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Strengthening the synergistic management of carbon and haze is an important means to realize China's "carbon peaking and carbon neutrality goals" and green development. In this paper, the entropy method is used to measure the key core technology innovation level of 30 provinces in China from 2011 to 2021, and the fixed-effect model is used to empirically test the impact of key core technology innovation on carbon haze synergistic governance and the internal mechanism. The study found that (1) key core technological innovation helps to promote carbon haze synergistic governance. (2) The mechanism test shows that key core technology innovation promotes the synergistic management of carbon haze by improving the clean energy structure. (3) The moderating effect shows that both market incentives and government environmental regulations will strengthen the positive relationship between key core technology innovation and carbon haze synergistic governance. The main contribution of this paper is to reveal the influence mechanism of key core technology innovation on carbon haze synergistic governance, and also to provide theoretical basis for the mechanism and law of carbon haze synergistic governance. [ABSTRACT FROM AUTHOR]

Background: Few studies are available on the relationship of androstenedione with inflammation and obesity and the effect of androstenedione and inflammation on the association between testosterone and obesity. This study intended to examine the mediation effect of inflammatory markers on the association of testosterone with obesity and the moderation effect of androstenedione on the association of testosterone with inflammation and obesity in Chinese rural men. Materials and methods: This cross‐sectional research enrolled 2536 male rural inhabitants from the Henan Rural Cohort study. The serum concentrations of testosterone and androstenedione were determined by liquid chromatography–tandem mass spectrometry. Linear and logistic regression were used to examine the relationships between testosterone, inflammatory markers, and obesity. Mediation and moderation analyses were carried out to evaluate the potential effects of inflammatory markers on the relationship between testosterone and obesity, as well as androstenedione on the relationships of testosterone with inflammation and obesity. Results: After adjusting for confounding factors, the results showed that testosterone and androstenedione were negatively related to obesity, and inflammatory markers were positively associated with obesity. Besides, testosterone and androstenedione were negatively associated with inflammatory markers. Mediation analysis showed that white blood cell, neutrophil, monocyte, and high‐sensitivity C‐reactive protein had mediating effects on the association between testosterone and obesity. The most vital mediator was high‐sensitivity C‐reactive protein, and its proportion of the effect was 11.02% (defined by waist circumference), 11.15% (defined by waist‐to‐hip ratio), 12.92% (defined by waist‐to‐height ratio), and full mediating effect (defined by body mass index). Moreover, androstenedione played negative moderation effects on the associations of testosterone with inflammation and obesity. Conclusion: Inflammatory markers and androstenedione were first found to have modifying effects on the association of testosterone with obesity. Higher levels of testosterone and androstenedione could reduce the inflammation level and risk of obesity, indicating their potential roles in the prevention and treatment of chronic diseases. [ABSTRACT FROM AUTHOR]

Based on the role of innovation in domestic economic development circulation (DEDC) and the impact of international economic development circulation (IEDC) on innovation, we construct an analytical framework for the mediation effect of innovation. Drawing on China's provincial panel data, we employ the causal steps approach to explore the impacts of IEDC on each link in the DEDC through the mediation effect of innovation. The results show that import have a direct effect on each link and export have a negative influence on distribution and consumption. Outward foreign direct investment (OFDI) has a negative impact on production and circulation through innovation. Foreign direct investment (FDI) and invisible ways have different indirect effects on each process. In addition, the influence of IEDC decreases from east to west in China, whereas import and export better promote DEDC in the central and western regions. [ABSTRACT FROM AUTHOR]

Individual typical endocrine-disrupting chemicals (EDCs), including organophosphate triesters (OPEs), parabens, triclosan (TCS), bisphenols, benzophenones (BPs), phthalates (PAEs), and synthetic phenolic antioxidants (SPAs), are associated with renal dysfunction. However, the combined effects and underlying mechanisms of mixed EDC exposure on renal function remain unclear. Two hundred ninety-nine adult participants were enrolled in the cross-sectional survey conducted in Guangzhou, China. Urinary levels of 7 OPEs, 6 parabens, TCS, 14 bisphenols, 8 BPs, 15 PAEs, 4 SPAs, and 8-hydroxy-2′-deoxyguanosine (8-OHdG) were determined, and estimated glomerular filtration rate (eGFR) was served as the outcome index. We found elevated levels of diphenyl phosphate (DPP), bisphenol A (BPA), mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), and mono-butyl phthalate (MBP) showed dose-responsive associations with eGFR decline, However, nonlinear associations were observed for bis(2-butoxyethyl) hydrogen phosphate (BBOEP), TCS, 4-hydroxybenzophenone (HBP), mono-n-pentyl phthalate (MnPP), and mono-benzyl phthalate (MBzP). The quantile-based g-computation model demonstrated that a quartile increase in the EDC mixture corresponded to a 0.383-SD decrease (95% CI − 0.658 ~ − 0.108, P = 0.007) in eGFR. Notably, BPA was identified as the primary contributor to this effect. Moreover, 8-OHdG mediated the eGFR decline associated with EDC mixtures with a mediation proportion of 25.49%. A sex-modified effect was also observed (P = 0.004), indicating that exposure to the mixture of EDC was linked to more pronounced renal dysfunction in females. Our novel findings suggest that exposure to a typical mixture of EDCs is associated with renal dysfunction in the general adult population of Southern China. Furthermore, 8-OHdG may play a role in the pathogenesis of EDC mixture-related renal dysfunction. [ABSTRACT FROM AUTHOR]

Supply chain security is a major prerequisite for China's successful industrial modernization, while the digital economy has significantly contributed to industrial transformation and upgrading. This study considers China's wooden furniture industry as its research object, constructing an evaluation index system of the digital economy and supply chain security of the wooden furniture industry. Then, it studies the impact of the digital economy on supply chain security through theoretical analysis and empirical methods using the two-way fixed model of provinces and time. The findings demonstrate that the digital economy effectively enhances the level of supply chain security in China's wooden furniture industry, further validating the digital economy's positive externality impact on the traditional real economy. The impact mechanism test shows that inventory turnover capacity is the focal point for the digital economy to improve the supply chain security of the wood furniture industry, specifying the starting point for that industry's digital transformation. The heterogeneity findings show that the role of the digital economy in improving the wood furniture industry's level of supply chain security is more significant in inland areas than in coastal areas. Additional analyses found a threshold effect of the digital economy's impact on supply chain security, indicating its limitations. This study explores the impact of the digital economy on the real economy from a traditional manufacturing industry, enriching research on the positive externalities of the digital economy as well as providing a reference for traditional manufacturing industries, such as that of wooden furniture, to probe the embedding points of the digital economy and appropriate digital transformation. [ABSTRACT FROM AUTHOR]

The integration of the advanced manufacturing industry and the modern service industry is an important direction for the transformation and upgrading of China's manufacturing industry. However, the existing research focuses more on the level, motivation, and economic effects of the integration of manufacturing and producer services, and less on its environmental effects. In this paper, based on the panel data from 30 provincial regions in China from 2005 to 2019, an evaluation system for the integration of manufacturing and producer services (IMP) is constructed, and the carbon emission efficiency (CEE) is calculated through the super-efficiency SBM model. Based on the analysis of the influence mechanism of IMP on CEE, the mediation effect model and the spatial Durbin model are used to test the influence of the IMP on CEE. The results show that the IMP can significantly improve CEE, and indirectly promote CEE through four intermediary factors: value addition, cost reduction, industrial agglomeration and structure upgrading. Finally, we found the level of economic development, property rights structure and regional innovation can promote CEE to varying degrees. The intensity of environmental regulation, opening level and the energy consumption structure inhibit the efficiency of carbon emissions. The total impact of the IMP on CEE is greater in the western region than in the eastern and central regions, and the western region shows a more significant spatial spillover effect. The IMP has a greater effect on improving CEE, and shows a strong spatial spillover effect. [ABSTRACT FROM AUTHOR]

Vascular calcification is a strong predictor of cardiovascular events. Essential metals play critical roles in maintaining human health. However, the association of essential metal levels with risk of aortic arch calcification (AoAC) remains unclear. We measured the plasma concentrations of nine essential metals in a cross‐sectional population and evaluated their individual and combined effects on AoAC risk using multiple statistical methods. We also explored the mediating role of fasting glucose. In the logistic regression model, higher quartiles of magnesium and copper were associated with the decreased AoAC risk, while higher quartile of manganese was associated with higher AoAC risk. The least absolute shrinkage and selection operator penalized regression analysis identified magnesium, manganese, calcium, cobalt, and copper as key metals associated with AoAC risk. The weighted quantile sum regression suggested a combined effect of metal mixture. A linear and positive dose–response relationship was found between manganese and AoAC in males. Moreover, blood glucose might mediate a proportion of 9.38% of the association between manganese exposure and AoAC risk. In summary, five essential metal levels were associated with AoAC and showed combined effect. Fasting glucose might play a significant role in mediating manganese exposure‐associated AoAC risk. [ABSTRACT FROM AUTHOR]

Protecting cropland quality is a fundamental national policy that China must adhere to for the long term. This study examines the impact of market-oriented allocation of land factors on farmers' cropland quality protection behaviors and its mechanism of action, based on survey data from 3804 farm households in the 2020 China Rural Revitalization Survey (CRRS). The study employs the Ordered Probit (O-probit) model, the mediated effect model, and other econometric tools to analyze the data. The study found that the market-oriented allocation of land factors can significantly promote farmers' adoption of cropland quality protection behaviors. The robustness test supports this conclusion. The market-oriented allocation of land factors indirectly promotes the adoption of cropland quality protection by expanding the plot size and improving agricultural income. The analysis of heterogeneity indicates that farmers are more likely to adopt cropland quality protection behaviors in the plains, suburban areas, or areas with better developed labor markets. Therefore, it is essential to continue promoting market-oriented reforms of rural land factors, actively promoting land transfer policies, and guiding the development of agricultural operations towards scaling, specialization, and modernization. This will achieve the rational allocation of land resources. It is important to consider geographical variations in each area when implementing policies to guarantee effective utilization and protection of cropland. [ABSTRACT FROM AUTHOR]

Based on the panel data of 16 cities in Hubei Province from 2009 to 2019 (excluding the data during Covid-19 pandemic period), we construct multi-temporal difference-in-differences model (DID) and Spatial Durbin model (SDM) to explore the impact of the High-speed Railway (HSR) construction on the regional economic development in terms of direct economic effect, indirect economic effect and spatial spillover effect. The main conclusions of this paper are as follows: firstly, HSR construction promotes the economic development of cities in Hubei Province in a long time and in a large spatial scope. And the impacts on the economic development are significantly heterogeneous among different types of cities. Also, HSR construction has widened the economic development gap among cities to some extent. Secondly, the upgrading of an industrial structure and the improvement of urbanization level both play mediating roles in the economic impact of HSR construction. Thirdly, the HSR construction has significant spatial spillover effect on economic development, but the spillover effect becomes insignificant with the increase of distance. [ABSTRACT FROM AUTHOR]

Objectives: This study explores the relationship among commuting, musculoskeletal (MS) pain, and burnout. Methods: An observational and cross-sectional study was conducted at a medical university-affiliated hospital in Taichung, Taiwan in 2021. The two questionnaire was used and they included the Copenhagen Burnout Inventory (CBI) and the Nordic Musculoskeletal Questionnaire (NMQ). All participants were invited to complete the cross-sectional survey. A multiple linear regression was assessed correlations between commuting, MS pain, and burnout. Results: After excluding those with missing data, 1,615 healthcare workers were deemed valid as research participants. In multiple linear regression, commuting time longer than 50 min was associated with personal burnout (PB) in the presence of adjusted confounders; however, long commuting time was not associated with work-related burnout (WB). Furthermore, the choice of commuting method did not affect PB or WB. Notably, both neck and shoulder pain (NBSP) and ankle pain (BAP) increase the risk of PB and WB. The mediation analysis demonstrated that NBSP is a mediating factor, increasing the level of PB and WB for commuting times longer than 50 min. Conclusions: Healthcare workers who commute for more than 50 min should be considered part of a high-risk group for burnout and musculoskeletal pain. They should also be provided with resources and programs focused on burnout prevention and MS pain relief. [ABSTRACT FROM AUTHOR]

Growing evidence has found the health protective effects of greenness exposure on tuberculosis (TB) and the impact of ambient air pollutants on TB drug-resistance. However, it remains unclear whether residential greenness is also beneficial to reduce TB drug-resistance, and whether air pollution modify the greenness-TB resistance relationship. We enrolled 5006 newly-diagnosed TB patients from Shandong, China, during 2014 to 2021. Normalized Difference Vegetation Index (NDVI) in 250 m and 500 m buffer around individuals' residential zone was used to assess greenness exposure. All patients were divided by quartiles of NDVI250-m and NDVI500-m (from low to high: Q1, Q2, Q3, Q4) respectively. Six logistic regression models (NDVI, NDVI + PM2.5/PM10/SO2/NO2/O3) were used to estimate the association of NDVI and TB drug-resistance when adjusting different air pollutants or not. All models were adjusted for age, gender, body mass index, complications, smoking, drinking, population density, nighttime light index, road density. Compared with participants in NDVI250-m Q1 and NDVI500-m Q1, other groups had lower rates of MDR-TB, PDR-TB, RFP-resistance, SM-resistance, RFP + SM resistance, INH + RFP + EMB + SM resistance. NDVI500-m reduced the risk of multidrug resistant tuberculosis (MDR-TB) and the adjusted odds ratio (aOR, 95% confidence interval, CI) compared with NDVI500-m Q1 were 0.736 (0.547–0.991) in NDVI + PM10 model, 0.733 (0.544–0.986) in NDVI + PM2.5 model, 0.735(0.546–0.99) in NDVI + SO2 model, 0.736 (0.546–0.991) in NDVI + NO2 model, respectively, P < 0.05. NDVI500-m contributed to a decreased risk of streptomycin (SM)-resistance. The aOR of rifampicin (RFP) + SM resistance were 0.132 (NDVI250-m, Q4 vs Q1, 95% CI: 0.03–0.578), 0.199 (NDVI500-m, Q3 vs. Q1, 95% CI: 0.057–0.688) and 0.264 (NDVI500-m, Q4 vs. Q1, 95% CI: 0.087–0.799). The adjusted ORs (Q2 vs. Q1, 95% CI) of isoniazid (INH) + RFP + ethambutol (EMB) + SM resistance in 500 m buffer were 0.276 (0.119–0.639) in NDVI model, 0.279 (0.11–0.705) in NDVI + PM10 model, 0.281 (0.111–0.713) in NDVI + PM2.5 model, 0.279 (0.11–0.709) in NDVI + SO2 model, 0.296 (0.117–0.754) in NDVI + NO2 model, 0.294 (0.116–0.748) in NDVI + O3 model, respectively. The study showed, for the first time, that residential greenness exposure in 500 m buffer is beneficial for reducing newly-diagnosed DR-TB (including PDR-RB, MDR-TB, MR-TB), and ambient air pollutants may partially mediate this association. [ABSTRACT FROM AUTHOR]

Introduction: Numerous observational studies have indicated that smoking is a substantial risk factor for esophageal cancer. However, there is a shortage of research that delves into the specific causal relationship and potential mediators between the two. Our study aims to validate the correlation between smokingrelated traits and esophageal cancer while exploring the possible mediating effects of immune factors. Methods: Initially, we conducted bidirectional univariate Mendelian Randomization (MR) analyses to forecast the causal effects linking smokingrelated traits and esophageal cancer. Subsequently, we employed a two-step MR analysis to scrutinize immune cell phenotypes that could mediate these effects. Finally, the coefficient product method was employed to determine the precise mediating impact. Additionally, we have refined our sensitivity analysis to ensure the reliability of the outcomes. Results: After analysis, Smoking status: Never had a significant negative association with the incidence of esophageal cancer (inverse-variance weighted (IVW) method, p=1.82e-05, OR=0.10, 95%CI=0.04~0.29). Ever smoked (IVW, p=1.49e-02, OR=4.31, 95%CI=1.33~13.94) and Current tobacco smoking (IVW, p=1.49e-02, OR=4.31, 95%CI=1.33~13.94) showed the promoting effect on the pathogenesis of esophageal cancer. Through further examination, researchers discovered 21 immune cell phenotypes that have a causal relationship with esophageal cancer. After careful screening, two immune cell phenotypes were found to have potential mediating effects. In particular, it was observed that in the case of the preventive effect of Smoking status: Never on esophageal cancer, the absolute count of CD62L plasmacytoid dendritic cells mediated a reduction of 4.21%, while the mediating effect of CD27 in CD20-CD38-B cells was -4.12%. In addition, sensitivity analyses did not reveal significant heterogeneity or level pleiotropy. Conclusion: The study provides new evidence for the causal relationship between smoking-related features and esophageal cancer and proposes immune factors with potential mediating effects. However, this finding needs to be further demonstrated by more extensive clinical studies. [ABSTRACT FROM AUTHOR]

There is evidence that childhood maltreatment (CM) is an important risk factor for adult criminal behavior. However, little is known about the cognitive processes mediating this relationship. This study examined the mediating role of executive functioning (EF) on the relationship between CM and history of criminal behavior on a sample of 334 male individuals in custody from Uruguay. Preliminary results showed that CM was significantly associated with past criminal behavior in all multivariate models. The mediation analysis found that behavioral regulation had a significant mediating role while the metacognition and EF total score did not. Finally, the inhibition domain was the strongest mediator. This suggests that CM is an important risk factor that needs to be considered in Uruguay, and addressing behavioral regulation may also help to address some of the long-term consequences of CM and targeting deficits in inhibition could be a potential target for treatment for individuals that commit criminal offenses. [ABSTRACT FROM AUTHOR]

【Objective】The digitization of agriculture and rural areas is considered to be a crucial element in promoting rural revitalization and enhancing agricultural construction, significantly contributing to the increase of farmers’ income. The study aims to develop an comprehensive framework for evaluating the digitization of agriculture and rural areas, empirically investigating its effectiveness in income increase and clarifying the action mechanisms. Additionally, it provides policy-oriented insights to alleviate the challenges of the “digital divide” and to advance the sophisticated development of the digital economy in agricultural and rural areas.【Method】The panel data from 31 provinces (region) in China from 2011-2020 was selected, and the Entropy-Weighted TOPSIS Method was applied for assessing the level of digitalization in agriculture and rural areas. The fixed and mediation effects were utilized to investigate the influence and mechanisms of digitalization on farmers’ income increase. A threshold model was employed to explore the threshold effects between the digitalization and the increase of farmers’ income.【Result】(1) Digitalization in agriculture and rural areas significantly enhances farmers’ income; with a 1% increase in digitalization level corresponding to an average income increase of 57.4 CNY for farmers. The positive effect is more pronounced in the eastern regions, while it appears to be inhibitory in the central regions and less evident in promoting income in the western regions, indicating the presence of a “digital divide”. (2) Digitalization in agriculture and rural areas contributes to farmers’ income increase through multiple channels: fostering diversification of farmers’ occupations, accelerating land circulation, enhancing the probability of farmers obtaining financing, and promoting the sales of agricultural products. (3) Digital inclusive finance exhibits significant dual threshold effects between digitalization in agriculture and rural areas and farmers’ income increase, with the first threshold value at 33.401 and the second at 148.370. As the threshold interval increases, the impact of digitalization on farmers’ income increase demonstrates a “positive U-shaped” relationship, showing as initially inhibitory and subsequently promotive.【Conclusion】Digitalization in agriculture and rural areas effectively facilitates income increase for farmers, however, the challenges of the “digital divide” persist. Consequently, it proposes policy implications such as enhancing digital infrastructure, providing training and education in agricultural digitalization, promoting the development of rural digital inclusive finance, and formulating region-specific digital development strategies to further augment farmers’ income. [ABSTRACT FROM AUTHOR]

Objective:To explore relationships among functions of non-suicidal self-injury(NSSI), addictions of NSSI and neuroticism personality in adolescents and young adults with mental disorders. Methods:A total of 305 inpatients aged 16-25 years old with depressive disorder, bipolar disorder or eating disorder according to diagnostic criteria in the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision(ICD-10) who reported lifetime NSSI were recruited. The subscale of function and subscale of addiction in the Ottawa self-injury inventory(OSI) were used to assess the functions and addictions of NSSI. The NEO Five Factor Inventory(NEOFFI) were used to assess the neuroticism personality. Results:There were significant moderate positive correlations among scores of NSSI functions, NSSI addictions and neuroticism personality(r=0. 32～0. 53, P ＜0. 001). Neuroticism played a moderating role between functions of NSSI and addictions of NSSI(β=0. 60, 0. 49, 0. 37, Ps ＜0. 001). Functions of NSSI played a partial mediating role between neuroticism and addictions of NSSI(β=0. 15, P ＜0. 001). The mediation effect accounted for 49. 4% of the total effect Conclusion: The higher the neuroticism of adolescents and young adults with mental disorders, the stronger the correlation between functions of NSSI and addictions of NSSI. Neuroticism may affect addictions of NSSI indirectly by strengthening NSSI function. [ABSTRACT FROM AUTHOR]

This study was conducted to explore barriers to ABC adoption in the Tanzanian manufacturing and service sectors, notwithstanding its superiority over the traditional costing system. It went further to suggest solutions to such barriers by evaluating the mediating role of behavioral preferences on the causal relationship between the innovation attributes composite and ABC adoption. Based on the cross-sectional survey design, primary data were collected from a sample of 188 companies located in the Dar es Salaam, Arusha and Dodoma regions. Partial least squares structural equation modeling (PLS-SEM) revealed that none of the behavioral preferences positively mediated the causal relationship between the innovation attributes composite and ABC adoption at level 1. At level 2, the findings show that, it was the mediating effect by the perceived usefulness (p = 0. 0 0 1 ,  β = 0. 2 3 8) only that was statistically significant. With the exception of the perceived ease of use, the mediating effects by perceived usefulness (p = 0. 0 0 9 ,  β = 0. 0 1 8) and normative beliefs (p = 0. 0 4 5 ,  β = 0. 0 1 6) were further confirmed to be statistically significant at level 3 of adoption. Moreover, the mediating effects by the perceived ease of use (p = 0. 0 3 9 ,  β = 0. 1 2 3) and normative beliefs (p = 0. 0 0 5 ,  β = 0. 1 1 5) were found to be statistically significant at level 4 of adoption. At the highest level 5 of ABC adoption, it was the normative belief (p < 0. 0 0 1 ,  β = 0. 2 2 1) only that positively mediated the causal relationship between the innovation attributes composite and ABC adoption. [ABSTRACT FROM AUTHOR]

IntroductionPrevious research has shown that leisure activities can positively influence perceived health outcomes by increasing individuals’ levels of physical activity. Yet, little has been discovered about the mechanisms that are driving this association. This study was conducted with the aim of examining the relationship between perceived health outcomes of recreation and happiness as well as the mediating effect of resilience.MethodsThe study comprised a total of 451 adult individuals residing in seven different geographical regions of Turkey, who were included using a convenience sampling method, and the data were collected between March and June 2023. Respondents completed assessments utilizing the Perceived Health Outcomes of Recreation, Brief Resilience Scale, and The Oxford Happiness Questionnaire-Short Form. Data analysis was executed employing the PROCESS macro for SPSS.ResultsThe study’s findings revealed that perceived health outcomes of recreation had a positive effect on both happiness (β = 0.146, [95% CI: 0.106, 0.186]) and resilience (β = 0.156, [95% CI: 0.107, 0.205]). Resilience had a positive effect on happiness (β = 0.435, [95% CI: 0.362, 0.507]). Furthermore, the relationship between perceived health outcomes of recreation and happiness was partially mediated by resilience (β = 0.068, [95% CI: 0.042, 0.096]).ConclusionAs a result, participating in leisure activities has been found to have a positive impact on perceived health outcomes, which in turn positively affects both happiness and resilience. Additionally, psychological resilience can be said to partially mediate the relationship between perceived health outcomes of recreation and happiness.

BackgroundAnxiety and depression are serious psychological and public health issues among the older adults. Currently, there is a lack of understanding of the relationship between Body Mass Index (BMI) and anxiety or depression symptoms in the older adult population in China. Therefore, the purpose of this study is to investigate the impact of BMI on anxiety and depression through correlation analysis in different subgroups and to examine the potential chain mediating effects of Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) between BMI and symptoms of anxiety and depression.MethodsFrom the CLHLS database conducted in 2017–2018, data regarding height, weight, anxiety symptoms, depression symptoms, as well as demographic, socioeconomic, behavioral, and health-related characteristics were collected. Multivariate logistic regression analysis was used to explore the impact of BMI on anxiety and depression symptoms. Finally, the SPSS macro process was utilized to test the multiple mediating effects of ADL and IADL between BMI and anxiety or depression symptoms.ResultsAfter screening, a final sample of 9,098 Chinese older adult individuals aged 65 and above was selected. Among them, 1,074 cases (11.8%) exhibited anxiety symptoms, 1,458 cases (16.0%) exhibited depressive symptoms. Compared to normal BMI, the adjusted analysis showed that underweight in Chinese older adult individuals was significantly associated with anxiety (OR = 1.316, p = 0.004) and depression (OR = 1.232, p = 0.013). This relationship was found to be more significant in males, individuals aged 80 and above, unmarried individuals, and those residing in town. ADL and IADL played a chain-mediated role between BMI and anxiety symptoms in the older adult. BMI not only had a direct effect on anxiety symptoms in the older adult (effect = −0.0159; SE = 0.0066; 95%CI: LL = −0.0288, UL = −0.0031), but also influenced them indirectly through two pathways: the independent mediating role of IADL (effect = −0.0010; SE = 0.0005; 95%CI: LL = −0.0018, UL = −0.0003) and the chain-mediated role of ADL and IADL (effect = −0.0012; SE = 0.0004; 95%CI: LL = −0.0020, UL = −0.0006).ConclusionIn the older adult individuals in China, underweight is associated with an increased risk of anxiety and depression symptoms. Improving the underweight condition of Chinese older adult individuals can reduce their ADL and IADL limitations, thereby benefiting their mental health.

IntroductionDepression can exacerbate diabetes by impairing self-care behaviors and increasing the risk of complication; however, the underlying mechanism is still unclear. Given the suggested associations between walking activity, depression status, and blood glucose levels this study explores the intricate relationship between depression and blood glucose (BG) control, with a focus on walking activity as a behavioral mediator. The purpose of this study is to examine walking activity’s mediating role in depression’s impact on BG levels, investigating and validating the non-linear association between BG levels and walking activity. This retrospective real-world study demonstrates the potential of regular walking activity as a simple and accessible intervention to mitigate the negative effects of depression on BG levels in T2D and prediabetes.MethodsA cohort of 989 users with T2D and prediabetes, who regularly tracked their steps levels and BG levels for 12 months using the Dario digital health platform was evaluated. The mediating role of the monthly average number of steps on the relationship between the self-reported depression status and lagged monthly average BG was assessed. Additionally, the association between monthly walking activity and monthly average BG was tested using a piecewise linear mixed effects model.ResultsUsers with self-reported depression demonstrated increased BG levels compared to users without depression (B=8.00, P=.01). The association between depression and monthly average number of steps was significant (B=-.27, P

Background: Little is known about the combined effect of bisphenol mixtures and metal mixtures on type 2 diabetes mellitus (T2DM) risk, and the mediating roles of metabolites. Methods: The study included 606 pairs of T2DM cases and controls matched by age and sex, and information of participants was collected through questionnaires and laboratory tests. Serum bisphenol and plasma metal concentrations were measured using ultra-performance liquid chromatography-mass spectrometry (UPLC-MS/MS) and inductively coupled plasma-mass spectrometry (ICP-MS), respectively. Widely targeted metabolomics was employed to obtain the serum metabolomic profiles. Conditional logistic regression models were used to assess the single associations of bisphenols and metals with T2DM risk after multivariable adjustment. Additionally, the joint effects of bisphenol mixtures and metal mixtures were examined using quantile-based g-computation (QG-C) models. Furthermore, differential metabolites associated with T2DM were identified, and mediation analyses were performed to explore the role of metabolites in the associations of bisphenols and metals with T2DM risk. Results: The results showed bisphenol mixtures were associated with an increased T2DM risk, with bisphenol A (BPA) identified as the primary contributor. While the association between metal mixtures and T2DM remained inconclusive, cobalt (Co), iron (Fe), and zinc (Zn) showed the highest weight indices for T2DM risk. A total of 154 differential metabolites were screened between the T2DM cases and controls. Mediation analyses indicated that 9 metabolites mediated the association between BPA and T2DM, while L-valine mediated the association between Zn and T2DM risk. Conclusions: The study indicated that BPA, Co, Fe, and Zn were the primary contributors to increased T2DM risk, and metabolites played a mediating role in the associations of BPA and Zn with the risk of T2DM. Our findings contribute to a better understanding of the mechanisms underlying the associations of bisphenols and metals with T2DM.

Exploring the longitudinal relationship between career adaptability, career commitment, career identity, and career well-being among Chinese undergraduate nursing students. A mediation effect analysis was performed. The Career Adaptability Scale, the Chinese version of Career commitment, the Career identity Scale, and the Career well-being Scale were used as research instruments. Six hundred ninety-two nursing students were followed up in two waves to explore the relationships among career adaptability, career commitment, career identity, and career well-being. Model comparison was performed to explore the differences in such relationships between low and high-career interests. Career commitment at T1 mediated the relationship between career adaptability at T1 and career identity at T2 and that between career adaptability at T1 and career well-being at T2. Significant differences were observed between the mediation models of nursing students with high and low career interests. Career commitment plays a longitudinal mediator role in the relationship between career adaptability and career identity and the relationship between career adaptability and career well-being.

Several studies have suggested an association between exposure to various metals and the onset of type 2 diabetes (T2D). However, the results vary across different studies. We aimed to investigate the associations between serum metal concentrations and the risk of developing T2D among 8734 participants using a prospective cohort study design. We utilized inductively coupled plasmamass spectrometry (ICP-MS) to assess the serum concentrations of 27 metals. Cox regression was applied to calculate the hazard ratios (HRs) for the associations between serum metal concentrations on the risk of developing T2D. Additionally, 196 incident T2D cases and 208 healthy control participants were randomly selected for serum metabolite measurement using an untargeted metabolomics approach to evaluate the mediating role of serum metabolite in the relationship between serum metal concentrations and the risk of developing T2D with a nested casecontrol study design. In the cohort study, after Bonferroni correction, the serum concentrations of zinc (Zn), mercury (Hg), and thallium (Tl) were positively associated with the risk of developing T2D, whereas the serum concentrations of manganese (Mn), molybdenum (Mo), barium (Ba), lutetium (Lu), and lead (Pb) were negatively associated with the risk of developing T2D. After adding these eight metals, the predictive ability increased significantly compared with that of the traditional clinical model (AUC: 0.791 vs. 0.772, P=8.85×10−5). In the nested casecontrol study, a machine learning analysis revealed that the serum concentrations of 14 out of 1579 detected metabolites were associated with the risk of developing T2D. According to generalized linear regression models, 7 of these metabolites were significantly associated with the serum concentrations of the identified metals. The mediation analysis showed that two metabolites (2-methyl-1,2-dihydrophthalazin-1-one and mestranol) mediated 46.81% and 58.70%, respectively, of the association between the serum Pb concentration and the risk of developing T2D. Our study suggested that serum Mn, Zn, Mo, Ba, Lu, Hg, Tl, and Pb were associated with T2D risk. Two metabolites mediated the associations between the serum Pb concentration and the risk of developing T2D.

[Objective] The purpose of this paper is to explore the impact path of technological innovation on carbon productivity, give full play to the carbon reduction and efficiency enhancement capabilities of technological innovation, and provide a reference for promoting regional high-quality development and the realization of the dual carbon goals. [Methods] Taking the Yellow River Basin and the Yangtze River Economic Belt as research regions, this study examined the influence path of technological innovation on carbon productivity and the mediation effect of digital finance by constructing a stochastic impacts by regression on population, affluence, and technology (STIRPAT) model and a mediation effect model respectively. [Results] The results show that: (1) Technological innovation of cities can improve regional carbon productivity levels, and the impact of technological innovation on carbon productivity exhibits regional heterogeneity. The impact of technological innovation on carbon productivity is stronger in the Yangtze River Economic Belt than in the Yellow River Basin. (2) Digital finance can partially mediate the impact of technological innovation on carbon productivity. Technological innovation can improve regional carbon productivity through digital finance. The mediation effect of digital finance is stronger in the Yangtze River Economic Belt than in the Yellow River Basin. (3) Improving the level of urbanization and economic development can promote the improvement of carbon productivity in the Yellow River Basin, and improving the level of urbanization and economic development and accelerating the upgrading of industrial structure can promote the improvement of carbon productivity in the Yangtze River Economic Belt. [Conclusion] This study suggests that local governments should enhance the technological innovation capabilities of cities, promote the deep integration of digital finance and traditional industries, strengthen regional industrial technology exchange and cooperation, promote the green transformation of industries in the Yellow River Basin and the Yangtze River Economic Belt, and ultimately achieve regional low-carbon and sustainable development.

Jiashu Zhu,1 Ye Li,1 Rui Wang,1 Jinfang Zhang,2 Can Liu,1 Hongyu Li,1 Deguang Yang,1 Shuqin Ma,2 Suzhen Guan1 1School of Public Health, Ningxia Medical University, Yinchuan City, Ningxia, People’s Republic of China; 2Obstetric Clinic, General Hospital of Ningxia Medical University, Yinchuan City, Ningxia, People’s Republic of ChinaCorrespondence: Suzhen Guan, School of Public Health, Ningxia Medical University, Yinchuan City, Ningxia, 750004, People’s Republic of China, Tel +86 13389511821, Email guansz_nx2017@sina.com Shuqin Ma, General Hospital of Ningxia Medical University, Yinchuan City, Ningxia, 750004, People’s Republic of China, Tel +86 13895493649, Email 3117957376@qq.comObjective: To examine the relationship between pregnancy-related anxiety, family functions, and sleep quality, and to determine whether family functions mediate the relationship between pregnancy-related anxiety and sleep quality.Methods: A cross-sectional survey was conducted on pregnant women between April to August in 2022 in the obstetrics outpatient clinic of a tertiary care hospital in the Ningxia Hui Autonomous Region of China. A total of 1014 pregnant women aged 18 years and older were surveyed. They completed questionnaires, including: general demographic characteristics, the Pregnancy-related anxiety scale (PAQ), the Family Adaptation, Partnership, Growth, Affection, and Resolve (APGAR), and the Pittsburgh Sleep Quality Index Questionnaire (PSQI). Model 4 in PROCESS was used to analyze the relationships among pregnancy-related anxiety, family functions, and sleep quality, with family functions as a mediator.Results: Among the 1014 pregnant women, the pregnancy-related anxiety scale score was (21.84 ± 5.64). The total score of the family functions scale was (8.10± 2.26), and the overall sleep quality scale score was (7.89± 2.99). When participants were grouped according to different socio-demographic characteristics, the study showed that all variables differed from anxiety, family functions or sleep quality, except for age, pre-pregnancy BMI and whether or not they had a first birth, which was not associated with anxiety, family functions, or sleep quality (P< 0.05). The pregnancy-related anxiety was positively associated with sleep quality (P< 0.01), while family functions were negatively associated with sleep quality (P< 0.01). In addition, family functions mediate the relationship between pregnancy-related anxiety and sleep quality during pregnancy, on the first and second trimesters, intermediation rate is 9.31% (P< 0.05), and on the third trimesters, intermediation rate is 21.38% (P< 0.05).Conclusion: Pregnancy- related anxiety is a risk factor for sleep quality, however, family functions are protective factors for sleep quality. Family functions play an intermediary role in sleep quality caused by pregnancy-related anxiety, especially on the third trimesters. This finding may provide a scientific basis for developing intervention strategies to improve the sleep quality of pregnant women.Keywords: pregnancy-related anxiety, family functions, sleep quality, mediation effect

Chih-Hsuan Huang,1– 3 Hsin-Hung Wu,4,5 Yii-Ching Lee,6 Xiumei Li1 1Business School, Hubei University of Economics, Wuhan City, People’s Republic of China; 2Hubei Enterprise Culture Research Center, Hubei University of Economics, Wuhan, People’s Republic of China; 3Research Center of Hubei Logistics Development, Hubei University of Economics, Wuhan, People’s Republic of China; 4Department of Business Administration, National Changhua University of Education, Changhua City, Taiwan; 5Faculty of Education, State University of Malang, Malang, East Java, Indonesia; 6Department of Health Business Administration, Hung Kuang University, Taichung City, TaiwanCorrespondence: Yii-Ching Lee, Department of Health Business Administration, Hung Kuang University, No. 34 Zhongqi Road, Shalu District, Taichung City, Taiwan, Tel +886-4-26318652, Email yiiching.lee@sunrise.hk.edu.twPurpose: This research aims to investigate the role of management leadership in promoting a culture of patient safety within healthcare organizations. Through a comprehensive mediation analysis of the Chinese version of the safety attitudes questionnaire (CSAQ) and patient safety culture, the study examines the interplay between these critical factors and their combined influence on healthcare outcomes.Patients and Methods: In a medical center located in Taiwan, a cross-sectional survey was carried out utilizing the CSAQ. Among the 1500 distributed surveys, 1037 were returned and deemed valid, resulting in a return rate of 69.13%. To investigate the main measures, Structural Equation Modeling with mediation analysis was employed to scrutinize the direct and indirect effects of factors including teamwork climate, job satisfaction, stress recognition, perceptions of management, working conditions, and emotional exhaustion on safety climate.Results: The findings reveal that effective management leadership plays a pivotal role in shaping safety attitudes and fostering a robust patient safety culture. The study identifies three critical facets of patient safety that are entirely mediated by management perceptions: teamwork climate, working conditions, and stress recognition. The results highlight the importance of enhancing these dimensions to advance the patient safety culture within healthcare organizations. Moreover, stress recognition is identified as a critical factor influencing the organizational culture of patient safety.Conclusion: This research offers valuable insights for healthcare organizations seeking to prioritize patient safety and improve overall quality of care. By enhancing our understanding of the critical factors that shape safety attitudes and patient safety culture, this study provides a roadmap for effective management leadership and a culture of patient safety within healthcare organizations. The study underscores the significance of management leadership in promoting patient safety culture and highlights the importance of enhancing teamwork climate, working conditions, and stress recognition to advance patient safety culture.Keywords: management leadership, safety attitudes questionnaire, patient safety culture, mediation effect

Abstract Background Self-management (SM) is the key factor in controlling the progression of chronic obstructive pulmonary disease (COPD). Previous studies have reported that majority of COPD patients later presented with frailty and mental health diseases, which affect self-management. This study attempted to explore the mediation role of depression and frailty between social support and self-management in elderly COPD population. Methods Six hundred twenty-seven stable elderly COPD patients admitted to 5 public hospitals in Ningxia, China were selected as study subjects by convenience sampling method. Self-management, frailty, depression and social support were assessed using the COPD Self-management Scale (COPD-SMS), Frail Scale (FS), 15-item Geriatric Depression Scale (GDS-15), and Social Support Rating Scale (SSRS) respectively. The Pearson correlation analysis was used to assess the correlation between variables. Additionally, SPSS25.0 PROCESS plugin Model 6 was used to explore the mediating effects of frailty and depression in the relationship between social support and self-management. Results The mean participant age was 72.87 ± 7.03 years, 60.4% of participants were male. The mean total score of the COPD-SMS was 156.99 ± 25.15. Scores for the SSRS, FS, and GDS-15 were significantly correlated with COPD-SMS (p

Background: The association between the frequency of going outdoors and the risk of poor oral health has been reported in several studies; however, the findings have been inconclusive. Methods: We conducted a 3-year longitudinal study of 19,972 Japanese adults aged ≥65 years who reported no poor oral condition at baseline in 2013. The respondents rated their frequency of going outdoors in three categories (≤1, 2–3, or ≥4 times/week), and the oral conditions reported in 2016 included tooth loss, chewing difficulty, swallowing difficulty, dry mouth, and composite outcomes. The associations between the frequency of going outdoors and the risk of poor oral health were examined as relative risk ratios (RRs) and 95% confidence intervals (CIs) using multivariable Poisson regression, while mediation analysis was performed to investigate indirect effects. Results: During the follow-up, 32.5% of participants developed poor oral health. In the mediation analysis, indirect effects were observed through low instrumental activities of daily living, depressive symptoms, little social network diversity, and underweight. Compared to going outdoors ≥4 times/week, the multivariable RRs of composite poor oral health conditions were 1.12 (95% CI, 1.05–1.20) for 2–3 times/week and 1.22 (95% CI, 1.07–1.39) for ≤1 time/week (P-trend < 0.001). Similar associations were observed for tooth loss, chewing difficulty, and swallowing difficulty; the corresponding RRs were 1.07 (95% CI, 0.97–1.19) and 1.36 (95% CI, 1.13–1.64) (P-trend = 0.002), 1.18 (95% CI, 1.06–1.32) and 1.30 (95% CI, 1.05–1.60) (P-trend < 0.001), and 1.15 (95% CI, 1.01–1.31) and 1.38 (95% CI, 1.08–1.77) (P-trend = 0.002), respectively. Conclusion: The frequency of going outdoors was inversely associated with the risk of poor oral health through several modifiable risk factors in the older population.

Abstract Objective The aim of this study is to investigate the potential association between a history of gestational diabetes mellitus (GDM) and lumbar bone mineral density (BMD) among premenopausal women, with an additional examination of the mediating role of serum total cholesterol (TC). Methods In this cross-sectional study, 1809 women aged 20–49 years with at least one live birth between 2011 and 2018, drawn from the NHANES dataset, were analyzed. GDM history was identified through questionnaires. Using weighted multiple linear regression, we assessed the relationship between GDM history and lumbar BMD. Additionally, mediation analysis was performed to investigate the potential mediating role of TC. Results The fully adjusted linear regression model revealed a negative association between a history of GDM and lumbar BMD, indicating a reduction in lumbar BMD (β = -0.023, 95% CI: -0.043, -0.003, P = 0.0275). Subgroup analysis highlighted a more pronounced trend in individuals aged ≥ 35 years and with a body mass index ≥ 30 kg/m². Furthermore, mediation analysis demonstrated a significant direct effect of a history of GDM on lumbar BMD (P

“Structural Equation Modeling is one of multivariate statistical method that used to explain multiple relationships between latent variables simultaneously to test a mediation model to conduct a formal test on mediation effects. Application PLS-SEM for exploratory research and theory development are increasing. Under certain conditions, the effect of exogenous variables on endogenous variable is also strengthened or weakened by moderating variable. In SEM, there are two approaches in analyzing moderation variables, namely the interaction method and the multigroup method. This article aims to compare the mediation effect on interaction approaches and multigroup approaches in Structural Equation Modeling. The data used is the case of timeliness of Bank X mortgage payments. In this article, statistical methods are evaluated to compare indirect effect between groups and examine indirect effect on each group. It was concluded that Collectability Status moderates the indirect relationship between Capital and the Timeliness of Payment through Willingness to Pay. Debtors with current collectability status more strongly effect the Timeliness of Payment than debtors with incurrect collectability status. Theresults of testing indirect effects on moderation with interaction and multigroup approaches are not much different. In the multigroup approach, the bootstrap interval bias is smaller than the bootstrap interval bias in the interaction approach. The Q-square Predictive Relevance value in both methods is quite high, indicating that the model is good. On the Current Collectibility Status group Q^2 is 89.3%, in the incurrect Collectibility Status Q^2 is 84.2%. While in the interaction approach, Q^2 is 70.4%. Researcher recommend a multigroup approach to data that has categorical moderation variables because differences between groups can be directly observed without adding interaction variables in the model.”

[Objective] Examining farming households’ homestead withdrawal willingness by considering the endowment effect and risk coping capacity has great significance for deepening homestead reform in China. [Methods] This study constructed a theoretical framework based on endowment effect, risk coping capacity, and homestead exit willingness, and used a mediation effect model to analyze the mediation effect of endowments on the impact of risk coping capacity on homestead exit willingness, used the threshold model to analyze the double threshold effect of risk coping capacity on homestead exit willingness, and explored the differences in the mediation role of endowments at each level of risk coping capacity. [Results] (1) The endowment effect has a significant negative impact on the willingness to withdraw from the homestead through the three paths of subject attachment, object dependence and uncertainty perception; (2) The impact of risk carrying capacity on the willingness to withdraw from the homestead has a double threshold effect. When the risk carrying capacity is between the two threshold values, the impact on the willingness to withdraw from the homestead is positive, and when it is too low or too high, the impact on the willingness to withdraw from the homestead is negative; (3) Endowment effect plays an intermediary role in the impact of risk carrying capacity on the willingness to withdraw from homestead. Among them, the order of mediating effect from large to small is homestead irreplaceability, psychological ownership and uncertainty perception; (4) In the process of accumulation of risk coping capacity, the mediation effect of endowments experienced the change of complete mediation-partial mediation-non-mediation, indicating that the accumulation of risk coping capacity helps to weaken the mediation effect of endowments. [Conclusion] The government should clarify the group of farmers with moderate risk carrying capacity, improve the mobilization and demonstration mechanism of homestead exit, improve the level of farmers’ policy cognition, improve the guarantee mechanism of farmers’ risk carrying capacity, and promote the transformation of homestead exit to people-oriented.

Abstract Background Body mass index (BMI) is an important risk factor for hypertension in diabetic patients. However, the underlying mechanisms remain poorly understood. Although liver-derived biological intermediates may play irreplaceable roles in the pathophysiology of diabetes, few studies have explored them in the association between BMI and hypertension in diabetes. Objective To investigate the role of liver enzymes in mediating the relationship between BIM exposure and hypertension in type 2 diabetes mellitus (T2DM). Methods We included a total of 1765 participants from the China National Diabetic Chronic Complications Study Cohort. Associations between liver enzymes and hypertension were estimated using multivariable regression models. The function of liver indicators in the relationship between BMI and hypertension was assessed using mediation analysis. Mediation analysis was conducted, taking into account age, diabetes duration, current smoking, fasting plasma glucose level, glycated hemoglobin, anti-diabetic therapy, and family history of diseases, including diabetes, hypertension, obesity, and hyperlipidemia. Results For men, the association of BMI with hypertension was partially mediated by alanine aminotransferase (ALT), with a proportion of mediation was 68.67%, by aspartate aminotransferase (AST) was 27.02%, and by γ-glutamyltransferase (GGT) was 38.58%, by AST/ALT was 63.35%; for women, the proportion mediated by ALT was 36.93%, and by AST was 37.47%, and GGT was 44.60%, and AST/ALT was 43.73% for BMI (all P

The rapid expansion of digital commerce, particularly same-day-delivery and next-day-delivery online shopping, is transforming daily life and community dynamics in urban settings. This study explores how these shopping behaviors impact the sense of community by mediating various social activities at both individual and community levels. Using an online survey design, this study analyzes the mediating roles of different types of social interactions, including informal social gatherings and organized community events, in shaping a sense of community. The findings reveal that while both unplanned, low-threshold interactions and more structured, organized activities contribute to a sense of community, their effects vary in strength. Stronger, more deliberate social interactions, such as resident-led events, show a full mediation effect, whereas casual, spontaneous encounters provide partial mediation. Similarly, organized community events demonstrate different levels of influence, with community-organized activities fully mediating certain sense of community dimensions and resident-engaged activities providing more comprehensive impacts. These findings highlight that same-day-delivery and next-day-delivery online shopping behaviors significantly shape the sense of community by facilitating both informal and organized social interactions.

Urinary polycyclic aromatic hydrocarbon (PAH) metabolites are associated with oxidative stress; however, epidemiological studies have not reported the impacts of these urinary PAH metabolites on blood lipid levels. This study investigated the relationship between urinary PAH metabolites, urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG), and blood lipid profiles. A total of 109 elderly volunteers were recruited with complete datasets for analysis. Blood and morning urine samples were collected in the winter of 2011. The PAH metabolites, creatinine, and 8-OHdG levels in urine samples were analyzed using Gas Chromatography–Mass Spectrometry, spectrophotometry, and an ELISA kit, respectively. The blood lipid profiles were analyzed using an automatic biochemical analyzer. The relationship between lipid profiles and 8-OHdG was assessed using a two-independent sample nonparametric test, categorized by gender, smoking, and alcohol consumption status. After normalizing the concentration values, a general linear regression model was employed to examine the correlations between PAH metabolites, 8-OHdG, and lipid profiles. A mediation model was developed to investigate the mediating effect of 8-OHdG on the relationship between PAH metabolites and lipid profiles. The median of eight PAH metabolite concentrations in urine samples ranged from 1 to 10 μmol/mol creatinine (Cr). Significant differences in lipid profiles were observed across genders. However, no significant differences were found in smoking or alcohol consumption status for both genders. Linear regression analysis revealed that an increase in the logarithmic concentration of 2-hydroxynaphthalene (2-OHNap), 9-hydroxyfluorene (9-OHFlu), 3-hydroxyfluorene (3-OHFlu), 2-hydroxyfluorene (2-OHFlu), 1-hydroxypyrene (1-OHPyr), and 6-hydroxychrysene (6-OHChr) was associated with an increase in urinary 8-OHdG levels, after adjusting for BMI and age. Specifically, 1-hydroxynaphthalene (1-OHNap) and 1-OHPyr correlated negatively with apolipoprotein A1 (Apo A1). Conversely, 1-OHPyr was positively correlated with low-density lipoprotein cholesterol (LDL-C). In addition, b,c-dihydroxyphenanthrene (2-OHBcPhe) was positively associated with apolipoprotein B (Apo B). Notably, 8-OHdG did not exhibit a significant correlation with lipid profiles. The mediating effect of 8-OHdG on the relationship between hydroxylated PAHs and lipid profiles was not statistically significant. However, the indirect effects of hydroxylated PAHs on blood lipids were statistically substantial, specifically for 1-OHNap to Apo A1 (−0.025, 95% CI: −0.041, −0.009), 1-OHPyr to LDL-C (0.107, 95% CI: 0.011, 0.203), and 2-OHBcPhe to Apo B (0.070, 95% CI: 0.005, 0.135). This study suggests that an increase in urinary PAH metabolites may elevate the levels of urinary 8-OHdG and influence blood lipid profiles. However, no direct relationship was found between 8-OHdG and lipid profiles. The mediation analysis indicated that the effects of PAH metabolites on lipid changes may operate through pathways other than oxidative stress.

The digital economy’s transformative impact on agriculture presents both opportunities and challenges for China’s pursuit of high-quality agricultural and rural development. This study investigates the complex interplay between digital economy, industrial structure transformation, and agricultural advancement using panel data from 31 Chinese provinces spanning 2012–2021. We employed mediation analysis and threshold effect models to uncover several key findings: (1) The digital economy influences high-quality agricultural and rural development through the dual-mediating mechanisms of industrial structure intensification and upgrading in China. (2) These mediating effects exhibit heterogeneous patterns: while industrial intensification positively channels the digital economy’s impact, industrial upgrading shows an initial negative indirect effect, suggesting potential short-term disruptions. (3) The relationship between digital economy and agricultural development is nonlinear, characterized by significant threshold effects. The digital economy’s positive impact becomes more pronounced as industrial structure surpasses certain sophistication and advancement thresholds. Our findings reveal the nuanced dynamics of digital-driven agricultural transformation, highlighting the need for targeted policies that leverage industrial-structure changes while mitigating potential adverse effects. This research contributes to a more comprehensive understanding of how digitalization can be harnessed to promote sustainable and high-quality agricultural and rural development in China, with implications for other developing economies navigating similar transitions.

The modern social media impact over the subjective cognition of the individuals should not be underestimated. According to the Chinese Comprehensive Social Survey data 2017, this article constructs a multiple mediation model as the mediating variable with social capital, and studies social capital's mediating role in the process of media use affecting social class identity. The research found that: (1) The application of established media and newly media has a chief impact on class identity; (2) Compared with new media, traditional media has a significant control over on class identity; (3) The two dimensions of social capital both demonstrates a considerable positive mediating role in the procedure of traditional media influencing class identification, and the mediation effect of social networks is stronger than social trust; (4) A significant role is being played by social media mediating role to process new media making class influential as the mediating impact of of having social trust is un-significant. The study's novelty lies in using social capital as an intermediary variable, exposing one of the impact channels of media consumption on class identity, and giving a new explanatory framework for the class identity influence mechanism. [ABSTRACT FROM AUTHOR]

Evidence around the relationship between air pollution and the development of diabetes mellitus (DM) remains limited and inconsistent. To investigate the potential mediation effect of asprosin on the association between fine particulate matter (PM2.5), tropospheric ozone (O3) and blood glucose homeostasis. A case–control study was conducted on a total of 320 individuals aged over 60 years, including both diabetic and non-diabetic individuals, from six communities in Taiyuan, China, from July to September 2021. Generalized linear models (GLMs) suggested that short-term exposure to PM2.5 was associated with elevated fasting blood glucose (FBG), insulin resistance index (HOMA-IR), as well as reduced pancreatic β-cell function index (HOMA-β), and short-term exposure to O3 was associated with increased FBG and decreased HOMA-β in the total population and elderly diabetic patients. Mediation analysis showed that asprosin played a mediating role in the relationship of PM2.5 and O3 with FBG, with mediating ratios of 10.2% and 18.4%, respectively. Our study provides emerging evidence supporting that asprosin mediates the short-term effects of exposure to PM2.5 and O3 on elevated FBG levels in an elderly population. Additionally, the elderly who are diabetic, over 70 years, and BMI over 24 kg/m2 are more vulnerable to air pollutants and need additional protection to reduce their exposure to air pollution. [ABSTRACT FROM AUTHOR]

As the mainstay of healthcare, the job satisfaction of medical staff deserves attention. This study aimed to explore the correlation between the perception of the high-performance work system (P-HPWS) and job satisfaction of medical staff in public hospitals and to further investigate the mediating effect of self-efficacy. From November 2019 to January 2020, a cross-sectional survey on working doctors and nurses was conducted in five tertiary public hospitals in China. A total of 520 participants were surveyed. The P-HPWS, job satisfaction, and self-efficacy were assessed using the 25-item self-administered scale, six-item job satisfaction questionnaire, and the General Self-Efficacy Scale, respectively. Linear regression and mediation effects models were used to identify the associations between primary variables. The results showed a significant positive correlation between P-HPWS and job satisfaction (P < 0.01), while self-efficacy played a mediating role between P-HPWS and job satisfaction. This finding reveals the benefits of improving employees' P-HPWS and self-efficacy on their job satisfaction, and that hospitals can improve their management systems by implementing and refining HPWS. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to explore the relationship among moral distress, psychological capital, and burnout in registered nurses. Ethical consideration: The study was approved by the Ethics Committee of the School of Nursing, Hangzhou Normal University (Approval no. 2022001). Methods: A cross-sectional descriptive survey was conducted with a convenience sample of 397 nurses from three Grade-A tertiary hospitals in Zhejiang Province, China. Participants completed demographic information, the Nurses' Moral Distress Scale, the Nurses' Psychological Capital Scale, and the Maslach Burnout Inventory Scale. The data were analyzed using Pearson's correlation analysis, structural equation modeling, and hierarchical multiple regression analysis. Results: The study found that moral distress and burnout are positively correlated, while psychological capital is negatively correlated with both moral distress and burnout. The path analysis in structural equation modeling revealed that moral distress has a significant direct effect on psychological capital, while psychological capital has a significant direct effect on burnout. In addition, moral distress also had a significant indirect effect on burnout through psychological capital. Moreover, both the direct effect of moral distress on burnout and the total effect of moral distress on burnout were significant. Conclusion: The findings suggest that psychological capital plays an important role in the relationship between moral distress and burnout. Promoting psychological capital among nurses may be a promising strategy for preventing moral distress and burnout in the workplace. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Numerous investigations have indicated a correlation between air pollution (AP) and an elevated ischemic stroke (IS) likelihood. The existing literature does not provide a consensus about the possible link between AP and IS. A two-sample Mendelian randomization (MR) analysis was utilized to systematically measure the causal link between AP and ischemic stroke. Furthermore, the mediating impact of inflammatory factors was also performed by a two-step MR. MATERIALS AND METHODS: A two-sample MR analysis was utilized to examine the AP impact on the incidence of IS. Additionally, a twostep MR approach was carried out to account for possible mediating variables. The indirect impact was determined by employing the product approach, which included multiplying the AP impact on inflammatory factors by the inflammatory factors' impacts on IS. The MR effect was identified through inverse variance-weighted (IVW) meta-analysis of each Wald Ratio. Additionally, complementary studies were conducted using the weighted median and MR-egger approaches. RESULTS: The IVW method with random effects showed that the per unit increase in genetically predicted PM2.5 was linked to the 0.362-fold elevated ischemic stroke risk (OR: 1.362, 95% CI: 1.032-1.796, p=0.029). Furthermore, the IVM technique, incorporating random effects, demonstrated that the per unit increase in genetically predicted PM2.5 was related to an elevated Interleukin (IL)-1β risk (OR: 1.529, 95% CI: 1.191-1.963, p=0.001), IL-6 (OR: 1.498, 95% CI: 1.094-2.052, p=0.012) and IL-17 (OR: 1.478, 95% CI: 1.021-2.139, p=0.038). IL-1β, IL-6, and IL-17 modulated the PM2.5 impact on ischemic stroke, while the proportion mediated by them was 59.5%. CONCLUSIONS: A positive correlation between genetically predicted PM2.5 levels and elevated ischemic stroke risk is mediated by IL-1β, IL-6, and IL-17. [ABSTRACT FROM AUTHOR]

Understanding how sport consumers' pro-environmental behaviors (PEBs) are shaped can be helpful for sport organizations in developing sport policies and establishing marketing strategies for the sport sector. To extend the literature on sport consumers' PEBs, this study explored the relationship between residents' place attachment and three types of PEBs using environmental concern as a mediator. Residents who ran habitually were recruited using an internet survey in Japan (N = 366). The results showed that place attachment was negatively associated with general PEB and place-specific PEB. However, place attachment was also positively and indirectly associated with general PEB, place-specific PEB, and ethically minded sport consumer behavior through environmental concerns. The findings contribute to the literature by identifying the mediating role of environmental concern in the relationship between place attachment and PEBs. [ABSTRACT FROM AUTHOR]