Dentists' stress level during the COVID-19 pandemic and their opinion on the oral health status of their patients.

Background and aims: "Severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2) is the name of the etiological agent of the pandemic Corona Virus Disease (COVID-19) which was declared on March 11, 2020 by the WHO and which affected all countries of the world, including Romania. Our study aimed to evaluate the psycho-affective implications and economic consequences for dentists in Romania during the COVID-19 (Corona Virus Disease) pandemic state of emergency and their opinion on the patients' oral health impact. Methods: A cross-sectional observational and analytical study based on a questionnaire was conducted. Dentists who work in Romania affiliated in 2020 to the Romanian College of Dental Practitioners was the target population. Results: Three hundred and seventy-three dentists participated in this survey. The age of the respondents ranged from 24 to 70. Men and women have the same expectation regarding the lockdown effect of worsening the oral health of the general population (worst, 79.5% of women and 81.3% of men, P=0.8842). Conclusions: The anxiety regarding the bank rates, supplementary investments, risk of COVID-19 infection and exposure to COVID-19 related mass-media information proved to be significantly higher among young dentists.

Assessment of stress level and depression among orthopaedic surgeons in Saudi Arabia.

PURPOSE: The aim of this study was to assess the stress level and depression among orthopaedic surgeons in Saudi Arabia. In addition, to evaluate orthopedic training programs related factors that might have a critical role in the development of depression among orthopaedic surgeons. METHODS: The study adopted a cross-sectional study design. Two validated questionnaires were utilized, the Patient Health Questionnaire 9 (PHQ-9) and the Perceived Stress Scale (PSS-10) for assessing depressive symptoms and stress levels. Data was collected by sending the survey to the Saudi Commission for Health Specialties so they could be distributed throughout all registered orthopaedic surgeons. RESULTS: The study sample consisted of 325 participants. The results revealed that the severity of depression varied across the different groups. As per the PHQ-9 criteria, 74 (22.8%) were initially diagnosed with major depression. Among assistant consultants, 39.5% reported severe depression, while 34.9% reported mild depression. Consultants predominantly reported moderate perceived stress (82.9%) with a notable proportion experiencing high perceived stress (12.4%). Assistant consultants showed a balanced distribution, with 93.0% reporting moderate perceived stress and 4.7% reporting high perceived stress. Demographic variables gender, relationship status and having children revealed statistically significant relationship with PHQ-9 scores (p-value < 0.05) but not with PSS-10 scores. CONCLUSION: The study highlights pressing need to address mental health concerns within orthopaedic surgeons. To address these challenges, healthcare institutions should implement comprehensive mental health support programs offering resources for stress management, counseling services, and peer support groups.

Adjunctive use of mindfulness-based mobile application in depression: randomized controlled study.

Mindfulness-based interventions (MBI) are effective in relapse prevention in Major Depressive Disorder (MDD). Internet-based interventions have been demonstrated to be effective in the treatment of MDD. Consequently, the integration of MBI through mobile applications emerges as a promising supplementary intervention for MDD, contributing to the augmentation of mental health services, particularly within ambulatory care contexts. The current randomized controlled study is designed to evaluate the efficacy of adjunctive MBI delivered via a mobile app in mitigating symptom severity and stress levels. This assessment involves a comparison with standard treatment practices in an ambulatory setting among individuals diagnosed with MDD. A total of 83 patients diagnosed with MDD (depressive episode, recurrent depression or depressive phase of bipolar disorder) were randomly allocated to the intervention (41 patients) or control condition (42 patients). The intervention consisted of the daily use of the mindfulness mobile application "Headspace" for thirty days. The control condition was treatment as usual (TAU) only. The symptom severity has been assessed by the Beck Depression Inventory (BDI-II) as well as the Hamilton Depression Rating Scale (HDRS-17). Blood pressure and resting heart rate have been assessed as secondary outcome. Upon hospital discharge, the mean scores on the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS) signaled partial remission of MDD in both treatment arms. In both groups, a subsequent decrease in both self-reported and expert-rated scores was evident after a 30-day period. However, the decrease in depression severity as measured by HDRS was significantly higher in the MBI group compared to the control group after 30 days. For secondary outcomes, systolic blood pressure was lower in the intervention group compared to control group. The total drop-out rate was 29%. Short term mindfulness intervention via mobile application (30 days) can be beneficial as adjunctive therapy to treatment as usual in patients with MDD.

Creep Failure Characteristics and Mathematical Modeling of High-Density Polyethylene Geomembranes under High Stress Levels.

To explore the creep characteristics of geomembrane under different tensile stresses, a series of creep tests were carried out on high-density polyethylene (HDPE) geomembrane specimens. For the interpretation and fitting of the experimental data, refined approximation functions were proposed. Particular attention was paid to the creep failure behavior under high tensile stresses, i.e., 70%, 80%, and 90% of maximum peak stress. To investigate the effects of size on the mechanical response, experiments with two different membrane thicknesses were conducted. The results obtained under high stress levels were compared with creep tests at medium and low stress levels. Depending on load level, different creep characteristics can be distinguished. In the secondary creep state, the creep velocity is higher for higher load levels. In contrast to the medium and low load levels, the geomembrane under high stresses underwent the tertiary creep stage after instantaneous deformation and primary and secondary creep stages. In some tests, it was observed that under very high stress levels, creep velocity does not necessarily follow the expected trend and creep rupture can occur within a short time. For numerical simulation, an improved mathematical model was proposed to reproduce in a unified manner the experimental data of the whole non-linear evolution of creep elongation under different stress levels.

BODY AWARENESS, STRESS AND SYMPTOMS IN AUTONOMIC DYSFUNCTION IN PATIENTS WITH CHRONIC PAIN: AN EXPLORATIVE STUDY.

Objective: To assess pain outcomes, stress levels and body awareness among patients with chronic pain and explore potential associations between these variables. Design: An explorative study. Methods: Patients with chronic pain in primary and specialist care were assessed regarding pain intensity using the Numerical Rating Scale (NRS; 0-10 point scale) and stress levels using the Stress and Crisis Inventory (SCI-93; 0-140). To assess body awareness, multidimensional assessment of interoceptive awareness (MAIA; 0-5), a widely used self-report measure of interoceptive bodily awareness was used. Results: Participants (n = 42) reported an average NRS of 4.4, elevated stress levels and low body awareness. Stress levels were moderately correlated with pain intensity (r = 0.53; p < 0.001; 95% confidence interval [CI] 0.25-0.72) and number of pain sites (r = 0.58; p < 0.001; 95% CI 0.32-0.76). The regression analysis showed that pain outcomes predicted stress level scores and explained almost 50% of variance (R 2 = 0.47, p < 0.001). Moreover, shorter pain duration predicted a higher body awareness (p = 0.04). Conclusion: In patients with chronic pain, high pain intensity and multiple painful sites seem to be associated with impaired stress regulation. The patients had low body awareness, which was negatively influenced by pain duration.

Change in self-image pressure level before and after autologous fat breast augmentation and its effect on social adaptability.

BACKGROUND: There is an increasingly strong demand for appearance and physical beauty in social life, marriage, and other aspects with the development of society and the improvement of material living standards. An increasing number of people have improved their appearance and physical shape through aesthetic plastic surgery. The female breast plays a significant role in physical beauty, and droopy or atrophied breasts can frequently lead to psychological inferiority and lack of confidence in women. This, in turn, can affect their mental health and quality of life. AIM: To analyze preoperative and postoperative self-image pressure-level changes of autologous fat breast augmentation patients and their impact on social adaptability. METHODS: We selected 160 patients who underwent autologous fat breast augmentation at the First Affiliated Hospital of Xinxiang Medical University from January 2020 to December 2022 using random sampling method. The general information, self-image pressure level, and social adaptability of the patients were investigated using a basic information survey, body image self-assessment scale, and social adaptability scale. The self-image pressure-level changes and their effects on the social adaptability of patients before and after autologous fat breast augmentation were analyzed. RESULTS: We collected 142 valid questionnaires. The single-factor analysis results showed no statistically significant difference in the self-image pressure level and social adaptability score of patients with different ages, marital status, and monthly income. However, there were significant differences in social adaptability among patients with different education levels and employment statuses. The correlation analysis results revealed a significant correlation between the self-image pressure level and social adaptability score before and after surgery. Multiple factors analysis results showed that the degree of concern caused by appearance in self-image pressure, the degree of possible behavioral intervention, the related distress caused by body image, and the influence of body image on social life influenced the social adaptability of autologous fat breast augmentation patients. CONCLUSION: The self-image pressure on autologous fat breast augmentation patients is inversely proportional to their social adaptability.

Comparative Study of Ergonomics in Conventional and Robotic-Assisted Laparoscopic Surgery.

BACKGROUND: This study aims to implement a set of wearable technologies to record and analyze the surgeon's physiological and ergonomic parameters during the performance of conventional and robotic-assisted laparoscopic surgery, comparing the ergonomics and stress levels of surgeons during surgical procedures. METHODS: This study was organized in two different settings: simulator tasks and experimental model surgical procedures. The participating surgeons performed the tasks and surgical procedures in both laparoscopic and robotic-assisted surgery in a randomized fashion. Different wearable technologies were used to record the surgeons' posture, muscle activity, electrodermal activity and electrocardiography signal during the surgical practice. RESULTS: The simulator study involved six surgeons: three experienced (>100 laparoscopic procedures performed; 36.33 ± 13.65 years old) and three novices (<100 laparoscopic procedures; 29.33 ± 8.39 years old). Three surgeons of different surgical specialties with experience in laparoscopic surgery (>100 laparoscopic procedures performed; 37.00 ± 5.29 years old), but without experience in surgical robotics, participated in the experimental model study. The participating surgeons showed an increased level of stress during the robotic-assisted surgical procedures. Overall, improved surgeon posture was obtained during robotic-assisted surgery, with a reduction in localized muscle fatigue. CONCLUSIONS: A set of wearable technologies was implemented to measure and analyze surgeon physiological and ergonomic parameters. Robotic-assisted procedures showed better ergonomic outcomes for the surgeon compared to conventional laparoscopic surgery. Ergonomic analysis allows us to optimize surgeon performance and improve surgical training.

Improved Memory and Lower Stress Levels in Male Mice Co-Housed with Ovariectomized Female Mice.

Aggressiveness, expressed by fighting, is a frequent problem in group-housed laboratory male mice and results in increased stress, injury, and death. One way to prevent fighting is by pairing the male mice with ovariectomized female mice to provide a compatible companion. However, the effect of these housing conditions remains unclear. Therefore, we aimed to evaluate behavior and stress levels in two different housing conditions, pair-housed with an ovariectomized female and group-housed with other males. Behavioral tests were performed to assess stress and anxiety-like behavior. Moreover, the corticosterone levels in plasma were measured by ELISA. Based on home cage behavior assessment, pair-housed male mice showed no signs of fighting, not even after isolation and regrouping. Our results also showed that the pair-housed males had a better memory and demonstrated less anxiety-like behavior. Subsequently, the pair-housed male mice had a larger reduction in corticosterone levels compared to group-housed males. Overall, pair-housing reduced anxiety-like behavior and stress levels in male mice compared to standard group-housing.

Stress level and associated factors among nurses working in the critical care unit and emergency rooms at comprehensive specialized hospitals in Southern Ethiopia, 2023: explanatory sequential mixed-method study.

BACKGROUND: Stress is a pervasive occurrence within certain professions, including nurses working in emergency and intensive care unit environments. Nurses in these settings often confront various stress-inducing factors, such as unsupportive management and distressing events like patient mortality, and experience notably higher levels of stress. Nevertheless, information is scarce regarding the precise level of stress in Ethiopia, particularly within southern hospitals. OBJECTIVE: To assess stress levels and associated factors among nurses working in the critical care unit and emergency rooms at comprehensive specialized hospitals in southern Ethiopia, 2023. METHODS: A facility-based cross-sectional explanatory sequential mixed-method study was undertaken, involving a total of 239 nurses. For the quantitative component, all nurses working in intensive care units and emergency rooms were included as participants, while a purposive sampling technique was employed to select participants for the qualitative aspect. Data for the quantitative study were gathered through the utilization of self-administered questionnaires, while interviews were conducted using a structured interview guide for the qualitative portion. Quantitative data entry and analysis were performed using EpiDataV4.6 and the Statistical Package for the Social Sciences software, respectively. Thematic analysis of the qualitative data was conducted using the OpenCode software. RESULTS: The level of stress among nurses in the emergency and intensive care units was low (19.3%), moderate (55.9%), and high (24.8%). Workload (Adjusted odds ratio (AOR) = 3.51, 95% confidence interval (CI) (1.17-10.56) and time constraints (AOR = 2.5, 95% CI (1.03-6.07) were significantly associated with moderate stress level, while duty demands (AOR = 3.03, 95% CI (1.17-7.14), availability of medical equipment and supplies (AOR = 1.42, 95% CI (1.18-4.97), and witnessing death and dying (AOR = 2.34, 95% CI (1.13-5.88) were significantly associated with high-stress level. The qualitative data analysis revealed that the participants underscored the significant impact of organizational factors, individual factors, and profession-related factors on the stress levels experienced by nurses in emergency and critical care settings. CONCLUSION AND RECOMMENDATION: Based on the findings, the participants in this study experienced some level of stress, to varying degrees. Therefore, it is crucial to implement effective strategies such as optimizing staffing and workflow, improving communication and collaboration, providing adequate support and resources, leveraging technology and innovation, emphasizing patient-centered care, and implementing data-driven quality improvement to alleviate the burden.

Role of stress and physical activity on primary dysmenorrhea: A cross-sectional study.

The initial physiological change in adolescent girls is the onset of menstruation. The most prevalent challenge they face regarding menstruation is primary dysmenorrhea, characterized by persistent or intermittent pelvic pain in the lower abdomen. The aim of this study was to investigate the influences of stress levels and physical activities on primary dysmenorrhea. A cross-sectional was conducted in Cirebon, Indonesia, in 2023 included young women who had never given birth (nullipara), aged 17-25 years old, had menstruated, and had no history of smoking and alcohol. The data were collected using a set of questionnaires consisting of the Numeric Rating Scale (NRS) to determine primary dysmenorrhea pain, the Depression Anxiety Stress Scales 42 (DASS 42) to determine the level of stress and the International Physical Activity Questionnaire (IPAQ) to determine physical activity. Pearson's correlation test was used to assess the correlation between the variables (stress levels, physical activity, and dysmenorrhea). A total of 150 young women were included in the study. Moderate stress levels (23.3%) and high physical activity (90.7%) were the most prevalent category observed among studied participants. Approximately 42% of them experienced mild dysmenorrhea pain. Our analysis indicated that stress levels and physical activities had strong positive and negative correlations with dysmenorrhea pain levels, with r=0.782 and r=-0.748, respectively, with both had p<0.001. This highlights that controlling stress could be beneficial in preventing dysmenorrhea pain among young women.

Dynamic greenspace exposure, individual mental health status and momentary stress level: A study using multiple greenspace measurements.

Previous research on the relationship between greenspace exposure and mental health has largely taken a residence-based approach to exposure assessment, ignoring the dynamic nature of people's daily movements. Moreover, most studies evaluated greenspace from an overhead perspective, whereas an eye-level perspective could potentially offer a more comprehensive understanding of individuals' encounters with greenspaces. Based on our survey in two communities in Hong Kong (Sham Shui Po and Tin Shui Wai), we captured people's eye-level greenspace exposure based on their travel routes and visited places using GPS trajectories, streetscape images, and deep learning methods. We then compared the results with those obtained with an overhead greenness exposure measure (the normalized difference vegetation index [NDVI]). The results indicate that these two greenspace measurements are not associated with each other, implying that they encompass distinct facets of greenspace, which may have different effects on mental health. Further, we examined the associations between various greenspace exposure measures and mental health using GPS trajectories and ecological momentary assessment data. The results reveal a negative association between eye-level greenspace exposure and momentary stress, while no similar association was observed when using the top-down NDVI as an indicator of greenspace exposure. Moreover, compared to the total volume of greenspace exposure, the distance-weighted average of greenspace exposure based on dynamic mobility contexts has a stronger association with individual overall mental health. Lastly, the relationship between greenspace exposure and mental health varies between the two communities with different socio-economic attributes. The study indicates that policymakers should focus not only on residential neighborhoods and overhead greenspace but also consider the dynamic environments and socio-economic contexts that people are embedded in.

Coping with stress styles and the level of perceived stress in hematopoietic cell transplant patients.

OBJECTIVE: Hematopoietic stem cell transplantation (HSCT) is considered an integral part of therapy in many hematological and non-hematological malignancies. The procedure can be highly stressful for patients. The primary objective of this study was to compare stress assessments in HSCT patients, depending on their stress coping style (CS) and type of treatment (autologous vs. allogeneic HSCT). METHODS: A short longitudinal study was conducted between May 2021 and June 2023 among patients with hematological cancers undergoing HSCT. The study involved four time points: the day of admission to hospital - T1, the day before HSCT - T2, 6 days after HSCT - T3, and the day of discharge - T4. Participants completed the Coping Inventory for Stressful Situations (CISS) on T1, and the Distress Thermometer (DT) on T1-T4. Descriptive statistics and a repeated measures ANOVA were conducted. RESULTS: A total of 128 participants completed the study: 54.2% female, mean age 48.7 years. They were divided into: (1) five groups based on their CS: task-oriented, emotion-oriented, avoidance-oriented, mix-oriented, differential-oriented; (2) two groups based on treatment type. The analyses showed significant differences in stress between the CS study groups (p = 0.001). The emotion-oriented group had the highest stress levels during the hospitalization period. There was also a significant time effect (p < 0.001): stress levels increased during the hospitalization period, peaking 6 days after HSCT, and decreased at discharge. CONCLUSIONS: Stress levels depend on coping styles and time points during the hospitalization period, which should be taken into account in planning psychological interventions for HSCT patients.

A deep learning-based approach for distinguishing different stress levels of human brain using EEG and pulse rate.

In today's world, people suffer from many fatal maladies, and stress is one of them. Excessive stress can have deleterious effects on the health, brain, mind, and nervous system of humans. The goal of this paper is to design a deep learningbased human stress level measurement technique using electroencephalogram (EEG), and pulse rate. In this research, EEG signals and pulse rate of healthy subjects are recorded while they solve four different question sets of increasing complexity. It is assumed that the subjects undergo through four different stress levels, i.e., 'no stress', 'low stress', 'medium stress', and 'high stress', while solving these question sets. An attention mechanism-based CNN-TLSTM (convolutional neural network-tanh long short-term memory) model is proposed to detect the mental stress level of a person. An attention layer is incorporated into the designed TLSTM network to increase the classification accuracy of the CNN-TLSTM model. The CNN network is used for the automated extraction of intricate features from the EEG signals and pulse rate. Then TLSTM is used to classify the stress level of a person into four different categories using the CNNextracted features. The obtained average accuracy of the proposed CNN-TLSTM model is 97.86%. Experimentally, it is found that the designed stress level measurement technique is highly effective and outperforms most existing state-of-the-art techniques. In the future, functional Near-Infrared Spectroscopy (fNIRS), ECG, and Galvanic Skin Response (GSR) can be employed with EEG and pulse rate to increase the effectiveness of the designed stress level measurement technique.

Stress Level Detection Based on the Capacitive Electrocardiogram Signals of Driving Subjects.

The automotive industry and scientific community are making efforts to develop innovative solutions that would increase successful driver performance in preventing crashes caused by drivers' health and concentration. High stress is one of the causes of impaired driver performance. This study investigates the ability to classify different stress levels based on capacitive electrocardiogram (cECG) recorded during driving by unobtrusive acquisition systems with different hardware implementations. The proposed machine-learning model extracted only four features, based on the detection of the R peak, which is the most reliably detected characteristic point even in inferior quality cECG. Another criterion for selecting the features is their low computational complexity, which enables real-time application. The proposed method was validated on three open data sets recorded during driving: electrocardiogram (ECG) recorded by electrodes with direct skin contact (high quality); cECG recorded without direct skin contact through clothes by electrodes built into a portable multi-modal cushion (middle quality); and cECG recorded through the clothes without direct skin contact by electrodes built into a car seat (lowest quality). The proposed model achieved a high accuracy of 100% for high-quality ECG, 96.67% for middle-quality cECG, and 98.08% for the lower-quality cECG.

The Relationship Between Depression, Anxiety, and Stress Levels and Eating Behavior in Emergency Service Workers.

Introduction It is seen that shift work causes various biological, psychological, and behavioral problems in individuals. This study aimed to determine the eating attitudes and behaviors of health workers working in shifts in a stressful environment such as the emergency service and to examine the relationship between depression, anxiety, and stress levels and eating behaviors (emotional eating, restrictive eating, and external eating) in terms of sociodemographic and clinical characteristics. Material and Methods Sociodemographic data form; Depression, Anxiety, and Stress Scale (DASS); and Dutch Eating Behavior Questionnaire (DEBQ) were used. The study sample consisted of 92 employees (doctor, nurse, emergency medical technician (EMT), medical secretary, and security, staff) who were actively on duty in the emergency department of Alanya Alaaddin Keykubat University Medical Faculty Training and Research Hospital. Results In our study, when the eating behavior of emergency service workers was evaluated in terms of "emotional, external, and restricted eating" sub-dimensions, depression (p=0.043), anxiety (p=0.017), increased stress levels (p=0.002), being female (p=0.022), nurse-emergency medical technician profession (p=0.001), working in 24-hour shifts (p=0.001), and diet history (p=0.013) were associated with "emotional eating." In addition, an increase in depression levels (p=0.048), being single (p=0.015), working in 24-hour shifts (p=0.005), a decrease in age (p<0.001) with "extrinsic eating," an increase in body mass index (BMI) (p=0.020) and waist circumference (p=0.049), and diet history (p<0.001) were associated with "restricted eating." Conclusions In our study, among the sociodemographic factors, being female, being single, working in 24-hour shifts, diet history, nurse-EMT profession, and undergraduate education level were found to increase the tendency to develop eating behavior problems. An increase in depression levels, being single, working in 24-hour shifts, and a decrease in age were associated with "extrinsic eating." There is a correlation between depression, anxiety, and stress scores and emotional eating scores. Additionally, we found significant correlations between body mass index, waist circumference, diet history, and restricted eating scores. In the approach to eating behavior problems, it is important to determine the individual eating behavior disorder. Due to the increased risk of eating behavior disorder in those who work in long shifts such as 24 hours, it will be possible to organize work programs and increase the quality of service.

From comfort zone to mortality: Sequence of physiological stress thresholds in Robinia pseudoacacia seedlings during progressive drought.

Introduction: Parameterizing the process of trees from the comfort zone to mortality during progressive drought is important for, but is not well represented in, vegetation models, given the lack of appropriate indices to gauge the response of trees to droughts. The objective of this study was to determine reliable and readily available tree drought stressindices and the thresholds at which droughts activate important physiological responses. Methods: We analyzed the changes in the transpiration (T), stomatal conductance, xylem conductance, and leaf health status due to a decrease in soil water availability (SWA), predawn xylem water potential (ψpd), and midday xylem water potential (ψmd) in Robinia pseudoacacia seedlings during progressive drought. Results: The results showed that ψmd was a better indicator of drought stress than SWA and ψpd, because ψmd was more closely related to the physiological response (defoliation and xylem embolization) during severe drought and could be measured more conveniently. We derived the following five stress levels from the observed responses to decreasing ψmd: comfort zone (ψmd > -0.9 MPa), wherein transpiration and stomatal conductance are not limited by SWA; moderate drought stress (-0.9 to -1.75 MPa), wherein transpiration and stomatal conductance are limited by drought; high drought stress (-1.75 to -2.59 MPa), wherein transpiration decreases significantly (T< 10%) and stomata closes completely; severe drought stress (-2.59 to -4.02 MPa), wherein transpiration ceases (T< 0.1%) and leaf shedding orwilting is > 50%; and extreme drought stress (< -4.02 MPa), leading to tree mortality due to xylem hydraulic failure. Discussion: To our knowledge, our scheme is the first to outline the quantitative thresholds for the downregulation of physiological processes in R. pseudoacacia during drought, therefore, can be used to synthesize valuable information for process-based vegetation models.

Impacts of COVID-19 crisis and some related factors on the mental health of 37150 Vietnamese students: a cross-sectional online study.

BACKGROUND: University students are vulnerable to changes due to COVID-19 pandemic. Although warning has been made about the impact of this crisis on students' mental health, there are barely any sufficient study. This work investigated how the pandemic affected the mental health of students at the Vietnam National University of Ho Chi Minh City (VNU-HCMC) and efficiency of available mental health supportive methods. METHODS: An online survey was conducted among students at Vietnam National University of Ho Chi Minh City (VNU-HCMC) from October 18, 2021, to October 25, 2021. Microsoft Excel 16.51 (Microsoft, USA) and R language, Epi packages 2.44 and 4.1.1 (rdrr.io) were used for data analysis. RESULTS: Thirty-seven thousand one hundred fifty students participated in the survey, including 48.4% female and 51.6% male. Online learning pressure was mainly recorded (65.1%). Many students suffered from sleeping disorders (56.2%). Some reported being victims of abuse (5.9%). Female students expressed a significantly higher level of distress than males, particularly the feeling of ambiguity about the purpose of life (p-value < 0.0001, OR: 0.94, 95% CI: [0.95-0.98]). Third-year students suffered higher stress levels than others, especially in online learning (68.8%, p-value < 0.05). Mental health statuses among students of different lockdown status regions were not significantly different. Therefore, lockdown status did not affect the stress levels of students which suggested that poor mental health outcomes seemed to root in the suspension of everyday university life rather than the prohibition of going out. CONCLUSIONS: During COVID-19, students experienced lots of stress and mental problems. These findings underscore the importance of academic and innovative activities, bringing attention to the needs of interactive study and extra-curricular activities.

Analysis of Factors Affecting Academic Performance of Mathematics Education Doctoral Students: A Structural Equation Modeling Approach.

Student academic performance is an important indicator of doctoral education quality, but limited research has focused on how multiple influential factors of doctoral students' academic performance work together. This study aims to explore the factors significantly affecting the academic performance of mathematics education doctoral students in Indonesia. Several factors were recognized from prior studies, such as the fear of delay, student engagement, parental support, teacher support, facilitating conditions, stress level, and well-being. An online questionnaire was designed and answered by a total of 147 mathematics education doctoral students. The partial least squares structural equation modeling (PLS-SEM) approach was adopted to analyze the questionnaire data. The results suggested that teacher support had the strongest positive effects on mathematics education doctoral students' academic performance in Indonesia. Student engagement was the most significant positive factor in improving doctoral students' well-being, while parental support could most significantly reduce their stress levels. Practically, these results are expected to provide implications to universities and supervisors regarding the improvement of doctoral students' well-being to promote their academic success and further the quality of doctoral programs in education. Theoretically, these results can also contribute to building an empirical model that can be used to explore and explain how multiple factors could affect doctoral students' academic performance in other contexts.

Stress Estimation Using Biometric and Activity Indicators to Improve QoL of the Elderly.

It is essential to estimate the stress state of the elderly to improve their QoL. Stress states change every day and hour, depending on the activities performed and the duration/intensity. However, most existing studies estimate stress states using only biometric information or specific activities (e.g., sleep duration, exercise duration/amount, etc.) as explanatory variables and do not consider all daily living activities. It is necessary to link various daily living activities and biometric information in order to estimate the stress state more accurately. Specifically, we construct a stress estimation model using machine learning with the answers to a stress status questionnaire obtained every morning and evening as the ground truth and the biometric data during each of the performed activities and the new proposed indicator including biological and activity perspectives as the features. We used the following methods: Baseline Method 1, in which the RRI variance and Lorenz plot area for 4 h after waking and 24 h before the questionnaire were used as features; Baseline Method 2, in which sleep time was added as a feature to Baseline Method 1; the proposed method, in which the Lorenz plot area per activity and total time per activity were added. We compared the results with the proposed method, which added the new indicators as the features. The results of the evaluation experiments using the one-month data collected from five elderly households showed that the proposed method had an average estimation accuracy of 59%, 7% better than Baseline Method 1 (52%) and 4% better than Baseline Method 2 (55%).

Spatiotemporal non-stationarity in green space and stress relationships: Recent evidence from South Korea.

A growing body of literature has linked exposure to "green space" (vegetation-rich areas) and other forms of nature to mental health. Exposure-outcome associations at regional or national scales can overlook local associations that define how geographically distinct populations may experience nature differently. Large-scale results might downplay the importance of lived experiences and heterogeneity of human-nature relationships at local scales. The current study examines three types of vegetative cover and identifies how they are associated with perceived stress in South Korea during and before the COVID-19 pandemic. We find forest cover is consistently negatively associated with perceived stress at nationwide scales. In contrast, grass cover and the normalized difference vegetation index (NDVI) show mixed associations with perceived stress at nationwide scales. Models accounting for spatial and temporal variability demonstrate that associations of forest cover, grass cover, and NDVI with perceived stress varies across the country and the study's four-year time horizon. Local governments may need divergent urban greening strategies for health promotion that respond to their specific sociodemographic and pre-existing environmental conditions.