[EQ-5D-3L based quality of life for patients of pneumoconiosis combined with tuberculosis and its influencing factors].

Objective: To understand the health-related quality of life for patients of pneumoconiosis combined with tuberculosis and its main influencing factors. Methods: This was a cross-sectional study, and 951 patients of pneumoconiosis combined with tuberculosis from the pneumoconiosis survey in 27 provinces and autonomous regions in China from December 2017 to December 2021 were selected for the study. The nonparametric Mann-Whitney test and the Kruskal-Wallis H test were used to compare the health utility values, and multiple linear regression was used for multifactor analysis. AMOS 24.0 was used to establish a structural equation modeling. Results: The mean age of 951 patients of pneumoconiosis combined with tuberculosis was (59.3±12.4) years. The main types were silicosis combined with tuberculosis (62.2%, 591/951) and coal-worker's pneumoconiosis combined with tuberculosis (34.9%, 332/951), and other type pneumoconiosis-combined tuberculosis was 2.9% (28/951). The proportion of patients with stage Ⅰ, Ⅱ, Ⅲ, and unstaged clinical diagnosis was 27.4% (261/951), 26.6% (253/951), 32.5% (309/951) and 13.5% (128/951), respectively. 63.3% (602/951) of study participants suffered from other chronic diseases, and the percentage of patients combined the number of chronic diseases with 1, 2, and more than 3 respectively were 24.1% (229/951), 16.3% (155/951) and 22.9% (218/951). The median and quartiles of health utility values and the mean±standard deviation of self-rating scores of patients of pneumoconiosis combined with tuberculosis were 0.562 (0.482, 0.766) and (53.7±18.4), respectively, which were lower than patients of pneumoconiosis without tuberculosis (Z=-11.29, P<0.001; t=8.97, P<0.01). The health utility values and self-rating scores for patients of pneumoconiosis combined with tuberculosis were significantly different between urban and rural areas (Z= -2.22, P=0.027; t=4.85, P<0.01). Pain/discomfort was the most frequently reported problem in the five-dimensional distribution of problems, followed by daily activities and anxiety/depression, and the difference in the percentage reported by anxiety/depression between urban and rural areas was significant (χ(2)=30.28, P<0.01). The results of multiple linear regression showed that the survey area, body mass index, education level, age, employment status, annual personal income, stage of pneumoconiosis, number of multi-morbidities, hemoptysis, acute exacerbation of symptoms in two-week, social support and minimum living standard were the main influences on the health utility values of the patients of pneumoconiosis combined with tuberculosis (P<0.05). The results of structural equation model showed that economic security and health status directly affected the health-related quality of life among patients of pneumoconiosis combined with tuberculosis and played a chain-mediating effect in the influence of socioeconomic status on the health-related quality of life among patients of pneumoconiosis combined with tuberculosis. Conclusion: Health-related quality of life was poorer in patients of pneumoconiosis with tuberculosis, with pain and discomfort and anxiety/depression problems being more pronounced, and economic status and health status played multiple mediating roles in the influence of general socio-demographic characteristics on quality of life in pneumoconiosis.

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.

Continuance intention and digital health resources from the perspective of elaboration likelihood model and DART model: a structural equation modeling analysis.

Background: Internet hospitals, online health communities, and other digital health APPs have brought many changes to people's lives. However, digital health resources are experiencing low continuance intention due to many factors, including information security, service quality, and personal characteristics of users. Methods: We used cross-sectional surveys and structural equation modeling analysis to explore factors influencing user willingness to continue using digital health resources. Results: Information quality (ß = 0.31, p < 0.05), service quality (ß = 0.19, p < 0.05), platform reputation (ß = 0.34, p < 0.05), and emotional support (ß = 0.23, p < 0.05) have significant positive effects on user value co-creation behavior. Additionally, user trust and perceived usefulness could mediate the association between user value co-creation behavior and continuance intention, with mediation effects of 0.143 and 0.125, respectively. User involvement can positively moderate the association between user value co-creation behavior and user trust (ß = 0.151, t = 2.480, p < 0.001). Also, user involvement can positively moderate the association between value co-creation behavior and perceived usefulness (ß = 0.103, t = 3.377, p < 0.001). Conclusion: The keys to solving the problem of low continuance intention are improving the quality and service level of digital health resources, and promoting users' value co-creation behavior. Meanwhile, enterprises should build a good reputation, create a positive communication atmosphere in the community, and enhance user participation and sense of belonging.

Loss of Sunda clouded leopards and forest integrity drive potential impacts of mesopredator release on vulnerable avifauna.

Amongst the unintended consequences of anthropogenic landscape conversion is declining apex predator abundance linked to loss of forest integrity, which can potentially re-order trophic networks. One such re-ordering, known as mesopredator release, occurs when medium-sized predators, also called mesopredators, rapidly increase in abundance following the decline in apex predator abundance, consequently reducing the abundance of mesopredator prey, notably including terrestrial avifauna. We examine the cascading impacts of declining Sunda clouded leopard abundance, itself consequent upon a reduction in forest integrity, on the mesopredator community of Sabah, Malaysia, to determine whether the phenomenon of mesopredator release is manifest and specifically whether it impacts the terrestrial avifauna community of pheasants and pittas. To explore this trophic interaction, we used a piecewise structural equation model to compare changes in the relative abundance of organisms. Our results suggest that loss of forest integrity may have broad impacts on the community and trigger mesopredator release, the two acting additively in their impact on already vulnerable species of terrestrial avifauna: a result not previously documented in tropical systems and rarely detected even on a global scale. The limiting effect that the Sunda clouded leopard has on the Sunda leopard cat could illuminate the mechanism whereby mesopredator release impacts this system. Both Bulwer's pheasant and pittas appear to be significantly impacted by the increase in Sunda leopard cats, while the great argus pheasant shows similar compelling, although not statistically significant, declines as Sunda leopard cats increase. The inverse relationship between Sunda clouded leopards and Sunda leopard cats suggests that if a mesopredator release exists it could have downstream consequences for some terrestrial avifauna. These results suggest the under-studied interface between mammalian carnivores and avifauna, or more broadly species interactions in general, could offer important conservation tool for holistic ecosystem conservation efforts.

Biochar effects on salt-affected soil properties and plant productivity: A global meta-analysis.

Biochar has been recognized as a promising practice for ameliorating degraded soils, yet the consensus on its effects remains largely unknown due to the variability among biochar, soil and plant. This study therefore presents a meta-analysis synthesizing 92 publications containing 987 paired data to scrutinize biochar effects on salt-affected soil properties and plant productivity. Additionally, a random meta-forest approach was employed to identify the key factors of biochar on salt-affected soil and plant productivity. Results showed that biochar led to significant reductions in electrical conductivity (EC), bulk density (BD) and pH by 7.4%, 4.7% and 1.2% compared to the unamended soil, respectively. Soil organic carbon (by 55.1%) and total nitrogen (by 31.3%) increased significantly with biochar addition. Moreover, biochar overall enhanced plant productivity by 31.5%, and more pronounced increases in forage/medicinal with higher salt tolerance than others. The results also identified that the soil salinity and biochar application rate were the most important co-regulators for EC and PP changes. The structural equation model further showed that soil salinity (P < 0.001), biochar pH (P < 0.001) and biochar specific surface area (P < 0.01) had a significant negative effect on soil EC, but it was positively impacted by biochar pyrolysis temperature (P < 0.05). Furthermore, plant productivity was positively affected by biochar pH (P < 0.001) and biochar feedstock (P < 0.01), while negatively influenced by biochar pyrolysis temperature (P < 0.01). This study highlights that woody biochar with 7.6 < pH < 9.0 and pyrolyzed at 400-600 °C under 30-70 t ha-1 application rate in moderately saline coarse soils is a recommendable pattern to enhance forage/medicinal productivity while reducing soil salinity. In conclusion, biochar offers promising avenues for ameliorating degradable soils, but it is imperative to explore largescale applications and field performance across different biochar, soil, and plant types.

Effects of dissolved organic matter on distribution characteristics of heavy metals and their interactions with microorganisms in soil under long-term exogenous effects.

Long-term waste accumulation (LTWA) in soil not only alters its physical and chemical properties but also affects heavy metals and microorganisms in polluted soil through the dissolved organic matter (DOM) it produces. However, research on the impact of DOM from LTWA on heavy metals and microorganisms in polluted soil is limited, which has resulted in an incomplete understanding of the mechanisms involved in LTWA soils remediation. This study focuses on the DOM generated by waste accumulation and analyses the physicochemical properties, microbial community structure, and vertical distribution of heavy metals in four types of LTWA soils at different depths (0-100 cm). A causal analysis is conducted using structural equation modelling. The results indicate that due to the retention effect of the soil and microorganisms, heavy metal pollution is concentrated on the soil surface layer (>30 cm). With increasing depth, there is a decrease in heavy metal concentration and an increase in microbial diversity and abundance. DOM plays a significant role in regulating the concentration of soil heavy metals and the diversity and abundance of microorganisms. The DOM from different soils gradually transforms into substances dominated by tyrosine, tryptophan, and fulvic acid, which sustain the normal life activities and gene expression of microorganisms. Bacteria such as Pseudarthrobacter, Desulfurivibrio, Thiobacillus, and Sulfurimonas, which are involved in energy transformation, along with genes such as water channel protein and YDIF, which enhance heavy metal metabolism, ensure that microbial communities can maintain basic life processes in polluted environments and gradually select for dominant species that are adapted to heavy metal pollution. These novel discoveries illuminate the potential for modulating the composition of DOM to amplify microbial activity, while concurrently offering insights into the migration patterns of various long-term exogenous pollutants. This foundational knowledge provides a foundation for the development of efficacious remediation strategies.

Comparing Life Expectancy Determinants Between Indonesia and Oman from 1980 to 2020.

Life expectancy (LE) is a health indicator of a population's health and well-being. Modeling the trajectory of LE aligns with the objectives of Indonesia's Vision 2045 and Oman's Vision 2040. This study examines the influence of health status-resources (HSR), macroeconomic (ME), and sociodemographic (SD) factors on LE in Indonesia and Oman. These two nations navigate the challenges of the middle-income trap in the Organization of Islamic Cooperation. This study adopted a national-scale population-based approach that focuses on retrospective observations. We used partial least square structural equation models with World Bank data from 1980 to 2020 to analyze the relationship between the mentioned factors and the LE of Oman and Indonesia. For Indonesia's model, the results showed that ME has a total effect of ß = 0.737 (p < 0.05) on LE, SD has a total effect of ß = 0.675 (p < 0.05) on LE, and HSR has a total effect of ß = 0.823 (p < 0.05) on LE. In Oman's model, ME has a total effect of ß = 0.848 (p < 0.05) on LE, SD has a total effect of ß = 0.755 (p < 0.05) on LE, and HSR has a total effect of ß = 0.335 (p < 0.05) on LE. The findings underscore the need for policies that meld health and societal perspectives to improve public health in both nations. A shift in public health interventions and perceptions towards socioeconomic well-being and societal issues is pivotal for advancing LE growth, potentially steering these countries from the middle-income trap.

Relationships between social networking sites use and subjective well-being--- a meta-analysis and meta-analytic structural equation model.

During the last decade, the amount of research on the relationship between social networking sites (SNS) use and users' subjective well-being (SWB) has increased, leading to discrepancies regarding the results. Our review of the literature generated 73 independent samples and indicated that considerable inconsistent results may be attributed to different measurements of SNS use, moderation effects, or media response states and their effects. In this study, meta-analytic procedures were used to assess the strength of the relationships between SNS use indicators, perceived social support (PSS), self-esteem and SWB. The results showed that PSS and self-esteem had stronger effects on SWB than SNS use indicators. Furthermore, a meta-analytic structural equation model was conducted to assess the strength of the relationships between SNS use indicators, PSS, self-esteem, and SWB. The results did not support the proposition SNS use is associated with SWB. Compared with SNS use indicators, media response states such as self-esteem and PSS, had more effects on SWB.

Phase-Transitions in Disgust During Self-Initiated Eating Among Adolescents With Anorexia Nervosa and Related Low-Weight Eating Disorders and Matched Controls.

BACKGROUND: Understanding the emotional context of feeding behavior may help identify causal mechanisms of food avoidance among individuals with anorexia nervosa. Although predominant food avoidance models assume fear of fat drives feeding behavior, disgust may be more theoretically and proximally relevant to moment-to-moment experiences of feeding. This study, therefore, aimed to examine affect and food avoidance using automated affect analysis from facial response by measuring time-specific transitions in disgust during a laboratory eating paradigm. We hypothesized that phase transitions in disgust would distinguish temporally self-initiated eating from food avoidance. METHODS: Sixty-three adolescents with anorexia nervosa or another low-weight eating disorder (LWED) and 27 age- and sex-matched controls were recruited as part of a larger study; 45 patients and 22 controls provided data on autonomous eating and facial affect during a laboratory meal. Dynamic structural equation models quantified moment-to-moment relationships between disgust and feeding behavior. RESULTS: Self-initiated eating was associated with greater increases in disgust, but not fear, intensity among those with LWED relative to control participants and greater disgust intensity predicted lower likelihood of self-initiated eating. DISCUSSION: Phasic transitions in disgust provide moment-to-moment evidence of affective influence on self-initiated eating and lend credibility to the hypothesis that disgust contributes to food avoidance and initiation in individuals with LWED.

Aberrant brain functional connectivity mediates the effects of negative symptoms on cognitive function in schizophrenia: A structural equation model.

BACKGROUND: Schizophrenia is a severe psychiatric disorder, characterized by positive symptoms, negative symptoms, and cognitive deficits. Elucidating the mechanism of negative symptom and cognitive deficits could contribute to the treatment and prognosis of schizophrenia. We hypothesized that abnormal functional connectivity would be involved in the indirect effects of negative symptoms on cognitive function. METHODS: A total of 150 schizophrenia male patients and 108 healthy controls matched for age, education and gender were enrolled in the study. The scores of Brief Negative Symptom Scale were divided into two factors: motivation and pleasure deficits (MAP) and diminished expression (EXP). Subsequently, a series of classic neurocognitive tests were used to evaluate cognitive functions. Resting-state fMRI data was collected from all participants. The Anatomical Automatic Labeling template was employed to establish regions of interest, thereby constructing the functional connectivity network across the entire brain. Eventually, scores of patients' negative symptoms scale, cognitive function, and strengths of abnormal functional connectivity were incorporated into a structural equation model to explore the interactions among variables. RESULTS: MAP exhibited a distinctly and significantly negative impact on cognitive function. The functional connectivity between the left insula and left precuneus, along with that between the left precuneus and right angular gyrus, collectively served as intermediaries, contributing to the indirect effects of MAP and EXP on cognitive function. CONCLUSIONS: Our findings demonstrated the moderating role of aberrant brain functional connectivity between negative symptoms and cognitive function, providing clues about the neural correlates of negative symptoms and cognitive deficits in schizophrenia.

Structural equation model analysis of the effect of visceral fat on osteoporosis.

BACKGROUND: Osteoporosis is a considerable public health challenge in Moyu County, Xinjiang. Here, we evaluated the influencing factors of osteoporosis in this region. METHODS: We recruited 7,761 participants and randomized them into normal and osteoporotic populations based on T-score. The effects of general conditions, body composition, calcium sources and exercise, respiratory exposure, and daily diet on osteoporosis were analyzed. Furthermore, a structural equation model was constructed to uncover the direct and indirect influencing factors of osteoporosis. RESULTS: Among the participants, 1,803 (23.23%) had normal bone mass while 1,496 (19.28%) had osteoporosis. The univariate analysis showed significant differences in the general conditions, body composition, calcium sources and exercise, respiratory exposure, and daily diet. Stratification based on age (45 years) and body mass index (BMI) (18.5 kg/m2) showed variations in the body composition between the two groups; however, the visceral fat differed significantly. Logistic regression analysis affirmed the association of visceral fat index as it was included in all equations, except for age and female menopause. The structural equation exhibited that the general conditions, body composition, and, calcium sources, and exercise were direct factors of osteoporosis, while respiratory exposure and daily diet were indirect factors. The standardized path coefficient was highest in general conditions, followed by body composition, and lastly, calcium sources and exercise. CONCLUSION: Obesity, besides age and female menopause, is also an influencing factor of osteoporosis. The visceral fat index plays a vital role in osteoporosis. Our findings may provide experimental evidence for early prevention and treatment of osteoporosis.

PathGPS: discover shared genetic architecture using GWAS summary data.

The increasing availability and scale of biobanks and "omic" datasets bring new horizons for understanding biological mechanisms. PathGPS is an exploratory data analysis tool to discover genetic architectures using Genome Wide Association Studies (GWAS) summary data. PathGPS is based on a linear structural equation model where traits are regulated by both genetic and environmental pathways. PathGPS decouples the genetic and environmental components by contrasting the GWAS associations of "signal" genes with those of "noise" genes. From the estimated genetic component, PathGPS then extracts genetic pathways via principal component and factor analysis, leveraging the low-rank and sparse properties. In addition, we provide a bootstrap aggregating ("bagging") algorithm to improve stability under data perturbation and hyperparameter tuning. When applied to a metabolomics dataset and the UK Biobank, PathGPS confirms several known gene-trait clusters and suggests multiple new hypotheses for future investigations.

The relationship between self-determined motivation, emotional involvement, cognitive involvement and leisure-time physical activity among college students.

Objective: Grounded in self-determination theory and the stimulus-organism-response framework, this study examines factors that affect college students' leisure-time physical activity by considering the basic psychological needs satisfaction (i.e., autonomy, competence, and relatedness), self-determined motivation, emotional and cognitive involvement. Methods: The sample included 526 students (47.8 % male; 57.2 % female) from four universities in central China. A structural equation model was used to analyze associations among variables. Results: The satisfaction of all three basic psychological needs had a significant positive impact on emotional involvement. Additionally, autonomy and competence need satisfaction had a significant positive impact on self-determined motivation and cognitive involvement. However, contrary to our expectation, there was no significant effect of relatedness need satisfaction on self-determined motivation and cognitive involvement. Furthermore, emotional involvement was found to have a significant effect on leisure-time physical activity intention for male students. Interestingly, the relationship between cognitive involvement and leisure-time physical activity intention is significant, but this effect was observed only among female students. Conclusion: Pedagogical strategies and tactics better satisfied students' psychological needs, promote physical education classes emotional and cognitive involvement, therefore, achieve autonomous active lifestyle behaviors in leisure time.

Pathways linking watershed development and riparian quality to stream water quality and fish communities: Insights from 233 subbasins of the Great Lakes region.

Anthropogenic stressors such as urban development, agricultural runoff, and riparian zone degradation impair stream water quality and biodiversity. However, the intricate pathways that connect these stressors at watershed and riparian scales to stream ecosystems-and their interplay with climate and hydrology-remain understudied. In this study, we used Partial Least Squares (PLS) path modeling to examine these pathways and their collective impacts on stream water quality and fish community structures across 233 watersheds in the Great Lakes region. Our study suggests that moderate levels of watershed development enhance overall fish richness, potentially due to increased water temperature and nutrient availability, but reduces both the percentages and richness of cold water and intolerant taxa. Riparian quality exerts indirect effects on water quality with climate and stream order serving as key mediators. Complementing our SEM analysis, we also used Multiple Linear Regression (MLR) models and identified a significant positive relationship between the proportion of clay and agricultural land with TN concentrations. However, TP concentrations are influenced by a more complex set of interactions involving developed areas, soil, and slope. These findings emphasize the necessity of adopting integrated management strategies to preserve the health and integrity of freshwater ecosystems in the Great Lakes region. These strategies should integrate watershed and riparian protection measures while also taking into account the effects of climate change and specific local conditions.

Medical ethics in childbirth: a structural equation modeling approach in south of Iran.

BACKGROUND: The existence of a valid instrument to evaluate the attitude of mothers towards compliance with medical ethics during childbirth can lead to appropriate interventions to create a positive attitude. The purpose of this study is to determine the construct validity of the MEAVDQ (Medical Ethics Attitude in Vaginal Delivery Questionnaire). METHODS: The study was carried out with 350 women. The main research instrument was MEAVDQ. This 59-item questionnaire comprises three parts A, B, J. Part A is concerned with the first principles. Part B deals with the second and third principles and part J addresses the fourth principle of medical ethics. Structural Equations Modeling (SEM) was used to determine the construct validity of MEAVDQ. RESULTS: The results of SEM revealed that there was a positive correlation between structures A and B. The relationship between structures B and J was also positive and significant. On the other hand, there was a direct and indirect relationship between structures A and J. One-unit increase in structure A led to 0.16 (95% CI: 0.01, 0.33) direct increase in structure J. Also, one-unit increase score increases in structure A caused 0.39 indirect rise (95% CI: 0.26, 0.53) in structure J with the mediating role of the structure B. CONCLUSIONS: It can be suggested to midwifery policy maker and midwives that respect for the first principle of medical ethics and autonomy is the most important principle of medical ethics in childbirth. By respecting the autonomy of mothers, a positive birth experience can be created for them.

Choice Function-Based Hyper-Heuristics for Causal Discovery under Linear Structural Equation Models.

Causal discovery is central to human cognition, and learning directed acyclic graphs (DAGs) is its foundation. Recently, many nature-inspired meta-heuristic optimization algorithms have been proposed to serve as the basis for DAG learning. However, a single meta-heuristic algorithm requires specific domain knowledge and empirical parameter tuning and cannot guarantee good performance in all cases. Hyper-heuristics provide an alternative methodology to meta-heuristics, enabling multiple heuristic algorithms to be combined and optimized to achieve better generalization ability. In this paper, we propose a multi-population choice function hyper-heuristic to discover the causal relationships encoded in a DAG. This algorithm provides a reasonable solution for combining structural priors or possible expert knowledge with swarm intelligence. Under a linear structural equation model (SEM), we first identify the partial v-structures through partial correlation analysis as the structural priors of the next nature-inspired swarm intelligence approach. Then, through partial correlation analysis, we can limit the search space. Experimental results demonstrate the effectiveness of the proposed methods compared to the earlier state-of-the-art methods on six standard networks.

Research on the Effects of the Relationship between Agronomic Traits and Dwarfing Genes on Yield in Colored Wheat.

This research focuses on 72 approved varieties of colored wheat from different provinces in China. Utilizing coefficients of variation, structural equation models, and correlation analyses, six agronomic traits of colored wheat were comprehensively evaluated, followed by further research on different dwarfing genes in colored wheat. Using the entropy method revealed that among the 72 colored wheat varieties, 10 were suitable for cultivation. Variety 70 was the top-performing variety, with a comprehensive index of 87.15%. In the final established structural equation model, each agronomic trait exhibited a positive direct effect on yield. Notably, plant height, spike length, and flag leaf width had significant impacts on yield, with path coefficients of 0.55, 0.40, and 0.27. Transcriptome analysis and real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) validation were used to identify three dwarfing genes controlling plant height: Rht1, Rht-D1, and Rht8. Subsequent RT-qPCR validation clustering heatmap results indicated that Rht-D1 gene expression increased with the growth of per-acre yield. Rht8 belongs to the semi-dwarf gene category and has a significant positive effect on grain yield. However, the impact of Rht1, as a dwarfing gene, on agronomic traits varies. These research findings provide crucial references for the breeding of new varieties.

Knowledge and attitude toward cervical cancer screening among women aged 30-49 years attending selected health facilities in Ethiopia: Using structural equation model.

Background: According to estimates, there were 570,000 new cases of cervical cancer in 2018, making it the fourth most common malignancy among women worldwide. Almost all 342,000 deaths from cervical cancer take place in low- and middle-income countries, accounting for 90 % of deaths. Few studies use structural equation modeling to comprehensively analyze the predictors of cervical cancer screening. Objective: The purpose of this study was to assess knowledge and attitude towards cervical cancer screening and its associated factors among women aged 30-49 years in Ethiopia. Methods: A facility-based cross-sectional study was conducted among eligible women attending health centers in Oromia and the southern nationality People regions. A systematic random sampling method was used to select 916 respondents. The data was collected using a structured interviewer-administered questionnaire. Structural equation modelling was employed to assess the direct and indirect relationship between knowledge and attitude toward cervical cancer screening. Results: The overall proportion of knowledge and attitude towards cervical cancer detection among women 30-49 years of age were 28 % and 57 %, respectively., income (adjusted ß= 0.075, 95 % CI: 0.042, 0.091), being urban (adjusted ß= 0.088, 95 % CI: 0.062, 0.093), being employee (adjusted ß= 0.119, 95 % CI: 0.113, 0.342), the number of parity (adjusted ß= 0.014, 95 % CI: 0.012, 0.021), usage of contraceptive (adjusted ß= 0.719, 95 % CI: 0.057, 0.082) and family history of cervical cancer (adjusted ß= 0.211, 95 % CI: 0.18, 0.302) were statistically significant associated factors with knowledge and Being smoker (adjusted ß=-0.157, 95 % CI: 0.265, -0.141). Having multiple sexual partnership (adjusted ß= 0.169, 95 % CI: 0.148, 0.349), having formal education (adjusted ß= 0.118, 95 % CI: 0.052, 0.294), live in urban area (adjusted ß= 0.116, 95 % CI: 0.023, 0.347), knowledge (adjusted ß= 0.42, 95 % CI: 0.301, 0.567) were statistically significant associated factors with the attitude of women toward cervical cancer screening. Conclusions: and recommendation: The study highlights a lack of awareness of cervical cancer screening, highlighting the need for improved routine practices, education campaigns, and treatment provision.

Associations of vegetable and fruit intake, physical activity, and school bullying with depressive symptoms in secondary school students: the mediating role of internet addiction.

BACKGROUND: Few studies have simultaneously focused on the associations of vegetable and fruit intake, physical activity, school bullying, and Internet addiction (IA) with depressive symptoms. This study aimed to explore the direct and indirect effects of the above factors on depressive symptoms in adolescents by constructing a structural equation model (SEM). METHODS: This study was conducted in Qingdao from September to November 2021. A total of 6195 secondary school students aged 10-19 years were included in the analysis. Information on all variables was assessed using a self-administered questionnaire. An SEM was constructed with depressive symptoms as the endogenous latent variable, IA as the mediating variable, and vegetable and fruit intake, physical activity, and school bullying as the exogenous latent variables. The standardized path coefficients (ß) were the direct effects between the latent variables, and the indirect effects were obtained by the product of direct effects between relevant latent variables. RESULTS: The median value with the interquartile range of depressive symptom scores was 7 (3,12). Vegetable and fruit intake (ß=-0.100, P<0.001) and physical activity (ß=-0.140, P<0.001) were directly negatively related to depressive symptoms. While school bullying (ß=0.138, P<0.001) and IA (ß=0.452, P<0.001) were directly positively related to depressive symptoms. IA had the greatest impact on depressive symptoms. Vegetable and fruit intake, physical activity, and school bullying could not only directly affect depressive symptoms, but also indirectly affect depressive symptoms through the mediating effect of IA, the indirect effects and 95% confidence intervals (CIs) were -0.028 (-0.051, -0.007), -0.114 (-0.148, -0.089) and 0.095 (0.060, 0.157), respectively. The results of the multi-group analysis showed that the SEM we constructed still fit in boy and girl groups. CONCLUSIONS: The results indicated that vegetable and fruit intake, physical activity, school bullying, and IA had a significant direct impact on depressive symptoms, among which IA had the greatest impact. In addition, both vegetable and fruit intake, school bullying, and physical activity indirectly affected depressive symptoms through the mediating effect of IA. The impact of IA on depressive symptoms should be given extra attention by schools and parents. This study provides a scientific and effective basis for the prevention and control of adolescent depressive symptoms.

Social support, health behavior self-efficacy, and anxiety on physical activity levels among lung cancer survivors: a structural equation modeling.

PURPOSE: The study aims to investigate the relationship among social support, health behavior self-efficacy, anxiety, and the physical activity (PA) levels of lung cancer survivors, and to analyze whether health behavior self-efficacy and anxiety mediate the relationship between social support and PA levels. METHODS: In a cross-sectional study of 1128 lung cancer survivors from 16 Chinese hospitals, we collected demographic data and administered the Social Support Rating Scale (SSRS), Self-Rated Abilities for Health Practices Scale (SRAHP), Anxiety Scale (AS), and International Physical Activity Questionnaire (IPAQ). SPSS 25.0 was used for descriptive analyses, while the structural equation model in SPSS AMOS 24.0 was used to identify the direct, indirect, and total effects among variables. RESULTS: There were significant correlations among SSRS, SRAHP, AS, and PA (P < 0.01). Model outcomes revealed a positive association between social support and health behavior self-efficacy (ß = 0.732, P < 0.001). Health behavior self-efficacy positively correlated with PA levels (ß = 0.228, P < 0.001) and negatively with anxiety (ß=-0.252, P = 0.001). Moreover, health behavior self-efficacy was found to partially mediate the relationship between social support and PA (ß = 0.174, P < 0.001). CONCLUSIONS AND IMPLICATIONS FOR CANCER SURVIVORS: This study revealed a positive correlation between social support and health behavior self-efficacy, and between health behavior self-efficacy and PA levels among lung cancer survivors. Additionally, health behavior self-efficacy mediated the relationship between social support and PA levels. In future clinical practice, medical and nursing staff should assess social support and health behavior self-efficacy in lung cancer survivors to inform personalized PA interventions.