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ObjectiveMental health has become a widely concerned topic worldwide. However, the impact and mechanism of positive activities on mental health still needed to be explored. This study aimed to apply the positive-activity model to investigate the effect of participation in positive activities on mental health and the mediating role of positive emotion.MethodsThis study used data from the 2021 China Comprehensive Social Survey (CGSS) and included 2,581 individuals. Ordinary Least Squares (OLS) and a three-step method was used for analysis.ResultsThe average of positive activities was 15.83. The positive activities affected positively mental health (β = 0.0132, p < 0.001). The positive emotion played a mediating role (β =0.2281, p < 0.001). The effect of positive activities on mental health was significant in older adults group (β = 0.024, p < 0.001), female (β = 0.015, p < 0.01) and male group (β = 0.01, p < 0.01), unmarried/divorced/widowed group (β = 0.024, p < 0.01), cohabitation/first marriage with spouse/remarriage with spouse/separation without divorce group (β = 0.010, p < 0.001), middle(β = 0.013, p < 0.05), and upper-middle-level SES group (β = 0.054, p < 0.001).ConclusionsWe concluded that the participation level of positive activities still needs to be improved and positive activities improve mental health through positive emotion, which implied that positive activities, as an easily implementable measure, should be greatly encouraged in mental health policies. And older adults, female, people without spouse, middle and upper-middle-income individuals need to be paid more attention.

Parkinson’s Disease (PD) and Drug-induced parkinsonism (DIP) are the most common subtypes of parkinsonism, yet no studies have reported that the subcortical volume alterations in DIP patients. This study aimed to identify specific alterations of subcortical structures volume in DIP patients, and investigate association between the subcortical structure modifications and clinical symptoms. We recruited 27 PD patients, 25 DIP patients and 30 healthy controls (HCs). The clinical symptom-related parameters (Unified Parkinson’s Disease Rating Scale, UPDRS) were evaluated. Structural imaging was performed on a 3.0 T scanner, and volumes of subcortical structures were obtained using FreeSurfer software. Analysis of covariance (ANCOVA) and partial correlation analysis were performed. DIP group had significantly smaller volume of the thalamus, pallidum, hippocampus and amygdala compared to HCs. ROC curve analysis demonstrated that the highest area under curve (AUC) value was in the right pallidum (AUC = 0.831) for evaluating the diagnostic efficacy in DIP from HCs. Moreover, the volumes of the putamen, hippocampus and amygdala were negatively correlated with UPDRSII in the DIP patients. The volume of the amygdala was negatively correlated with UPDRSIII. The present study provides novel information regarding neuroanatomical alteration of subcortical nuclei in DIP patients, suggesting that these methods might provide the basis for early diagnosis and differential diagnosis of DIP.

Abstract Background This study aims to explore the impacts of knowledge and attitude on the behavior of antibiotic use during the treatment of the common cold based on the expanding KAP model, and then identify the critical behavioral stage. Methods A cross-sectional study was conducted on 815 public from 21 community health centers (CHCs) in Chongqing, China. Based on the expanding KAP model, a self-administered questionnaire was designed to measure knowledge, attitude, multi-stage behavior, and perceived threat, in which multi-stage behavior was divided into pre-use antibiotic behavior, during-use antibiotic behavior, and post-use antibiotic behavior. A structural equation model was used to examine the model fit and the direct, indirect, mediating effects, and moderating effect of the variables. Results The expanding KAP showed good model fit indices with χ²/df = 0.537, RMSEA = 0.033, CFI = 0.973, GFI = 0.971, NFI = 0.934, TLI = 0.979. Knowledge had a positive effect on attitude (β = 0.503, p

BackgroundImproving the rural residents’ accessibility to and affordability of health care is recognized as a common target globally. The Health in All Policies approach, from the Declaration of Helsinki to the United Nations’ Decade Of Healthy Ageing, strengthened the far-reaching effect of large-scale public policies on health care–seeking behavior; however, the effects of national transport policy on health care–seeking behavior is unclear. ObjectiveThis quasi-experimental study aimed to examine the effects of the implementation of transport-driven poverty alleviation (TPA) policy on health care–seeking behavior and medical expenditure among older adults in rural areas and the mechanism underlying these effects. MethodsWe designed a quasi-experiment to estimate the effects of TPA policy implementation on health care–seeking behavior and medical expenditure among older adults in rural areas through a difference-in-differences (DID) analysis based on data from the China Health and Retirement Longitudinal Study in 2011, 2013, 2015, and 2018. The underlying mechanism was analyzed and effect modification patterns were further investigated by poor households, health status, and age. ResultsOur findings validated a positive contribution of TPA policy on health care–seeking behavior among older adults in rural areas. After the implementation of TPA policy, the number of inpatient visits increased by annually 0.35 times per person, outpatient medical expenditure increased by 192% per month, and inpatient medical expenditure increased by 57% annually compared with those of older adults in rural areas without the implementation of TPA policy. Further, there was a significant modification effect, with a positive effect among poor households, healthier older adults, and those aged 60-80 years. Additionally, the policy improved the patients’ capabilities to seek long-distance care (β=23.16, 95% CI –0.99 to 45.31) and high-level hospitals (β=.08, 95% CI –0.02 to 0.13), and increased individual income to acquire more medical services (β=4.57, 95% CI –4.46 to 4.68). ConclusionsThese findings validate the positive contribution of TPA policy on health care–seeking behavior among older adults in rural areas; however, the medical expenditure incurred was also high. Concerted efforts are needed to address health care–seeking dilemmas in rural areas, and attention must be paid to curbing medical expenditure growth for older adults in rural areas during TPA policy implementation.

BackgroundChronic pain, sleep disorders, and depression are major global health concerns. Recent studies have revealed a strong link between sleep disorders and pain, and each of them is bidirectionally correlated with depressive symptoms, suggesting a complex relationship between these conditions. Social participation has been identified as a potential moderator in this complex relationship, with implications for treatment. However, the complex interplay among sleep disorders, pain, depressive symptoms, and social participation in middle- and old-aged Asians remains unclear. ObjectiveThis study aimed to examine the bidirectional relationship between sleep disorders and pain in middle- and old-aged Chinese and measure the role of depression as a mediator and social participation as a moderator in this bidirectional relationship through a dynamic cohort study. MethodsWe used data from the China Health and Retirement Longitudinal Study across 5 years and included a total of 7998 middle- and old-aged people (≥45 years old) with complete data in 2011 (T1), 2015 (T2), and 2018 (T3). The cross-lag model was used to assess the interplay among sleep disorders, pain, depressive symptoms, and social participation. Depressive symptoms were assessed by the 10-item Centre for Epidemiological Studies Depression scale. Sleep disorders were assessed by a single-item sleep quality scale and nighttime sleep duration. The pain score was the sum of all pain locations reported. Social participation was measured using self-reported activity. ResultsOur results showed significant cross-lagged effects of previous sleep disorders on subsequent pain at T2 (β=.141; P

Humans and rodents exhibit a divergent obesity phenotype where not all individuals exposed to a high calorie diet become obese. We hypothesized that in C57BL/6NTac mice, despite a shared genetic background and diet, variations in individual gut microbiota function, immune cell phenotype in the intestine and adipose determine predisposition to obesity. From a larger colony fed a high-fat (HF) diet (60% fat), we obtained twenty-four 18–22-week-old C57BL/6NTac mice. Twelve had responded to the diet, had higher body weight and were termed obese prone (OP). The other 12 had retained a lean frame and were termed obese resistant (OR). We singly housed them for three weeks, monitored food intake and determined insulin resistance, fat accumulation, and small intestinal and fecal gut microbial community membership and structure. From the lamina propria and adipose tissue, we determined the population of total and specific subsets of T and B cells. The OP mice with higher fat accumulation and insulin resistance harbored microbial communities with enhanced capacity for processing dietary sugars, lower alpha diversity, greater abundance of Lactobacilli and low abundance of Clostridia and Desulfobacterota. The OR with less fat accumulation retained insulin sensitivity and harbored microbial communities with enhanced capacity for processing and synthesizing amino acids and higher diversity and greater abundance of Lactococcus, Desulfobacterota and class Clostridia. The B cell phenotype in the lamina propria and mesenteric adipose tissue of OR mice was characterized by a higher population of IgA+ cells and B1b IgM+ cells, respectively, compared to the OP. We conclude that variable responses to the HF diet are associated with the function of individuals’ gut microbiota and immune responses in the lamina propria and adipose tissue.

Student performance predictive analysis has played a vital role in education in recent years. It allows for the understanding students’ learning behaviours, the identification of at-risk students, and the development of insights into teaching and learning improvement. Recently, many researchers have used data collected from Learning Management Systems to predict student performance. This study investigates the potential of clickstream data for this purpose. A total of 5341 sample students and their click behaviour data from the OULAD (Open University Learning Analytics Dataset) are used. The raw clickstream data are transformed, integrating the time and activity dimensions of students’ click actions. Two feature sets are extracted, indicating the number of clicks on 12 learning sites based on weekly and monthly time intervals. For both feature sets, the experiments are performed to compare deep learning algorithms (including LSTM and 1D-CNN) with traditional machine learning approaches. It is found that the LSTM algorithm outperformed other approaches on a range of evaluation metrics, with up to 90.25% accuracy. Four out of twelve learning sites (content, subpage, homepage, quiz) are identified as critical in influencing student performance in the course. The insights from these critical learning sites can inform the design of future courses and teaching interventions to support at-risk students.

The overuse of antibiotics remains serious and has led to a dramatic increase in antimicrobial resistance, which poses a significant threat to global public health, although much action has been taken by World Health Organization and countries. As the direct evidence to guide the prescribing of antibiotics, the Antimicrobial Susceptibility Testing (AST) results were biased by sample errors, which was urgent and poorly explored in quality management. This study aimed to analyze sample errors pre-AST and its influencing factors from the perspective of hospital management, to provide evidence for promoting rational antibiotic use and antimicrobial stewardship. A cross-sectional survey of 5963 clinical nurses involved in pathogenic sample collection was conducted in 118 public hospitals in Hubei province, China. Dependent variables were sample errors attributed to resources and technology-oriented, capability-oriented, and attitude-oriented errors, which were measured by times per week. Independent variables were sample management information such as guidelines, record after collection, performance appraisal, training, and publicity activities, in which guidelines, record time, and record method were dummy variables, with 1 indicating having and 0 not. Others were continuous variables ranging from 0 to 4 times per month. Ordinary Least Square regression models were performed to analyze influencing factors on sample error times. The averages of sample errors on resource and technology-oriented, capability-oriented, and attitude-oriented were 1.48, 1.35, and 1.36 times per week, and their proportion were 25.3%, 38.9%, and 35.8%, respectively. The results showed that recording timeliness (r = −0.354, p < 0.01), record using both paper and digital methods(r = −0.060, p < 0.01), performance appraisal(r = −0.188, p < 0.01), and publicity activities (r = −0.186, p < 0.01) significantly reduced times of resource and technology-oriented errors. Performance appraisals(r = −0.171, p < 0.01) and training activities (r = −0.208, p < 0.01) had a positive impact on the reduction of capability-oriented error times. The times of attitude-oriented error decreased significantly when recording timeliness (r = −0.299, p < 0.01), implementing performance appraisal (r = −0.164, p < 0.01), and training activities (r = −0.188, p < 0.01). This study found that there was a high frequency of sample errors in quality management, especially capability-oriented and attitude-oriented errors. Sample information management, performance appraisal, training, and publicity activities were associated with the quality of samples valuable for the rational use of antibiotics.

Cancer is caused primarily by genomic alterations resulting in deregulation of gene regulatory circuits in key growth, apoptosis, or DNA repair pathways. Multiple genes associated with the initiation and development of tumors are also regulated at the level of mRNA decay, through the recruitment of RNA-binding proteins to AU-rich elements (AREs) located in their 3′-untranslated regions. One of these ARE-binding proteins, tristetraprolin (TTP; encoded by Zfp36), is consistently dysregulated in many human malignancies. Herein, using regulated overexpression or conditional ablation in the context of cutaneous chemical carcinogenesis, we show that TTP represents a critical regulator of skin tumorigenesis. We provide evidence that TTP controlled both tumor-associated inflammation and key oncogenic pathways in neoplastic epidermal cells. We identify Areg as a direct target of TTP in keratinocytes and show that EGFR signaling potentially contributed to exacerbated tumor formation. Finally, single-cell RNA-Seq analysis indicated that ZFP36 was downregulated in human malignant keratinocytes. We conclude that TTP expression by epidermal cells played a major role in the control of skin tumorigenesis.

Cruciferous vegetables have been widely studied for cancer prevention and cardiovascular health. Broccoli is the cruciferous vegetable whose phytochemistry and physiological effects have been most extensively studied. Kale (Brassica oleracea var. acephala) appears on lists of 'healthiest, nutrient dense foods' but, there is paucity of data on kale as a functional food. In a 12-week study, we tested the effect of curly green kale on high fat diet (HFD) induced obesity and insulin resistance, lipid metabolism, endotoxemia and inflammation in C57BL/6J mice fed isocaloric diets. Kale supplementation did not attenuate HFD diet induced fat accumulation and insulin resistance (P = ns; n = 9) but, it lowered serum triglycerides, low density lipoprotein (LPL) cholesterol and prevented HFD induced increases in systemic endotoxemia and inflammation (serum LPS and Ccl2) (P

This study aimed to identify factors influencing student engagement in online and blended courses at one Australian regional university. It applied a data science approach to learning and teaching data gathered from the learning management system used at this university. Data were collected and analysed from 23 subjects, spanning over 5500 student enrolments and 406 lecturer and tutor roles, over a five-year period. Based on a theoretical framework adapted from Community of Inquiry (CoI) framework by Garrison et al. (2000), the data were segregated into three groups for analysis: Student Engagement, Course Content and Teacher Input. The data analysis revealed a positive correlation between Student Engagement and Teacher Input, and interestingly, a negative correlation between Student Engagement and Course Content when a certain threshold was exceeded. The findings of the study offer useful suggestions for future course design, and pedagogical approaches teachers can adopt to foster student engagement.

The outbreak of COVID-19 worldwide in 2020 has posed tremendous challenges to higher education globally. Teaching English as a foreign language (TEFL) is among the many areas affected by the pandemic. The unexpected transition to online teaching has increased challenges for improving and/or retaining students’ language proficiency. WeChat, a popular social application in China, was widely used for TEFL at Chinese universities before COVID-19. However, it remains unclear whether the use of WeChat can facilitate Chinese university students’ English-language lexical proficiency during the pandemic. To fill this gap, the aim of the present study was two-fold: (1) it initially explored the relationship between the variables including students’ academic years, genders, and academic faculties/disciplines, and their lexical proficiency; and (2) it evaluated the effectiveness of a WeChat-assisted lexical learning (WALL) program in facilitating learning outcomes of English-language vocabulary. One hundred and thirty-three students at a university in Northern China participated in the WALL program for three weeks. As the results indicated, the independent variables had no correlation with the students’ lexical proficiency. More importantly, the students had a decline in the test scores after using the program, compared to their initial test scores. Moreover, the difference was reported to be medium. The findings further proposed questions on applying WeChat to vocabulary teaching in a large-scaled transition. The study is expected to provide insights for tertiary institutions, language practitioners, and student stakeholders to troubleshoot the potential problems regarding implementing WeChat-based TEFL pedagogies.

Kale (Brassica oleracea var. acephala) is a vegetable common in most cultures but is less studied as a functional food compared to other cruciferous vegetables, such as broccoli. We investigated the effect of supplementing a high-fat diet (HFD) with kale (HFKV) in C57BL/6J mice. We particularly explored its role in metabolic parameters, gut bacterial composition and diversity using 16S rRNA sequencing, systematically compared changes under each phylum and predicted the functional potential of the altered bacterial community using PICRUSt2. Like other cruciferous vegetables, kale attenuated HFD-induced inflammation. In addition, kale modulated HFD-induced changes in cecal microbiota composition. The HFD lowered bacterial diversity, increased the Firmicutes: Bacteroidetes (F/B) ratio and altered composition. Specifically, it lowered Actinobacteria and Bacteroidetes (Bacteroidia, Rikenellaceae and Prevotellaceae) but increased Firmicutes (mainly class Bacilli). Kale supplementation lowered the F/B ratio, increased both alpha and beta diversity and reduced class Bacilli and Erysipelotrichi but had no effect on Clostridia. Within Actinobacteria, HFKV particularly increased Coriobacteriales/Coriobacteriaceae about four-fold compared to the HFD (p < 0.05). Among Bacteroidia, HFKV increased the species Bacteroides thetaiotaomicron by over two-fold (p = 0.05) compared to the HFD. This species produces plant polysaccharide digesting enzymes. Compared to the HFD, kale supplementation enhanced several bacterial metabolic functions, including glycan degradation, thiamine metabolism and xenobiotic metabolism. Our findings provide evidence that kale is a functional food that modulates the microbiota and changes in inflammation phenotype.

Internationally, parks have been shown to be an important community asset for physical activity (PA), but little is known about the relationship between park usage and physical activity in China. The purpose of this study was to determine the association between park user characteristics and PA in Nanchang, China. In June 2014, 75,678 people were observed in eight parks over 12 days using SOPARC, a validated systematic observation tool. A logistic regression analysis was used to determine the association between PA and park user characteristics. Most park users were older adults (53.5%) or adults (34.6%). Overall, 55% of park users engaged in moderate-to-vigorous physical activity (MVPA). Fewer women were observed in parks than men, but were 66% more likely to be engaged in MVPA than men. Park users were more likely to be observed in MVPA between 6–9 am and when the temperature was below 30 °C. Chinese park users were more active (55%) than US studies in Tampa (30%), Chicago (49%), and Los Angeles (34%). More research is necessary to identify features of parks that are associated with greater PA so that effective interventions can be developed to promote active park use in Chinese citizens.

Enrolment numbers in online higher education courses have continued to increase over the last decade. The challenges brought about by the COVID-19 pandemic have further accelerated the growth in online and blended course offerings. The development of institutional support services, however, does not reflect this growth. Many students are not equipped with the skills or given adequate support to engage and succeed in their courses, leading to student disengagement and attrition. This study investigated the perceptions of students in online and blended subjects, regarding both the academic and institutional support they were provided. The research team collected interview data from 41 online and blended-learning students and then analysed these data using an iterative thematic analysis approach. This article introduces the key findings with two models: one presenting support strategies at multiple levels within this university; the other presenting three key elements of subject-level teacher support, which were identified by the interviewees as the most significant, effective, and relevant support mechanism in this context. The findings will inform higher education institutions who aim to engage and support online and blended students better, through an improved understanding of how support is perceived by this student cohort. This study was conducted at one Australian university; however, the findings are relevant to higher education institutions in other countries that strive to bring about positive experiences and enhance retention rates for online and blended students.

Connectivity is intrinsic to all aspects of our life today, be it political, economic, technological, scientific, or personal. Higher education is also transcending the previous paradigm of technology enabled content delivery and e-learning, with a new emphasis on connectivity, enabling participants to exchange knowledge and collaborate to meet educational goals. In this study, a social media technology supported website—digiMe—was developed and evaluated at the School of Medicine of one Australian university. Connectivity to other medical learners and health professionals is intrinsic to digiMe. This paper reports the functionalities of this website, results of a post-intervention evaluative survey, and statistics of website usage generated from Google Analytics. The results revealed more active adoptions and a more positive attitude towards digiMe from Year 4 students compared to Year 5 students. The participants showed a desire for access to a recommended collection of apps, such as those offered through digiMe. However, many participants did not use digiMe beyond initial introduction to it. digiMe demonstrated its potential in raising awareness of web and mobile apps useful for enhancing connectivity, although it needs to be introduced to students in earlier years of their medical education to achieve a higher impact on their learning.