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Background/Aims: The role of neuroticism in predicting nightmare distress have been highlighted, and negative coping style may contribute to this relationship, but how these variables interact is limited. The present study aimed to explore how neuroticism and ruminative response contribute to producing nightmare distress, and to explore whether sex influences this relationship. Methods: We recruited 758 university students, aged an average of 19.07. A moderated mediation model was built to examine the relationships among neuroticism, rumination, and nightmare distress (measured by dream anxiety scale), and explore whether sex could affect this relationship, using the SPSS PROCESS 3.5 macro. Results: The moderated mediation analyses results showed that ruminative response-depression related can significantly partially mediate the relationship between neuroticism and dream anxiety (β = 0.32), dream anxiety-sleep-related disturbances (β = 0.11) and dream anxiety-daytime dysfunctions (β = 0.21). However, the moderating effects of sex were not significant in all path from neuroticism to dream anxiety. Conclusion: The study provides a novel architecture on the underlying psychological mechanisms of neuroticism and nightmare distress. This interplay is assumed to be facilitated by ruminations, suggesting that interventions for individuals who suffer from nightmares may focus on their repetitive negative response strategies, especially in people with high neuroticism, irrespective of sex differences. [ABSTRACT FROM AUTHOR]

This work aims to explore the impact of intellectual property income (a guarantee for promoting technological advance) on energy efficiency (indicating the technological advance) considering the mediation role of trade openness. To this end, this article uses the available data of 50 countries from 2000 to 2019 to study the influence of intellectual property income and trade openness. The Fully Modified Ordinary Least Square and Dynamic Ordinary Least Square methods are applied in this article to study the long-term relationship between different variables. The empirical results show that there is a mediation effect between intellectual property income and energy intensity. In other words, intellectual property income can not only directly affect energy intensity, but also indirectly affect energy intensity through trade openness. Fully considering the impact of regional heterogeneity, the countries are divided into high-income (HI) countries and middle-income (MI) countries. The results indicate there are noticeable regional differences in the impact of intellectual property income on energy intensity via the mediation effect of trade openness. The improvement of intellectual property income and trade openness benefits the HI countries most, but not for MI countries. Targeted policy implications are proposed to enable a reduction in energy intensity for countries at different income levels. [ABSTRACT FROM AUTHOR]

Increasing carbon efficiency is a key path to sustainable development, and information and communication technology (ICT) may help realize a win-win situation for the economy and the environment. However, the existing literature on the impact of ICT on carbon efficiency is relatively shallow. Using a database of Chinese cities, this study empirically explores the role of ICT in carbon efficiency from the aspects of direct impact, mediation effect, and threshold effect. Results show that ICT significantly improves the carbon efficiency represented by single-factor and total-factor carbon efficiency. The mediation effect indicates that technological innovation, industrial structure upgrading, and external openness are effective ways for ICT to play its role. The threshold model shows that the promoting effect between the two depends on the local institutional environment. Further heterogeneity analysis shows that ICT plays a more remarkable role in promoting carbon efficiency in eastern regions. This study provides evidence for aggressively digitizing economies to shift towards a low-carbon economy. Policymakers are encouraged to consider better integrating ICTs into sustainable development strategies. [ABSTRACT FROM AUTHOR]

Introduction: This study aims to explore the mechanisms by which the digital economy influences urban carbon emissions in China, with a particular focus on potential threshold effects and the mediating role of technology. As the digital economy grows, it impacts various environmental metrics, including carbon emissions, necessitating a deeper understanding of its nonlinear dynamics and implications for sustainable urban development. Methods: Using panel data from 286 prefecture-level cities in China spanning from 2012 to 2021, we apply threshold effect models and mediation effect tests. The threshold effect model is employed to investigate non-linear characteristics of the digital economy's impact on carbon emissions, while the mediation effect model assesses the role of technology as an intermediary in this relationship. Results: The threshold effect model reveals a single threshold in the impact of the digital economy on urban carbon emissions, indicating a nonlinear relationship. Initially, the influence of the digital economy on emissions is weak, but as the digital economy develops, its effect becomes more pronounced. The mediation effect model demonstrates that technological advancement can offset the increase in emissions associated with digital economic growth, thus showcasing technology's potential to mitigate environmental impacts. Discussion: The findings suggest that while the digital economy generally promotes urban carbon emissions, its impact is non-linear and mitigatable through technological innovation. To curb emissions in urban areas, fostering technological innovation and supporting green technology research and development are critical. Moreover, enhancing management and supervision within the digital economy sector can contribute to balancing economic growth with environmental goals. These insights are valuable for policymakers striving to harmonize digital economic expansion with sustainable environmental practices. [ABSTRACT FROM AUTHOR]

Whether digital village construction can effectively promote agriculture's green development is essential for modernizing agriculture and rural areas. Using panel data from 30 provinces in China between 2011 and 2022, this study empirically examines the relationship between digital village construction and agroecological efficiency and explores its mechanism of action and threshold effect, contributing to the exploration of agricultural digitization and sustainable development. This study shows that (1) AEE is positively associated with digital village construction; (2) the positive association size varies in regions and construction levels; (3) agricultural land transfer and technological innovation play a mediating role in the positive effect; and (4) there is a single threshold value for the positive effect of digital village construction, and after crossing the threshold value, its marginal effect shows a positive and increasing nonlinear characteristic. This study enhances our comprehension of digital village development to advance agroecological efficiency and offers theoretical insights and policy recommendations for optimizing the rural digital infrastructure and fostering sustainable agricultural growth. [ABSTRACT FROM AUTHOR]

Reducing the urban–rural income gap stands as a pivotal factor in attaining sustainable economic development. Policymakers and researchers have focused on whether digital inclusive finance can narrow the urban–rural income gap. Utilizing provincial-level panel data from 31 regions in China, this paper empirically tests the impact of digital inclusive finance on the urban–rural income gap across different areas of China, specifically analyzing the mediation effect of rural loan availability. The findings indicate that (1) the expansion of digital inclusive finance can enhance the inclusiveness of financial services in rural areas and narrow the urban–rural income gap; (2) the effect of digital inclusive finance on the urban–rural income gap exhibits regional heterogeneity; (3) the rural loan availability has a mediation effect on the urban–rural income gap, but its growth will weaken the narrowing effect of digital inclusive finance on urban–rural income gap; and (4) the reduction in the urban–rural income gap attributable to digital inclusive finance exhibits a nonlinear relationship with the level of urbanization. This paper recommends guiding the digital transformation of rural financial institutions and enhancing farmers' financial literacy to increase the availability of loans in rural areas. Furthermore, implementing region-specific policies and regulations could effectively narrow the urban–rural income gap. [ABSTRACT FROM AUTHOR]

Purpose: This investigation aimed to examine the mediating effect of inflammatory biomarkers on the relationship between dust exposure and lung function levels among steelworkers. Methods: The study comprised 2,315 front-line workers employed at an iron and steel company in Tangshan, who underwent occupational health assessments through cluster sampling. Demographic and lifestyle data were collected via a self-administered questionnaire, while physical examinations measured parameters such as height and weight. Lung function was assessed using a portable pulmonary function tester (CHEST). Blood cell counts were uniformly analyzed using a Mindray fully automated biochemistry analyzer (BS-800). Inflammatory biomarkers, including leukocyte count, neutrophil count, lymphocyte count, and platelet count, were assessed, and the neutrophil-to-lymphocyte ratio and systemic immune inflammation index were computed. Generalized linear models and Spearman rank correlation analyses were employed to explore the interplay among dust exposure, inflammatory biomarkers, and alterations in lung function. A mediation analysis model was constructed to elucidate how inflammatory biomarkers mediate the relationship between dust exposure and lung function levels. Results: After adjusting for covariates, dust exposure was significantly associated with reduced lung function levels, with statistically significant differences observed between dust-exposed and non-exposed groups across various lung function indicators (P < 0.001). In the dust-exposed group, inflammatory biomarkers were elevated, showing significant correlations with FVC and FEV1 (P < 0.05). However, the correlation between FEV1/FVC and various inflammatory biomarkers was insignificant (P > 0.05). Mediation analysis revealed that white blood cells and neutrophils partially mediated the association between dust exposure and FVC, with proportions of 1.75% and 1.09%, respectively. Similarly, white blood cells, neutrophils, and the systemic immune inflammation index partially mediated the association between dust exposure and FEV1, with proportions of 1.15%, 0.82%, and 0.82%, respectively. Conclusion: In conclusion, dust exposure poses a risk for decreased lung function levels. Inflammatory biomarkers derived from blood cells offer a valuable and easily obtainable means of identifying changes in lungfunction levels. Among these biomarkers, white blood cells, neutrophils, and the systemic immune inflammation index significantly mediate the association between dust exposure and lung function levels, although further exploration is needed to understand their underlying mechanisms. [ABSTRACT FROM AUTHOR]

Objective: The aim was to investigate the mediating role of inflammatory biomarkers in the causal effect of body composition on glycaemic traits and type 2 diabetes. Methods: A retrospective observational study and a Mendelian randomization (MR) study were used. Observational analyses were performed using data from 4717 Chinese children and adolescents aged 6–18 years who underwent dual‐energy X‐ray absorptiometry for body composition. MR analyses were based on summary statistics from UK Biobank, deCODE2021, Meta‐Analysis of Glucose and Insulin‐Related Traits Consortium (MAGIC) and other large consortiums. Inflammatory biomarkers included leptin, adiponectin, osteocalcin, fibroblast growth factor 23 (FGF23) and parathyroid hormone (PTH). Results: In a retrospective observational study, increased fat mass had a positive effect on homeostasis model assessment of insulin resistance (HOMA‐IR) and homeostasis model assessment of pancreatic beta cell function (HOMA‐β) through FGF23, whereas fat‐free mass produced the opposite effects. PTH and osteocalcin played significant roles in the association of fat mass and fat‐free mass with fasting glucose, fasting insulin and HOMA‐IR (all p < 0.05). Mediation MR results indicated that childhood body mass index affected glycaemic traits through leptin and adiponectin. There existed a causal effect of fat‐free mass on type 2 diabetes via FGF23 (indirect effect: OR [odds ratio]: 1.14 [95% CI, confidence interval: 1.01–1.28]) and adiponectin (OR: 0.85 [95% CI: 0.77–0.93]). Leptin mediated the causal association of fat mass (indirect effect: β: −0.05 [95% CI: −0.07, −0.02]) and fat‐free mass (β: 0.03 [95% CI: 0.01, 0.04]) with fasting glucose. Conclusions: Our findings suggest that different body compositions have differential influences on glycaemic traits and type 2 diabetes through distinct inflammatory biomarkers. The findings may be helpful in tailoring management of body composition based on inflammatory biomarkers with different glycaemic statuses. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: This study aims to investigate the relationships between the Chinese Healthy Eating Index (CHEI), psychological balance, depressive symptoms, and cognitive function in the rural older population. Additionally, it examines the impact of CHEI on cognitive function and the potential chain mediating roles of psychological balance and depressive symptoms. Methods: The study utilized data from 2,552 rural older adults aged 65 and above, drawn from the Chinese Longitudinal Healthy Longevity Study (CLHLS). The CHEI was self-reported, with scores ranging from 0 to 50, representing adherence to healthy eating habits. Psychological balance was assessed using status and personality-emotion characteristics recorded in the database, with scores ranging from 6 to 30. Cognitive function was measured using the Mini-Mental State Examination (MMSE), with scores ranging from 0 to 30; higher scores indicated better cognitive function. Depressive symptoms were evaluated using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10), with scores ranging from 0 to 30, where higher scores reflected more severe depressive symptoms. Results: The median CHEI score was 40.0 (IQR: 34.0–45.0), reflecting moderate adherence to healthy dietary practices. The median Psychological Balance score was 19.0 (IQR: 17.0–21.0), and the median Depressive Symptoms score was 13.0 (IQR: 10.0–15.0), indicating mild depressive symptoms among participants. Additionally, the median Cognitive Function score was 28.0 (IQR: 27.0–29.0), suggesting relatively stable cognitive abilities within the sample. Correlational analysis revealed the following: (1) Depressive symptoms were negatively correlated with both cognitive function (rs = -0.100, p < 0.001) and CHEI (rs = -0.206, p < 0.001), as well as with psychological balance (rs = -0.142, p < 0.001). (2) CHEI was positively correlated with both cognitive function (rs = 0.144, p < 0.001) and psychological balance (rs = 0.131, p < 0.001). (3) Cognitive function was also positively correlated with psychological balance (rs = 0.096, p < 0.001). Mediation analysis demonstrated that both psychological balance and depressive symptoms partially mediated the relationship between CHEI and cognitive function, forming a chain-mediating effect. Conclusion: The Chinese Healthy Eating Index was found to have a direct positive impact on cognitive function in rural older adults. Furthermore, it exerted an indirect effect through the independent and chain-mediating roles of psychological balance and depressive symptoms. These findings suggest that dietary adherence can influence cognitive health not only directly but also by improving psychological well-being and reducing depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: Numerous single nutrients have been suggested to be linked with leukocyte telomere length (LTL). However, data on nutrient patterns (NPs), particularly in Chinese population, are scarce. This study aimed to examine the relationship between nutrient-based dietary patterns and LTL, and the potential role of metabolic factors. Methods: Dietary data was obtained via 24-hour food recalls, and principal component analysis (PCA) was used to identify NPs. LTL was assessed using a real-time PCR assay. Multiple linear regression was conducted to determine the association between NPs and LTL. The potential role of metabolism among them was analyzed using mediation models. Results: A total of 779 individuals from northern China were included in this cross-sectional analysis. Five main nutrient patterns were identified. Adjusted linear regression showed that the "high sodium" pattern was inversely associated with LTL (B=-0.481(-0.549, -0.413), P < 0.05). The "high vitamin E-fat" pattern exhibited a positive correlation (B = 0.099(0.029, 0.170), P < 0.05), whereas the "high vitamin A-vitamin B2" pattern was negatively correlated with LTL (B=-0.120(-0.183, -0.057), P < 0.05), respectively. No significant associations were observed for the remaining nutrient patterns. The mediation model demonstrated that diastolic blood pressure and waist circumference could individually and collectively mediate the negative impact of the "high sodium" pattern on LTL (BDBP=-0.0173(-0.0333, -0.0041), BWC=-0.0075(-0.0186, -0.0004), Bjoint=-0.0033 (-0.0072, -0.0006), all P < 0.05). Moreover, glycosylated hemoglobin and non-high-density lipoprotein cholesterol mediate the relationship between the "high vitamin E-fat" pattern and LTL (BHbA1c=0.0170(0.0010,0.0347), Bnon-HDL-C= 0.0335 (0.0067, 0.0626), all P < 0.05), respectively. Conclusions: The "high sodium" and "high vitamin E-fat" nutrient patterns demonstrated negative and positive associations with LTL and metabolic indicators may play complex mediating roles in these relationships. [ABSTRACT FROM AUTHOR]

The aim of this study is to examine the mediating effect of intrinsic motivation on the relationship between psychological empowerment and employees' organizational cynicism in the insurance sector. In this context, a survey consisting of verified scales was administered to insurance employees operating in the Central Anatolia region. Out of the 412 valid surveys obtained, it was found that data from 2 surveys did not show normal distribution and were filled out in a manner that affected the other 410 surveys. Following the removal of these 2 unhealthy data points, 410 surveys were included in the analysis. Regression analysis, t-test, and ANOVA tests were utilized in the study. When examining the mediating effect, it was determined that intrinsic motivation did not mediate the effect of psychological empowerment on organizational cynicism (p=0.231). There was a statistically significant difference in intrinsic motivation based on gender (p=0.025). It was found that the average intrinsic motivation of males (Mean=4.04) was higher than that of females. According to the research findings, organizational cynicism also differed significantly by gender (p=0.038), with males having a higher average score compared to females (Mean=2.35). This indicates that males are more prone to organizational cynicism. The study found that intrinsic motivation did not significantly vary by marital status, whereas organizational cynicism varied significantly by marital status (p=0.037). It was observed that married individuals were more affected by organizational cynicism (Mean=2.36). Lastly, there were no statistically significant differences in intrinsic motivation or organizational cynicism based on educational level (p=0.102 & p=0.629). [ABSTRACT FROM AUTHOR]

Background: The association between inflammatory score, insulin resistance (IR), and metabolic‐associated fatty liver disease (MAFLD) is inconclusive. Objective: The objective of this study was to examine the relationship between the inflammatory score and MAFLD and investigate the potential mediating effect of IR (evaluated by triglyceride‐glucose index) in this association. Methods: Calculating inflammatory score was performed based on white blood cells and high‐sensitivity C‐reactive protein. The association between the inflammatory score and MAFLD was evaluated based on the weighted multifactor logistic regression model. Restricted cubic splines (RCS) were used to visualize the dose–response relationship between the inflammatory score and MAFLD. We also conducted a mediation analysis to assess the extent to which IR mediates this association. Results: Among the 1090 participants, 563 were ultimately diagnosed with MAFLD. Multivariate logistic regression results indicated a close positive association between inflammatory score and MAFLD (odds ratio = 1.235, 95% confidence interval 1.069–1.427, p =.007). The RCS results indicated a linear dose–response relationship between the inflammatory score and the risk of MAFLD after adjusting for potential confounding factors. Furthermore, the mediation analysis results showed that IR partially mediated the association between the inflammatory score and MAFLD (percent mediation = 33%). Conclusion: Our research results indicate that the inflammatory score is positively associated with the risk of MAFLD, and IR plays a partial mediating effect in this association. [ABSTRACT FROM AUTHOR]

The digital economy, which boasts general technology, intense penetration, platform ecology, and low marginal cost, is a product of advanced digital technology. This new engine has become a driving force for high-quality economic development. From the three aspects of development momentum, efficiency, and structure, this paper profoundly explores internal mechanisms to lead the high-quality growth of the regional economy. By constructing an econometric model, the influence effect and means of the digital economy on the high-quality development of the regional economy are empirically tested. The digital economy and its three sub-dimensions can significantly promote the high-quality development of the regional economy. However, industrial digitalization has the most vital role in promoting it. The digital economy has shown a more vital promotion role in the central and western regions and provinces with low total factor productivity, and it can indirectly impact high-quality economic development by promoting dynamic, efficient, and structural changes. [ABSTRACT FROM AUTHOR]

A number of health issues, including high serum uric acid (SUA) and cardiovascular disease (CVD), have been linked to obesity based on observational evidence, though it's currently unclear how these issues are causally related. In order to determine whether obesity mediates this association, we set out to investigate the causal relationship between SUA, obesity, and CVD. From publicly available genome-wide association studies, we acquired instrumental variables that had a strong correlation to SUA and body mass index (BMI). We employed multiple two-step Mendelian randomization (MR) analyses, using genetic and clinical data from various publicly available biological databases. The mediating role of BMI was examined through mediation analysis. SUA was genetically correlated with BMI [OR = 1.080, 95% CI: 1.024–1.139, P = 0.005]. There was a positive causal effect of SUA on AF [OR = 0.892, 95% CI: 0.804–0.990, P = 0.032], CAD [OR = 0.942, 95% CI: 0.890–0.997, P = 0.037], and EHT [OR = 1.080, 95% CI: 1.024–1.139, P = 0.005]. Among them, BMI mediated the effects of SUA on AF (42.2%; 95% CI, 35.3%–51.9%), CAD (76.3%; 95% CI, 63.4%–92.0%), and EHT (10.0%; 95% CI, 0%–20.0%). Our research revealed a causal relationship between high SUA exposure and an increased risk of obesity. Additionally, a high SUA level was linked to an increased risk of various CVDs. Given that individuals with high SUA are more likely to be susceptible to AF, CAD, and EHT, attention must be given to their weight status. • This study applied a two-step MR analysis to confirm the causal relationship among serum uric acid, BMI and six different cardiovascular diseases. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the prevalence of disorders of gut-brain interaction (DGBI) and life stress in college students, and explore risk factors of DGBI in college students and the role of life stress. Methods: A total of 2,578 college students filled up validated questionnaires assessing GI symptoms, lifestyle, and life stress. Participants were diagnosed as DGBI based on the Rome III criteria. Multivariate ordinal logistic regression analysis and mediation effect model were employed to explore potential risk factors of DGBI and the mediating role of life stress and lifestyle in DGBI. Results: A total of 437 of 2,578 (17.0%) college students were diagnosed with DGBI. College students with DGBI had higher levels of life stress, including eight specific categories. Females (1.709 [1.437, 2.033]), staying up late (1.519 [1.300, 1.776]), and life stress (1.008 [1.006, 1.010]) were risk factors for DGBI, while postgraduates (0.751 [0.578, 0.976]) and regular diet (0.751 [0.685, 0.947]) were protective factors. Males and poor family economic were associated with a higher risk of DGBI after controlling stress, while an association between grade and DGBI was mediated by stress, regular diet, and sleep habits. Conclusion: DGBI was common among college students. Life stress and lifestyle were associated with DGBI and mediated partial association between grade and DGBI in college students. More attention should be paid to undergraduates. [ABSTRACT FROM AUTHOR]

This research examines the intricate connection between Borderline Personality Disorder (BPD), life's meaning and the interpersonal difficulties related to the search for meaning, in the cultural context in Pakistan. As BPD is frequently accompanied by extreme interpersonal problems and problems with identity, it's valuable to learn how these elements interact to influence one's pursuit of meaning. Employing a mixed-methods design, the study included a quantitative assessment of BPD symptoms, interpersonal challenges, and meaning in life in a sample of 150 adults (75 with BPD and 75 controls) using validated scales. The qualitative component was based on semi structured interviews with 15 BPD members. Quantitative results showed significantly more interpersonal challenges in conjunction with an even more intense search for the meaning of life for those with BPD when compared with controls. BPD symptoms were positively correlated with interpersonal difficulties and negatively correlated with the presence of meaning. Cultural factors moderated the impact of interpersonal challenges on the search for meaning. Qualitative data were thematically analyzed and themes of familial expectation, societal pressure and cultural perception emerged about how these themes influenced participants' relational struggles and existential outlooks were identified. Thus, these findings help to support the need for culturally sensitive interventions that address the interpersonal and existential dimensions of those with BPD. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Carbon emission goals need China to upgrade its industrial structure to formulate a low-carbon economy. As a new form of industrial structure change, manufacturing and production service industries influence each other and become a collaborative agglomeration. This trend may have some impacts on carbon productivity. However, little research has been conducted whether and how the industrial collaborative agglomeration affects carbon productivity. To fill this research gap, this study employed panel data of 27 cities in the Yangtze River Delta urban agglomerations region from 2006 to 2020. First, by using the location entropy index, this study assessed the degree with regard to the collaborative agglomeration index of manufacturing and production services in the cities of the Yangtze River Delta urban agglomerations. Second, the study used a non-radial non-angular SBM model with the global Malmquist-Luenberger index to decompose the green technological progress index from each city's green total factor productivity. Third, this paper also used a mediating effect model to determine whether green technological progress played a mediating role with regard to the effect among industrial collaboration agglomeration and carbon productivity. The results indicate that (1) Industrial collaborative agglomeration significantly increased carbon productivity and green technological progress, with the industrial collaboration agglomeration index increasing by 1%, carbon productivity increasing by 28.8%, and green technological progress index increasing by 5.3%. (2) Green technological progress shows a significant partial mediating effect in carbon productivity effects of industrial collaborative agglomeration, with the mediating effect accounting for 19.82% of the overall effect. (3) There was a heterogeneity effect between high-end productive service and manufacturing industries collaborative agglomeration along with traditional productive service and manufacturing industries collaborative agglomeration. Former collaborative agglomeration increased 1%, carbon productivity increased by 37.9% and the mediating effect of collaborative agglomeration on carbon productivity through green technological progress accounted for 23.18% of the total effect. This mediating effect was not significant for traditional productive service and manufacturing industries collaborative agglomeration. This paper can provide some suggestions for construction of a low-carbon economy in Yangtze River Delta urban agglomerations to improve the cities' carbon productivity. [ABSTRACT FROM AUTHOR]

Wen-Jun Wang,1 Shu-Ping Zhou,2 Yun Liang,3 Chan-Juan Ma,4 Xin-Cui Wan4 1Yunnan Key Laboratory of Statistical Modeling and Data Analysis, Yunnan University, Kunming, 650091, People’s Republic of China; 2Department of Nursing, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, People’s Republic of China; 3Department of Nursing, Haikou Maternal and Child Health Care Hospital, Haikou, 570311, People’s Republic of China; 4Department of Central Sterile Supply, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, 570311, People’s Republic of ChinaCorrespondence: Shu-Ping Zhou, Nursing Department, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, No. 19, Xiuhua Road, Xiuying District, Haikou, Hainan Province, 571199, People’s Republic of China, Tel +86 13976603351, Email shupingzhouzsp@126.comObjective: This study aimed to investigate whether noise exposure in hospital sterile supply centers exacerbated the psychological burden on staff, potentially mediated by concerns about physiological health.Methods: Between July 5 and August 4, 2023, 308 staffs from central sterile supply departments in 30 hospitals in Hainan were chosen by convenient sampling method. They completed self-administered questionnaires to assess noise exposure status and used the Self-Reporting Inventory-90 to quantify the psychological state of staff across three dimensions: somatization, anxiety, and sleep and diet. Binary logistic regression analysis was used to assess the influencing factors of their psychological symptoms, while a mediation model was used to analyze the pathway of noise affecting psychology.Results: (1) Predominantly, respondents reported air gun sounds (76.3%) and pressure steam sterilizer noises (78.2%) within central sterile supply departments to be the most troublesome. (2) Approximately 25.33% of participants expressed that their sleep was significantly impacted by noise, while 32.14% expressed concerns about the potential serious effects on their health. (3) Logistic regression analysis revealed that age (OR,1.06, 95% CI, [1.01, 1.11]), educational background (OR, 0.65, 95% CI, [0.49, 0.85]), perceived noise exposure (OR,1.57, 95% CI, [1.04, 2.48]), health concerns (OR, 1.91, 95% CI, [1.06, 3.52]), and hearing loss (OR, 1.46,95% CI [1.02, 2.10]) emerged as significant influencing factors of psychological symptoms. (4) Mediation effect model analysis demonstrated that health concerns (mediation effect value=0.11, 95% CI [0.08, 0.16], Effect ratio=53.83%) mediated the impact of noise affecting psychological state.Conclusion: Noise exposure represents a concealed risk factor for service quality within hospital central sterile supply departments, with health concerns serving as a mediating factor in the relationship between noise exposure and psychological well-being.Keywords: exposure to noise, health concerns, mediation effect, psychological state, staff in central sterile supply department, China

Abstract Background This study aims to investigate the relationships between the Chinese Healthy Eating Index (CHEI), psychological balance, depressive symptoms, and cognitive function in the rural older population. Additionally, it examines the impact of CHEI on cognitive function and the potential chain mediating roles of psychological balance and depressive symptoms. Methods The study utilized data from 2,552 rural older adults aged 65 and above, drawn from the Chinese Longitudinal Healthy Longevity Study (CLHLS). The CHEI was self-reported, with scores ranging from 0 to 50, representing adherence to healthy eating habits. Psychological balance was assessed using status and personality-emotion characteristics recorded in the database, with scores ranging from 6 to 30. Cognitive function was measured using the Mini-Mental State Examination (MMSE), with scores ranging from 0 to 30; higher scores indicated better cognitive function. Depressive symptoms were evaluated using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10), with scores ranging from 0 to 30, where higher scores reflected more severe depressive symptoms. Results The median CHEI score was 40.0 (IQR: 34.0–45.0), reflecting moderate adherence to healthy dietary practices. The median Psychological Balance score was 19.0 (IQR: 17.0–21.0), and the median Depressive Symptoms score was 13.0 (IQR: 10.0–15.0), indicating mild depressive symptoms among participants. Additionally, the median Cognitive Function score was 28.0 (IQR: 27.0–29.0), suggesting relatively stable cognitive abilities within the sample. Correlational analysis revealed the following: (1) Depressive symptoms were negatively correlated with both cognitive function (rs = -0.100, p

Mediation analysis is conducted to make inferences on the effects of mediators that intervene in the relationship between an exposure variable and an outcome. Bayesian mediation analysis (BMA) naturally considers the hierarchical structure of the effects from the exposure variable to mediators and then to the outcome. We propose three BMA methods on survival outcomes, where mediation effects are measured in terms of hazard rate, survival time, or log of survival time respectively. In addition, we allow setting a limited survival time in the time-to-event analysis. The methods are validated by comparing the estimation precision at different scenarios through simulations. The three methods all give effective estimates. Finally, the methods are applied to the Surveillance, Epidemiology, and End Results Program (SEER) supported special studies to explore the racial disparity in breast cancer survival. The included variable completely explained the observed racial disparities. We provide visual aids to help with the result interpretations. [ABSTRACT FROM AUTHOR]

• Explore the effect of arsenic (As) and serum uric acid (SUA) simultaneously using a prospective design. • Higher level of blood As was remarkably associated with the elevated risk of metabolic syndrome (MetS). • Individuals with high levels of As and SUA had a much higher MetS risk. • SUA might partly mediate the association of As with MetS risk. Growing evidences showed that heavy metals exposure may be associated with metabolic diseases. Nevertheless, the mechanism underlying arsenic (As) exposure and metabolic syndrome (MetS) risk has not been fully elucidated. So we aimed to prospectively investigate the role of serum uric acid (SUA) on the association between blood As exposure and incident MetS. A sample of 1045 older participants in a community in China was analyzed. We determined As at baseline and SUA concentration at follow-up in the Yiwu Elderly Cohort. MetS events were defined according to the criteria of the International Diabetes Federation (IDF). Generalized linear model with log-binominal regression model was applied to estimate the association of As with incident MetS. To investigate the role of SUA in the association between As and MetS, a mediation analysis was conducted. In the fully adjusted log-binominal model, per interquartile range increment of As, the risk of MetS increased 1.25-fold. Compared with the lowest quartile of As, the adjusted relative risk (RR) of MetS in the highest quartile was 1.42 (95% confidence interval, CI: 1.03, 2.00). Additionally, blood As was positively associated with SUA, while SUA had significant association with MetS risk. Further mediation analysis demonstrated that the association of As and MetS risk was mediated by SUA, with the proportion of 15.7%. Our study found higher As was remarkably associated with the elevated risk of MetS in the Chinese older adults population. Mediation analysis indicated that SUA might be a mediator in the association between As exposure and MetS. [Display omitted] [ABSTRACT FROM AUTHOR]

• There is a positive correlation between isofenphos, isocarbophos levels with T2DM. • Isofenphos and isocarbophos significantly increased the risk of T2DM. • The association may be mediated by WBC and NE. To investigate the associations between isocarbophos and isofenphos with impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM), and to assess the mediation roles of inflammation cells. There were 2701 participants in the case-control study, including 896 patients with T2DM, 900 patients with IFG, 905 subjects with NGT. Plasma isocarbophos and isofenphos concentrations were measured using gas chromatography and triple quadrupole tandem mass spectrometry. Generalized linear models were used to calculate the relationships between plasma isofenphos and isocarbophos levels with inflammatory factor levels and T2DM. Inflammatory cell was used as mediators to estimate the mediating effects on the above associations. Isocarbophos and isofenphos were positively related with T2DM after adjusting for other factors. The odds ratio (95% confidence interval) (OR (95%CI)) for T2DM was 1.041 (1.015, 1.068) and for IFG was 1.066 (1.009, 1.127) per unit rise in ln-isocarbophos. The prevalence of T2DM increased by 6.4% for every 1 unit more of ln-isofenphos (OR (95% CI): 1.064 (1.041, 1.087)). Additionally, a 100% rise in ln-isocarbophos was linked to 3.3% higher ln-HOMA2IR and a 0.029 mmol/L higher glycosylated hemoglobin (HbA1c) (95% CI: 0.007, 0.051). While a 100% rise in ln-isofenphos was linked to increase in ln-HOMA2 and ln-HOMA2IR of 5.8% and 3.4%, respectively. Furthermore, white blood cell (WBC) and neutrophilic (NE) were found to be mediators in the relationship between isocarbophos and T2DM, and the corresponding proportions were 17.12% and 17.67%, respectively. Isofenphos and isocarbophos are associated with IFG and T2DM in the rural Chinese population, WBC and NE have a significant role in this relationship. [Display omitted] [ABSTRACT FROM AUTHOR]

Abstract Background People with epilepsy (PWE) frequently experience sleep disturbances that can severely affect their quality of life. Depression is also a common symptom in the PWE population and can aggravate sleep problems. However, the interplay between epilepsy, depression, and sleep disturbances is not yet fully understood. Our study was designed to investigate the association between epilepsy and sleep disturbances in US adults and to determine whether depressive symptoms play a mediating role in this relationship. Methods We examined data from the National Health and Nutrition Examination Survey (NHANES) spanning January 1, 2015, to March 2020, before the pandemic.A total of 10,093 participants aged ≥ 20 years with complete data on epilepsy and sleep disturbance were included. Weighted multiple logistic regression and mediation analysis were used to explore the associations among depression, epilepsy, and sleep disturbance. Interaction effects of epilepsy with various covariates were also investigated. Results Epilepsy was associated with depression and sleep disturbances. Weighted logistic regression analysis revealed a significant association between epilepsy and sleep disturbances (OR = 3.67, 95% CI = 1.68–8.04). Depression partially mediated this relationship, demonstrating a mediation effect of 23.0% (indirect effect = 0.037, P

The present study explored the correlation between different types of stress (acute and chronic) and the influence of their negative emotional manifestations on delinquent tendencies in adolescent students. Within the framework of the general strain theory, the study aims to analyse the intermediary role of depression in the relationship between anxiety and stress. This study investigated the relationship between stress, anxiety, depression, and delinquency proneness in adolescent school students in Sonepat, India.

Abstract Background The implementation of Electronic Health Record (EHR) systems is a critical challenge, particularly in low-income countries, where behavioral intention plays a crucial role. To address this issue, we conducted a study to extend and apply the Unified Theory of Acceptance and Use of Technology 3 (UTAUT3) model in predicting health professionals' behavioral intention to use EHR systems. Methods A quantitative research approach was employed among 423 health professionals in Southwest Ethiopia. We assessed the validity of the proposed model through measurement and structural model statistics. Analysis was done using SPSS AMOS version 23. Hypotheses were tested using structural equation modeling (SEM) analysis, and mediation and moderation effects were evaluated. The associations between exogenous and endogenous variables were examined using standardized regression coefficients (β), 95% confidence intervals, and p-values, with a significance level of p-value

Abstract Background Nurses' nursing competence and nutritional care literacy directly affect patients' health and safety. Self-directed learning ability was pervasive throughout the entire work process of nursing work and was the basis for improving both. However, there are few studies has explored the mechanism from the perspective of nutritional care literacy. The purpose of this study was to analyze the relationship between self-directed learning ability and nursing competence, and to explore the mediating role of nutritional care literacy between self-directed learning and nursing competence among clinical nurses in China. Methods A cross-sectional survey was conducted among 805 clinical nurses recruited from seven general hospitals in Hunan Province, China, between January 25 and March 6, 2022. The self-directed learning ability, nutritional care literacy and nursing competence of nurses were evaluated through investigation. A total of 799 questionnaires were received, resulting in an response rate of 99.25%.We performed an intermediary modeling to examine the mediating roles of nutritional care literacy on the relationship between self-directed learning ability and nursing competence in clinical nurses. Results Self-directed learning ability was positively correlated with nutritional care literacy (r=0.792, P

Abstract Numerous studies have suggested that the perceived built environment is shaped by the objective built environment and influences human physical activity. However, the empirical examination of this pathway remains scant. Addressing this gap, our study investigates whether the built environment affects leisure-time physical activity through its impact on the perceived built environment, utilizing data collected from 760 residents in Fuzhou, China. Structural Equation Modeling results reveal a modest correlation between objective and perceived built environment elements, with the objective built environment being a stronger predictor of leisure-time physical activity. Notably, perceived recreational facilities significantly mediate the relationship between objective recreational facilities and leisure-time physical activity, accounting for 15% of the variance in physical activity due to objective recreational facilities. This mediation effect is consistent across subpopulations, irrespective of residential self-selection biases. These results highlight the imperative for urban planning and policy to extend beyond mere spatial allocation of amenities to enhancing both the actual and perceived accessibility of these facilities, thus underlining the study's profound implications for public health and urban development strategies.

Objective: Conflicting associations have been noted between thyroid function and gestational diabetes mellitus (GDM), with indications that pre-pregnancy BMI might influence these relationships. This study aims to examine the effect of thyroid hormone indices and their mediation role on the risk of GDM. Methods: Pregnant women in our study were recruited from the Zhoushan Pregnant Women Cohort, Zhejiang Province, China. Participants who had their first prenatal follow-up and measured thyroid biomarkers in the first trimester, and oral glucose tolerance test (OGTT) records in the second trimester were eligible for inclusion in this study. The data were extracted from the Electronic Medical Record System database, at Zhoushan Maternal and Child Care Hospital. Maternal information about sociodemographic and health-related characteristics was extracted from the dataset. A unique personal identification number was provided to link both datasets. Multivariate logistic regression models were applied to investigate the correlations between thyroid hormone indices with GDM. The interaction effects of first-trimester thyroid hormone indices with pre-pregnancy BMI on GDM risk using a generalized linear regression model. Furthermore, the mediation analysis was used to explore the potential mediating effects of thyroid hormone indices on the relationship between pre-pregnancy BMI and GDM. Results: Overall, 5895 pregnant women were included in this study. The first-trimester FT4, thyroid feedback quantile-based index (TFQI), thyrotropin index (TSHI) and thyrotroph thyroxine resistance index (TT4RI) levels were negatively associated with fasting blood glucose (FBG) and postprandial blood glucose (PBG2H) in the second trimester (all P<0.05); FT3 and the FT3-to-FT4 ratio levels were positively associated with PBG1H and PBG2H in the second trimester (all P<0.05). Moreover, there were significant correlations between the highest quartile FT4, FT3, FT3-to-FT4 ratio, TSHI, and TFQI with GDM (all P < 0.05). The mediating effect of thyroid hormone parameters was 24.9% on the association between pre-pregnancy BMI and GDM. Conclusions: In conclusion, the low FT4, high FT3-to-FT4 ratio, and low TFQI in the first trimester significantly increase the risk of GDM and should be given more attention. Furthermore, increased pre-pregnancy BMI might partially increase the risk of GDM by influencing the body's thyroid function. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationships between stress, sleep reactivity, dysfunctional beliefs about sleep and to estimate the distinct roles of occupational and family stress on sleep among military populations in China. A cross-sectional study was conducted with a sample of 389 members of the armed forces stationed on islands in China. The Likert scales, Pittsburgh Sleep Quality Index (PSQI), Ford Insomnia Response to Stress Test (FIRST) and Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS) were used to measure occupational and family stress, sleep quality, sleep reactivity, and dysfunctional beliefs about sleep, respectively. Mediation and moderation effects were tested using logistic regression. The indirect path between occupational stress and PSQI via FIRST scores was significant (a*b = 0.564, p < 0.001). Mediation accounted for 38.2% of the total effects. The indirect path between family stress and PSQI via FIRST scores was also significant (a*b = 0.295, p < 0.001). The mediating effects accounted for 100%. The mediation effects of sleep reactivity on the association between occupational or family stress and sleep quality became attenuated at one standard deviation (SD) above the mean and one SD below the mean of DBAS scores. Occupational stress can affect sleep quality both in direct and indirect paths, whereas family stress only affects sleep quality through the sleep reactivity system. Geographical factors may prevent individuals on islands from facing family stress directly. These results may open a new avenue for studying the mechanisms of sleep reactivity and ways to prevent sleep disturbance. [ABSTRACT FROM AUTHOR]

In online health communities based on doctor-doctor interactions, the sustained participation of doctors in information exchange within the community is not only crucial for the long-term development of online health communities but also contributes to enhancing the knowledge and professional capabilities of doctors across different regions. The purpose of this study is to explore the antecedents and consequences of information exchange behaviour among doctors. We collected interaction data among doctors from an online health community in China and utilised text mining to process unstructured data. This study employed a combination of econometric methods and generalised random forests to examine the causal mechanisms between antecedents and consequences of doctors’ information exchange behaviour. The results indicate that social capital and group characteristics have significant effects on information exchange behaviour, which in turn has significant positive effects on social benefits. In addition, the positive relationship between doctor information exchange and social benefit is higher in the clinical medicine discussion group. Information exchange behaviour mediates the relationship between group characteristics, social capital, and social benefits. Our study enriches the application of theories, deepens the understanding of social benefits, and is conducive to the stable and rapid development of online health communities based on doctor-doctor interactions. [ABSTRACT FROM AUTHOR]

Background: People with epilepsy (PWE) frequently experience sleep disturbances that can severely affect their quality of life. Depression is also a common symptom in the PWE population and can aggravate sleep problems. However, the interplay between epilepsy, depression, and sleep disturbances is not yet fully understood. Our study was designed to investigate the association between epilepsy and sleep disturbances in US adults and to determine whether depressive symptoms play a mediating role in this relationship. Methods: We examined data from the National Health and Nutrition Examination Survey (NHANES) spanning January 1, 2015, to March 2020, before the pandemic.A total of 10,093 participants aged ≥ 20 years with complete data on epilepsy and sleep disturbance were included. Weighted multiple logistic regression and mediation analysis were used to explore the associations among depression, epilepsy, and sleep disturbance. Interaction effects of epilepsy with various covariates were also investigated. Results: Epilepsy was associated with depression and sleep disturbances. Weighted logistic regression analysis revealed a significant association between epilepsy and sleep disturbances (OR = 3.67, 95% CI = 1.68–8.04). Depression partially mediated this relationship, demonstrating a mediation effect of 23.0% (indirect effect = 0.037, P < 0.001). Subgroup analyses revealed variations in the relationship between epilepsy and sleep disturbances among different groups. Furthermore, interaction analyses revealed significant interactions between epilepsy and age (P = 0.049) and hypertension (P = 0.045). Conclusions: Our study utilizing NHANES data confirmed that depression partially mediated the association between epilepsy and sleep disturbance. Additionally, we observed differences in this association across demographic groups. Addressing depressive symptoms in PWE may improve their sleep quality, but further research is needed to explore the underlying mechanisms. [ABSTRACT FROM AUTHOR]

Water resources are a prerequisite constraint for agricultural development, and their utilization efficiency has a significant impact on economic and social development. Effectively measuring the impact of agricultural subsidies on irrigation water use efficiency is important for assessing agricultural subsidy policies and improving water use efficiency. To assess the impact of agricultural subsidies and farmland operation scale on cotton irrigation water use efficiency on the basis of research data of 312 farm households in Xinjiang, China, in 2023, we used the transcendental logarithmic stochastic frontier production function model and analyzed the nonlinear impacts of agricultural subsidies and farmland operation scale on the irrigation water use efficiency of Xinjiang cotton with the Tobit model. The results showed that the average cotton irrigation water use efficiency of the farmers was 0.560, and the loss of efficiency was relatively serious. The agricultural subsidies and farmland operation scale of the farmers had a direct inverted“U”effect on the cotton irrigation water use efficiency. The farmland operation scale had a mediating effect on the impact of agricultural subsidies on cotton irrigation water use efficiency. The study shows that, to improve irrigation water use efficiency in the context of the coexistence of severe water scarcity and low water use efficiency in Xinjiang, policy efforts should be increased in terms of promoting moderate agricultural subsidies and guiding farmers to operate on an appropriate scale. [ABSTRACT FROM AUTHOR]

Big data analytics capabilities are playing an increasingly important role in enhancing innovation capabilities and establishing competitive advantages for enterprises. Based on RBT and dynamic capability theory, this study established the interaction model between big data analysis capability(BDAC), agility and ambidextrous innovation. Through the research data of 191 technology-based enterprises in China, this paper explore the relationship between BDAC and ambidextrous innovation, and analyse the mediating role of agility. The study found that among the three dimensions of BDAC (tangible resources, intangible resources, human resources), big data human resources and intangible resources have significant roles in promoting ambidextrous innovation capabilities, while big data tangible resources have no significant impact on ambidextrous innovation capability. Among them, intangible resources play a more significant role in promoting exploratory innovation, human resources play a more significant role in promoting exploitative innovation, and agility plays a partial mediating role in this. The research results have certain implications for enterprises to obtain value from big data systems. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the association between vitamin D and sleep health and to investigate whether depression could mediate this relationship. Methods: A cross-sectional analysis was performed using the 2005–2014 US National Health and Nutrition Examination Survey (NHANES) data. The logistic regression models were conducted to evaluate association of serum vitamin D concentrations with sleep health and depression. Mediation analyses were conducted to investigate the mediated effects of depression on the association of vitamin D with sleep health. Results: In multivariate logistic models, vitamin D was found to be negatively associated with an increased risk of poor sleep health, with an odds ratio (OR) of vitamin D deficiency versus sufficiency was 1.256 (95% CI = 1.084–1.455). Additionally, univariate logistic models showed that vitamin D was also negatively associated with depression risk (vitamin D deficiency vs. sufficiency: OR = 1.699, 95% CI = (1.373–2.103). Further mediation analyses showed that the association of vitamin D with sleep health was mediated by depression, with the mediating effects of depression accounted for 44.56% of the total effects. Conclusion: Vitamin D affects sleep health directly and indirectly through depression. The results suggest that interventions increasing intake of vitamin D should be prioritized to promote sleep health of persons with or at risk of depression. [ABSTRACT FROM AUTHOR]

Self-efficacy, perceived social support, and resilience in caregivers of first-stroke patients are closely related, while the interaction mechanism remains unclear. This research explores the mediation effect of self-efficacy in the relationship between perceived social support and resilience in caregivers of first-stroke patients in China. Convenience sampling was designed and used to recruit participants from the General Hospital of Northern Theater in Shenyang, Liaoning Province, China, from February to October 2022, in which 207 self-reported participants completed the Connor-Davidson Resilience Scale (CD-RISC), Multidimensional Scale of Perceived Social Support (MSPSS) and General Self Efficacy Scale (GSES). In addition, the mediation effect of self-efficacy between perceived social support and resilience was determined by the PROCESS macro for SPSS. Among the 207 caregivers of patients with first-stroke, the mean CD-RISC, MSPPS and GSES scores were (72.17 ± 11.28), (71.17 ± 8.99), and (29.64 ± 5.03) respectively. Caregivers' self-efficacy was positively correlated with perceived social support (r = 0.439, p < 0.01) and resilience (r = 0.730, p < 0.01). Self-efficacy served a mediation function partially between perceived social support and resilience, whose effect accounted for 52.90% of the total. Both simple and mediation roles of perceived social support and self-efficacy are established in the relationship of resilience among caregivers of first-stroke patients. Positive social support and self-efficacy are two important targets for future interventional studies, and interventions on them may synergistically improve resilience. Hence, the nurses and community workers should correctly evaluate social support and self-efficacy, confirm the health education requirements, and implement counseling intervention to protect and improve the health of first-stroke patients and their families. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the relationship between triglyceride-glucose (TyG) index and cardiovascular disease (CVD) and all-cause mortality in adults with metabolic syndrome (MeS) and explore the mediating role of oxidative stress. Methods: This study included 6131 adults with MeS from the National Health and Nutrition Examination Survey (NHANES). The relationships between TyG index and mortality were elucidated using multivariate Cox proportional hazards models, restricted cubic splines (RCS) Fine-Gray competing risk model. In addition, mediation analysis was used to test the indirect effect of oxidative stress indicators. Results: Over a median 106-month follow-up, a total of 357 CVD and 1292 allcause deaths were recorded. After multivariate adjustment, there was a J-type relationship between TyG index and CVD and all-cause mortality, with optimal inflection point of 9.13 and 8.92. After the threshold point, TyG index was positively associated with CVD (HR: 4.21, 95%CI: 1.82, 9.78) and all-cause mortality(HR: 2.93, 95%CI: 2.05, 4.18). Even using non-cardiovascular mortality as a competitive risk, the Fine-Gray model also illustrated that the cumulative CVD mortality incidence was higher in MeS with TyG index >9.13 (Fine-Gray P< 0.01). Mediation analysis revealed that biomarkers of oxidative stress, including gamma-glutamyl transferase and uric acid, collectively mediated 10.53% of the association between the TyG index and CVD mortality, and 8.44% of the association with all-cause mortality (P < 0.05). Conclusion: In the cohort study, TyG index was found to have a J-shaped association with CVD mortality and all-cause mortality in MeS population and oxidative stress may play a key mediating role in this relationship. [ABSTRACT FROM AUTHOR]

This study aims to investigate: (a) the differences in how human resource (HR) practice bundles, which enhance skills, motivation, and opportunities, account for the turnover of high performers versus non-high performers; (b) whether the turnover of high performers has a stronger impact on firm performance compared to that of non-high performers; and (c) whether the turnover of high performers, rather than that of non-high performers, mediates the relationship between HR practices and firm performance. Research hypotheses were tested using data collected from 153 South Korean companies. The results indicated that (a) HR practice bundles enhancing motivation were most effective in retaining high performers, compared to those enhancing skills or opportunities; (b) the turnover of high performers had a substantially stronger impact on firm financial performance compared to that of non-high performers; and (c) the turnover of high performers mediated the impact of motivation-enhancing HR practices on firm financial performance. [ABSTRACT FROM AUTHOR]

This study evaluates the impact of green finance on agricultural non-point source pollution control and emission reduction in 30 Chinese provinces from 2005 to 2022. Utilizing the entropy value method and the unit survey inventory method, the research measures the levels of green finance development and agricultural non-point source pollution. It employs a mediation effect model to empirically assess the pollution control efficacy of green finance and to elucidate the mechanisms underlying its influence. The findings indicate that green finance development significantly curtails agricultural non-point source pollution emissions. This conclusion is still valid after a series of robustness tests. The results of mechanism analysis show that environmental regulation and land transfer are important channels for green finance to reduce agricultural non-point source pollution. However, the slowing effect of green finance is stronger in provinces where the economic development level is still in the catch-up zone. Consequently, this study suggests strengthening green finance infrastructure in rural areas, coordinating green finance and environmental regulation policies, optimizing land transfer systems to promote scale management, and developing differentiated green finance policies based on regional economic development levels. These measures aim to augment the role of green finance in pollution treatment and emission reduction, thereby optimizing the green financial system, advancing environmental protection, and fostering sustainable development in China's agricultural sector. [ABSTRACT FROM AUTHOR]

Objective: The objective of the present investigation is to examine the predictive influence of parenting style on the spirit of student participation, with an emphasis on the mediating role of self-efficacy. Methods: The methodological approach employed is descriptive-correlation. The statistical population encompasses both male and female high school students in Parsian, totaling 934 individuals. Following a cluster random sampling procedure, a sample of 272 students, comprising 136 females and 136 males, was analyzed. The research instruments utilized consist of three questionnaires: the parenting styles questionnaire by Baumrind (1973), the self-efficacy scale developed by Jink and Morgan (1999), and the student participation spirit measure articulated by Anderson et al. (2019). Results: The findings derived from correlation coefficients and path analysis of the variables indicated that 1- a significant relationship exists between each of the parenting style subscales and the variables of self-efficacy and participation spirit. However, the permissive parenting style does not exhibit a significant correlation with the spirit of participation. 2- In the path analysis, it was revealed that solely the negligent parenting style fails to significantly predict the spirit of participation. Conversely, the authoritative parenting style demonstrates a positive and significant predictive capacity for the spirit of participation when mediated by self-efficacy. In contrast, the authoritarian parenting style exhibits a negative predictive influence on the spirit of participation. Conclusions: These measures are essential steps toward creating a more agile organization, as recommended for managers and officials. [ABSTRACT FROM AUTHOR]

Background & Aims: Major depressive disorder and schizophrenia have been hypothesized to be closely associated with cancer. However, the associations between these psychiatric conditions and the development of lung cancer remain uncertain. This study aimed to explore the causal relationship among major depressive disorder, schizophrenia, and the risk of lung cancer. Methods: Two-sample bidirectional/multivariable and mediation Mendelian randomization (MR) analyses were conducted. Genome-wide summary data on major depressive disorder (N=500,199) and schizophrenia (N=127,906) were utilized. Data on the risk of lung cancer (overall, adenocarcinoma, and squamous cell) were collected from a cohort of individuals of European ancestry (N=27,209). Three smoking-related behaviors (smoking initiation, pack years of smoking, and cigarettes smoked per day) were included in the multivariable and mediation MR analyses. Results: Patients with schizophrenia had a significantly greater risk of developing lung cancer (odds ratio (OR) = 1.144, 95% confidence interval (95% CI): 1.048-1.248, P = 0.003). The number of cigarettes smoked per day partially mediated the relationship between schizophrenia and the overall risk of lung cancer (OR = 1.185, 95% CI: 1.112-1.264, P = 0.021, proportion of mediation effect: 61.033%). However, there is no reliable evidence indicating an association between major depressive disorder and the risk of lung cancer (overall, adenocarcinoma, and squamous cell cancer). Conclusions: The findings indicated an association between schizophrenia and an increased risk of lung cancer, with smoking served as a partial mediator. When smoking was included in the regression analysis, the explanatory power of schizophrenia diagnosis was reduced, suggesting that smoking may be an important causal contributor to lung cancer in this population. Given the high prevalence of smoking among individuals with schizophrenia, these results underscore the need for further research to explore the underlying mechanisms of smoking's impact. Consequently, greater emphasis should be placed on monitoring the respiratory health of individuals with schizophrenia and implementing early interventions to address smoking-related behaviors. [ABSTRACT FROM AUTHOR]

Craving is a core feature of addiction. Rumination and depression play a crucial role in the process of methamphetamine addiction. The aim of this study was to examine the relationship between rumination, depression and craving in methamphetamine patients, which has not been explored yet. A total of 778 patients with methamphetamine user disorder (MUD) at the Xinhua Drug Rehabilitation Center, located in Mianyang City, Sichuan Province, China. We used a set of self-administered questionnaires that included socio-demographic, detailed drug use history, rumination, depression and craving information. The Rumination Response Scale (RRS) was used to measure rumination, the Beck Depression Inventory (BDI) to measure depression and the Visual Analogue Scale (VAS) to measure craving. There was a significant positive correlation between rumination and craving, or depression, and between depression and craving. Furthermore, depression mediated between rumination and craving, with a mediation effect of 160%. Our findings suggest that there is a close interrelationship between rumination, craving and depression in MUD patients, and that depression may play a mediating role between rumination and craving. This is the first study to investigate the relationship between rumination and craving during withdrawal in methamphetamine dependent patients and the mediating role of depression. Among methamphetamine patients, it was found that reflection was positively correlated with rumination and depression, depression and craving, rumination and craving, and depression plays the mediating role between rumination and craving. These findings suggest that interventions to reduce depression and rumination may also be effective for withdrawal and relapse reduction in methamphetamine patients, providing further rationale for the treatment of methamphetamine patients. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to explore the relationship between multidimensional factors, such as environment, health status, behavior, social support, and the well-being of middle-aged and older adults. Methods: This study utilized data from 2 waves of the nationally representative Taiwan Longitudinal Study on Aging Survey Report (TLSA) conducted in 2015 and 2019. The TLSA assesses socioeconomic status, physical and health status, the 5-item World Health Organization Well-Being Index (WHO-5 index), and social support. Data regarding the degree of digital development were obtained from the 2020 Township Digital Development Report. We applied a generalized estimating equation (GEE) to analyze the influencing factors. Results: This study included 4796 participants. Residing in areas with a higher degree of digital development, having a higher socioeconomic status, and experiencing better physical and mental health were significantly associated with well-being. Furthermore, emotional and attentive support mediated the association between physical and mental status and well-being. Conclusion: People's awareness of searching for and receiving social support and medical resources is important for enhancing their well-being. It is also crucial to pay attention to the living environment and maintain one's health status to promote well-being. [ABSTRACT FROM AUTHOR]

Tourism eco-efficiency has played a significantly essential role in the sustainable development of tourism destinations and tourism industries, providing ideal inputs and outputs amidst the deepening environmental crisis. This study evaluates the development level of tourism eco-efficiency using the Super-SBM model with undesirable outputs, employing the Malmquist-Luenberger (ML) index to analyse the internal optimisation forces of tourism eco-efficiency. Furthermore, human capital is assessed through both horizontal and vertical education levels, followed by a panel Tobit econometric analysis to explore the external impact mechanisms on tourism eco-efficiency. The results show that (1) Technological advancement is the core intrinsic driver for optimising tourism eco-efficiency. (2) In the analysis of influencing mechanisms, Human capital significantly contributes to enhancing tourism eco-efficiency, a conclusion upheld even after conducting robustness tests. (3) Analysis of mediating mechanisms indicates that tourism industry agglomeration is a critical pathway through which human capital enhances tourism eco-efficiency. This correlation has been proven reliable by regional regression analysis. (4) Results of the threshold model test suggest a law of "increasing marginal effect" concerning the positive impact of human capital on tourism eco-efficiency within the regulation of tourism industry agglomeration. Consequently, regions should actively promote the roles of human capital and tourism industry agglomeration in advancing tourism eco-efficiency, improving resource utilization efficiency, and tourism industry specialization to foster sustainable tourism development. [ABSTRACT FROM AUTHOR]

Purpose: This study investigates the impact of e-commerce on high-quality agricultural development (HQAD) in China. As the agricultural sector transitions towards higher quality production in the digital era, understanding the influence pathways and mechanisms of e-commerce becomes crucial. We aim to quantify this influence through a hierarchical approach. Methods: Utilizing provincial panel data from 2000 to 2021, we construct a comprehensive HQAD evaluation system using the entropy method. Parallel mediating effect models are employed to empirically assess the multi-level effects of e-commerce on HQAD. Results: Benchmark regression analyzes reveal a significant positive effect of e-commerce on HQAD, indicating its role as a key driver in China's agricultural advancement. Mechanism tests identify several intermediary pathways through which e-commerce indirectly promotes HQAD, including market expansion, agricultural value chain optimization, enhanced social services, and improved infrastructure. Notably, market expansion and value chain optimization demonstrate the most substantial mediation effects, accounting for 43.27 and 14.18% of the total effect, respectively. Discussion: This research contributes to the literature by establishing a comprehensive HQAD evaluation framework, providing a theoretical foundation for future studies. By incorporating circulation factors into the production system, we elucidate the complex influence mechanisms of e-commerce on agricultural production, addressing a significant research gap. Furthermore, we propose a novel "demand-driven supply optimization" paradigm, offering valuable insights for policy formulation aimed at fostering HQAD in China. [ABSTRACT FROM AUTHOR]