Multilevel testing of constraints induced by structural equation modeling in fMRI effective connectivity analysis: A proof of concept

In functional MRI (fMRI), effective connectivity analysis aims at inferring the causal influences that brain regions exert on one another. A common method for this type of analysis is structural equation modeling (SEM). We here propose a novel method to test the validity of a given model of structural equation. Given a structural model in the form of a directed graph, the method extracts the set of all constraints of conditional independence induced by the absence of links between pairs of regions in the model and tests for their validity in a Bayesian framework, either individually (constraint by constraint), jointly (e.g., by gathering all constraints associated with a given missing link), or globally (i.e., all constraints associated with the structural model). This approach has two main advantages. First, it only tests what is testable from observational data and does allow for false causal interpretation. Second, it makes it possible to test each constraint (or group of constraints) separately and, therefore, quantify in what measure each constraint (or, e..g., missing link) is respected in the data. We validate our approach using a simulation study and illustrate its potential benefits through the reanalysis of published data.

Predictors of quality of life in primary caregivers of patients with heart failure: A model of health literacy and caregiving burden

BACKGROUND

Heart Failure (HF) is a chronic disease that impairs patients' ability to care for themselves. The accumulation of caregiving activities by caregivers to patients creates stress.

OBJECTIVES

This study intends to investigate the mediating role of caregiving burden in the relationship between health literacy and quality of life of caregivers.

METHODS

This study is a cross-sectional research conducted through a questionnaire survey. A convenience sampling method was employed to select 410 primary caregivers for the study.

RESULTS

The overall mean score for quality of life for caregivers of patients with HF was (49.30±9.64). The results showed that the caregiving burden mediated the relationship between health literacy and quality of life, with the mediating effect accounting for 39.04 % (P < 0.05) of the total effect.

CONCLUSION

Caregiving burden is a mediating variable in the relationship between health literacy and quality of life. Therefore, we offer some recommendations for healthcare professionals: ①We suggest that healthcare professionals provide relevant education and training to caregivers, as this can enhance their knowledge and skills in effectively managing the health condition of patients;②Healthcare professionals can also proactively assess the caregiver's burden level and design personalized support plans based on the assessment results.

Power analyses for measurement model misspecification and response shift detection with structural equation modeling

PURPOSE

Statistical power for response shift detection with structural equation modeling (SEM) is currently underreported. The present paper addresses this issue by providing worked-out examples and syntaxes of power calculations relevant for the statistical tests associated with the SEM approach for response shift detection.

METHODS

Power calculations and related sample-size requirements are illustrated for two modelling goals: (1) to detect misspecification in the measurement model, and (2) to detect response shift. Power analyses for hypotheses regarding (exact) overall model fit and the presence of response shift are demonstrated in a step-by-step manner. The freely available and user-friendly R-package lavaan and shiny-app 'power4SEM' are used for the calculations.

RESULTS

Using the SF-36 as an example, we illustrate the specification of null-hypothesis (H0) and alternative hypothesis (H1) models to calculate chi-square based power for the test on overall model fit, the omnibus test on response shift, and the specific test on response shift. For example, we show that a sample size of 506 is needed to reject an incorrectly specified measurement model, when the actual model has two-medium sized cross loadings. We also illustrate power calculation based on the RMSEA index for approximate fit, where H0 and H1 are defined in terms of RMSEA-values.

CONCLUSION

By providing accessible resources to perform power analyses and emphasizing the different power analyses associated with different modeling goals, we hope to facilitate the uptake of power analyses for response shift detection with SEM and thereby enhance the stringency of response shift research.

Biochar and vegetation effects on discharge water quality from organic-substrate green roofs

Green roofs have been increasingly used to improve stormwater management, but poor vegetation performance on roof systems, varying with vegetation type, can degrade discharge quality. Biochar has been suggested as an effective substrate additive for green roofs to improve plant performance and discharge quality. However, research on the effects of biochar and vegetation on discharge quality in the long term is lacking and the underlying mechanisms involved are unclear. We examined the effects of biochar amendment and vegetation on discharge quality on organic-substrate green roofs with pre-grown sedum mats and direct-seeded native plants for three years and investigated the key factors influencing discharge quality. Sedum mats reduced the leaching of nutrients and particulate matter by 6-64% relative to native plants, largely due to the higher initial vegetation cover of the former. Biochar addition to sedum mat green roofs resulted in the best integrated water quality due to enhanced plant cover and sorption effects. Structural equation modeling revealed that nutrient leaching was primarily influenced by rainfall depth, time, vegetation cover, and substrate pH. Although biochar-amended sedum mats showed better discharge quality from organic-substrate green roofs, additional ecosystem services may be provided by native plants, suggesting future research to optimize plant composition and cover and biochar properties for sustainable green roofs.

Carbon emissions, wastewater treatment and aquatic ecosystems

As a nexus of environmental pollution, fossil fuel consumption and the global warming, carbon emissions are critical in China's long-term environmental strategies. In the water cycle, carbon is released during wastewater discharge, wastewater treatment, and subsequent changes in aquatic ecosystems. To gain a comprehensive understanding of this entire process, we investigate the intricate connections using balanced panel data from 261 prefecture-level cities in China spanning the period from 2000 to 2020. Each sample is quantified using 48 features derived from hydrosphere, biosphere, anthroposphere, atmosphere, pedosphere and lithosphere. This paper contributes to the relevant studies in the following ways: Firstly, to analyze the basic interaction within the water cycle, we utilize Structural Equation Modeling (SEM). Our results indicate a weak linear relationship between wastewater treatment and carbon emissions. We also substantiate the crucial role of the aquatic ecosystems in carbon fixation. Secondly, in order to comprehend the intricate interactions within the Earth system, we employ eight machine learning models to predict carbon emissions. We observe that extremely randomized trees (ET) exhibit the highest predictive accuracy among these models. Thirdly, in interpreting the ET model, we utilize Explainable artificial intelligence (XAI) techniques, including Shapley Additive Explanations (SHAP) and Accumulated Local Effects (ALE). Our 3D-SHAP analysis reveals heterogeneity in the emission effects of wastewater treatment across different sub-groups, indicating that emissions are especially sensitive to increased wastewater treatment in agricultural and tourism cities. Furthermore, 3D-SHAP analysis of the aquatic ecosystems exhibits a series of spikes, signifying that aquatic plants will abruptly lose their carbon storage ability once the degradation of the aquatic ecosystems exceeds a certain threshold. Finally, our ALE evaluation, depicting the dispersion tendency of feature importance, identifies the uncertainty of wastewater carbon release in agricultural and tourism cities, while also affirming the vulnerability of the aquatic ecosystems.

What shapes food waste behaviors? New insights from a comprehensive action determination model

The sharp increase in food waste poses a serious threat to food security and environmental sustainability. However, most existing studies have investigated the determinants of food waste behaviors in a separate behavioral process without considering the potential impacts of different factors in an integrated process. To narrow this gap, a comprehensive action determination model (CADM), which integrates network embeddedness and incentive measures, was constructed to explore the impact of various determinants in different processes on food waste behaviors, using data collected from 913 residents in eastern China via an online survey. The empirical results showed that environmental concern was the largest positive factor in predicting personal norms (β = 0.80, p < 0.001), followed by network embeddedness. With the habitual process considered, residents with ingrained waste habits were more likely to waste food (β = 0.38, p < 0.001). Moreover, the normative process alleviates behavioral decisions via intentions to reduce food waste. This study confirmed the differences in the situational process and suggested that menu tips increase food waste behaviors, while incentive measures reinforce the influence of intentions on behavior. We therefore address the insufficient ingredients on the effects of different processes on behavior and provide a new perspective for formulating behavioral intervention policies.

The greenhouse gas emissions from meat sheep production contribute double of household consumption in a Eurasian meadow steppe

With the rapid development of the economy, household activities have emerged as an important source of greenhouse gas (GHG) emissions, making them a crucial focal point for research in the pursuit of sustainable development and carbon emission reduction. Hulunber, as a typical steppe region in eastern Eurasia, is representative of studying the GHG emissions from household ranches, which are the basic production units in this region. In this paper, based on survey data of 2018 and 2019, we quantified and assessed GHG emissions from household ranches by combining life cycle assessment (LCA) and structural equation modeling (SEM) approaches, with LCA to define household ranches system boundary and SEM to determine the key driving factors of emissions. The results showed that GHG emissions of meat sheep live weight was 23.54 kg CO2-eq/kg. The major contributor to household GHG emissions was enteric methane (55.23 %), followed by coal use (20.80 %) and manure management systems (9.16 %), and other contributing factors (14.81 %). The SEM results indicated that the GHG emissions from household ranches were derived primarily by economic level, while the economic level was significantly affected by income. This study also found a significant positive and linear correlation between household GHG emissions and the number of meat sheep (R2 = 0.89, P < 0.001). The GHG emissions from meat sheep production (67.52 %) were double times greater than household livelihood consumption (32.48 %). These findings emphasized the importance of reducing emissions from meat sheep production and adjusting the energy mix of household livelihood, contributing to the establishment of a low-carbon household livelihood operation.

Understanding Composite-Based Structural Equation Modeling Methods From the Perspective of Regression Component Analysis

Regression component analysis (RCA) replaces the factors in a factor analysis model with weighted composites of the model's observed variables. The weight matrix may be calculated from the factor model's parameter estimates. Thus, RCA parameter estimates can be obtained using factor model software, but RCA composites have determinate scores, rather than the indeterminate scores of factors. Analytically, RCA equates to modeling with "regression method" factor scores, except that, while those scores will be inconsistent with the original factor model, they are strictly consistent with the RCA model. When the original factor model is strictly correct in the population and the composites in RCA are standardized, RCA parameter estimates replicate those from regression-weighted forms of partial least squares (PLS) path modeling and generalized structured component analysis (GSCA)-affirming that those methods also equate to modeling with regression method factor scores under the same conditions. Parallel measurement allows RCA to replicate both correlation weight and regression weight versions of PLS and GSCA. These results suggest that RCA and regression-weighted forms of PLS and GSCA are all consistent approaches for modeling data that conforms to a factor model. All analytical methods are described using one consistent symbol palette. Complete R syntax is provided.

Exercise identity and physical activity behavior during late adolescence: A four wave cross-lagged panel model

Research has shown that physical activity behavior tends to decline across adolescence before stabilizing in adulthood. Identifying salient factors underlying these behavioral changes is therefore imperative for informing intervention development. This study explored the temporal nature of the relationship between exercise identity and physical activity behavior during the transition out of high school. An analysis of data from the Application of integrated Approaches to understanding Physical activity during the Transition to emerging adulthood (ADAPT) prospective cohort study was conducted, involving 1451 Canadian adolescents (Mage = 15.93 ± 0.53 years; 52.4% female). Participants completed the International Physical Activity Questionnaire-Short Form to report weekly moderate-to-vigorous physical activity and an abbreviated version of the Exercise Identity Scale yearly for four years beginning in Grade 11. A four-wave cross-lagged panel model was used to test bi-directional associations between exercise identity and physical activity behavior. Significant auto-regressive effects for exercise identity and physical activity were observed across all four time points. Significant positive cross-lagged paths were observed for exercise identity predicting future physical activity at all time points; however, none of the cross-lagged paths with physical activity predicting future exercise identity were significant. Collectively, these findings support existing theory that emphasizes the role that identity plays in physical activity behavior. Interventions seeking to attenuate the physical activity declines typically observed during the transition to emerging adulthood should therefore consider adopting behavior change techniques that target identity, as it appears to be an important psychological determinant underlying future physical activity engagement.

Boredom and engagement at work: do they have different antecedents and consequences?

This study aimed to demonstrate the empirical distinctiveness of boredom at work and work engagement in relation to their potential antecedents (job demands and job resources) and consequences (psychological distress and turnover intention) based on the Job Demands-Resources model. A three-wave longitudinal survey was conducted among registered monitors of an Internet survey company in Japan. The questionnaire included scales for boredom at work, work engagement, psychological distress, and turnover intention as well as participants' job characteristics and demographic variables. The hypothesized model was evaluated via structural equation modeling with 1,019 participants who were employed full-time. As expected, boredom at work was negatively associated with quantitative job demands and job resources and positively associated with psychological distress and turnover intention. In contrast, work engagement was positively associated with job resources and negatively associated with turnover intention. Thus, boredom at work and work engagement had different potential antecedents and were inversely related to employee well-being and organizational outcomes. However, contrary to expectations, qualitative job demands were not significantly associated with boredom at work. Further investigation is needed to understand the relationship between boredom and qualitative job demands, which require sustained cognitive load and the use of higher skills.

Examining the performance of the chi-square difference test when the unrestricted model is slightly misspecified

Structural equation models are used to model the relationships between latent constructs and observable behaviors such as survey responses. Researchers are often interested in testing nested models to determine whether additional constraints that create a more parsimonious model are also supported by the data. A popular statistical tool for nested model comparison is the chi-square difference test. However, there is some evidence that this test performs suboptimally when the unrestricted model is misspecified. In this paper, we examine the type I error rate of the difference test within the context of single-group confirmatory factor analyses when the less restricted model is misspecified but the constraints imposed by the restricted model are correct. Using empirical simulations and analytic approximations, we find that the chi-square difference test is robust to many but not all forms of realistically sized misspecification in the unrestricted model.

Cognitive flexibility's role in shaping self-perception of aging, body appreciation, and self-efficacy among community-dwelling older women

BACKGROUND

Cognitive flexibility, the capacity to adjust to new information, affects how aging is perceived. In Egyptian culture, older women's views on aging are shaped by societal gender roles and expectations. These views influence their body image and belief in their abilities, all melded by cultural standards and values.

AIM

Investigate the mediating role of cognitive flexibility in the relationship between self-aging perception, body appreciation, and self-efficacy among community-dwelling older women.

METHODS

A correlational analytical design was used on 200 women aged 60 years or older using the Cognitive Flexibility Inventory, Self-Perceptions of Aging, General Self-Efficacy Scale, and Body Appreciation Scales. Structural equation modeling was used in the analysis.

RESULTS

The study found that cognitive flexibility is positively related to self-perception of aging and body appreciation and is also significantly related to general self-efficacy. However, no significant relationship was found between body appreciation and general self-efficacy. Additionally, the study found that cognitive flexibility partially mediates the relationship between self-perception of aging and body appreciation and fully mediates the relationship between body appreciation and self-efficacy.

CONCLUSION

Cognitive flexibility is vital in the relationships between self-perceptions of aging, body appreciation, and self-efficacy among older women. Therefore, nursing interventions targeting cognitive flexibility are recommended to promote positive self-aging perceptions, body appreciation, and self-efficacy in this population.

Structural equation modeling for identifying the drivers of health-related quality of life improvement experienced by patients with migraine receiving eptinezumab

BACKGROUND

As new migraine therapies emerge, it is crucial for measures to capture the complexities of health-related quality of life (HRQoL) improvement beyond improvements in monthly migraine day (MMD) reduction. Investigations into the correlations between MMD reduction, symptom management, and HRQoL are lacking, particularly those that focus on improvements in canonical symptoms and improvement in patient-identified most-bothersome symptoms (PI-MBS), in patients treated with eptinezumab. This exploratory analysis identified efficacy measures mediating the effect of eptinezumab on HRQoL improvements in patients with migraine.

METHODS

Data from the DELIVER study of patients with 2-4 prior preventive migraine treatment failures (NCT04418765) were inputted to two structural equation models describing sources of HRQoL improvement via Migraine-Specific Quality-of-Life Questionnaire (MSQ) scores. A single latent variable was defined to represent HRQoL and describe the sources of HRQoL in DELIVER. One model included all migraine symptoms while the second model included the PI-MBS as the only migraine symptom. Mediating variables capturing different aspects of efficacy included MMDs, other canonical symptoms, and PI-MBS.

RESULTS

In the first model, reductions in MMDs and other canonical symptoms accounted for 35% (standardized effect size [SES] - 0.11) and 25% (SES - 0.08) of HRQoL improvement, respectively, with 41% (SES - 0.13) of improvement comprising "direct treatment effect," i.e., unexplained by mediators. In the second model, substantial HRQoL improvement with eptinezumab (86%; SES - 0.26) is due to MMD reduction (17%; SES - 0.05) and change in PI-MBS (69%; SES - 0.21).

CONCLUSIONS

Improvements in HRQoL experienced by patients treated with eptinezumab can be substantially explained by its effect on migraine frequency and PI-MBS. Therefore, in addition to MMD reduction, healthcare providers should discuss PI-MBS improvements, since this may impact HRQoL. Health technology policymakers should consider implications of these findings in economic evaluation, as they point to alternative measurement of quality-adjusted life years to capture fully treatment benefits in cost-utility analyses.

TRIAL REGISTRATION

ClinicalTrials.gov (Identifier: NCT04418765 ; EudraCT (Identifier: 2019-004497-25; URL: https://www.clinicaltrialsregister.eu/ctr-search/search?query=2019-004497-25 ).

Impact of using virtual avatars in educational videos on user experience

Popularization of knowledge is of considerable importance and necessity, and traditional knowledge popularization activities suffer from high cost and low acceptance, which affect their effectiveness and coverage. Applying virtual avatars to educational videos may be an effective way to solve the problem. This study investigates the impact of applying virtual avatars to educational videos on user experience. Constructed a model of the impact of user experience on educational videos with virtual avatars, collected data from the target population, and analyzed it empirically. The video quality and virtual avatar expressiveness dimensions of the influencing factors have a significant positive effect on the learning effect, emotional experience and user engagement dimensions of user experience; the content quality dimension of the influencing factors has a significant negative effect on the three dimensions of user experience. The video quality and virtual avatar expressiveness dimensions of the influencing factors have a significant positive effect on the learning effect, emotional experience and user engagement dimensions of user experience; the content quality dimension of the influencing factors has a significant negative effect on the three dimensions of user experience.

Investigating weight constraint methods for causal-formative indicator modeling

Causal-formative indicators are often used in social science research. To achieve identification in causal-formative indicator modeling, constraints need to be applied. A conventional method is to constrain the weight of a formative indicator to be 1. The selection of which indicator to have the fixed weight, however, may influence statistical inferences of the structural path coefficients from the causal-formative construct to outcomes. Another conventional method is to use equal weights (e.g., 1) and assumes that all indicators equally contribute to the latent construct, which can be a strong assumption. To address the limitations of the conventional methods, we proposed an alternative constraint method, in which the sum of the weights is constrained to be a constant. We analytically studied the relations and interpretations of structural path coefficients from the constraint methods, and the results showed that the proposed method yields better interpretations of path coefficients. Simulation studies were conducted to compare the performance of the weight constraint methods in causal-formative indicator modeling with one or two outcomes. Results showed that higher biases in the path coefficient estimates were observed from the conventional methods compared to the proposed method. The proposed method had ignorable bias and satisfactory coverage rates in the studied conditions. This study emphasizes the importance of using an appropriate weight constraint method in causal-formative indicator modeling.

Exploring relationships among appetitive traits, negative affect, and binge eating in adults with overweight or obesity

Binge eating (BE) is a significant public health concern due to its prevalence and impact on mental and physical health. While research has suggested both negative affect and appetitive traits are associated with BE, few studies have investigated these constructs concurrently. Structural equation modeling (SEM) evaluated relationships between negative affect, reward-related appetitive traits, and BE among 293 adults with overweight or obesity (OW/OB) seeking treatment for BE, overeating, and weight management (m age = 46.6; m body mass index[BMI] = 34.5; 81.2 % female; 20.1 % Latinx, 60.8 % White non-Latinx). BE was related to negative affect (β = 0.53; p < 0.01) and appetitive traits (β = 1.53; p < 0.001). Negative affect and appetitive traits were related to one another (r = 0.42; p < 0.001), and the full model accounted for 77 % of the variance in BE. In an exploratory follow-up analysis, multigroup SEM evaluated the above relationships in models stratified by sex. Exploratory findings demonstrated both negative affect and appetitive traits were related to BE across sex, particularly when examining BE cognitions and behaviors. However, relationships in men depended upon BE assessment tool. These findings highlight that both negative affect and appetitive traits are related to BE, and jointly may represent significant risk and maintenance factors, particularly in adults with OW/OB. Our findings also highlight the importance of future investigation of sex differences in BE and the potential impact of assessment method.

Spatiotemporal evolution of agricultural drought and its attribution under different climate zones and vegetation types in the Yellow River Basin of China

Ecological protection and high-quality development of the Yellow River Basin (YRB) are major national strategies in China. Agricultural drought (AD) is one of the most important stress factors of the ecological security of the YRB. Currently, there is a lack of exploration of the spatiotemporal evolution of AD in the YRB under different climatic zones and vegetation types, and the mechanisms by the driving factors influence AD remain unclear. The Temperature Vegetation Dryness Index (TVDI) for the YRB in China during 2000-2020 was calculated using Land Surface Temperature (LST) and the Normalized Difference Vegetation Index (NDVI). We analyzed the spatiotemporal evolution of AD from the perspective of upstream of the YRB (UYRB), midstream of the YRB (MYRB), and downstream of the YRB (DYRB), as well as different climate zones and vegetation types. The driving factors were selected based on the Pearson correlation analysis, Geographical detector, and Mantel test. Structural equation modeling (SEM) was employed to quantify the direct and indirect effects of the driving factors on AD in the YRB. We found a slowing trend of AD in the YRB, mainly in the Loess Plateau, which is distributed in UYRB and MYRB, but an increasing trend for AD in DYRB. Temperature, which is the most direct influential factor, has exacerbated AD in UYRB and MYRB. However, surface solar radiation (SSR) has the greatest constraining effect on DYRB. AD increased in arid and desert zones, while a decreasing trend is observed for other climatic zones and vegetation types. In arid and semiarid zones, human activities and SSR were the largest indirect factors exacerbating AD. In humid and subhumid zones, the largest indirect factor exacerbating AD was potential evapotranspiration (PET). Temperature is the most direct factor exacerbating AD in cropland and forest, while PET is the largest indirect factor exacerbating AD in grassland. This study elucidates the driving factors and mechanisms of AD in the YRB to provide scientific decision support for mitigating regional drought and promoting regional sustainable development.

A structural equation modeling approach using behavioral and neuroimaging markers in major depressive disorder

Major depressive disorder (MDD) has consistently proven to be a multifactorial and highly comorbid disease. Despite recent depression-related research demonstrating causalities between MDD-related factors and a small number of variables, including brain structural changes, a high-statistical power analysis of the various factors is yet to be conducted. We retrospectively analyzed data from 155 participants (84 healthy controls and 71 patients with MDD). We used magnetic resonance imaging and diffusion tensor imaging data, scales assessing childhood trauma, depression severity, cognitive dysfunction, impulsivity, and suicidal ideation. To simultaneously evaluate the causalities between multivariable, we implemented two types of MDD-specified structural equation models (SEM), the behavioral and neurobehavioral models. Behavioral SEM showed significant results in the MDD group: Comparative Fit Index [CFI] = 1.000, Root Mean Square Error of Approximation [RMSEA]) = 0.000), with a strong correlation in the scales for childhood trauma, depression severity, suicidal ideation, impulsivity, and cognitive dysfunction. Based on behavioral SEM, we established neurobehavioral models showing the best-fit in MDD, especially including the right cingulate cortex, central to the posterior corpus callosum, right putamen, pallidum, whole brainstem, and ventral diencephalon, including the thalamus (CFI >0.96, RMSEA <0.05). Our MDD-specific model revealed that the limbic-associated regions are strongly connected with childhood trauma rather than depression severity, and that they independently affect suicidal ideation and cognitive dysfunction. Furthermore, cognitive dysfunction could affect impulsivity.

Age effect on the shared etiology of glycemic traits and serum lipids: evidence from a Chinese twin study

PURPOSE

Diabetes and dyslipidemia are among the most common chronic diseases with increasing global disease burdens, and they frequently occur together. The study aimed to investigate differences in the heritability of glycemic traits and serum lipid indicators and differences in overlapping genetic and environmental influences between them across age groups.

METHODS

This study included 1189 twin pairs from the Chinese National Twin Registry and divided them into three groups: aged ≤ 40, 41-50, and > 50 years old. Univariate and bivariate structural equation models (SEMs) were conducted on glycemic indicators and serum lipid indicators, including blood glucose (GLU), glycated hemoglobin A1c (HbA1c), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), in the total sample and three age groups.

RESULTS

All phenotypes showed moderate to high heritability (0.37-0.64). The heritability of HbA1c demonstrated a downward trend with age (HbA1c: 0.50-0.79), while others remained relatively stable (GLU: 0.55-0.62, TC: 0.58-0.66, TG: 0.50-0.63, LDL-C: 0.24-0.58, HDL-C: 0.31-0.57). The bivariate SEMs demonstrated that GLU and HbA1c were correlated with each serum lipid indicator (0.10-0.17), except HDL-C. Except for HbA1c and LDL-C, as well as HbA1c and HDL-C, differences in genetic correlations underlying glycemic traits and serum lipids between age groups were observed, with the youngest group showing a significantly higher genetic correlation than the oldest group.

CONCLUSION

Across the whole adulthood, genetic influences were consistently important for GLU, TC, TG, LDL-C and HDL-C, and age may affect the shared genetic influences between glycemic traits and serum lipids. Further studies are needed to elucidate the role of age in the interactions of genes related to glycemic traits and serum lipids.

Temporal changes in factors associated with COVID-19 vaccine hesitancy among Chinese adults: Repeated nationally representative survey

Background

COVID-19 vaccine hesitancy has been cited as one of the main obstacles impacting vaccine coverage. However, factors that affect hesitancy may change over time. Understanding these evolving concerns and adapting strategies accordingly are crucial for effectively addressing vaccine hesitancy effectively and promoting public health. We aimed to explore the temporal changes in factors associated with COVID-19 VH during the COVID-19 pandemic and assess the dynamic evolution of VH.

Methods

In August 2022 and February 2023, repeated online surveys were undertaken to collect information from 5378 adults across four regions of China. Multiple linear regression models assessed the influencing factors of COVID-19 VH. The association between protective motive theory (PMT) (perceived severity, susceptibility, benefits, barriers, and self-efficacy) and VH was evaluated by structural equation modeling (SEM).

Results

Repeated measures showed that 573 (10.7%) and 1598 (29.7%) of the 5378 participants reported COVID-19 VH in the baseline and follow-up surveys, respectively. Educational levels, chronic disease, history of allergy, COVID-19 infection, and trust in medical staff and vaccine developers were positively associated with COVID-19 VH (P＜0.05). The application of SEM revealed that perceived severity, susceptibility, vaccination barriers, and self-efficacy in the PMT directly impacted on VH (P＜0.05). In addition, severity, susceptibility, benefits, and barriers had a significant direct effect on self-efficacy as β = 0.113, β = 0.070, β = 0.722, β = -0.516 respectively with P < 0.001.

Conclusion

The prevalence of COVID-19 VH was relatively low in the baseline survey and much higher in the follow-up survey, with a significant increase in hesitancy rates among mainland Chinese residents. Acknowledging the substantial impact on the shaping of COVID-19 VH, one must consider factors including perceived severity, susceptibility, vaccination barriers, and self-efficacy.

Pooling test statistics across multiply imputed datasets for nonnormal items

In structural equation modeling, when multiple imputation is used for handling missing data, model fit evaluation involves pooling likelihood-ratio test statistics across imputations. Under the normality assumption, the two most popular pooling approaches were proposed by Li et al. (Statistica Sinica, 1(1), 65-92, 1991) and Meng and Rubin (Biometrika, 79(1), 103-111, 1992). When the assumption of normality is violated, it is not clear how well these pooling approaches work with the test statistics generated from various robust estimators and multiple imputation methods. Jorgensen and colleagues (2021) implemented these pooling approaches in their R package semTools; however, no systematical evaluation has been conducted. In this simulation study, we examine the performance of these approaches in working with different imputation methods and robust estimators under nonnormality. We found that the naïve pooling approach based on Meng and Rubin (Biometrika, 79(1), 103-111, 1992; D3SN) worked the best when combining with the normal-theory-based imputation and either MLM or MLMV estimator.

Determining factors affecting Filipino consumers' behavioral intention to use cloud storage services: An extended technology acceptance model integrating valence framework

Cloud Storage (CS) is a service that digitally stores, remotely manages, backs up, and renders internet-accessible data. However, despite its known benefits compared to traditional storage devices, this service is not widely used in developing nations such as the Philippines. This study integrated the Valence Theoretical Framework into the Extended Technology Acceptance Model (ETAM) to evaluate the influence of twelve variables on Filipino consumers' behavioral intention (BI) toward adopting CS services. The data is gathered through an online survey. Structural Equation Modeling was employed to examine the responses of 431 cloud users, mainly students and working professionals. Results showed that Perceived Benefit and Perceived Usefulness were the strongest determinants of BI. The Job Relevance was also found to be a significant factor. Therefore, CS providers should find additional ways to make their offerings more beneficial for the daily tasks of students and working individuals. Furthermore, considering the substantial influence of Perceived Risk and Subjective Norms on BI, CS providers must strengthen their security measures to boost users' trust in their services. Consumers who receive excellent service are likely to give positive reviews, which can be helpful to individuals who might also be considering purchasing CS for their data. Although the focus of this study is CS services, this can also serve as a reference when analyzing the BI of consumers concerning the adoption of other novel technologies applied in various sectors, including education, e-commerce, healthcare, and more.

Concurrent factors associated with adherence to adjuvant endocrine therapy among women with non-metastatic breast cancer

PURPOSE

Adjuvant endocrine therapy (AET) reduces breast cancer morbidity and mortality, yet women often report suboptimal adherence. Though correlates of AET adherence are well-documented, few studies examine the relative importance of multi-level factors associated with adherence. The aim of this study was to identify factors most strongly associated with AET adherence in women with breast cancer.

METHODS

Between 10/2019 and 6/2021, women (N = 100) with non-metastatic, hormone receptor-positive breast cancer, taking AET who reported AET-related distress enrolled into a clinical trial. Participants completed baseline measures, including the Medication Adherence Rating Scale-5, sociodemographics, and validated measures of anxiety, depression, medication-taking self-efficacy, social support, and treatment satisfaction. We created a latent factor and tested associations between sociodemographic, medical, and psychosocial characteristics and adherence. Associated predictors (p < .10) were entered into a structural model, which was corroborated via multivariate regression modeling.

RESULTS

A four-indicator latent adherence factor demonstrated good model fit. Participants (Mage = 56.1 years, 91% White) who were unemployed (B = 0.27, SE = 0.13, p = .046) and reported greater treatment convenience (B = 0.01, SE = 0.01, p = .046) reported greater adherence. Scores of participants who reported greater medication-taking self-efficacy (p = .097) and social support (p = .062) approached better adherence. Greater medication-taking self-efficacy (B = 0.08, SE = 0.02, p < .001) and being unemployed (B = 0.28, SE = .14, p = .042) were most strongly associated with greater adherence, independent of other predictors. Multivariate modeling confirmed similar findings.

CONCLUSIONS

Medication-taking self-efficacy and employment status were associated with AET adherence above other related factors.

IMPLICATIONS FOR CANCER SURVIVORS

Enhancing patients' confidence in their ability to take AET for breast cancer may represent an important intervention target to boost adherence.

Predictable shifts in diversity and ecosystem function in phytoplankton and zooplankton communities along thermocline stratification intensity continua

Thermocline stratification is a global threat to water quality in drinking water reservoirs, though its underlying mechanisms are not clear. The impacts of thermocline stratification intensity on biodiversity-ecosystem relationships were assessed using phytoplankton and zooplankton indicators from four stages of stratification in Lake Qiandaohu. There were significant differences in biomass, species diversity, and resource use efficiency (RUEpp = phytoplankton biomass/total phosphorus) for phytoplankton between continuous stratification and mixing periods, but only in FDis and RaoQ diversity indices for zooplankton. Phytoplankton species diversity and RUE were higher in the formative and stable periods, while zooplankton species diversity and zooplankton biomass/phytoplankton biomass (RUEzp) were lower. When combining the data from the four periods, a negative linear pattern was found between phytoplankton Simpson's, functional dispersion (FDis), and Rao's Quadratic (RaoQ) diversity indices, and thermocline depth (TD). Only zooplankton FDis and RaoQ diversity indices were significantly positively related to TD. Phytoplankton RUE was significantly negatively related only to its Pielou's evenness (J) diversity, while zooplankton RUE was significantly negatively related to its J, FDis, and RaoQ diversity indices. The results of structural equation models (SEMs) showed that the R2 of RUE for phytoplankton was much higher than that for zooplankton. Thermocline stratification intensity exerted an indirect positive effect on phytoplankton RUE by affecting species diversity but had a negative effect on zooplankton RUE. These findings underscore the negative influence of thermocline stratification resulting in various biodiversity changes in freshwater ecosystems.

The distribution structure of medical and care resources based on regional characteristics throughout Japan in 2020

BACKGROUND

Given Japan's rapidly aging population, the Ministry of Health, Labour and Welfare's policy of reducing hospital beds and replacing medical care with nursing care requires the establishment of a coordinated system of medical and care services tailored to regional characteristics. To gain useful knowledge for the development of such a system, this study aimed to identify differences in the structure of the relationship between medical and care resources due to differences in regional characteristics.

METHODS

Initially, regional characteristics were used to group all 334 secondary medical areas (SMA) in Japan by principal component analysis. Subsequently, the related structure of the distribution of medical and care resources for each group were compared. For these　comparisons, first, the related structure of the distribution of medical and care resources nationwide was modeled using structural equation modeling. Secondly, multigroup analysis was conducted to investigate differences among the models across groups.

RESULTS

The nationwide SMAs were grouped largely based on urbanicity and middle-density regionality. The groups with high urbanicity and high middle-density regionality consisted of SMAs with a high and medium population density. By contrast, the low middle-density regionality group consisted of SMAs containing large cities with a high population density and depopulated areas with a low population density. The model of the related structure of the distribution of medical and care resources differed among these groups. In the non-urbanicity and middle-density regionality groups, nursing care abundance tended to increase acute care abundance. In addition, in all groups, nursing care abundance tended to increase long-term hospitalization care abundance and clinic care abundance (with beds).

CONCLUSIONS

The key finding of this study was that the government's objective of reducing hospital beds may not be achieved solely by expanding nursing homes. This is because many of the models did not show a tendency that higher nursing care abundance reduces the values of the factors which increase more hospital beds. This finding was particularly relevant in middle-density regionality groups. This finding suggests that the location of nursing homes should be monitored because of concerns about the oversupply of nursing homes and sprawl in those areas.

Cultural threads in writing mastery: a structural analysis of perfectionism, learning self-efficacy, and motivation as mediated by self-reflection in Chinese EFL learners

BACKGROUND

The study explores language acquisition in Chinese English as a Foreign Language (EFL) education, where English proficiency is crucial for global opportunities. As China gains prominence, the demand for English skills rises beyond communication to include academic and business success. The Chinese education system emphasizes proficient English writing for further education and professional achievement. This research investigates the complex linguistic context for EFL learners in China, analyzing the intersection of psychological factors, cultural nuances, varied pedagogy, and individual experiences.

METHODS

Structural Equation Modeling (SEM) is utilized for analysis, enabling the creation of a metric set to explore intangibles such as perfectionism, learning self-efficacy, motivation, study habits, cultural influences, and introspection. The research utilizes a diverse sample from multiple universities across different regions of China, incorporating demographic factors to encompass the varied characteristics within the EFL learner community.

RESULTS

Results reveal that perfectionism (β = 0.30, p < 0.001), learning self-efficacy (β = 0.25, p = 0.005), motivation (β = 0.35, p < 0.001), study habits (β = 0.20, p = 0.01), and self-reflection (β = 0.28, p < 0.001) significantly predict writing proficiency. Cultural effects (Beta = 0.15, p = 0.05) show a statistically significant, albeit minimal, impact. Mediation-moderation analysis underscores perfectionism as a mediator (Beta = 0.25, p = 0.005), emphasizing its influence on other predictors. Cultural factors act as moderators (Beta = 0.15, p = 0.01), shaping the link between predictors and writing skills. The combined mediation and moderation effects on writing proficiency are positively significant (Beta = 0.20, p = 0.02).

CONCLUSIONS

This study makes a significant theoretical contribution, enhancing existing models and providing practical insights for EFL educators and policymakers. Emphasizing the intricate relationship between psychological factors and cultural dynamics underscores the necessity for a sophisticated, culturally sensitive approach to language acquisition in Chinese EFL instruction. Beyond language skills, the research recognizes the importance of fostering a conducive environment that encourages personal development, socio-cultural awareness, and a holistic learning approach.

Analyzing Preceding factors affecting behavioral intention on communicational artificial intelligence as an educational tool

During the pandemic, artificial intelligence was employed and utilized by students around the globe. Students' conduct changed in a variety of ways when schooling returned to regular instruction. This study aimed to analyze the student's behavioral intention and actual academic use of communicational AI (CAI) as an educational tool. This study identified the variables by utilizing an integrated framework based on the Unified Theory of Acceptance and Use of Technology (UTAUT2) and self-determination theory. Through the use of an online survey and Structural Equation Modeling, data from 533 respondents were analyzed. The results showed that perceived relatedness has the most significant effect on the behavioral intention of students in using CAI as an educational tool, followed by perceived autonomy. It showed that students use CAI based on the objective and the possibility of increasing their productivity, rather than any other purpose in the education setting. Among the UTAUT2 domains, only facilitating conditions, habit, and performance expectancy provided a significant direct effect on behavioral intention and an indirect effect on actual academic use. Further implications were presented. Moreover, the methodology and framework of this study could be extended and applied to educational technology-related studies. Lastly, the outcome of this study may be considered in analyzing the behavioral intention of the students as the teaching-learning environment is still continuously expanding and developing.

Organizational characteristics of nursing practice environments related to registered nurses' professional autonomy and job satisfaction in two Finnish Magnet-aspiring hospitals: structural equation modeling study

BACKGROUND

Nurses are leaving their profession because of poor personal job satisfaction, heavy workload, and unfavorable work environments with low professional autonomy. Professional autonomy involves the possibility to influence one's work and have a sense of control - the ability to contribute to a workplace culture and influence how decisions are made. This study explores registered nurses' perceptions of the nursing practice environment, using the Nursing Work Index-Revised (NWI-R), and its relationships with professional autonomy and job satisfaction.

METHODS

A cross-sectional study along with instrument re-validation was conducted using a web-based survey for nurses in two Magnet-aspiring hospitals in Finland in September 2021 (n = 586). Structural equation modeling was used to find out the relationships of the NWI-R components with professional autonomy and job satisfaction.

RESULTS

Principal component analysis and confirmatory factor analysis supported seven components with 34 items. Collegial nurse-doctor relationships, organization's quality standards, and nursing involvement and expertise sharing (means of 3.23, 2.96, and 2.66, respectively) demonstrated a favorable nursing practice environment; professional nursing standards, nurse management and leadership, staffing and resource adequacy, and professional advancement (means of 2.38, 2.18, 2.15, and 2.13, respectively) demonstrated an unfavorable nursing practice environment. The presented model (RMSEA 0.068, CFI 0.987, TLI 0.946) indicated that nursing involvement and expertise sharing, organization's quality standards, nurse management and leadership, and collegial nurse-doctor relationships were related to professional autonomy. Nurse management and leadership, staffing and resource adequacy, and organization's quality standards were related to job satisfaction. Moreover, professional autonomy was related to job satisfaction.

CONCLUSION

Nurses' professional autonomy is important due to its relationship with job satisfaction. When factors that increase professional autonomy are taken into account and attention is paid to the promotion of autonomy, it is possible to improve nurses' job satisfaction. These issues cannot be solved at the unit level; investment is needed at the organizational and political levels. The results introduce nurses, managers, researchers, and stakeholders to improvements in the nursing practice environment toward an organizational culture where nurses may utilize their professional autonomy to its full potential.

Social victimization, default mode network connectivity, and psychotic-like experiences in adolescents

Social victimization (SV) and altered neural connectivity have been associated with each other and psychotic-like experiences (PLE). However, research has not directly examined the associations between these variables, which may speak to mechanisms of psychosis-risk. Here, we utilized two-year follow-up data from the Adolescent Brain Cognitive Development study to test whether SV increases PLE through two neural networks mediating socio-affective processes: the default mode (DMN) and salience networks (SAN). We find that a latent SV factor was significantly associated with PLE outcomes. Simultaneous mediation analyses indicated that the DMN partially mediated the SV-PLE association while the SAN did not. Further, multigroup testing found that while Black and Hispanic adolescents experienced SV differently than their White peers, the DMN similarly partially mediated the effect of SV on PLE for these racial groups. These cross-sectional results highlight the importance of SV and its potential impact on social cognitive neural networks for psychosis risk.

Assessing the interchangeability of linked scores in multivariable statistical analyses

PURPOSE

Using the lens of classical test theory, we examine a linkage's generalizability with respect to use in multivariable analyses, including multiple regression and structural equation modeling, rather than comparison of established subpopulations as is most common in the literature.

METHODS

To aid in this evaluation, we present a structural-equation-modeling based statistical method to examine the suitability of a given linkage for use cases involving continuous and categorical variables external to the linkage itself.

RESULTS

Using the PROMIS® Parent Proxy and Early Childhood Global Health measures, we show that, although a high correlation between the scores (here, r = .829) may imply a general suitability for linking, a more detailed investigation of content, measurement structure, and results of the proposed methodology reveal important differences between the measures which can compromise interchangeability in certain use cases.

CONCLUSION

In addition to the statistical quality of a linkage, users of linking methodology should also assess the question of whether the linkage is appropriate to apply to particular use cases of interest.

Access to healthcare among transgender women living with and without HIV in the United States: associations with gender minority stress and resilience factors

BACKGROUND

Transgender women (TW) experience significant inequities in healthcare access and health disparities compared to cisgender populations. Access to non-transition related healthcare is understudied among TW. We aimed to assess the association between access to care and gender minority stress and resilience factors among TW living with and without HIV in eastern and southern United States.

METHODS

This study was a cross-sectional analysis of baseline data drawn from a cohort of 1613 adult TW from the LITE Study. The cohort permitted participation through two modes: a site-based, technology-enhanced mode and an exclusively online (remote) mode. Exploratory and confirmatory factor analyses determined measurement models for gender minority stress, resilience, and healthcare access. Structural equation modeling was used to assess the relationships between these constructs. Models were evaluated within the overall sample and separately by mode and HIV status.

RESULTS

Higher levels of gender minority stress, as measured by anticipated discrimination and non-affirmation were associated with decreased access to healthcare. Among TW living with HIV, higher levels of anticipated discrimination, non-affirmation, and social support were associated with decreased healthcare access. Among TW living without HIV in the site-based mode, resilience was positively associated with positive healthcare experiences and inversely associated with barriers to healthcare access. Among TW living without HIV in the online mode, anticipated discrimination was associated with barriers to healthcare access; resilience was positively associated with positive healthcare experiences and inversely associated with barriers to healthcare access.

CONCLUSIONS

Gender minority stress was associated with increased barriers to healthcare access among TW in the US, regardless of HIV status. Resilience factors did not mediate this effect. Interventions aiming to increase healthcare access among TW can be aided by efforts to mitigate drivers of gender minority stress and improve patient experiences in healthcare facilities.

Trust in AI-augmented design: Applying structural equation modeling to AI-augmented design acceptance

With the emergence of Artificial Intelligence (AI) 2.0, computers are now equipped with new creative capabilities and are playing an increasingly significant role in design. The use of AI augmentation has the potential to enhance design performance, however, there is limited research on the acceptance of AI-augmented design. The research gap under consideration in this study is addressed by presenting an acceptance model designed for AI-augmented design. This model integrates a range of variables including perceived privacy risk, enjoyment, perceived value, perceived usefulness, perceived ease of use, perceived behavioral control, social influence, and behavioral intention. The proposed model was validated through a questionnaire survey of 249 designers in China. The results reveal that enjoyment, perceived value, perceived ease of use, perceived behavioral control, and social influence have a significant positive impact on users' intention to use AI-augmented design, while perceived privacy risk has a significant negative impact. Perceived value was found to mediate the relationship between enjoyment and behavioral intention, while perceived behavioral control play a mediation role in the relationship between social influence and behavioral intention. In conclusion, this study highlights the variables that influence the acceptance of AI-augmented design and provides valuable insights into the potential benefits and drawbacks of integrating AI technologies in design. The proposed acceptance model serves as a framework for future research in this area and can guide the development of more user-friendly and effective AI-augmented design tools and technologies.

An insight into tissue culture-induced variation origin shared between anther culture-derived triticale regenerants

BACKGROUND

The development of the plant in vitro techniques has brought about the variation identified in regenerants known as somaclonal or tissue culture-induced variation (TCIV). S-adenosyl-L-methionine (SAM), glutathione (GSH), low methylated pectins (LMP), and Cu(II) ions may be implicated in green plant regeneration efficiency (GPRE) and TCIV, according to studies in barley (Hordeum vulgare L.) and partially in triticale (× Triticosecale spp. Wittmack ex A. Camus 1927). Using structural equation models (SEM), these metabolites have been connected to the metabolic pathways (Krebs and Yang cycles, glycolysis, transsulfuration), but not for triticale. Using metabolomic and (epi)genetic data, the study sought to develop a triticale regeneration efficiency statistical model. The culture's induction medium was supplemented with various quantities of Cu(II) and Ag(I) ions for regeneration. The period of plant regeneration has also changed. The donor plant, anther-derived regenerants, and metAFLP were utilized to analyze TCIV concerning DNA in symmetric (CG, CHG) and asymmetric (CHH) sequence contexts. Attenuated Total Reflectance-Fourier Transfer Infrared (ATR-FTIR) spectroscopy was used to gather the metabolomic information on LMP, SAM, and GSH. To frame the data, a structural equation model was employed.

RESULTS

According to metAFLP analysis, the average sequence change in the CHH context was 8.65%, and 0.58% was de novo methylation. Absorbances of FTIR spectra in regions specific for LMP, SAM, and GSH were used as variables values introduced to the SEM model. The average number of green regenerants per 100 plated anthers was 2.55.

CONCLUSIONS

The amounts of pectin demethylation, SAM, de novo methylation, and GSH are connected in the model to explain GPRE. By altering the concentration of Cu(II) ions in the medium, which influences the amount of pectin, triticale's GPRE can be increased.

Community ambulation in older adults and people with OA - a model verification using Canadian Longitudinal Study on Aging (CLSA) data

BACKGROUND

There are health and well-being benefits of community ambulation; however, many older adults do not regularly walk outside of their home. Objectives were to estimate the associations between latent constructs related to community ambulation in older adults aged 65-85 (65+), and in adults with osteoarthritis (OA) aged 45-85.

METHODS

Secondary data analysis of the comprehensive baseline and maintaining contact questionnaire data from the Canadian Longitudinal Study of Aging (CLSA) was completed. Based on a previous model of community ambulation post-stroke, structural equation modeling (SEM) was used to develop measurement and structural models for two groups: older adults 65+ and people with OA. Multi-group SEM was conducted to test measurement invariance across sex and age groups. Measurement models were developed for the following latent factors: ambulation (frequency of walking outside/week, hours walked/day, ability to walk without help, frequency and aids used in different settings); health perceptions (general health, pain frequency/intensity); timed functional mobility (gait speed, timed up-and-go, sit-to-stand, balance). Variables of depression, falls, age, sex, and fear of walking alone at night were covariates in the structural models.

RESULTS

Data were used from 11,619 individuals in the 65+ group (mean age 73 years ±6, 49% female) and 5546 individuals in the OA group (mean age 67 ± 10, 60% female). The final 65+ model had a close fit with RMSEA (90% CI) = 0.018 (0.017, 0.019), CFI = 0.91, SRMR = 0.09. For the OA group, RMSEA (90% CI) = 0.021 (0.020, 0.023), CFI = 0.92, SRMR = 0.07. Health perceptions and timed functional mobility had a positive association with ambulation. Depression was associated with ambulation through negative associations with health perceptions and timed functional mobility. Multi-group SEM results reveal the measurement model was retained for males and females in the 65+ group, for males and females and for age groups (65+, < 65) in the OA group.

CONCLUSIONS

The community ambulation model post-stroke was verified with adults aged 65+ and for those with OA. The models of community ambulation can be used to frame and conceptualize community ambulation research and clinical interventions.

Association of health behaviors with function and health-related quality of life among patients with Parkinson's disease

BACKGROUND

Current evidence on chronic conditions favors promotion of health behaviors as a mean to positively impact health outcomes. In Parkinson's disease, performing health behaviors is indicated as a means to fight the long-lasting burden of the disease. Understanding actual engagement in health behaviors and patient activation and their association to function and health-related quality of life is therefore important. Our objectives were, among people with Parkinson's disease: (1) to characterize health behaviors including utilization of rehabilitative treatments, physical activity, and patient activation levels, and (2) to test the associations between these health behaviors and health outcomes.

METHODS

A cross-sectional study of 88 people with Parkinson's disease (age 66.84 ± 8.8) was conducted. Participants answered questionnaires measuring health behaviors including utilization of health professions treatments, physical activity, patient activation, and health outcomes consisting of function and health-related quality of life. Linear regression models were conducted to test associations between measured health behaviors, function and health-related quality of life.

RESULTS

Participants rarely engage in rehabilitative treatments, but showed high levels of patient activation. Controlled by demographics and disease severity, physical activity and patient activation were associated with function (b = 0.41, p < .001; b = 0.2, p = .02, respectively) and physical activity but not patient activation, which was associated with health-related quality of life (b = 0.19, p = .03). There was also interaction effects of physical activity and non-motor symptoms, and physical activity and motor symptoms on health-related quality of life (b = 0.19, p = .02 and b = - 0.22, p = .01, respectively).

CONCLUSIONS

In respect to their potential health-related benefits for people with Parkinson's disease, health professionals' treatments are underutilized. Findings supported the importance of health behaviors for maintaining function and health-related quality of life among people with Parkinson's disease. They also show a differential contribution of motor and non-motor symptoms to the association between physical activity and quality of life. It is suggested that policy makers encourage opportunities for physical activity tailored for people with Parkinson's disease and adopt a proactive stance towards enhancing awareness and use of rehabilitation services. Trial registration NCT05211700, ClinicalTrials.gov ID: NCT05211700 first release 12/30/2021, https://classic.

CLINICALTRIALS

gov/ct2/show/NCT05211700.

Does a decade of soil organic fertilization promote copper and zinc phytoavailability? Evidence from a laboratory biotest with field-collected soil samples

Despite chronic contamination, long-term organic fertilization tends to decrease copper (Cu) and zinc (Zn) availability in agricultural soils. Root activities of crop plants can also induce substantial changes in rhizosphere chemistry and consequently in the Cu and Zn availability in the rhizosphere. The balance between these two drivers and the overall effect of organic fertilization on Cu and Zn bioavailability to plants (i.e., phytoavailability) remains a matter of debate. We assessed the effect of a decade of agronomically realistic organic fertilization on Cu and Zn availability in the rhizosphere and their phytoavailability. Using a laboratory biotest, Festuca arundinacea was exposed to 34 soil samples collected from three agricultural field trials that had received no, mineral, or organic fertilization for a decade. Dissolved organic matter (DOM) properties (i.e., concentration, aromaticity, and binding properties toward Cu), pH, and Cu and Zn availability (i.e., total dissolved concentration and free ionic activity) were determined in the rhizosphere solutions. Cu and Zn phytoavailability was measured as the plant uptake flux. Contrary to bulk soils, organic fertilization induced very few changes in the chemistry and Cu and Zn availability in the rhizosphere solutions compared to no and mineral fertilization. Consistently, Cu and Zn phytoavailability did not increase with organic fertilization, but it was mostly driven by soil properties rather than by fertilization. Despite increasing soil Cu and Zn contamination, a decade of soil organic fertilization did not increase Cu and Zn phytoavailability, presumably due to the root-mediated levelling of Cu and Zn availability in the rhizosphere.

The mediating role of neighborhood social cohesion and trust in the relationship between childhood material hardship and adolescent depression

OBJECTIVE

The purpose of this study is to examine the association between childhood material hardship and adolescent depression and how the relationship is mediated by neighborhood social cohesion and trust. Previous studies on childhood material hardship and adolescent depression have consistently pointed to the importance of social and environmental contexts in explaining health inequalities among children in socially disadvantaged families. However, little is known about the extent to which neighborhood social context contributes to increasing or decreasing the strength of the association between childhood material hardship and adolescent depression.

METHOD

Using data from the Future of Families and Child Wellbeing Study (FFCWS) waves 3 and 6, this study conducted Structural Equation Modeling (SEM) analysis to examine whether levels of neighborhood social cohesion and trust mediates the association between childhood material hardship and adolescent depression. The study sample consisted of 2,096 children at age 3 and 15.

RESULTS

Findings from the SEM analysis suggest that childhood material hardship is linked with higher levels of adolescent depression and this pathway is partially mediated by neighborhood social cohesion and trust.

DISCUSSION

Results suggest that neighborhood conditions played a role in mediating the association between childhood material hardship and adolescent depression. The implications of the findings are discussed in relation to policy and practice.

Mental Health During Early Adolescence and Later Cardiometabolic Risk: A Prospective Study of US Latinx Youth

PURPOSE

Rising rates of cardiometabolic risk and mental health problems are serious public health concerns for US adolescents, particularly those of Latinx origin. This research examines how Latinx youth's internalizing symptoms during early adolescence are related to sleep problems, overweight/obesity, sedentary behavior, physical activity, healthy diet, and hypertension or diabetes risk during middle and late adolescence.

METHODS

Participants included 547 adolescents listed as "Hispanic" on 2017-18 middle school enrollment lists in a suburban Atlanta, GA school district. Survey data collected at baseline (2018) and four years later (2022) were analyzed using Structural Equation Model. Path estimates from baseline internalizing symptoms to later health behaviors and physical health outcomes adjusted for demographics, the follow-up measure of internalizing symptoms, and correlations among outcome variables. Missing data were handled using Full Information Maximum Likelihood.

RESULTS

At baseline, the 244 (44.6%) male and 303 (55.4%) female participants had a mean (standard deviation) age in years of 13.31 (0.97). Early adolescent internalizing symptoms were associated positively with later sleep problems (ß = 0.36 [95% confidence interval (CI), 0.24-0.48]), overweight/obesity (adjusted odds ratio, 2.57; 95% CI, 1.29-5.15), sedentary behavior (ß = 0.19 [95% CI, 0.09-0.30]), and internalizing symptoms (ß = 0.48 [95% CI, 0.39-0.56]) and inversely with later physical activity (ß = -0.16 [95% CI, -0.27 to -0.05]) and a healthy diet (ß = -0.21 [95% CI, -0.32 to -0.09]).

DISCUSSION

Latinx youth's internalizing symptoms during early adolescence not only track into later adolescence, but they also relate to health behaviors and outcomes underlying cardiometabolic risk during middle and late adolescence.

Exploring the intentional unsafe behavior of workers in prefabricated construction based on structural equation modeling

Compared with traditional onsite construction, prefabricated construction has a more complex working environment, resulting in more safety risks. While cognitive failure has been identified as a primary cause of intentional unsafe behaviors, there remains a lack of knowledge on the formation mechanism underlying intentional unsafe behaviors among workers in precast construction. Using the Theory of Planned Behavior and the risk preference variable, this study constructs a theoretical model for intentional unsafe behaviors of precast construction workers. Data related to precast construction and safety management activities is collected from 208 frontline workers. Structural Equation Modeling is used to test and modify the theoretical model in order to identify the formation mechanism and pathway underlying intentional unsafe behaviors. The findings show that: (1) workers' perceptual behavior control, behavior and attitude, risk preference, and subjective norms influence their intention to engage in unsafe behavior and subsequently lead to intentional unsafe behavior; (2) the effect of personal risk preference on intentional unsafe behaviors is significant, contributing 7.71% to overall intentional unsafe behavior; and (3) the effects of the observed variables are more evident than the initial theoretical model. The most prominent of these are the effects of task intensity (IBC1), safety equipment (IBC2), worker behavior (IOW1), historical behavior (IBC3), and behavioral belief (BAA3). Finally, comprehensive measures to control the intentional unsafe behaviors of precast construction workers are recommended. The results of this study are useful for reducing the occurrence of intentional unsafe behaviors by workers and reducing the incidence of accidents in a complex manufacturing-oriented construction environment.

Spatial dynamics and risk assessment of phosphorus in the river sediment continuum (Qinhuai River basin, China)

This study investigated the concentration and fractionation of phosphorus (P) using sequential P extraction and their influencing factors by introducing the PLS-SEM model (partial least squares structural equation model) along this continuum from the Qinhuai River. The results showed that the average concentrations of inorganic P (IP) occurred in the following order: urban sediment (1499.1 mg/kg) > suburban sediment (846.1-911.9 mg/kg) > rural sediment (661.1 mg/kg) > natural sediment (179.9 mg/kg), and makes up to 53.9-87.1% of total P (TP). The same as the pattern of IP, OP nearly increased dramatically with increasing the urbanization gradient. This spatial heterogenicity of P along a river was attributed mainly to land use patterns and environmental factors (relative contribution affecting the P fractions: sediment nutrients > metals > grain size). In addition, the highest values of TP (2876.5 mg/kg), BAP (biologically active P, avg, 675.7 mg/kg), and PPI (P pollution index, ≥ 2.0) were found in urban sediments among four regions, indicating a higher environmental risk of P release, which may increase the risk of eutrophication in overlying water bodies. Collectively, this work improves the understanding of the spatial dynamics of P in the natural-rural-urban river sediment continuum, highlights the need to control P pollution in urban sediments, and provides a scientific basis for the future usage and disposal of P in sediments.

The Influence of Education and Occupation Type on Birth Cohort Differences in Cognitive Function of Mexican Older Adults

OBJECTIVES

Mexico's population aging is occurring in the context of social changes such as increased educational attainment and occupational shifts from agriculture to service and industry. The current study compares cognitive function between two birth cohorts of Mexican adults aged 60-76 to determine if population-level changes in education and occupation type contribute to cohort differences in cognitive function.

METHODS

We used the Mexican Health and Aging Study to examine adults aged 60-76 in 2001 (men: 2,309; women: 2,761) and 2018 (men: 2,842; women: 3,825). Global cognition was calculated from five measures. Five main lifetime occupation types were created: no main job; agriculture; service; professional; and industrial. Ordinary least squares regression and structural equation models (SEM) were used to examine cohort differences in cognitive functioning.

RESULTS

Ordinary least squares models that adjusted for age, community size, and marital status indicated that men and women had higher global cognition in 2018 than 2001 (men: b = 0.44, p < .01; women: b = 0.54, p < .01). These differences were reduced after adjusting for education and occupation type (men: b = 0.27, p < .01; women: b = 0.37, p < .01). Results from SEM indicated that the indirect effects of education on cognitive functioning were larger than occupation type for men (education: b = 0.18, p < .05; occupation: b = 0.001, p = .91) and women (education: b = 0.18, p < .05; occupation: b = 0.002, p = .22).

DISCUSSION

Cognitive functioning is higher among more recent birth cohorts of older adults in Mexico. These cohort differences are partially mediated by education but not main lifetime occupation. Additional factors may contribute to cohort differences in cognitive function for older adults in Mexico.

Extending the theory of planned behavior to examine the role of meat-eater identity: The case of dry-aged beef

Dry-aged beef provides superior qualities and a unique taste experience due to its exceptional sensory attributes, including tenderness, juiciness, and flavor, compared to traditional beef. Our study focused on the factors that impact consumers' intention to consume and willingness to pay for dry-aged beef. We implemented an extended version of the Theory of Planned Behavior (TPB) model that contains a measure of meat-eater identity to analyze the intention to consume and the willingness to pay a premium for dry-aged beef steak that has undergone 21-30 days of aging. An online survey was conducted with a stratified sample of Italian respondents (n = 944). The data were analyzed using partial least squares structural equation modeling (PLS-SEM). The TPB's effectiveness was enhanced by adding the meat-eater identity construct to the model. Specifically, it was found that the participants' meat-eater identity significantly influenced their intention to consume. The results also revealed that the most critical impact of identity comes from the mediated influence of attitudes, subjective norms, and perceived behavioral control. Finally, the intention to consume strongly influenced the willingness to pay for a dry-aged beef steak.

Structural equation modeling for associated factors with patient safety behaviors among nursing interns: A cross-sectional study based on the capability opportunity motivation-behavior model

BACKGROUND

Nursing interns are one of the most crucial providers of nursing services. Their safety behaviors are closely associated with adverse events. Therefore, it is vital to explore the factors influencing nursing intern safety behavior to improve patient safety.

OBJECTIVE

To evaluate patient safety behavior among nursing interns and explore latent influencing mechanisms based on the capability opportunity motivation-behavior (COMB) model.

DESIGN

A cross-sectional study SETTINGS AND PARTICIPANTS: The participants were 422 nursing interns recruited through convenience sampling from a comprehensive teaching hospital.

METHODS

Data on general information, nursing interns' patient safety behavior, metacognitive ability, clinical internship environment, and moral sensitivity were collected. Nursing interns' patient safety behavior was described with means and standard deviations. The independent sample t-test, ANOVA, Pearson's correlation, and SEM were used to determine contributing factors to nursing interns' patient safety behavior.

RESULTS

The mean total score for patient safety behavior was 53.08 ± 6.22. The results indicated that metacognitive ability not only directly affects the patient safety behavior of nursing interns (β = 0.554, P < 0.001, 95 % CI = [0.446, 0.637]) but indirectly affects interns' safety behavior through professional identity (β = 0.009, P = 0.031, 95 % CI = [0.001, 0.019]). The clinical internship environment also has both direct (β = 0.258, P = 0.001, 95 % CI = [0.166, 0.349]) and indirect (β = 0.007, P = 0.029, 95 % CI = [0.001, 0.015]) effects on the patient safety behavior of nursing interns.

CONCLUSION

There are some specific areas where nursing interns' safety behaviors need to be improved. This study reveals that strong metacognitive ability and a clinical internship environment with rich opportunities might be essential for the development of patient safety behaviors. To promote nursing interns' patient safety behaviors, clinical teachers could use reflective teaching methods and provide a supportive clinical environment to nurture nursing interns' professional identities and patient safety behaviors.

Validation of the Chinese version of academic goals orientation questionnaire in nursing student: a study based on SEM and IRT multidimensional models

OBJECTIVE

To translate the Academic Goals Orientation Questionnaire (AGOQ) into Chinese and to determine the validity and reliability of the (AGOQ) in Chinese nursing students based on SEM and IRT multidimensional models.

METHODS

The participants were 654 nursing students with an age range of 17-26 years (mean age 21.61 ± 1.73 years). The psychometric properties of AGOQ were investigated based on a dual analytical perspective of structural equation modeling (SEM) and item response theory (IRT).

RESULTS

The Cronbach's α value of the questionnaire is 0.895. A four-factor model was obtained by exploratory factor analysis, which explained the variance of 71.892%. With confirmatory factor analysis, a new four-factors model was built and showed an acceptable goodness-of-fit, chi-square/degree of freedom (CMIN/DF) = 4.008, goodness of fit index (GFI) = 0.932, adjusted goodness of fit index (AGFI) = 0.905, comparative fit index (CFI) = 0.952, incremental fit index (IFI) = 0.952, Tucker Lewis index (TLI) = 0.941. In the analysis part of IRT, according to the comparison between Akek's information criterion (AIC) and Bayesian information criterion (BIC), we choose the Graded Response Model (GRM) for analysis. The results show that the difficulty value is monotonically increasing, and the discrimination of all items is greater than 0.19, which shows that 16 items can be retained.

CONCLUSIONS

This study tested the psychometric characteristics of AGOQ of nursing students in China. The results confirmed that the Chinese version of AGOQ has good psychometric characteristics and can be used to measure the academic goal orientation of nursing students in China.

What makes nurses flourish at work? How the perceived clinical work environment relates to nurse motivation and well-being: A cross-sectional study

BACKGROUND

Literature shows that the work environment is a main determinant of nurses' well-being and psychological strain; yet, the (psychological) mechanisms underlying this relationship remain understudied.

OBJECTIVE

This study explored the underlying (psychological) mechanisms (why) and boundary conditions (when) by which characteristics present in the clinical work environment influence nurses' well-being. We investigated the mediating role of intrinsic motivation in the relationship of job demands and job resources with burnout vs. work engagement. In addition, we examined if job resources strengthen the relationship of job demands with intrinsic motivation and burnout.

DESIGN

A cross-sectional survey study.

SETTING(S)

General acute care hospitals in Belgium (n = 14).

PARTICIPANTS

Direct care nurses (n = 1729).

METHODS

Data were collected by means of online questionnaires between October 2020 and July 2021. Study variables included burnout, work engagement, intrinsic motivation and a set of different job demands (workload, role conflicts, emotional demands, red tape) and job resources (performance feedback, autonomy, skill use, opportunity for growth, and value congruence). All variables were obtained using self-report measures. The central hypotheses were tested using structural equation modeling.

RESULTS

Job resources appeared to be a crucial factor for nurses' health showing positive associations with work motivation (β = 0.513) and work engagement (β = 0.462) and negative associations with burnout (β = -0.216). Job demands remained an essential factor that harms psychological health and is associated with increased burnout (β = 0.489). Our results confirmed that intrinsic motivation mediated the relationship of job resources with work engagement (β = 0.170) and burnout (β = -0.135). In addition, job resources moderated the relationship of job demands with burnout (β = -0.039). Against our expectations, we found no associations between job demands and intrinsic motivation or a moderation effect of job resources on the respective relationship.

CONCLUSIONS

A highly demanding work environment can be a source of significant stress which may put nurses' health at severe risk. Nurses who perceive sufficient job resources such as feedback, autonomy and opportunities for growth and development, are likely to feel intrinsically motivated at work. In addition, it will foster their work engagement and prevent them from burning out, particularly when job demands are high.

REGISTRATION

The study described herein is funded under the European Union's Horizon 2020 Research and Innovation program from 2020 to 2023 (Grant Agreement 848031). The protocol of Magnet4Europe is registered in the ISRCTN registry (ISRCTN10196901).

TWEETABLE ABSTRACT

Providing nurses with sufficient resources will not only increase their motivation and engagement at work but also reduce their feelings of burnout.

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 to Schistocephalus solidus infection in freshwater threespine stickleback (Gasterosteus aculeatus) has collateral effects on their locomotion. 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. We quantified the locomotor effects of the fibrosis immune response in the absence of parasites to investigate whether there are incidental costs of fibrosis that could help explain why some fish forego this effective defense. To do this, we induced fibrosis in stickleback and then tested their C-start escape performance. Additionally, we measured 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 revealed 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.

Using structural equation modelling to examine the relationship between place identity, sense of community, and environmental attitude

This study aimed to examine the association between place identity, sense of community, and environmental attitude. Within the theoretical framework, a connection has been identified among the variables of place identity, sense of community, and environmental attitude. However, the experimental analysis of this connection remains limited, with just a few research providing an explanation for the relationship between these three concepts. In this context, 121 inhabitants of Kültür neighborhood (Duzce City) were interviewed verbally. Structural equation modeling (SEM) was used to learn the relationship between these concepts.SEM is a statistical technique utilized in the social sciences to determine relationships between latent variables. To achieve this, oral interview data went through a reliability test using Statistical Package for the Social Sciences SPSS. Subsequently, confirmatory and regression analyses were conducted using LISREL to modify the model. Ultimately, the fit indices of the proposed model were assessed within the allowed range of fit values. The findings are significant in that they empirically highlight the importance of developing environmental and social policies to strengthen place identity and sense of community in order to improve environmental attitudes. As a result, it has been found that developing environmental awareness and consciousness is achievable through the bond and meaning that the community creates both within itself and with its place.•The theoretical relationship presented in the literature was evaluated experimentally using this method.•Data from oral interviews were analyzed using SPSS and LISREL softwares.

An integrated methodology for green human resource management in construction industry

Today, by increasing public awareness about environmental issues and pressures from governments and other stakeholders, companies have dealt with environmental challenges more than ever. This paper focuses on environmentally sustainable performance using an integrated methodology based on meta-synthesis, Delphi, and structural equation modeling (SEM) techniques which are utilized in different phases. In the first phase, an in-depth review of green human resources management (GHRM) literature is conducted based on the meta-synthesis method, and as a result, 38 codes are extracted. Next, to adapt and customize the codes with the nature of the construction industry, 2 rounds of Delphi method are implemented to extract the expert judgment from a panel of 15 industry professionals, resulting in 21 codes in 7 categories. To validate the developed methodology, a dataset from 33 Iranian construction companies are collected along with 15 factors in 5 categories determined using SEM. The findings reveal that among 9 main GHRM components extracted from the literature, just 5 components including green recruitment and selection, green performance management, green-reward, green-based employee empowerment, and green training have significant and positive relationships with GHRM. Finally, managerial insights, limitations, and future research directions are discussed.

Developmental factors associated with inappropriate coping strategies among sexual aggressors of children

BACKGROUND

Many studies in the field of sexual offending focus on the presence of inadequate coping strategies prior to sexual offending, and the role these strategies play in the sequence of the offense. However, little is known about the development of strategies-such as substance abuse and, especially, deviant sexual fantasies-to manage daily difficulties.

OBJECTIVE

To better understand the antecedents of the development of inadequate coping strategies, we conducted a series of structural equation modeling (SEM) analyses.

PARTICIPANTS AND SETTINGS

Based on 274 sexual aggressors of children, these analyses were based on components of Maniglio (2011a) theoretical model, in which victimization before the age of 18 leads to the development of psychological problems and, ultimately, the reliance on deviant sexual fantasies as a coping strategy.

METHODS

Two models were created through exploratory factorial analysis: the first model comprised 19 manifest variables, while the second model consisted of 15 manifest variables. All the retained variables were related to Maniglio's (2011a) hypothesis.

RESULTS

The analyses not only confirm Maniglio's hypothesis but also produced two statistically significant models (RMSEA = 0.069, CFI = 0.93 and TLI = 0.92 for Model 1 & RMSEA = 0.074, CFI = 0.93 and TLI = 0.91 for Model 2) composed of three indirect trajectories and one direct trajectory on the one hand, and four indirect trajectories and one direct trajectory on the other hand.

CONCLUSIONS

These results are consistent with those of studies that have highlighted the heterogeneity of sexual aggressors of children.

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.