Cognitive Level Research Articles

The Role of Motivation in Decision-Making and Underlying Neural Mechanism

This paper presents crucial findings on how motivation, both internal and external, significantly influences decision-making processes at cognitive and neural levels. It highlights the role of reward anticipation and uncertainty in shaping decision-making behavior, particularly focusing on brain regions like the prefrontal cortex, amygdala, and dopaminergic pathways, which govern strategic and risk-related decisions. Studies involving psychiatric conditions, such as schizophrenia, and healthy individuals using fMRI reveal that increased motivation enhances decision-making strategies by activating frontal and parietal brain regions, while certain areas like the Orbitofrontal Cortex (OFC) show less involvement. Additionally, the essay explores the role of insight-driven internal motivation, showing that moments of sudden clarity (AHA! experiences) can elevate risk-taking behavior by stimulating the nucleus accumbens (NAcc), a key region involved in reward processing. The research also delves into strategic decision-making theories, emphasizing the balance between logical reasoning and instinctive, politically influenced decision-making processes within organizations. The essay concludes by underscoring the need for further research into the neural mechanisms linking motivation and decision-making, particularly the impact of neurotransmitter systems and individual differences in neural responsiveness to rewards. This deeper understanding could lead to enhanced strategies for improving decision-making outcomes across various fields, including healthcare, management, and personal decision-making, offering insights into the complex interplay between motivation, cognition, and neural activity.

Digital eye strain symptoms worsen during prolonged digital tasks, associated with a reduction in productivity

PurposeIt is often stated that digital eye strain can impact productivity and/or work accuracy, but the relationship between symptoms, productivity, and work accuracy has been unclear. Hence this study tracked the development of visuo-ocular symptoms during prolonged digital tasks and to explore the impact of higher and lower cognitive load levels on visuo-ocular symptoms, productivity, and work accuracy. MethodsThirty-five participants (23.2 ± 4.0 years) who had digital eye strain (diagnosed with the Computer Vision Syndrome Questionnaire) undertook an uninterrupted laptop adapted Eriksen Flanker task for 60 min on two separate days, once with a high cognitive load in randomised sequence. Symptoms were assessed at baseline and every 10 min throughout the task. ResultsAll visuo-ocular symptom scores significantly worsened (F = 87.783, p < 0.001) with time, with the symptom severity increasing faster with the higher cognitive load (F = 7.110, p < 0.001). The mean total number of tasks completed was greater for the lower (1060.8 ± 296.5) than the higher (532.2 ± 123.4) cognitive load tasks (F = 138.830, p < 0.001), reducing with time (F = 7.339, p < 0.001), but in a similar way for both cognitive loads (F = 1.795, p = 0.154). Task accuracy was not affected by the cognitive load of the task (F = 1.729, p = 0.197) and was consistent over time (F = 1.885, p = 0.135). ConclusionsSymptoms increased with task duration in individuals with digital eye strain, with a faster rate for more demanding tasks. This was associated with a decrease in the task completion rate (productivity), but not the work accuracy.

An examination of the cognitive demand levels posed by problems in the middle grades mathematics textbooks

This research investigated the cognitive demand levels of mathematics tasks within the middle school mathematics textbooks endorsed by the Ministry of National Education for the academic year of the 2023-2024. To achieve this, a qualitative research method was utilized, and document analysis was performed. In this direction, the textbooks were analyzed using descriptive analysis. The tasks within the textbooks were examined through the lens of Smith and Stein’s (1998) theoretical framework. The findings indicate that the majority of mathematics tasks in middle school mathematics textbooks exhibit a low level of cognitive demand. It was found that over 80% of the tasks fell into the categories of memorization and procedures without connections levels. It has been revealed that tasks at the levels of procedures with connections and doing mathematics, which are high cognitive demand levels, are uncommon. This shows that textbooks do not sufficiently support the potential of students to develop mathematical thinking and problem-solving skills. Based on these results, various suggestions have been made for textbooks. The most important of these suggestions include ensuring that students are cognitively exposed to higher level tasks and increasing the number of tasks that will improve their mathematical thinking skills. Thus, it will be possible for students to have a more effective learning process by deepening their mathematical understanding.

Cognitive flexibility and emotion regulation in eating disorder patients with comorbid generalized anxiety and posttraumatic stress symptoms

ABSTRACT Research has found that difficulties in emotion regulation negatively impact mental health, whereas cognitive flexibility may promote stress resilience and positive mental health. Little is known about cognitive flexibility and emotion regulation in people with comorbid eating disorder (ED) and anxiety and stress disorders. A transdiagnostic ED population (N = 227) at an outpatient ED treatment facility completed several self-report instruments that measured cognitive flexibility, emotion regulation difficulties, posttraumatic stress disorder (PTSD) symptoms, and generalized anxiety disorder (GAD) symptoms upon admission. We investigated cognitive flexibility and emotion regulation differences for those with an ED without comorbidity and those with various combinations of comorbidity. In a one-way between-groups ANOVA, we investigated differences in cognitive flexibility for those with GAD, PTSD, neither, and both comorbidities. We found a statistically significant difference between these groups, with mean cognitive flexibility inventory scores being the lowest in the group with both comorbidities. However, when controlling for emotion regulation, a one-way between-groups ANCOVA indicated no significant differences in cognitive flexibility between comorbidity groups F(3, 222) = 1.20, p = .31 Partial η 2 = .02. Though self-reported cognitive flexibility levels differ among ED patients with and without comorbidities, it appears that these differences are better explained by emotion regulation. Therefore, addressing emotion regulation early in treatment for all individuals with EDs, regardless of comorbidity, is recommended as a future research focus to enhance treatment outcomes. Further research is needed to understand the impact of treating emotion regulation on ED treatment engagement, dropout, and effectiveness.

Capabilities of GPT-4 in ophthalmology: an analysis of model entropy and progress towards human-level medical question answering

BackgroundEvidence on the performance of Generative Pre-trained Transformer 4 (GPT-4), a large language model (LLM), in the ophthalmology question-answering domain is needed.MethodsWe tested GPT-4 on two 260-question multiple choice question...

Are HPV Vaccines Well Accepted among Parents of Adolescent Girls in China? Trends, Obstacles, and Practical Implications for Further Interventions: A Five-Year Follow-Up Study.

In 2020, the WHO proposed the global strategic goal of accelerating the elimination of cervical cancer (CC). One of the key strategies is that, by 2030, 90% of girls will complete HPV vaccination by age 15. In 2017, HPV vaccines were first marketed in China. This study aimed to explore the changes in parents' knowledge about CC, HPV, HPV vaccines, and acceptance of HPV vaccination 5 years after the introduction of HPV vaccines into China. Associated factors and reasons for refusal by parents were also explored. A school-based follow-up study was conducted among parents in China from May 2018 to May 2023. Comparison using Chi-square tests was performed to measure the changes. Univariate and multivariate analyses were used to explore factors associated with HPV vaccination among teenage girls. The overall cognitive level in terms of CC- and HPV-related knowledge among parents increased, and they expressed more willingness to vaccinate their daughter (35.4% in 2018 vs. 56.6% in 2023). The HPV vaccination rate among teenage girls remained at a low level (4.4% in 2018, 9.8% in 2023). The main obstacles reported by parents were limited knowledge (42.0%), scarcity of the HPV vaccine (29.2%), waiting until their daughter was older (27.5%), safety concerns (14.7%), high cost (9.0%), and effectiveness concerns (4.6%). Parents who are elderly, local residents, have received HPV vaccines themselves, have had experience of vaccinating their children with influenza vaccines, and have a higher knowledge level of CC, HPV and HPV vaccines are more likely to vaccinate their children with HPV vaccines. Although we observed an increment in parents' knowledge level in terms of CC, HPV, HPV vaccines, and HPV vaccine uptake over the past 5 years, the HPV vaccine coverage among girls still falls short of the WHO's 2030 target. Comprehensive intervention strategies, including tailored health education among adolescents and their parents, doctor recommendations, and providing financial subsidies or free HPV vaccines are needed in China.

Impact of peer-to-peer online experience on cultural tourism marketing

Peer-to-peer (P2P) online experience offers low-cost immersive cultural experiences, but enterprises fear that it will negatively affect local tourism marketing. This study proposes a sequential mediation model to explore how P2P online experience stimulates travel intentions and attraction recommendations. We find that P2P online experience increases cultural presence, which in turn leads to higher situational empathy. This increased empathy then contributes to predicted tourism experience, which ultimately shapes behavioral intentions toward travel and attraction recommendations. Furthermore, the study finds that the impact of P2P online experience on behavioral intentions is stronger for consumers with lower cultural cognitive levels of tourist attractions. Our findings demonstrate the importance of P2P online experience on cultural presence and situational empathy in shaping travel behavior.

Intervention in Time Processing Ability and Everyday Functioning for Preschool Children in Need of Special Support: A Randomized Controlled Study

ABSTRACT Children in need of special support in preschool (INS) often exhibit delayed time processing ability (TPA) which can significantly impact their everyday functioning (EDF). This study evaluates whether the MyTime intervention could improve TPA and EDF in preschool children aged five to six-year INS. A registered randomized controlled trial (ISRCTN85136134) using a waiting-list control group investigated the effectiveness of MyTime, an occupational therapy intervention program given to preschool children INS in their classrooms for 8 weeks. Data collection included KaTid-Child® for the assessment of TPA, the Time-Parent scale, the Adaptive Behavior Assessment System, and the Autonomy scale for assessing EDF. To evaluate between-group differences, data were analyzed using linear regression. The results show that both groups improved from baseline to post-intervention in TPA and everyday functioning but at the post-intervention, there were no between-group differences. To summarize, the MyTime intervention, indicated an increase in TPA and EDF but no between-group differences were found. Early cognitive levels of TPA in preschool children INS advocate for a longer intervention period. It is possible that long-term follow-up or additional measuring of the teacher’s attitudes and the children’s engagement in the preschool context could have yielded other results.

Fractal Biology — Evolution from Molecular to Cognitive, and Psychological Dimensions

Biological and artificial intelligence (BI and AI) share the fundamental principles of space-time information processing based on symmetry transformation. Therefore, cognitive-science-inspired AI represents a promising area of exploration. A convincing example are the fractal structure of human languages and protein assembly. Biological processes’ temporal and spatial plasticity links them to basic laws of physics. Continuous advances in fundamental physical theories allow understanding of all aspects of space-time symmetry (STS) natively intertwined with the principle of relativity and causality. Spatial aspects of symmetry represented by three sub-domains such as chirality, fractality, and topology, are widely studied in biology. The role of chirality in biology has been analyzed in several recent reviews. However, the fractals and topological states of biological structures is a relatively new and fast-developing branch of science. Here, we trace publications exploring the role of fractal symmetry in all hierarchical states of biological organization, including at the molecular, cellular, morphological, physiological, perceptual, cognitive, and psychological levels. The coverage of the above-listed areas in current studies is sharply unequal and unsystematic. A broad view of biological fractality opens a unique opportunity to discriminate between a healthy state and a wide range of disease conditions. Psychiatric, neurological, and immune disorders are associated with aberrant molecular assembly and morphological changes in neural circuits, suggesting that the chain of chirality/fractality transfer through all levels of physiological organization deserves persistent attention.

Student-Centered Active Learning Improves Performance in Solving Higher-Level Cognitive Questions in Health Sciences Education

Student-centered active learning (SCAL) shifts the focus from the teacher to the student. Implementing SCAL requires the development of new forms of assessment beyond memorization and comprehension. This paper aims to demonstrate the effectiveness of SCAL by analyzing student performance at different cognitive levels. In flipped classrooms, students completed tasks with varying cognitive demands. The tests measured knowledge (level 1), comprehension (level 2), application (level 3) and analysis (level 4). This approach to assessment assesses not only the acquisition of content, but also skills that are critical to a health science student’s future career. The results of expository learning were compared with student-centered collaborative learning in the Anatomy and Embryology I course over three academic years. Student opinions were collected through 326 anonymous Wooclap® (Version: 2019101500) surveys. No differences in performance were found for low-cognitive-level questions. However, SCAL significantly improved performance on higher-cognitive-level questions that required problem solving and application of knowledge. Despite the benefits of SCAL, it requires more effort from both teachers and students. The current assessment system at Universidad Complutense, which measures teaching quality primarily in terms of student satisfaction, tends to penalize efforts to innovate. Many students are attracted to passive learning techniques because they provide a clear and structured path to success. This approach, which focuses on memorizing information for exams, provides a sense of security. Teachers need to have a strong belief in the effectiveness of SCAL methods to persist in their implementation.

The audio-visual incongruency asymmetry. Natural sounds in an urban visual setting are more relaxing than urban sounds in visual nature

Audio-visual interactions play a crucial role in environmental perception. Incongruent audio-visual environments, although prominent in the urban fabric, have been underlit in research. Contrasting exposures to visually natural environments combined with urban sounds, as well as the reverse scenario of visually urban environments with natural sounds, are explored for their restorative potential, both at the cognitive level by means of self-reported evaluations and instinctively through measurements of electrodermal activity. The test panel (n=67) results point at a strong audio-visual urban-nature incongruency asymmetry. Eventful natural sounds in an urban setting were perceived as more pleasant and relaxing than eventful urban sounds in a green environment. So augmenting an urban environment with natural sounds, even in absence of any visual natural features, could be an interesting soundscape intervention. In contrast, a visually natural environment paired with urban sounds is strongly negatively perceived. The findings further contribute to a growing body of literature emphasizing the importance of the sonic environment in designing restorative spaces.

New Evidence of Healthier Aging: Positive Cohort Effects on Verbal Fluency.

Cross-sectional studies have shown improvements in cognition in later-born cohorts. However, it remains unclear whether these cohort effects extend beyond cognitive levels and are also detectable in the rate of age-related cognitive decline. Additionally, evidence is scarce on the presence and consistency of cohort effects throughout different segments of the distribution of cognitive trajectories. This study evaluates the existence and variability of cohort effects across the entire distribution of aging-related trajectories of verbal fluency. With this purpose, we develop sex and education-adjusted longitudinal norms of verbal fluency using data from 9 waves of the English Longitudinal Study of Aging (ELSA) by fitting quantile mixed models. The effect of age was modeled using splines to assess birth cohort effects, after grouping individuals in 5-year groups from 1920 to 1950 according to their age at study entry. To test for possible cohort effects across the 10th, 50th, and 90th quantiles, the coefficients associated with the splines were allowed to vary among cohorts. Our results suggest that, consistently across longitudinal quantiles, decline in verbal fluency across age is less pronounced for later-born individuals (p < .001), supporting the hypothesis of cohort effects. Additionally, we also found that quantiles of verbal fluency at any age are shifted upwards in later-born cohorts compared to those in earlier-born cohorts. These results enhance our understanding of cognitive decline in older adults by demonstrating that cohort effects on cognition are observable both cross-sectionally and longitudinally, affecting the entire range of verbal fluency trajectories.

Relationships between brain structure-function coupling in normal aging and cognition: A cross-ethnicity population-based study

Increased efforts in neuroscience seek to understand how macro-anatomical and physiological connectomes cooperatively work to generate cognitive behaviors. However, the structure-function coupling characteristics in normal aging individuals remain unclear. Here, we developed an index, the Coupling in Brain Structural connectome and Functional connectome (C-BSF) index, to quantify regional structure-function coupling in a large community-based cohort. C-BSF used diffusion tensor imaging (DTI) and resting-state functional magnetic resonance imaging (fMRI) data from the Polyvascular Evaluation for Cognitive Impairment and Vascular Events study (PRECISE) cohort (2007 individuals, age: 61.15 ± 6.49 years) and the Sydney Memory and Ageing Study (MAS) cohort (254 individuals, age: 83.45 ± 4.33 years). We observed that structure-function coupling was the strongest in the visual network and the weakest in the ventral attention network. We also observed that the weaker structure-function coupling was associated with increased age and worse cognitive level of the participant. Meanwhile, the structure-function coupling in the visual network was associated with the visuospatial performance and partially mediated the connections between age and the visuospatial function. This work contributes to our understanding of the underlying brain mechanisms by which aging affects cognition and also help establish early diagnosis and treatment approaches for neurological diseases in the elderly.

The Co-Inhibiting Effect of Managerial Myopia on ESG Performance-Based Green Investment and Continuous Innovation

Under the new pattern of “double carbon” development, good ESG performance is the best way to promote the sustainable development of enterprises, and ESG investment strategies are directly affected by the strategic vision of managers. Based on the upper echelons theory and stakeholder theory, this paper selected Chinese A-share listed companies from 2011 to 2022 as samples to empirically analyze the impact of managerial myopia on corporate ESG performance. The results show that managerial myopia significantly inhibits corporate ESG performance, mainly by inhibiting corporate green investment and green innovation sustainability. Furthermore, for state-owned enterprises (SOE), heavy polluting enterprises (HPE), and non-high-tech enterprises, the inhibitory effect of manager myopia on ESG performance is stronger. When the enterprise is in the growth stage, the above inhibition effect is more severe. For external governance, the greater the analyst attention and public environmental attention are, the more conducive they are to alleviating the restraining effect of managerial myopia on enterprise ESG performance. Therefore, effectively improving the cognition level of managers with regard to long- versus short-term profitability and strengthening external supervision are important measures for comprehensively optimizing ESG performance.

Valence-dependent dopaminergic modulation during reversal learning in Parkinson’s disease: A neurocomputational approach

Reinforcement learning, crucial for behavior in dynamic environments, is driven by rewards and punishments, modulated by dopamine (DA) changes. This study explores the dopaminergic system’s influence on learning, particularly in Parkinson’s disease (PD), where medication leads to impaired adaptability. Highlighting the role of tonic DA in signaling the valence of actions, this research investigates how DA affects response vigor and decision-making in PD. DA not only influences reward and punishment learning but also indicates the cognitive effort level and risk propensity in actions, which are essential for understanding and managing PD symptoms.In this work, we adapt our existing neurocomputational model of basal ganglia (BG) to simulate two reversal learning tasks proposed by Cools et al. We first optimized a Hebb rule for both probabilistic and deterministic reversal learning, conducted a sensitivity analysis (SA) on parameters related to DA effect, and compared performances between three groups: PD-ON, PD-OFF, and control subjects.In our deterministic task simulation, we explored switch error rates after unexpected task switches and found a U-shaped relationship between tonic DA levels and switch error frequency. Through SA, we classify these three groups. Then, assuming that the valence of the stimulus affects the tonic levels of DA, we were able to reproduce the results by Cools et al.As for the probabilistic task simulation, our results are in line with clinical data, showing similar trends with PD-ON, characterized by higher tonic DA levels that are correlated with increased difficulty in both acquisition and reversal tasks.Our study proposes a new hypothesis: valence, signaled by tonic DA levels, influences learning in PD, confirming the uncorrelation between phasic and tonic DA changes. This hypothesis challenges existing paradigms and opens new avenues for understanding cognitive processes in PD, particularly in reversal learning tasks.

Analysis of Activities in Senior English Textbook from the Perspective of Deep Learning: Taking Required Course Book One by FLTR Press (2019 Edition) as an Example

Deep learning is an effective way to cultivate students’ core competencies. As an organic part and crucial resource of deep learning in English class, the textbook presents activities at diverse cognitive levels. In this study, the cognitive levels of activities are analyzed in a senior English textbook by adopting a qualitative method, which intends to reveal the characteristics of deep learning activities. Then in the study an even distribution is revealed between surface and deep learning activities, the latter featuring integration, contextualization, and participatory nature. Finally, three suggestions are put forward to promote students’ deep learning.

Gender differences in the association between education and late-life cognitive function in the LifeAfter90 Study: A multiethnic cohort of the oldest-old.

Few studies have examined the relationship between education and cognition among the oldest-old. Cognitive assessments were conducted biannually for 803 participants (62.6% women) of LifeAfter90, a longitudinal study of individuals ≥90 years old. Gender differences in associations between education (<high school, high school, some college, and ≥ college) and cognition (verbal episodic memory, semantic memory, and executive function) were examined at baseline and longitudinally using linear mixed models. Higher education levels were associated with better cognitive performance at baseline for both men and women. College completion was more strongly associated with better baseline executive function among women. Education-cognition associations for baseline verbal episodic memory and baseline semantic memory did not differ by gender. Education was not associated with a decline in any domain-specific cognitive scores, regardless of gender. Education is associated with cognitive function among the oldest-old and varies by gender and cognitive domain at baseline but not over time. In the oldest-old, higher education was associated with better cognitive function. College completion was more strongly associated with executive function in women. Education was not associated with cognitive decline after age 90 regardless of gender. Improving education could decrease gaps in cognitive level among older individuals.

Clinical effect of psychological nursing and nutritional intervention in radiopharmaceutical therapy of patients with thyroid carcinoma.

To investigate the clinical value of psychological nursing and nutritional intervention in radiopharmaceutical therapy of patients with thyroid carcinoma. This was retrospective study. One hundred and twenty patients with thyroid carcinoma were included at Baoding No.1 Central Hospital from May 10, 2021 to July 10, 2023 to as subjects and randomly divided into the control group and the experimental group (n=60 each group). Patients in the control group were given conventional nursing, while those in the experimental group received psychological nursing and nutritional intervention. The differences in quality of life, compliance, satisfaction and cognitive level between the two groups before and after intervention were compared. After intervention, the scores of emotional functions, role function, cognitive function, physical function and social function of the experimental group were significantly higher than those of the control group, with statistically significant differences (P= 0.00); The compliance of the experimental group was 100%, which was significantly higher than 90% of the control group, with a statistically significant difference (P= 0.01). Moreover, the scores of SAS and SDS in the experimental group were significantly lower than those in the control group after intervention, with a statistically significant difference (P= 0.00). Psychological nursing and nutritional intervention may result in a variety of benefits for patients with thyroid carcinoma receiving radiopharmaceutical therapy, such as effectively ameliorating the quality of life of patients, improving the cognitive level of patients with the disease and treatment compliance, reducing anxiety and depression, and enhancing patient satisfaction with nursing.

The influence of public awareness on public participation in environmental governance: Empirical evidence in China

Abstract Public participation in environmental governance is conducive to alleviating environmental pollution. In order to mobilize the enthusiasm of public to participate in environmental governance, based on the CGSS samples oriented to the whole China, we analyze the influence of public awareness on four kinds of public participation in environmental governance: consciousness participation, inducement participation, input participation and ex-post participation. The results show that environmental risk awareness and media usage awareness have positive effects on four kinds of public participation behaviors. The public with a frugal lifestyle in daily life tend to choose inducement participation. Governmental interaction awareness promotes public participation in environmental governance, especially the input participation behavior. The public with a positive legal awareness tends to opt for ex-post participation. Unobstructed channels of environmental rights protection and higher level of environmental cognition are important factors to promote public participation in environmental governance. However, the public's low evaluation of the government environmental governance and the public's pursuit of short-term economic interests will lead to the reduction of participation enthusiasm. The results have passed the endogenous test and robustness test. As the real environmental governance of the local government is not always consistent with the public's evaluation of the local government's environmental governance, the inconsistency may influence the public participation in environmental governance.

Drug Use Behaviors and the Risk of HIV Infection Among Drug Users in China Between 2014 and 2021: Cross-Sectional Study.

Drug users are a high-risk group for HIV infection and are prominent HIV carriers. Given the emergence of new drugs, we explored current drug-using behaviors, HIV infections, and the correlation between drug-using behaviors and HIV infection risk among drug users from 2014 to 2021. We aimed to identify the prevalence of HIV infection risk among drug users and explore drug use behaviors based on the updated data, which could provide evidence for the precision of HIV prevention strategies among drug users. Data were collected from sentinel surveillance of drug users in rehabilitation centers and communities in Hangzhou (2014-2021), including sociodemographic characteristics, HIV awareness, drug use, risky sexual behaviors, and HIV infection status. Multivariate logistic regression was used to identify the factors influencing HIV infection and risky sexual behaviors among drug users. In total, 5623 drug users (male: n=4734, 84.19%; age: mean 38.38, SD 9.94 years) were included. New drugs dominated among the participants (n=3674, 65.34%). The main mode of drug use was noninjection (n=4756, 84.58%). Overall, for 27.45% (n=1544) of injected drugs in the last month before the investigation, the average daily injection frequency was 3.10 (SD 8.24). Meanwhile, 3.43% of participants shared needles. The incidence of sexual behaviors after drug use was 33.13% (n=1863), with 35.75% (n=666) of them using a condom in the last time. Overall, 116 participants tested positive for HIV antibodies (infection rate=2.06%). New drug users exhibited more postuse sexual behaviors than traditional drug users (odds ratio [OR] 7.771, 95% CI 6.126-9.856; P<.001). HIV-aware drug users were more likely to engage in risky sexual behaviors (OR 1.624, 95% CI 1.152-2.291; P=.006). New-type drug users were more likely to engage in unprotected sexual behavior (OR 1.457, 95% CI 1.055-2.011; P=.02). Paradoxically, drug users with greater HIV awareness were more prone to engaging in unprotected sexual behavior (OR 5.820, 95% CI 4.650-7.284; P<.001). Women engaged less in unprotected sex than men (OR 0.356, 95% CI 0.190-0.665; P=.001). HIV rates were higher among injecting drug users (OR 2.692, 95% CI 0.995-7.287; P=.04) and lower among drug users who used condoms during recent sex than those who did not (OR 0.202, 95% CI 0.076-0.537; P=.001). Higher education levels were associated with higher HIV infection rates. However, there was no significant correlation between HIV cognition level and HIV infection. New drug types and noninjection were the main patterns in last 7 years. Using new types of drugs, rather than traditional drugs, was associated with an increased risk of HIV infection. Injection drug use was a risk factor for HIV infection. HIV awareness among drug users was high, but the incidence of risky sexual behaviors remained high. Therefore, it is important to promote the behavioral transformation of high-risk populations from cognition to attitude, and then to taking protective measures.