People who share encounters with racism are silenced online by humans and machines, but a guideline-reframing intervention holds promise.

Are members of marginalized communities silenced on social media when they share personal experiences of racism? Here, we investigate the role of algorithms, humans, and platform guidelines in suppressing disclosures of racial discrimination. In a field study of actual posts from a neighborhood-based social media platform, we find that when users talk about their experiences as targets of racism, their posts are disproportionately flagged for removal as toxic by five widely used moderation algorithms from major online platforms, including the most recent large language models. We show that human users disproportionately flag these disclosures for removal as well. Next, in a follow-up experiment, we demonstrate that merely witnessing such suppression negatively influences how Black Americans view the community and their place in it. Finally, to address these challenges to equity and inclusion in online spaces, we introduce a mitigation strategy: a guideline-reframing intervention that is effective at reducing silencing behavior across the political spectrum.

The Effects of Age and Treatment Intensity on Behavioral Target Mastery With Applied Behavior Analysis (ABA) Intervention Using Causal Moderation Models.

Introduction Applied behavior analysis (ABA) is a therapy that focuses on improving specific behaviors using positive and negative reinforcement through antecedents, behaviors, and consequences, particularly in individuals with autism and other developmental disorders. It uses the principles of learning theory to bring about meaningful and positive changes in behavior. In ABA treatment, intensity refers to the amount and frequency of therapy an individual receives. This includes weekly hours, session trials, and overall duration. Intensive treatment involves more hours and trials tailored to individual needs and responses. Younger individuals, particularly those with autism, often receive more intensive therapy because early intervention leads to better outcomes. Programs may recommend 25-40 hours per week for young children. As children age, therapy may become less intensive, focusing on specific skills. The study explores how age and treatment intensity affect the mastery of behavioral targets in ABA interventions. Materials and methods This study involved 100 participants (89 children, four adults, and seven instances where the individuals' ages were not recorded due to random data entry errors (MCAR)) who received ABA treatment over three months. The treatments included functional analysis, discrete trials, and mass and naturalistic training. Data on the mastery of target behaviors were collected using the Catalyst software (New York, New York). The primary outcome was the percentage of mastered behavioral targets, indicating the effectiveness of the ABA treatment. Several predictors were examined, including the participant's age and treatment intensity variables, such as the average number of trials and teaching days to achieve behavioral mastery. The interaction effects between age and these treatment intensity variables were analyzed. The study used descriptive and inferential statistics to explore these interactions, including correlational and multiple regression analyses with causal moderator modeling. Results In Model 1, a baseline multiple regression analysis showed that average teaching days significantly predict the percentage of targets mastered. However, its limited explanatory power suggests other variables also play a role. Model 2 introduced interaction effects using causal models, revealing that age moderates the relationship between treatment variables and behavioral outcomes. This model provided a more nuanced understanding but still had room for improvement. Model 3 further refined the approach, achieving higher R-values and lower standard error. It highlighted age's significant role in modifying the impact of teaching days on mastery. This model's superior performance emphasizes the importance of considering age as a moderating factor in ABA interventions, leading to more effective and personalized behavior therapy. Conclusions This study significantly enhances our understanding of the complex interactions between age and treatment intensity within ABA interventions. Practitioners and researchers can develop more tailored and effective therapeutic strategies by identifying and leveraging these interactions. This approach optimizes the treatment process and ensures that interventions are personalized to meet the unique needs of each individual. Ultimately, this leads to more successful outcomes in behavioral therapy, fostering improved adaptive behaviors and overall development.

Relations between perceived social support and prosocial behavior among Chinese college students during online learning: Testing mediation and moderation models of meaning in life.

Base the protective role of perceived social support and meaning in life, the function of meaning in life as a mediator and moderator of perceived social support and prosocial behavior among Chinese college students enrolled in online learning was examined in this study. This survey was completed by 459 college students in total (Mean age = 19.65, SD = 1.21). The results shown that Chinese college students' perceived social support and prosocial behavior during online learning were significant lower than normal offline learning, but meaning in life was no significant difference. Perceived social support, prosocial behavior and meaning in life were all positive correlated with each other. The relationship between perceived social support and prosocial behavior was mediated and moderated by meaning in life. These findings enrich the research on prosocial behavior among college students by examining possible pathways linking factors associated to prosocial behavior during online learning. The findings suggest the need to promote prosocial behavior development through cultivate perceived social support and meaning in life among college students.

Patients with worse disability respond best to cognitive functional therapy for chronic low back pain: a pre-planned secondary analysis of a randomised trial.

QUESTION: Do five baseline moderators identify patients with chronic low back pain who respond best to cognitive functional therapy (CFT) when compared with usual care? DESIGN: Secondary analysis of the RESTORE randomised controlled trial. PARTICIPANTS: A total of 492 adults with low back pain for > 3 months with at least moderate pain-related activity limitation. INTERVENTION: Participants were allocated to CFT alone or CFT plus biofeedback; these two groups were combined for this secondary analysis. The control group was usual care. OUTCOME MEASURES: The outcome was activity limitation measured using the Roland Morris Disability Questionnaire (RMDQ) at 3, 6, 13, 26, 40 and 52 weeks. Investigated effect modifiers were baseline measures of activity limitation, cognitive flexibility, pain intensity, self-efficacy and catastrophising. RESULTS: Baseline levels of activity limitation and, potentially, cognitive flexibility were associated with different effects of CFT treatment, while pain intensity, self-efficacy and catastrophising were not. Patients who had higher baseline activity limitation had greater treatment effects at 13 and 52 weeks. A person with a baseline RMDQ score of 18 (90th percentile) would on average be 6.1 (95% CI 4.8 to 7.4) points better at 13 weeks if they received CFT compared with usual care. However, a person with a baseline score of 7 (10th percentile) would on average be 3.6 (95% CI 2.6 to 4.6) points better at 13 weeks. CONCLUSION: The finding that CFT is most effective among patients who are most disabled and incur the greatest burden strongly suggests that CFT should be considered as a treatment for this group of patients. REGISTRATION: ACTRN12618001396213.

Socioeconomic Moderators of the Association Between Delayed Breastfeeding Initiation and Place of Delivery: Cross-Sectional Study.

BACKGROUND: Breastfeeding is a crucial and irreplaceable method of feeding infants. Despite the well-established advantages of early breastfeeding initiation, its progress remains constrained. Over half of Indian mothers witness delayed breastfeeding initiation. Various factors have been implicated to influence breastfeeding initiation, with institutional deliveries emerging as a crucial factor among them. OBJECTIVE: We tested the hypothesized association between institutional delivery and initiation delays and identified how various socioeconomic variables moderate (weaken, strengthen, or reverse) the association between breastfeeding initiation delays and place of delivery. METHODS: This cross-sectional study analyses data of 106,569 breastfeeding mothers from the NFHS-5 (National Family Health Survey, 2019-21). Missing data were managed by using a complete case analysis approach. The outcome variable was the timing of breastfeeding initiation for the most recent child, with the place of delivery being the explanatory variable. Socioeconomic factors including age, education level, marital status, place of residence, and wealth index were considered moderating variables. Logistic regression-based moderation analysis explored how these variables influence the relationship between breastfeeding initiation delays and place of delivery. Separate binary logistic regression models analyzed the effect of each moderating variable. Statistical analysis was conducted using IBM SPSS Statistics 26. RESULTS: The highest occurrence of delayed breastfeeding initiation was observed among mothers aged ≥36 years (58.3%), lacking formal education (60.9%), belonging to lower wealth groups (58.1%), residing in rural areas (57.4%), and having home births (64.1%). Results confirmed the primary hypothesis that institutional delivery significantly and negatively affects delayed breastfeeding initiation (odds ratio [OR] 0.705, 95% CI 0.676-0.735, P<.001). Age as a moderating variable significantly affected this association (adjusted OR [aOR] 0.757, 95% CI 0.696-1.307, P=.02 for the 15-25 age group). Notably, education level (aOR 0.616, 95% CI 0.429-1.930, P=.005 for no education and aOR 0.510, 95% CI 0.429-1.772, P=.04 for primary education) and poor wealth index (aOR 0.672, 95% CI 0.528-1.432, P=.004) as moderating factors significantly strengthened the negative effect of institutional delivery on delayed initiation. Poor mothers and those without education or a lower level of education (primary) when delivering the child at the health institution further reduced the chances of witnessing delayed initiation. CONCLUSIONS: Institutional delivery significantly lowers the likelihood of delayed breastfeeding initiation, and this negative effect is significantly strengthened when uneducated women or lesser-educated women and those with lower wealth deliver their children at the institutional facilities, underscoring the significance of these moderating factors. Developing strategies targeting these socioeconomic moderating factors is crucial. Tailored awareness programs crafted to address the needs of uneducated mothers from economically disadvantaged backgrounds can enhance coverage. Outreach initiatives aimed at promoting health care service use during pregnancy and delivery, as well as raising awareness about breastfeeding practices, are warranted for the adoption and implementation of early breastfeeding initiation.

Role of Parenting Status in the Relationship Between Maternal Depression and Infant-Mother Attachment: A Longitudinal Cohort Study in China.

This study in China aimed to explore the impact of maternal depression on infant-mother attachment and whether parenting status moderated this relationship. Women underwent depression assessments at seven perinatal time points: ≤12, 17, 21, 31, and 37 weeks of pregnancy, as well as 1 and 6 weeks postpartum. Those completing at least three times assessments, along with their infants, were invited for infant-mother attachment assessment at 12-18 months postpartum. Among 233 infant-mother pairs completing the infant-mother attachment assessment, 62 and 80 mothers had postnatal depression and perinatal major depression, respectively; 75 (32.2%) of infants exhibited insecure attachment. While infants whose mothers had maternal depression showed a slightly elevated rate of insecure attachment, this difference did not achieve statistical significance. Additionally, parenting status did not influence the relationship between maternal depression and infant-mother attachment. Nevertheless, the study hinted that more physical contact between mother and infant might reduce insecure attachment likelihood. Future research should expand sample sizes and assessment points for better understanding. In addition, encouraging close interaction and physical touch between mother and infant may be beneficial.

Why rejection sensitivity leads to adolescents' loneliness: Differential exposure, reactivity, and exposure-reactivity models.

INTRODUCTION: Rejection sensitivity is considered a risk factor for loneliness; however, the underlying mechanisms remain unknown. Adopting the constructs of exposure, reactivity, and exposure-reactivity from the personality framework, this study investigated three models of rejection sensitivity, bullying victimization, and loneliness to reveal why rejection sensitivity leads to loneliness among Chinese early adolescents. METHODS: Using a longitudinal design, three-wave data were obtained (with approximately 6-month intervals) from 2381 Chinese early adolescents (51.2% boys at Time 1, Mage = 13.38, SD = 0.59) from 7 secondary schools. Students reported on their rejection sensitivity at Time 1, bullying victimization at Times 1 and 2, and their loneliness at Times 2 and 3. A longitudinal moderated mediation model was conducted to analyze the association between variables. RESULTS: Path analyses demonstrated that rejection sensitivity was associated with greater loneliness for adolescents in which association was mediated by bullying victimization. High levels of rejection sensitivity exacerbate the adverse effect of bullying victimization on loneliness. Furthermore, in line with the differential exposure-reactivity model, the effect of rejection sensitivity on loneliness mediated by bullying victimization only existed for high rejection-sensitive adolescents. CONCLUSIONS: The findings emphasize the dual role of rejection sensitivity in the development process of adolescents' loneliness and highlight the importance of identifying rejection-sensitive adolescents for intervention and prevention efforts.

Estimating power in complex nonlinear structural equation modeling including moderation effects: The powerNLSEM R-package.

The model-implied simulation-based power estimation (MSPE) approach is a new general method for power estimation (Irmer et al., 2024). MSPE was developed especially for power estimation of non-linear structural equation models (SEM), but it also can be applied to linear SEM and manifest models using the R package powerNLSEM. After first providing some information about MSPE and the new adaptive algorithm that automatically selects sample sizes for the best prediction of power using simulation, a tutorial on how to conduct the MSPE for quadratic and interaction SEM (QISEM) using the powerNLSEM package is provided. Power estimation is demonstrated for four methods, latent moderated structural equations (LMS), the unconstrained product indicator (UPI), a simple factor score regression (FSR), and a scale regression (SR) approach to QISEM. In two simulation studies, we highlight the performance of the MSPE for all four methods applied to two QISEM with varying complexity and reliability. Further, we justify the settings of the newly developed adaptive search algorithm via performance evaluations using simulation. Overall, the MSPE using the adaptive approach performs well in terms of bias and Type I error rates.

How collaborative, interpersonal, and disaster-responsive tendencies work together in non-face-to-face environments: lessons from prolonged pandemic experiences.

This study investigates the dynamics of collaborative characteristics, interpersonal reactivity, and disaster situation responses in non-face-to-face settings, a response mechanism increasingly relevant in the wake of prolonged pandemics. By examining a group of 123 university students engaged in a seven-week non-face-to-face collaborative project, the research identifies relational patterns between collaborative traits such as regulation and efficacy, interpersonal empathy, and responses to disaster situations. The research methodology employs a sophisticated analytical framework comprising factor and canonical correlation analyses to identify how empathy and collaborative efficacy significantly related with disaster response in online collaborations. The mediation and moderation models analyzed confirm mutual mediation effects of collaborative regulation and interpersonal reactivity on situational empathy without significant moderation effects. This suggests there were direct causal relationships of collaborative regulation, collaborative efficacy, interpersonal reactivity on situational empathy. The findings underscore the pivotal role of empathy in collaboration during disasters offering a nuanced understanding of the social and psychological underpinnings that enable collective responses to crises in environments lacking physical interaction and illuminating the critical role of collaborative and interpersonal skills in such settings.

Thyroid hormones and oxidative stress moderated the association between urinary phthalate metabolites and cardiovascular risk factors.

While previous studies suggested that phthalate exposure poses a risk to cardiovascular health, the results are mixed and indicated variability based on population characteristics and health outcomes assessed. Research that simultaneously investigates the association between urinary phthalate metabolites and multiple cardiovascular risk factors within a single study is relatively scarce. This study assessed human exposure to phthalates by determining urinary metabolite concentrations, and applied multiple statistical techniques to systematically evaluate the individual dose-response relationships and joint effects of phthalate exposure on blood lipids, blood pressure, and fasting blood glucose. The results revealed significant negative associations between urinary phthalate metabolites and low-density lipoprotein cholesterol, triglycerides, total cholesterol, diastolic blood pressure, systolic blood pressure, and fasting blood glucose. Significant nonlinear associations were obtained between specific individual metabolites and diastolic blood pressure. The oxidative stress biomarker 8-hydroxydeoxyguanosine levels in urine and thyroid hormone levels in paired serum were measured simultaneously. Then, we examined the indirect roles of thyroid hormones and oxidative stress in the association between urinary phthalate metabolites and cardiovascular risk factors by mediation and moderation analysis. While the mediation effect was not statistically significant, the negative associations of urinary phthalate metabolites with fasting blood glucose, triglyceride, and lipoprotein cholesterol were statistically significant at lower levels of thyroid hormones by moderation analysis. The association was also significant under certain levels of oxidative stress. The results demonstrated that phthalate exposure is associated with several cardiovascular risk factors, and maintaining appropriate oxidative stress levels and ensuring sufficient thyroid hormone levels may attenuate these associations.

An online game-based cognitive bias modification for interpretation (CBM-I) program to reduce fear during the COVID-19 pandemic: resilience as a moderator.

Introduction: This study examined the training effects of an online game-based cognitive bias modification for interpretation (CBM-I) program in reducing fear during the COVID-19 pandemic in Hong Kong. In addition to investigating the changes in both proximal (i.e. negative and positive interpretations) and distal outcomes (i.e. fear of COVID-19), we examined whether individuals with higher baseline resilience levels would benefit more from the CBM-I program. Methods: A total of 68 Hong Kong undergraduate students were randomized into either the CBM-I group or a control group, among which 66 participants completed the pretest, post-test, and follow-up on negative and positive interpretations, fear of COVID-19, and resilience. Results: Compared to the control group, the CBM-I training group showed a significantly greater decrease in negative interpretations, a significantly greater increase in positive interpretations of COVID-19-related ambiguous scenarios, and a trend toward a greater reduction in fear of COVID-19. The CBM-I training was more effective at reducing fear among those with higher levels of resilience at baseline, whereas the control group showed the opposite effect, albeit to a lesser extent. Conclusion: This online game-based CBM-I training shows the potential to modify the negative interpretation bias toward fear-inducing scenarios and contributes to the reduction of fear. Baseline screening of resilient individuals may optimize the training effects.

Nonrestorative sleep and its associated factors in Chinese adolescents and the moderation effects of coffee or tea consumption.

BACKGROUND: Nonrestorative sleep (NRS) is related to numerous adverse outcomes. There is rare evidence of its associated factors, especially in Chinese adolescents. This study aimed to explore the factors associated with NRS in Chinese adolescents and the potential moderation effects of coffee or tea consumption. METHODS: This cross-sectional study invited adolescents attending Grades 7-11 in Nanjing, China, to complete a self-administered questionnaire, including their NRS, stress, anxiety, physical symptoms, depression, sociodemographics, and lifestyles. Linear regressions were applied to investigate the associated factors of their NRS, with the moderation effects of coffee or tea consumption and other characteristics being tested by additionally including their interactions. RESULTS: Totally 481 adolescents (49% male, age 15.5 ± 1.5 years) were enrolled, with the average global NRS score of 42.16 ± 7.57. Higher family income (ß = 2.01, P = 0.007), longer sleep duration (ß = 2.33, P = 0.011), and moderate after-class activity (ß = 1.50, P = 0.044) contributed less NRS, while higher educational level (ß = -2.60, P = 0.033), more coffee or tea consumption (ß = -1.68, P = 0.013), physical symptoms (ß = -3.85, P < 0.001), stress (ß = -0.23, P = 0.005), anxiety (ß = -1.54, P = 0.045), and depression (ß = -0.13, P = 0.014) contributed more NRS. Females (ß = 0.82, P = 0.005), older age (ß = -0.46, P = 0.029), and higher education level (ß = -1.68, P < 0.001) contributed less refreshment from sleep, more physical/medical symptoms of NRS, and less daytime function, respectively. Coffee or tea consumption moderated the associations of somatic symptoms (ß = 0.25, P = 0.021), stress (ß = 0.29, P = 0.022), anxiety (ß = 0.27, P = 0.005), and depression (ß = 0.17, P = 0.021) with NRS. CONCLUSIONS: Longer sleep duration, moderate after-class activity, reduced coffee or tea consumption, and promotion of physical and mental health may help reduce adolescents' NRS. Coffee or tea consumption may help buffer the negative associations of somatic symptoms, stress, anxiety, and depression with NRS.

Are there potential costs for humility in a pluralistic democracy?: A longitudinal investigation of immigrants in the New Zealand attitudes and values study.

Introduction: In this longitudinal study, we examine the potential costs and benefits of humility for well-being and civic trust among immigrants in a pluralistic democracy. Methods: With data from 14,864 immigrant participants from a nationwide random sample in New Zealand, we used multilevel modeling to examine the associations of general humility (i.e., honesty-humility modesty) with well-being (life satisfaction and meaning) and civic trust (trust in police) over time in contexts with varying levels of ethnic deprivation and perceived religious discrimination. We hypothesized that (a) humility would correlate positively with well-being and civic trust (Hypothesis 1), (b) these associations would be attenuated in the contexts where perceptions of ethnic deprivation and religious discrimination are high (Hypothesis 2), and (c) these interaction effects would become more pronounced when cultural identities are salient (Hypothesis 3). Results: Multilevel modeling revealed partial support for these hypotheses. Although humility correlated positively with well-being and trust in police over time, the two-way and three-way interactions did not yield substantial support for Hypotheses 2 and 3, respectively. The context of religious discrimination did, however, marginally attenuate the positive association between humility and trust in police. Discussion: Collectively, these results demonstrate that humility is associated with multiple benefits to well-being and civic trust and has few-if any-potential drawbacks.

Exploring Moderation Dynamics: Callous-Unemotional Traits, Parental Practices and Conduct Problems in Juvenile Delinquency.

INTRODUCTION: Callous-unemotional (CU) traits, parental practices and conduct problems (CP) have been consistently identified across numerous studies as significant predictors of the severity and persistence of juvenile delinquency. AIMS: This study seeks to investigate the moderation dynamics underlying the relationships between these variables among Arab incarcerated youth. Specifically, the study aims to (1) explore whether parental practices moderate the relationship between CU traits and CP among incarcerated youth in Jordan and (2) examine the bidirectional moderating influence of CU traits in shaping the dynamic relationship between parental practices and CP within the context of Arab juvenile delinquency. METHODS: An observational survey design was employed, gathering data from 184 incarcerated youth across 11 rehabilitation centres in Jordan. Latent profile analysis identified three parental practice classes: more positive, balanced and more negative. RESULTS: Moderation analyses indicated significant associations between CU traits, parental practices and CP. Parental practices, especially positive ones, moderated the relationship between CU traits and CP, highlighting the protective influence of balanced parenting. Furthermore, bidirectional moderation effects were observed: CU traits moderated the link between parental practices and CP, while CP influenced parenting practices, particularly in the presence of elevated CU traits. IMPLICATIONS FOR PRACTICE: The findings of this study underscore the vital role mental health nurses can play in addressing the behavioural and psychological challenges faced by youth involved in the justice system and their families. Specifically, mental health nurses can aid in ameliorating mental distress by supporting parents in understanding and managing CU traits and CP. Nurses can provide targeted educational programmes that empower parents with strategies to reinforce positive parenting practices and reduce negative interactions. Furthermore, nurses can facilitate access to community resources and therapy options, helping families build a supportive environment conducive to the mental well-being of the youth. These interventions are crucial not only for the direct treatment of juveniles but also in providing holistic support to their families, thereby enhancing the overall efficacy of mental health care in juvenile delinquency. RELEVANCE TO MENTAL HEALTH NURSING: This study highlights the essential role that mental health nurses play in managing behavioural issues among youth, emphasising the significance of implementing culturally sensitive interventions. Mental health nurses possess a pivotal position in early detection and intervention, which enables them to guide families in fostering positive parenting practices, essential for preventing delinquent behaviours. Their efforts to promote understanding and responsiveness within family dynamics make a significant contribution to the mental well-being of individuals, highlighting the necessity of their role in global mental health.

Adverse childhood experiences, education, and involvement in terrorist violence: Examining mediation and moderation.

Most perpetrators of terrorist violence have had some level of post-secondary school education, with many enrolled in education at the time of their attacks. Exploring this premise in the context of prevention, this article draws from data gathered on a purposive sample (N = 206) of radicalized individuals from Europe and North America, half of whom became involved in terrorist violence at the end of their radicalization trajectories. Through a lens of educational participation, we propose novel, non-linear frameworks for understanding radicalization outcomes. To do so, two factors are explored that uniquely intersect when an individual enters a school setting: Adverse childhood experiences (ACE) and the human capital provided by education. As hypothesized, exposure to ACE was found to be associated with radicalization trajectories culminating in terrorist violence at the bivariate level (OR = 2.08). Consistent with the developmental-assets framework, it was further hypothesized that this relationship would be mediated by enrollment in education; however, results did not support this hypothesis. Instead, consistent with resiliency-based models, it was found that the relationship between ACE and involvement in terrorist violence was significant for those who abandoned education during radicalization (OR = 2.07). As well as contributing to theoretical models of radicalization to terrorist violence, identifying the furtherance of education as a moderator of risk may signal an important preventative strategy for violent extremism. Keeping enrolled students engaged in their programs, even if only nominally, may also forego the need for educators to engage in potentially controversial practices such as alerting the authorities to students who display signs of radicalization.

Moderate BMI accumulation modified associations between blood benzene, toluene, ethylbenzene and xylene (BTEX) and phenotypic aging: mediating roles of inflammation and oxidative stress.

The associations between blood benzene, toluene, ethylbenzene, and xylenes (BTEX) and biological aging among general adults remain elusive. The present study comprised 5780 participants from the National Health and Nutrition Examination Survey 1999-2010. A novel measure of biological aging, phenotypic age acceleration (PhenoAge.Accel), derived from biochemical markers was calculated. Weighted generalized linear regression and weighted quantile sum regression (WQS) were utilized to assess the associations between BTEX components and mixed exposure, and PhenoAge.Accel. The mediating roles of systemic immune-inflammation index (SII) and oxidative stress indicators (serum bilirubin and gamma-glutamyl transferase), along with the modifying effects of body mass index (BMI) were also examined. In the single-exposure model, the highest quantile of blood benzene (b = 0.89, 95%CI: 0.58 to 1.20), toluene (b = 0.87, 95%CI: 0.52 to 1.20), and ethylbenzene (b = 0.80, 95%CI: 0.46 to 1.10) was positively associated with PhenoAge.Accel compared to quantile 1. Mixed-exposure analyses revealed a consistent positive association between BTEX mixed exposure and PhenoAge.Accel (b = 0.88, 95%CI: 0.56 to 1.20), primarily driven by benzene (92.78%). The association between BTEX and PhenoAge.Accel was found to be partially mediated by inflammation and oxidative stress indicators (ranging from 3.2% to 13.7%). Additionally, BMI negatively modified the association between BTEX mixed exposure and PhenoAge.Accel, with a threshold identified at 36.2 kg/m^2. Furthermore, BMI negatively moderated the direct effect of BTEX mixed exposure on PhenoAge.Accel in moderated mediation models, while positively modified the link between SII and PhenoAge.Accel in the indirect path (binteraction = 0.04, 95%CI: 0.01 to 0.06). Overall, BTEX mixed exposure was associated with PhenoAge.Accel among US adults, with benzene may have reported most contribution, and inflammation and oxidative damage processes may partially explain this underlying mechanism. The study also highlighted the potential benefits of appropriate BMI increased. Additional large-scale cohort studies and experiments were necessary to substantiate these findings.

Self-reported alcohol consumption during participation in a text messaging-based online drinking moderation platform.

BACKGROUND: Many individuals with excessive alcohol consumption desire moderation but do not seek formalized treatment. Commercially available, technology-assisted options are flexible and highly accessible, yet often not empirically validated. METHODS: Individuals desiring alcohol moderation (age 21+) self-selected to use Sunnyside®, a web application with tailored and adaptive text messaging. The evaluable dataset included 46,411 members who completed a baseline assessment, enrolled in the program, and tracked their drinking at least once. An adaptive and customizable weekly plan was generated from typical drinking patterns, goals, and weekly reported progress. Personalized daily messages included reminders for real-time drink tracking, plans, and available interactive messaging with peer coaches. Generalized mixed-effect growth models characterized change in drinks per week and daily drinking for 12 weeks after enrollment. Models allowed for nonlinear change and individual variability across members and weeks. RESULTS: A majority (64.3%) of members reported typically drinking 7 of 7 days per week at baseline. During tracking, drinks per week decreased most in the initial weeks and slowed thereafter, with an overall 33% reduction in weekly drink counts. More severe alcohol-use patterns and concern over drinking at baseline were associated with greater relative benefit. CONCLUSIONS: Drinking patterns appeared amenable to change during 12 weeks of daily drink tracking with Sunnyside®, a tailored web program to reduce drinking and improve overall wellness. Overall, the findings of this naturalistic study, one of the first of its kind, supplement data from randomized clinical trials and support the use of adaptive, technology-assisted tools for alcohol moderation.

Understanding the predictors of health professionals' intention to use electronic health record system: extend and apply UTAUT3 model.

BACKGROUND: The implementation of Electronic Health Record (EHR) systems is a critical challenge, particularly in low-income countries, where behavioral intention plays a crucial role. To address this issue, we conducted a study to extend and apply the Unified Theory of Acceptance and Use of Technology 3 (UTAUT3) model in predicting health professionals' behavioral intention to use EHR systems. METHODS: A quantitative research approach was employed among 423 health professionals in Southwest Ethiopia. We assessed the validity of the proposed model through measurement and structural model statistics. Analysis was done using SPSS AMOS version 23. Hypotheses were tested using structural equation modeling (SEM) analysis, and mediation and moderation effects were evaluated. The associations between exogenous and endogenous variables were examined using standardized regression coefficients (ß), 95% confidence intervals, and p-values, with a significance level of p-value < 0.05. RESULTS: The proposed model outperformed previous UTAUT models, explaining 84.5% (squared multiple correlations (R2) = 0.845) of the variance in behavioral intention to use EHR systems. Personal innovativeness (ß = 0.215, p-value < 0.018), performance expectancy (ß = 0.245, p-value < 0.001), and attitude (ß = 0.611, p-value < 0.001) showed significant associations to use EHR systems. Mediation analysis revealed that performance expectancy, hedonic motivation, and technology anxiety had significant indirect effects on behavioral intention. Furthermore, moderation analysis indicated that gender moderated the association between social influence, personal innovativeness, and behavioral intention. CONCLUSION: The extended UTAUT3 model accurately predicts health professionals' intention to use EHR systems and provides a valuable framework for understanding technology acceptance in healthcare. We recommend that digital health implementers and concerned bodies consider the comprehensive range of direct, indirect, and moderating effects. By addressing personal innovativeness, performance expectancy, attitude, hedonic motivation, technology anxiety, and the gender-specific impact of social influence, interventions can effectively enhance behavioral intention toward EHR systems. It is crucial to design gender-specific interventions that address the differences in social influence and personal innovativeness between males and females.

Further Examining Positive Affect in Relation to Worry: A Synergistic Effect Between Positive Affect Expressivity and Proneness to Positive Affect.

There is emerging interest in understanding positive affect dysfunction in relation to anxiety, including worry. This set of two studies examined the association between the inhibition of affect expression (general affect expressivity in Study 1, positive affect expressivity in Study 2) and worry, with a particular interest in the moderating role of proneness to experience positive affect. Subjects were US-residing adults (Study 1 N = 502, Study 2 N = 250) who were recruited through a crowdsourcing website and completed self-report measures of study variables. Moderated regression was used to examine study predictions that affect expression would negatively correlate with worry when coupled with diminished positive affect. Proneness toward negative affect was included as a covariate within multivariate analyses. An interactive effect between affect expressivity and positive affect was supported in Study 2 (positive affect expressivity) but not Study 1 (general affect expressivity) in relation to worry. A diminished tendency to express positive affect was associated with greater worry when coupled with less positive affect. Study results and future directions are discussed in terms of the potential emotion-regulatory functions of positive affect expressivity as it relates to worry.

Relationship Between Direct Aggression and Prosocial Behavior: The Role of Attention and Intelligence Among Children at Risk for Behavioral Problems.

This study aimed to investigate the influence of attention and intelligence in the prediction of prosocial behavior by direct aggression (proactive or reactive) in school-aged children at risk for behavioral problems. The sample was composed of 64 children aged 6 to 8 years screened for risk of behavioral problems, who were enrolled in a clinical trial. Multiple regression models were tested to investigate the prediction of prosocial behavior by direct aggression (proactive or reactive), attention, and intelligence. Additive multiple moderation models were tested to analyze the conditional effect of attention and intelligence in the prediction of prosocial behavior by proactive and reactive aggression. Aggression (proactive or reactive), attention, and intelligence did not linearly predict prosocial behavior. Conditional effects were found only for the proactive aggression model. Negative impacts on prosocial behavior were observed among children with low attention and high intelligence performance, while medium and high levels of attention showed to be protective factors among low to medium intellectual ability children. Clinical impacts of the results are discussed.