepsis showed LIAS had a range of 0.793-0.906, while PDHB achieved values of 0.882 and 0.975 in the training and validation sets, respectively. ssGSEA analysis revealed a lower number of immune cells in the sepsis group, and there was a correlation between immune cell population and CRGs (LIAS, PDHB). Analysis in the septic mouse model demonstrated no significant difference in mRNA expression levels and IHC staining between LIAS and PDHB in heart and liver tissues, but up-regulation was observed in lung tissues. Furthermore, the mRNA expression levels and IHC staining of LIAS and PDHB were down-regulated in renal tissues.

Conclusions

Cuproptosis is emerging as a significant factor in the development of sepsis. LIAS and PDHB, identified as potential diagnostic biomarkers for cuproptosis-associated sepsis, are believed to play crucial roles in the initiation and progression of cuproptosis-induced sepsis.

Development of an automated optimal distance feature-based decision system for diagnosing knee osteoarthritis using segmented X-ray images

Knee Osteoarthritis (KOA) is a leading cause of disability and physical inactivity. It is a degenerative joint disease that affects the cartilage, cushions the bones, and protects them from rubbing against each other during motion. If not treated early, it may lead to knee replacement. In this regard, early diagnosis of KOA is necessary for better treatment. Nevertheless, manual KOA detection is time-consuming and error-prone for large data hubs. In contrast, an automated detection system aids the specialist in diagnosing KOA grades accurately and quickly. So, the main objective of this study is to create an automated decision system that can analyze KOA and classify the severity grades, utilizing the extracted features from segmented X-ray images. In this study, two different datasets were collected from the Mendeley and Kaggle database and combined to generate a large data hub containing five classes: Grade 0 (Healthy), Grade 1 (Doubtful), Grade 2 (Minimal), Grade 3 (Moderate), and Grade 4 (Severe). Several image processing techniques were employed to segment the region of interest (ROI). These included Gradient-weighted Class Activation Mapping (Grad-Cam) to detect the ROI, cropping the ROI portion, applying histogram equalization (HE) to improve contrast, brightness, and image quality, and noise reduction (using Otsu thresholding, inverting the image, and morphological closing). Besides, the focus filtering method was utilized to eliminate unwanted images. Then, six feature sets (morphological, GLCM, statistical, texture, LBP, and proposed features) were generated from segmented ROIs. After evaluating the statistical significance of the features and selection methods, the optimal feature set (prominent six distance features) was selected, and five machine learning (ML) models were employed. Additionally, a decision-making strategy based on the six optimal features is proposed. The XGB model outperformed other models with a 99.46 % accuracy, using six distance features, and the proposed decision-making strategy was validated by testing 30 images.

Knowledge structure and emerging trends of cognitive impairment induced by sleep deprivation: A bibliometric analysis based on CiteSpace and VOSviewer from 2000 to 2022

This paper implements a bibliometric approach to investigate the research hotspots and future research directions in the relevant field literature. It also offers research ideas and methods for preventing and treating cognitive impairment induced by sleep deprivation in the clinical setting. The evolution of various clusters in the field is summarized through Citespace's projection function for keywords in the literature. CiteSpace and Vosviewer are utilized to analyze and visualize the attributes of the articles, including number of publications, citation frequency, country/region, institution, journal, authors, keywords, and references, from the 2280 publications obtained. A total of 2280 publications were collected, with the number of papers and citations in the field continuously increasing year by year. The most influential country in this field is the United States, and the University of Washington is the most influential institution. The most authoritative journal in the field is identified as SLEEP. Sleep deprivation, prefrontal cortex, and performance are the current topics of interest. The article with the strongest citation burst, lasting from 2015 to 2018, is "Sleep Drives Metabolite Clearance from the Adult Brain." The most influential article and co-cited reference, "Neurocognitive Consequences of Sleep Deprivation," highlights that sleep deprivation from various causes may lead to cognitive impairment. Future research should investigate all forms of cognitive impairment resulting from sleep deprivation. The findings of this study will assist researchers in improving their knowledge structure, identifying research hotspots, and revealing future directions in the field.

Risk factors of peripheral venous catheter-related complication and infection in children with bronchopneumonia

OBJECTIVE

To investigate the risk factors associated with the peripheral venous catheter-related complication and infection in children with bronchopneumonia.

METHODS

A total of 185 patients were divided into case group (n = 114) and control group (n = 71) according to the presence of catheter-related infection and complications related to indwelling needle. We performed a multivariate logistic regression analysis to explore the risk factors associated with the infection.

RESULTS

Age was divided into 4 categories (0 < age ≤ 1, 1 < age ≤ 3, 3 < age ≤ 6, age > 6). The case group had a higher percentage of patients with 0 < age ≤ 1 than the control group (21% vs. 9.7%) and the age distribution was significant different between the two groups (P = 0.045). The case group had a longer retention time than the control group (≥ 3 days: 56% vs. 35%, P < 0.001). The results of binary logistics regression analysis revealed that the indwelling time and indwelling site were the factors that influenced the complications or bacterial infection. Among the three indwelling sites, the hand is more prone to infection and indwelling needle-related complications than the head (OR: 2.541, 95% CI 1.032 to 6.254, P = 0.042). The longer the indwelling time, the more likely the infection and indwelling needle related complications (OR: 2.646, 95% CI 1.759 to 3.979, P< 0.001).

CONCLUSION

Indwelling time and indwelling site are the influencing factors of complications or bacterial infection, which should be paid more attention to prevent the catheter-related infection in children with bronchophenumonia.

E-learning enhancement through educational data mining with Covid-19 outbreak period in backdrop: A review

E-learning is fast becoming an integral part of the teaching- learning process, particularly after the outbreak of Covid-19 pandemic. Educational institutions across the globe are striving to enhance their e-learning instructional mechanism in accordance with the aspirations of present-day students who are widely using numerous technological tools - computers, tablets, mobiles, and Internet for educational purposes. In the wake of the evident incorporation of e-learning into the educational process, research related to the application of Educational Data Mining (EDM) techniques for enhancing e-learning systems has gained significance in recent times. The various data mining techniques applied by researchers to study hidden trends or patterns in educational data can provide valuable insights for educational institutions in terms of making the learning process adaptive to student needs. The insights can help the institutions achieve their ultimate goal of improving student academic performance in technology-assisted learning systems of the modern world. This review paper aims to comprehend EDM's role in enhancing e-learning environments with reference to commonly-used techniques, along with student performance prediction, the impact of Covid-19 pandemic on e-learning and priority e-learning focus areas in the future.

Effects of health concept model-based detailed behavioral care on mood and quality of life in elderly patients with chronic heart failure

BACKGROUND

With the intensification of social aging, the susceptibility of the elderly population to diseases has attracted increasing attention, especially chronic heart failure (CHF) that accounts for a large proportion of the elderly.

AIM

To evaluate the application value of health concept model-based detailed behavioral care in elderly patients with CHF.

METHODS

This study recruited 116 elderly CHF patients admitted from October 2018 to October 2020 and grouped them according to the nursing care that they received. The elderly patients who underwent health concept model-based detailed behavioral care were included in a study group (SG; n = 62), and those who underwent routine detailed behavioral nursing intervention were included as a control group (CG; n = 54). Patients’ negative emotions (NEs), quality of life (QoL), and nutritional status were assessed using the self-rating anxiety/ depression scale (SAS/SDS), the Minnesota Living with Heart Failure Ques-tionnaire (MLHFQ), and the Modified Quantitative Subjective Global Assessment (MQSGA) of nutrition, respectively. Differences in rehabilitation efficiency, NEs, cardiac function (CF) indexes, nutritional status, QoL, and nursing satisfaction were comparatively analyzed.

RESULTS

A higher response rate was recorded in the SG vs the CG after intervention (P < 0.05). After care, the left ventricular ejection fraction was higher while the left ventricular end-diastolic dimension and left ventricular end systolic diameter were lower in the SG compared with the CG (P < 0.05). The post-intervention SAS and SDS scores, as well as MQSGA and MLHFQ scores, were also lower in the SG (P < 0.05). The SG was also superior to the CG in the overall nursing satisfaction rate (P < 0.05).

CONCLUSION

Health concept model-based detailed behavioral care has high application value in the nursing care of elderly CHF patients, and it can not only effectively enhance rehabilitation efficiency, but also mitigate patients’ NEs and improve their CF and QoL.

Australian parental perceptions of genomic newborn screening for non-communicable diseases

Background: Newborn bloodspot screening (NBS) programs have improved neonatal healthcare since the 1960s. Genomic sequencing now offers potential to generate polygenic risk score (PRS) that could be incorporated into NBS programs, shifting the focus from treatment to prevention of future noncommunicable disease (NCD). However, Australian parents' knowledge and attitudes regarding PRS for NBS is currently unknown. Methods: Parents with at least one Australian-born child under 18 years were invited via social media platforms to complete an online questionnaire aimed at examining parents' knowledge of NCDs, PRS, and precision medicine, their opinions on receiving PRS for their child, and considerations of early-intervention strategies to prevent the onset of disease. Results: Of 126 participants, 90.5% had heard the term "non-communicable disease or chronic condition," but only 31.8% and 34.4% were aware of the terms "polygenic risk score" and "precision medicine" respectively. A large proportion of participants said they would consider screening their newborn to receive a PRS for allergies (77.9%), asthma (81.0%), cancer (64.8%), cardiovascular disease (65.7%), mental illness (56.7%), obesity (49.5%), and type 2 diabetes (66.7%). Additionally, participants would primarily consider diet and exercise as interventions for specific NCDs. Discussion: The results from this study will inform future policy for genomic NBS, including expected rate of uptake and interventions that parents would consider employing to prevent the onset of disease.

Correlation of polypill and blood pressure level: A systematic review of clinical trials

BACKGROUND

High blood pressure (BP) is considered as the most important risk factor for cardiovascular disease (CVD). The main aim of this study was to investigate the effect of polypill on BP by reviewing clinical trial studies.

MATERIALS AND METHODS

In this systematic review study, online databases such as PubMed, Scopus, and Web of Science databases with no limited time were systematically searched until July 10, 2020. Clinical trial studies published in English that examined the effect of polypill on BP were included. BP was the main outcome investigated.

RESULTS

Eleven original articles with a population of 17,042 people were reviewed. The polypill drugs studied in this study had different compounds. Compared to conventional care, treatment with polypill compounds has a positive and significant effect on lowering BP (P < 0.05).

CONCLUSION

Our finding confirmed that polypills could reduce BP in patients. It seems that changing routine care and replacing it with a polypill strategy could facilitate the achievement of BP control goals.

Utilization obstacles to hypertension services provided at comprehensive health centers: a content analysis study

INTRODUCTION

Hypertensive patients' failure to refer to health centers for the management of their disease is the most fundamental public health challenge in most societies. The aim of this study was to identify the utilization obstacles to hypertension services provided at comprehensive health centers (CHCs) from the perspective of patients and the staff of health centers.

METHODS

This was a qualitative study using conventional content analysis which was conducted in 2022. Participants included 15 hypertensive patients referring to CHCs and 10 staff (including personnel of CHCs and expert staff) of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, southwest of Iran. Data were collected using semi-structured interviews. Interviews were analyzed using content analysis method, and coding was done manually.

RESULTS

In total, 15 codes and 8 categories were extracted from the interviews which were organized in two main themes of "individual problems" and "systemic problems". More particularly, the main theme of "individual problems" involved attitudinal obstacles, occupational obstacles, and economic obstacles. The main theme of "systemic problems" included educational obstacles, motivational obstacles, procedural obstacles, structural obstacles, and managerial obstacles.

CONCLUSION

In order to address individual problems associated with the patients' failure to refer to CHCs, we need to take appropriate measures. These include using motivational interviewing techniques and utilizing the effective activity of healthcare liaisons and volunteers in CHCs to increase patients' awareness and change their negative attitudes and misconceptions. To solve systemic problems, it is imperative that effective training courses be held for health center staff.

The moderating role of information technology governance in the relationship between board characteristics and continuity management during the Covid-19 pandemic in an emerging economy

The main aim of the current study is to investigate the relationship between governance characteristics, information technology governance, and continuity management during Covid-19 in an emerging economy. The study also examines the moderating role of information technology governance in the relationship between governance characteristics and business continuity management. The quantitative approach is used by utilising a survey questionnaire. A sample of 232 questionnaire surveys has been collected from the board of directors, top and middle management executives, external auditors, information technology experts, and some other respondents. The results were estimated using structural equation modelling. The results indicate that information technology governance has a statistically significant effect on business continuity. Board size, board independence, audit committee independence, audit committee diligence, and external audit have a statistically significant positive effect on information technology governance. Further, the results indicate that information technology governance significantly moderates the effect of board size, board independence, board diligence, audit committee independence, audit committee diligence, and external audit on business continuity. However, information technology governance does not moderate the relationship between board committees and business continuity, which indicates less board involvement in information technology governance. The current research provides insight into the role of information technology governance in business continuity management during crises. The present study provides a unique contribution as it investigates the relationship between corporate governance characteristics, information technology governance, and business continuity management during Covid-19, providing empirical evidence from an emerging country.

Development of inferiority-compensation scale among high school students

An increasing number of high school students are inflicted by different degrees of mental disorders in learning, such as moodiness, learning difficulties, test anxiety, difficulty coping with frustration, etc., which are one of the factors leading to the inferiority of students. In the present study, the initial scale of inferiority compensation for high school students was developed through literature searching, expert evaluation, interviews, and an open scale. 1187 high school students were tested in different periods, after deleting an invalid 83 scales, including 461 copies of valid scale of exploratory factor analysis in the first stage and 643 copies of valid scale of confirmatory factor analysis in the second stage. The results showed that the inferiority compensation scale for high school students consisted of two sub-scale: self-compensation and others-compensation, ach two were composed of five dimensions including academic performance, physical fitness, social communication, appearance, and self-esteem. Confirmatory factor analysis showed that the total scale and the two sub-scale all had good structural validity (RMSEA≤0.08; CFI&IFI ≥ 0.9), and the combined reliability and values (such as the correlation coefficient of each dimension) of the two sub-scale were within the ideal range. With good reliability and validity (Cronbacα&KMO ≥ 0.90), and meeting the requirements of psychometrics, the scale can be used in the relevant research and practice of inferiority compensation for high school students.

The rise of diarrheal illnesses in the children of Pakistan amidst COVID-19: A narrative review

Background

In Pakistan, 74 children out of 1000 lose their lives annually due to diarrheal illness. This commentary addresses the contributing factors aggravating this growing dilemma and the effect of a simultaneous rise in COVID-19 cases in a healthcare system ready to collapse, along with providing recommendations to alleviate the problems causing this spike in diarrheal cases.

Methods

This narrative review has emphasized the causes of the spike in pediatric diarrheal illnesses in Pakistan as well as recommendations offered to lessen the burden by incorporating recent literature (n = 68). Tactics to tackle COVID-19 alongside diarrheal illnesses were also included. Pakistan was chosen to be assessed due to its high burden of child and infant mortality due to preventable causes.

Results

The provision of safe drinking water, the proper use of Integrated Management of Newborn and Childhood Illnesses (IMNCI), adequate awareness of the benefits of breastfeeding, the use of correct rehydration techniques such as Oral Rehydration Therapy, and the crucial implementation of the EPI vaccination schedule can curb this increase in diarrheal cases.

Conclusion

The increased prevalence of diarrheal diseases amongst the pediatric population of Pakistan can be attributed largely due to unsanitary drinking water. Emphasis must be put in the provision of safe drinking water. During the first years of life, children can be kept safe from deadly pathogens just by adequate breastfeeding. IMNCI and EPI must also be properly implemented.

The relationship between use of complementary and alternative medicine and health literacy in chronically ill outpatient cases: a cross-sectional study in southeastern Iran

Background

Chronically ill outpatient cases use a variety of complementary and alternative medicines due to their diseases and therapeutic complications. Chronic condition, quality of life, and health literacy all affect the use of complementary medicine among chronically ill outpatient cases. Health literacy helps patients make fully informed decisions about the use of complementary and alternative medicine. This study aimed to investigate the relationship between complementary and alternative medicine and health literacy in chronically ill outpatient cases.

Method

This cross-sectional analytical-descriptive study was conducted on 400 chronically ill outpatient cases referred to medical centers affiliated to Kerman University of Medical Sciences. Convenience sampling was used. Research tools included the complementary and alternative medicine questionnaire and the health literacy questionnaire. SPSS25 was used to analyze data.

Results

The mean use of complementary and alternative medicine in a recent year was 16.75 ± 7.89, which was lower than the mid-point of the questionnaire (84). Prayer, medicinal plants, vitamin supplements, music therapy, and art therapy were the mostly used complementary and alternative medicine methods. The most common reasons for using complementary medicine were to reduce physical complications and improve anxiety and stress. The mean satisfaction with the use of complementary and alternative medicine was 34.96 ± 6.69. The mean health literacy score was 67.13 ± 19.90. Decision-making and the use of health information had the highest mean score among the dimensions of health literacy, whereas reading skills received the lowest mean score. We found a significant and direct relationship between the use of complementary and alternative medicine, health literacy, and all its dimensions.

Conclusion

The study results showed that health literacy predicted the use of complementary and alternative medicine. Health education and promotion programs may be useful for improvement of health literacy in the community.

Lockdown in Chinese university dormitories: Significant increase in negative feelings and time perception distortion

The COVID-19 pandemic has led to a global crisis resulting in lockdowns worldwide. Studies found that these could amplify negative affects predictive of disturbances in time perception. However, all existing studies on this topic concentrated on the general population during a lockdown at home. There was no research on university students living in dormitories. This study fills a gap in the literature by investigating the affective states and awareness of the passage of time of Chinese university students during an exceptional dormitory lockdown. Using a snowball sampling approach, this web-based study recruited 225 volunteers (136 girls, 17-27 years old) during a dormitory lockdown. The online survey consisted of questions on demographic information, affective states (the Chinese version of the depression anxiety stress scales-21 (DASS-21) on depression, anxiety, and stress), and sense of the passage of time (the translated version of the assessment of passage of time over daily, weekly and yearly periods). The researchers shared the questionnaire link via the social media application WeChat. The study applied descriptive statistics and column charts to represent students' affective states and sense of the passage of time under extreme conditions and Pearson's correlation analysis to examine the impact of affective states on their sense of time. The study's results indicate that the dormitory lockdown caused a significant increase in all depression, anxiety, and stress categories of the DASS-21, as well as a distortion of the sense of time passing. However, the direction of the distortion differed from that in previous studies. Moreover, a Pearson correlation analysis showed that none of the three negative affects could be associated with students' sense of time. The findings of this study indicate an increased vulnerability of students due to the lockdown. Their emotions were strongly affected, requiring particular interventions to preserve their mental well-being. In addition, they showed a different distortion direction of time passage. Finally, they differed in the correlations between negative affect and the sense of passage of time compared to the general population in lockdown at home. This shows a need to investigate the impact of psychological states on students' routines and quality of life in emergencies. This study's scope should be expanded by incorporating additional factors pertaining to the passage of time and by integrating cross-cultural comparisons.

Land-use and food security in energy transition: Role of food supply

Food security in a just energy transition is a growing debate about designing sustainable food secure networks worldwide. Energy transition, land-use change, and food security are crucial factors for food security and provision. The increased demand for food products and customer preferences regarding food safety provide various issues for the current agriculture food supply chain (AFSC). Along with rising sustainability concerns, strict government regulation, food security, and traceability concerns compel managers, business houses, and practitioners working in AFSC to adopt new tools, techniques, and methodologies to model current food supply chain problems. Thus, in turn, design the food logistics network for food security. Hence, this study investigates the core determinants of food security and supply in Egypt, Morocco, Tunisia, and Lebanon over the period of 2010–2019. In order to estimate the objectives of the study, we employ the fully modified ordinary least square (FMOLS) and dynamic ordinary least squares estimators (DOLS) to draw the study findings. However, the estimated results show a negative association of land use with food security and supply. Likewise, energy transition, gross domestic product, and agricultural value added (AVA) contribute to the food security supply. In contrast, urbanization's negative but insignificant contribution to the food supply in selected economies exists. Besides, another core objective of the study is to investigate the moderate role of the energy transition on the gross domestic product, agriculture sector, and land use and find the significant contribution to the food supply. However, the current study also tries forecasting for the next 10 years and employs the impulse response function (IRF) and variance decomposition analysis (VDA). Congruently, this study uses the pairwise panel causality test and finds exciting outcomes. The COVID-19 crisis has posed challenges such as energy consumption and food security issues. On behalf of the results, the current study proposes imperative policies to investigate the desired level of food supply. The findings provide valuable insights for experts, policymakers, and officials to take practical measures for energy use and food security challenges.

How public confidence was established during the COVID-19 pandemic by Chinese media: A corpus-based discursive news value analysis

During the COVID-19 pandemic, Chinese media played a significant role in dispelling the public panic, establishing the public confidence and stabilizing the society during the COVID-19 pandemic. This corpus-based discourse study explored the discursive construction of news values by Chinese media to reveal how the COVID-19 pandemic was packaged and sold to the public to establish confidence in the news reporting. Adopting corpus linguistic method and the Discursive news values analysis (DNVA) framework, this study examines news values through key words, news quotations, and images in the Chinese domestic mainstream media (http://www.people.com.cn/) during two different phases of the pandemic. The results show that during the first pandemic phase (2019.12.27-2020.4.28) when there had been no treatment protocol or understanding of the medical ramifications, Chinese media dominantly constructed political Eliteness through multimodal resources to portray a people-oriented government, a transparent notification mechanism and an immediate response capability to crises, and to give the public psychological support and to cultivate positive attitudes toward the government's policy. This news reporting way exposes the universal trust of Chinese society in the political authorities. During the second phase (2020.4.29-2020.8.31) when the cognition about the COVID-19 virus had been greatly improved and more medical treatment and prevention methods had been developed, the political Eliteness was replaced by medical Eliteness which was more vital to people's safety during the health crisis. We propose actionable recommendations for scholars to use this in-depth DNVA framework to examine the social trend of thoughts during major public health crisis.

Research on the relationship between marital commitment, sacrifice behavior and marital quality of military couples

Based on the actor-partner interdependence model, this paper studied the relationship between marital commitment, sacrifice behavior and marital quality of military couples. A convenience sample of 171 Chinese military couples from Guangdong, Jiangsu and Sichuan province was used. All participants completed the self-report questionnaires independently including the Dimension of Commitment Inventory (DCI), the Couples Sacrifice Behavior Scale (CSBS) and the Evaluation and Nurturing Relationship Issues, Communication and Happiness (ENRICH). Results showed that the scores of marital commitment and marital quality of male soldiers were significantly higher than that of their spouses. Compared to their spouses, male soldiers reported higher frequency of sacrifice behaviors and perceiving sacrifice behaviors of spouses. Furthermore, the marital commitment of military couples had significant influence on their own marital quality and frequency of perceiving each other’s sacrifice behavior Military couples’ perception of the frequency of each other’s sacrifice behavior partially mediated the effect of marital commitment on their marital quality. Male soldiers’ perception of spouse’s sacrifice behavior frequency significantly predicted the marital quality of their spouses.

From Cultural Tourism to Social Entrepreneurship: Role of Social Value Creation for Environmental Sustainability

Cross-cultural exchanges among the locals and the tourists have been beneficial in terms of social value creation and sustainability. The present study has examined the role of cultural tourism and social entrepreneurship on social value creation and environmental sustainability. The study has drawn a sample through a non-probabilistic convenience sampling method for desired data collection, as investigators approached tourists visiting the tourism destinations. The study reports data received with the help of tourists visiting cultural heritage in the Gilgit-Baltistan region of Pakistan. The study has employed the PLS_SEM approach for analysis purposes to draw the results. The findings showed a significant relationship between cultural tourism, environmental sustainability, and social value creation that significantly predicts environmental sustainability. The results revealed a significant positive association between social entrepreneurship, social value creation, and environmental sustainability. Besides, results showed that social value creation mediates the relationship between cultural tourism and environmental sustainability and social entrepreneurship and environmental sustainability. The study’s findings climax the importance of cross-cultural interactions that enriches the cultural understanding and gives new perspectives to the existing cultural traditions. Pursuing environmental sustainability through social value creation requires an excellent combination of the administrative and political collaborative strategy that integrates cultural tourism and social entrepreneurship in tourist destination development and aims to attain improved tourist attractions. Besides, this research identifies a significant effect of cultural tourism on environmental sustainability. However, the relationship between tourism and environmental sustainability is bidirectional. It might provide direction for further study. The findings deliver valuable insight into global cultural tourism and social entrepreneurship activities that provide tourism destinations for community development. This investigation produces a systematic and holistic research framework to help explore the influence of cultural tourism and social value creation on the environmental sustainability at tourism destinations. The generalizability of the findings supplies helpful directions for future research on environmental sustainability related to social entrepreneurship and cultural tourism that leads to social value creation.

Investigating the Effects of Capital Structure and Corporate Governance on Firm Performance: An Analysis of the Sugar Industry

The objective of this paper is to investigate the impact of capital structure and corporate governance on firm performance. To test the hypothesis of study, data was collected from annual reports of sugar sector companies listed in PSX. This study data covers from 2015 to 2020. The results of study showed that both proxies of capital structure, i.e., D/A and D/E negatively influence the company performance. Whereas two out of three proxies of corporate governance, i.e., board size and chairman/CEO duality negatively indicate association with company performance while audit committee size has a positive impact on the company performance.

Corporate Business Strategy and Tax Avoidance Culture: Moderating Role of Gender Diversity in an Emerging Economy

Tax payments stimulate business enterprises to choose tax management through tax avoidance activities, which is the legal practice to reduce the amount of tax payable. In developing economies, taxation is considered more critical for budget and revenues of a country. This paper investigates whether various business strategies influence corporate tax avoidance decisions of firms by adopting business strategies. Besides, it explores how gender diversity can ease this relationship. This study has chosen a sample of organizations from non-financial sector in Pakistan. The time frame is 5 years, including once a year. The present model employed a generalized moment method (GMM) and tested the proposed hypothesis to draw the results. The study has taken the size, leverage, and business profitability as control variables of firms. The study outcomes by using the GMM method demonstrate that the presence of female directors reduces tax avoidance behavior in prospector companies. This study provides insight into future research for stakeholders, government officials, tax authorities, and policymakers. The findings offer valuable recommendations and practical insights and implications. The findings provide future directions for research to test different frameworks to attain beneficial results to promote the responsibility of tax payment culture.

Social Media Application as a New Paradigm for Business Communication: The Role of COVID-19 Knowledge, Social Distancing, and Preventive Attitudes

Business firms and the public have encountered massive consequences of the COVID-19 pandemic. This pandemic has become the most significant challenge and influenced all communities. This research study focuses on exploring the relationship between COVID-19 knowledge, social distancing, individuals' attitudes toward social media use, and practices of using social media amid the COVID-19 crisis. This study examines how attitudes toward social media use mediate the linkage between COVID-19 knowledge, social distancing, and practices for social media use. This survey uses a non-probability convenience sampling approach to collect samples and recruit willing respondents with their consent for data collection. This study recorded the feedback from 348 participants who encountered the indirect/direct effects of nationwide lockdowns, restrictions on social gatherings, and COVID-19 infection. The findings validate the proposed hypotheses for their direct effects and indicate significant β-values, t-statistics, and the p-values at p <0.001. The results validate a relationship between the COVID-19 knowledge of and social distancing practices. Similarly, the results approved a positive link between social distancing and attitudes toward social media use amid COVID-19. The findings validate the relation between social distancing and attitudes toward social media use during COVID-19 challenges (β-value = 0.22 and t-statistics = 3.078). The results show the linkage between attitudes toward social media use and practices of using social media (β-value = 0.41, and t-statistics = 7.175). Individuals' attitude toward social media use during COVID-19 mediates the connection between COVID-19 knowledge and COVID-19 practices of using social media use. The results validate the first mediation at β-value = 0.21 and t-statistic = 5.327. Similarly, the findings approve that attitudes toward social media use in the pandemic have positively mediated the relation between distancing and practices for social media use amid the crisis of COVID-19 (β-value = 0.09 and t-statistic = 2.633). The findings indicate how people have been indulged in social media to pave their business communication needs. The results provide valuable insights for the global business community. This study provides a systematic and holistic research model that helps in exploring the consequences of COVID-19. The generalizability of the findings provides valuable directions for future research related to the current pandemic.

Examining the Relationship Between Product Market Competition and Chinese Firms Performance: The Mediating Impact of Capital Structure and Moderating Influence of Firm Size

This study emphasized the relationship between the Chinese companies' product market competition and organizational performance. This article explored the mediating effect of capital structure and the moderating impact of firm size in achieving better performance of Chinese companies. This study employed a sample of 2,502 Chinese firm observations and identified that market competition positively influenced firm performance. Additionally, capital structure partly mediated the relationship between product market competition and firm performance. Similarly, the present study also tested the moderating effect of firm size (both small and large) on the association between product market competition and firm performance. The results showed that moderating large businesses affects the nexus between product market competition and firm performance. Conversely, small firms' moderating role revealed a substantial adverse impact on the association between product market competition and firm performance. These findings contribute to the literature on the complex implications of market competition on business firms' performance. The results provide insightful and practical implications for future research directions.

Investigating the factors of enterprise social media strain: The role of enterprise social media's visibility as a moderator

The significant effect of enterprise social media (ESM) usage has been extensively researched. However, recent studies and analysis have also emphasized the importance of understanding the negative aspects of ESM's use. By applying uses and gratifications theory (UGT), this study proposes a research model that tests how employees' ESM usage (hedonic, social, and information values) leads to ESM-related strain through perceived information overload. The study collected data from 315 Chinese employees using a survey method and analyzed the results using AMOS 21.0 software. Structural equation modeling (SEM) was applied to analyze the proposed hypothesis. The results indicate that perceived hedonic, social, and information values are significant predictors of perceived information overload. Such overload is also significantly associated with ESM-related strain. The results also indicate that ESM visibility strengthens the significant relationship between perceived information overload and ESM-related strain. Furthermore, managers can also train individuals to use ESM appropriately. We recommend that employees can better control and manage their ESM usage by recognizing the causes of excessive use.

Tourists' Health Risk Threats Amid COVID-19 Era: Role of Technology Innovation, Transformation, and Recovery Implications for Sustainable Tourism

Technology innovation has changed the patterns with its advanced features for travel and tourism industry during the outbreak of COVID-19 pandemic, which massively hit tourism and travel worldwide. The profound adverse effects of the coronavirus disease resulted in a steep decline in the demand for travel and tourism activities worldwide. This study focused on the literature based on travel and tourism in the wake global crisis due to infectious virus. The study aims to review the emerging literature critically to help researchers better understand the situation. It valorizes transformational affordance, tourism, and travel industries impacts posed by the virus COVID-19. The study proposed a research model on reviving the international tourism activities post COVID-19 pandemic to gain sustainable development and recovery. The scholars have debated seeking the best possible ways to predict a sustainable recovery of travel, tourism, and leisure sectors from the devastating consequences of coronavirus COVID-19. In the first phase, the study describes how the current pandemic can become transformational opportunities. It debates the situation and questions related to the emergence of the COVID-19 outbreak. The present research focuses on identifying fundamental values, organizations, and pre-assumptions related to travel and tourism revival and help academia and researchers to a breakthrough in initiating the frontiers based on research and practice. This study aims at exploring the role of technological innovation in the crisis management of COVID-19 tourism impacts, tourists' behavior, and experiences. The travel and tourism industry's main stakeholders include tourism demand and organizations that manage tourists' destinations and policymakers. They have already experienced the stages of responses, recovery, and resetting tourism recovery strategies. The study provides valuable insight into the coronavirus consequences on travel and tourism and practical implications for global tourism and academic research revitalization.

Salt Consumption and Blood Pressure in Rural Hypertensive Participants: A Community Filed Trial

Purpose. Hypertension is a major cause of morbidity and mortality in the world. This study aimed to evaluate an intervention based on the Health Belief Model regarding the whole family’s salt consumption and blood pressure among hypertensive patients in rural areas in Iran. Methods. This clinical multicenter trial (clinical and community) with a control and an intervention group was conducted on the residents of 14 villages covered by 14 health houses. Totally, 200 hypertensive patients (n = 100 in each group) were selected via multistage random sampling. The intervention included a two-day workshop on blood pressure and reducing salt consumption based on HBM structures for health personnel and an eight-session workshop on how to reduce salt intake and blood pressure for mothers who were responsible for the families’ diets. Participants completed the questionnaires before and immediately after the intervention. Results. Compared to the control group, in the intervention group, a significant reduction was observed in salt consumption by the families (urine sodium and creatinine reduced by 35 mEq/l and 7.5 mg/dL, respectively). The results also revealed a significant decrease in blood pressure in the intervention group. Conclusion. The results showed that the mothers’ model-based education could effectively improve the diet of the whole family members and, as a result, reduce the associated diseases. The main advantage of this study was the involvement of the rural health personnel, which helped run longer and larger-scale health-promotion programs in the communities.

Community Wellbeing Under China-Pakistan Economic Corridor: Role of Social, Economic, Cultural, and Educational Factors in Improving Residents' Quality of Life

This present article explores the effects of cultural value, economic prosperity, and community mental wellbeing through multi-sectoral infrastructure growth projects under the Belt and Road Initiative. The implications of the social exchange theory are applied to observe the support of the local community for the China-Pakistan Economic Corridor (CPEC). This study explores the CPEC initiative, it's direct social, cultural, economic development, and risk of environmental factors that affect residents' lives and the local community's wellbeing. CPEC is a multibillion-dollar project to uplift economic growth and free trade between Pakistan, China, and other regional stakeholders. Although CPEC is still in its initial phases with partial startups, policymakers and government officials claim this mega project as a "game-changer" in the region, mainly for Pakistan and China. This gigantic project offers the significant potential to generate business slews and employment opportunities with international outreach. Due to the term's newness, numerous studies have recently explored the macro and microeconomic benefits of the CPEC initiatives; still, these projects are theoretical. The existing literature insufficiently explored how helpful CPEC would be to a specific group and how residents perceive its advantages. This study fills in the literature gaps and explores the likely advantageous potential of the CPEC for the regional states. The study applied a convenient sampling technique for the data collection process. It used a mixed-method approach to gain scientific results, with a standardized questionnaire survey of 459 people (300 men and 159 women) from five major cities of Pakistan. The study results designate that residents believe that CPEC infrastructure projects will significantly improve residents' life quality through more job openings and community poverty reduction. Still, they raised their concerns regarding environmental protection issues in the region. The findings specified that residents had an optimistic approach to better educational productivity by adopting environment-oriented policies. Policymakers should establish new CPEC study centers in different areas, and investors should be encouraged to participate in the industrial sector. Officials can overwhelm community worries about environmental degradation. Government officials in both countries can utilize the findings to raise public awareness about CPEC's social, economic, cultural, mental wellbeing, and ecological implications.

Product Market Competition and Firm Performance: Business Survival Through Innovation and Entrepreneurial Orientation Amid COVID-19 Financial Crisis

The product market competition has become a global challenge for business organizations in the challenging and competitive market environment in the influx of the COVID-19 outbreak. The influence of products competition on organizational performance in developed economies has gained scholars' attention, and numerous studies explored its impacts on business profitability. The existing studies designate mixed findings between the linkage of CSR practices and Chinese business firms' healthier performance in emerging economies; however, the current global crisis due to the coronavirus has made product market completion fierce, which ultimately affects business firms' performance. This study focuses on this logical global challenge, investigates the rationale, and examines product-market completion impact on firms' performance operating in the Chinese markets. The study collected data from the annual reports of Chinese business organizations with A-share listing and registered with the database of China Stock Markets and Accounting Research (CSMAR). The study employed a Generalized Method of Moment technique and investigated the connection between product market competition and Chinese firm performance. The empirical analysis of this study highlights the conclusion that market competition positively and significantly affected business firms' performance. This study specified that product market competition play a dynamic and indispensable role in achieving healthier firm performance in the Chinese markets. This study provides valuable insights on practical implications and future research directions for the scholars to draw interesting results with new study models.

Enabling Self-Directed Academic and Personal Wellbeing Through Cognitive Education

Background

The international crisis of declining learner wellbeing exacerbated by the COVID-19 pandemic with its devastating effects on physical health and wellbeing, impels the prioritization of initiatives for specifically enabling academic and personal wellbeing among school learners to ensure autonomous functioning and flourishing in academic and daily life. Research emphasizes the role of self-directed action in fostering wellbeing. However, there is limited research evidence of how self-directed action among school learners could be advanced.

Aim

We explore the effectiveness of an intervention initiative that exposes teachers to foregrounding Cognitive Education – the explicit and purposeful teaching of thinking skills and dispositions to learners that would advance self-regulated action - to establish the latent potential of the intervention for assisting learners to develop self-regulating abilities that progressively inspires increased self-directed action.

Method

We illuminate the qualitative outcomes of an exploratory pilot study with a heterogeneous group of willing in-service teachers from two public primary schools (n = 12), one private primary school (n = 3), and one pre-school (n = 2) in South Africa who received exposure to an 80-h intervention that comprised seven study units. The article delineates the experiences of the teachers concerning their participation in the intervention as reflected in their written reflections, as well as their perceptions about the value of the intervention probed with semi-structured one-on-one interviews after completion of the intervention.

Results

The findings revealed that exposure to the intervention holds benefits for equipping teachers with teaching strategies to create classroom conditions that nurture the development of thinking skills and dispositions that are important for self-regulating, and ultimately self-directing academic and personal wellbeing.

Conclusion

Cognitive Education is a form of strengths-based education that can play an indispensable role in enabling self-directed academic and personal wellbeing among school learners.

Nexus between integrating technology readiness 2.0 index and students' e-library services adoption amid the COVID-19 challenges: Implications based on the theory of planned behavior

BACKGROUND

The advent of the pandemic COVID-19 has resulted in a global crisis that resulted in the closure of universities and educational institutions worldwide. This study aims to explore the determinants of students' intention towards e-library services usage amid the challenging time of the COVID-19 pandemic. This paper reviews the technology-oriented individual attitude based on four dimensions of the technology readiness 2.0 index factors, which affect medical students' perspectives.

MATERIALS AND METHODS

The authors provided a self-administered questionnaire to medical students to investigate their e-library adoption attitude during the COVID-19 crisis. The authors distributed 542 questionnaires, received 361 complete responses and analyzed the data through path modeling/partial least squares structural equations modeling technique (PLS-SEM) with the smart PLS software version 3.3.3. The structural equation-modelling tool permits the estimation of results.

RESULTS

The main finding revealed that medical students have a positive and explicit approach to use the services available at the e-library. Technology use and online services helped students continue their educational needs in the advent of the current pandemic COVID-19. Attitude and subjective norms have significant influence and are strong predictors of intention. However, due to inadequate support for the government side, the perceived behavioural control has an insignificant impact on intention. This paper indicated one of the pioneers investigating the determinants of e-library adoption among medical students based on technology-oriented personality traits, employing the four dimensions of the technology readiness 2.0 index during the challenges of the COVID-19 outbreak.

CONCLUSION

The study's findings provide useful insight that offers valuable insights to implement specific strategies from the government officials to address medical students' uncertainties and increase the technology adoption amid the COVID-19 pandemic in medical education for developing nations.

Social Media Efficacy in Crisis Management: Effectiveness of Non-pharmaceutical Interventions to Manage COVID-19 Challenges

The new identified virus COVID-19 has become one of the most contagious diseases in human history. The ongoing coronavirus has created severe threats to global mental health, which have resulted in crisis management challenges and international concerns related to health issues. As of September 9, 2021, there were over 223.4 million patients with COVID-19, including 4.6 million deaths and over 200 million recovered patients reported worldwide, which has made the COVID-19 outbreak one of the deadliest pandemics in human history. The aggressive public health implementations endorsed various precautionary safety and preventive strategies to suppress and minimize COVID-19 disease transmission. The second, third, and fourth waves of COVID-19 continue to pose global challenges to crisis management, as its evolution and implications are still unfolding. This study posits that examining the strategic ripostes and pandemic experiences sheds light on combatting this global emergency. This study recommends two model strategies that help reduce the adverse effects of the pandemic on the immune systems of the general population. This present paper recommends NPI interventions (non-pharmaceutical intervention) to combine various measures, such as the suppression strategy (lockdown and restrictions) and mitigation model to decrease the burden on health systems. The current COVID-19 health crisis has influenced all vital economic sectors and developed crisis management problems. The global supply of vaccines is still not sufficient to manage this global health emergency. In this crisis, NPIs are helpful to manage the spillover impacts of the pandemic. It articulates the prominence of resilience and economic and strategic agility to resume economic activities and resolve healthcare issues. This study primarily focuses on the role of social media to tackle challenges and crises posed by COVID-19 on economies, business activities, healthcare burdens, and government support for societies to resume businesses, and implications for global economic and healthcare provision disruptions. This study suggests that intervention strategies can control the rapid spread of COVID-19 with hands-on crisis management measures, and the healthcare system will resume normal conditions quickly. Global economies will revitalize scientific contributions and collaborations, including social science and business industries, through government support.

The Relationship Between CEO Duality and Business Firms' Performance: The Moderating Role of Firm Size and Corporate Social Responsibility

This study focuses on exploring the relationship between chief executive officer (CEO) duality and firm performance. We focus on how the size and corporate social responsibility (CSR) of firms moderate this relationship. In terms of size, business organizations are of two types: small and large firms. This study uses datasets of listed Chinese business firms included in the China Stock Market and Accounting Research database. It employs a generalized method of moment's technique to explore the connection between CEO duality and the performance of Chinese business firms through double mediation effects. Our empirical analysis showed that CEO duality has a significant negative relationship with firm performance. We also explored the moderating effects of firm size (small and large) and CSR practices on the relationship between CEO duality and improved performance of Chinese firms. Large firms and CSR practices showed significant and positive moderating effects on the relationship between CEO duality and firm performance. Conversely, with CEO duality, small firms showed a negative moderating influence on firm performance. This inclusive model provides valuable insights into how the dual role of the CEO of a firm affected the performance of Chinese firms through the moderating role of CSR practices and firm size for better business performance. The study offers empirical and theoretical contributions to the corporate governance literature. This research framework might help researchers in designing robust strategies to evaluate the effects on firm performance. Researchers may gain helpful insights using this methodology.

Human health risk assessment of selected pharmaceuticals in the five major river basins, China

Pharmaceuticals in aquatic environment have raised wide attention in recent years due to their potential adverse effects and bioaccumulation in biota. China has been a major producer and consumer of pharmaceuticals, however, the potential human health risk of these chemicals is yet to be determined in China. In this study, we evaluated available exposure data for twenty pharmaceuticals in surface waters from Chinese five major river basins (the Yangtze, Haihe, Pearl, Songliao, and Yellow River Basins), and human health risk assessment was performed. Based on the concentration data and risk data, we conducted research on the source, cause, and control measures of the pharmaceuticals. The twenty pharmaceuticals were found to be ubiquitous in China with median concentrations between 0.09 and 304 ng/L. The estimated daily intake of pharmaceuticals from drinking water and eating fish was calculated. The intake via drinking water was significantly lower than that via eating fish. The risk quotients via water intake and fish consumption ranged from 0 to 17.2, with estrogen and sulfapyridine highest among the twenty pharmaceuticals. High risks of exposure were mainly in North China, including the Haihe and Songliao River Basins. This is the first analysis in Chinese major river basins that has filled the gaps in the research on the human health risks of pharmaceuticals. The results of the study provide basic information of pharmaceutical intake from drinking water and eating fish in China and provide insights into the risk management guidance of pharmaceuticals, and will facilitate the optimization of health advisories and policy making.

Hypertension and pre-hypertension in Middle East and North Africa (MENA): A meta-analysis of prevalence, awareness, treatment, and control

Hypertension (HTN) is one of the most important public health challenges, especially in developing countries. Despite individual studies, information on the exact prevalence of prehypertension (pre-HTN) and HTN in the Middle East and North Africa (MENA) is lacking. This meta-analysis was conducted to evaluate prevalence of pre-HTN and HTN, awareness, treatment, and control in the MENA region. PubMed, Web of Science, and Scopus databases were searched from inception to April 30, 2021. Keywords included hypertension, pre-hypertension, awareness, treatment, and control. The quality of the included studies was evaluated using the Hoy scale. A random-effects model was evaluated based on overall HTN. The heterogeneity of the preliminary studies was evaluated using the I² test. A total of 147 studies involving 1,312,244 participants were included in the meta-analysis. Based on the results of the random-effects method (95% CI), the Prevalence of pre-HTN and HTN were 30.6% (95% CI: 25.2, 36.0%; I² = 99.9%), and 26.2% (95% CI: 24.6, 27.9%; I² = 99.8%), respectively. The prevalence of HTN awareness was 51.3% (95% CI: 47.7, 54.8; I² = 99.0%). The prevalence of HTN treatment was 47.0% (95% CI: 34.8, 59.2; I² = 99.9%). The prevalence of HTN control among treated patients was 43.1% (95% CI: 38.3, 47.9; I² = 99.3%). Considering the high prevalence of HTN, very low awareness, and poor HTN control in the region, more attention should be paid to preventive programs for HTN reduction.

Game Analysis on Epidemic Prevention and Resuming Production: Based on China's Experience With COVID-19

Since the outbreak of COVID-19, it became urgent to deal with the relationship between the prevention and control of the epidemic and the resumption of work and production. The purpose of this study is to observe and describe which approach seemed more important for the Chinese government and people, and how this trend evolved through time. To this end, a game model of resuming production and preventing the epidemic is constructed, using the evolutionary stable strategy (ESS). By combing China's measures on epidemic prevention and resuming production during critical periods of epidemic outbreak, it is clarified that the present stage is considered a period of equal emphasis on both epidemic prevention and resuming production. Based on the dynamic between these two strategies and further theoretical research, present policies should equally focus on both preventive and controlling measures as well as on the socioeconomic development for most countries in the world.

The Teaching Design Methods Under Educational Psychology Based on Deep Learning and Artificial Intelligence

This study aims to evaluate the practical application value of the teaching method under the guidance of educational psychology and artificial intelligence (AI) design, taking the deep learning theory as the basis of teaching design. The research objects of this study involve all the teachers, students, and students' parents of Ningbo Middle School. The questionnaires are developed to survey the changes in the performance of students before and after the implementation of the teaching design and the satisfaction of all teachers, students, and parents to different teaching methods by comparing the two results and the satisfaction ratings. All objects in this study volunteer to participate in the questionnaire survey. The results suggest the following: (1) the effective return rates of the questionnaires to teachers, students, and parents are 97, 99, and 95%, respectively, before implementation; whereas those after implementation are 98, 99, and 99%, respectively. Comparison of the two return results suggests that there was no significant difference statistically (P > 0.05). (2) Proportion of scoring results before and after implementation is given as follows: the proportions of levels A, B, C, and D are 35, 40, 15, and 10% before implementation, respectively; while those after implementation are 47, 36, 12, and 5%, respectively. After the implementation, the proportion of level A is obviously higher than that before the implementation, and the proportions of other levels decreased in contrast to those before the implementation, showing statistically obvious differences (P < 0.05). (3) The change in the performance of each subject after 1 year implementation is significantly higher than that before the implementation, and the change in the average performance of each subject shows an upward trend. In summary, (1) the comparison on the effective return rate of the satisfaction survey questionnaire proves the feasibility of its scoring results. (2) The comparison of the survey scoring results shows that people are more satisfied with the new educational design teaching method. (3) The comparison of the change in the performance of each subject before and after the implementation indirectly reflects the drawbacks of partial subject education, indicating that the school should pay the same equal attention to every subject. (4) Due to various objective and subjective factors, the results of this study may be different from the actual situation slightly, and its accuracy has to be further explored in the future.

Patient and healthcare provider perspectives on adherence with antihypertensive medications: an exploratory qualitative study in Tanzania

Background

Poor medication adherence is an extraordinarily common problem worldwide that contributes to inadequate control of many chronic diseases, including Hypertension (HT). Globally, less than 14% of the estimated 1.4 billion patients with HT achieve optimal control. A myriad of barriers, across patient, healthcare provider, and system levels, contributes to poor medication adherence. Few studies have explored the reasons for poor medication adherence in Tanzania and other African countries.

Methods

A qualitative study applying grounded theory principles was conducted in the catchment area of two semi-urban clinics in Dar es Salaam, Tanzania, to determine the perceived barriers to HT medication adherence. Ten key informant interviews were conducted with healthcare providers who manage HT patients. Patients diagnosed with HT (SBP ≥ 140 and DBP ≥ 90), were randomly selected from patient registers, and nine focus group discussions were conducted with a total 34 patients. Inductive codes were developed separately for the two groups, prior to analyzing key thematic ideas with smaller sub-categories.

Results

Affordability of antihypertensive medication and access to care emerged as the most important barriers. Fee subsidies for treatment and medication, along with health insurance, were mentioned as potential solutions to enhance access and adherence. Patient education and quality of physician counseling were mentioned by both providers and patients as major barriers to medication adherence, as most patients were unaware of their HT and often took medications only when symptomatic. Use of local herbal medicines was mentioned as an alternative to medications, as they were inexpensive, available, and culturally acceptable. Patient recommendations for improving adherence included community-based distribution of refills, SMS text reminders, and family support. Reliance on religious leaders over healthcare providers emerged as a potential means to promote adherence in some discussions.

Conclusions

Effective management of hypertensive patients for medication adherence will require several context-specific measures. These include policy measures addressing financial access, with medication subsidies for the poor and accessible distribution systems for medication refill; physician measures to improve health provider counseling for patient centric care; and patient-level strategies with reminders for medication adherence in low resource settings.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06858-7.

Religious Affiliation, Daily Spirituals, and Private Religious Factors Promote Marital Commitment Among Married Couples: Does Religiosity Help People Amid the COVID-19 Crisis?

Religious studies are a vital branch of social science that seeks to explain the beliefs of human society and deals with the practices and beliefs of individuals. This distinctive study focuses on such influential aspects of a healthy life, which could play a vital role in the marital quality and matrimonial commitment of individuals. The study principally focused on inspecting the role of religiosity in healthy marital commitment among individuals. It is a distinctive and central value in regulating a healthy social life. This research designed a conceptual model for assessing marital commitment, and the study model comprised two primary variables. The study received datasets through a survey questionnaire based on participants from five private and public sectors. The research study conducted an empirical analysis to test the proposed conceptual framework. The findings exhibited that the value of the R 2 model was 0.484, meaning the level of religiosity had a substantial impression on healthy and lasting marital commitment. According to the final outline of the model factors associated with building religious support factors (β = 0.491), the marital commitment had a better and healthier impact. The goodness-of-fit of the measurement of the conceptual model showed a value of 0.51, which indicated that the theoretical model had sufficient consistency and rationality, and accurately fitted the data. Such an advanced statistical model is missing from the previous literature. The study results provide helpful insight to elucidate the social dynamics of marital commitment. The findings designate that religious practices strengthen and promote nuptial commitment. The study is novel in the context of religiosity impact on martial commitment with a cultural background of Pakistan. The generalizability of the study does not apply to the entire population or other regions. Future studies can investigate other religious variables to explore further research findings. The findings are helpful for decision-makers and policymakers to concentrate on marital issues and challenges confronted by couples worldwide.

Global Financial Crisis, Smart Lockdown Strategies, and the COVID-19 Spillover Impacts: A Global Perspective Implications From Southeast Asia

This present study primarily emphasizes to seek the COVID-19 adverse impacts posing health challenges and global economic crisis. The pandemic (COVID-19) continues to hit the global economies adversely. Pakistan is the 5th-most-populous nation, and recorded positive cases with the third-highest positivity ratio in South Asia, and 26th-highest deaths toll of 21,450 and 29th number of most COVID-19 positive cases with 933,750 worldwide, as of June 6, 2021. The first wave appeared at the end of May 2020, and mid of June reported its peak, which ended by mid-July 2020. Early November 2020 witnessed the second wave with low intensity reached the climax by mid-December. The COVID-19's third wave severely affected the country during mid-March 2021. It exhibited the highest positivity rate, around 20%. New positive patients and deaths toll commenced to skyrocket and reported peak by April 15, 2021. Then situation gradually improved with effective measures and restrictions. The pandemic coronavirus (COVID-19) has affected 220 territories, regions, and countries and resulted in more than 174.116 million infections, deaths, 3.75 million, and 157.157 million positive cases fully recovered from this infectious disease, as of June 7, 2021. The pandemic has caused a severe crisis of healthcare facilities and economic challenges worldwide. Pakistani economy reported GPD's negative growth (-0.05) for the first time over the last 60 years in 2020, which caused a massive financial crisis. The Government's relief package intervened to reduce public mental stress and improve the quality of their lives. IMF reported that Pakistan's GPD bounced back at 4% growth by June 2021. This article determines that economic instability and health burden happened in Pakistan for a longer time than financial disequilibrium that occurred globally. Pakistan encountered this crisis due to its feeble healthcare systems and fragile economy. This study explores adverse health issues and spillover consequences on the economic crisis in Pakistan with global implications. It recommends smart lockdown restrictions in most affected areas to reopen the economic cycle with strict preventive measures to minimize the COVD-19 adverse consequences.