Multiple Mediation Research Articles

Relationship between frailty and executive function by age and sex in the Canadian Longitudinal Study on Aging.

Frailty reflects age-related damage to multiple physiological systems. Executive dysfunction is often a presenting symptom of diseases characterized by cognitive impairment. A decline in cardiovascular health is associated with worse executive function. We tested the hypothesis that higher frailty would be associated with executive dysfunction and that cardiovascular health would mediate this relationship. Middle- and older-aged adults at baseline (n = 29,591 [51% female]) and 3-year follow-up (n = 25,488 [49% females]) from the Canadian Longitudinal Study on Aging (comprehensive cohort) were included. Frailty was determined at baseline from a 61-item index, a cumulative cardiovascular health score was calculated from 30 variables at baseline, and participants completed a word-color Stroop task as an assessment of executive function. Multiple linear regressions and mediation analyses of cardiovascular health were conducted between frailty, Stroop interference-condition reaction time, and cardiovascular health in groups stratified by both age and sex (middle-aged males [MM], middle-aged females [MF], older-aged males [OM], older-aged females [OF]). Frailty (MM, 0.15 ± 0.05; MF, 0.16 ± 0.06; OM, 0.21 ± 0.06; OF, 0.23 ± 0.06) was negatively associated with cardiovascular health (MM, 0.12 ± 0.08; MF, 0.11 ± 0.07; OM, 0.20 ± 0.10; OF, 0.18 ± 0.09; β > 0.037, p < 0.001), as well as the Stroop reaction time at 3-year follow-up (MM, 23.7 ± 7.9; MF, 23.1 ± 7.3; OM, 32.9 ± 13.1; OF, 30.9 ± 12.0; β > 2.57, p < 0.001) across all groups when adjusted for covariates. Cardiovascular health was a partial (~ 10%) mediator between frailty and reaction time, aside from MFs. In conclusion, higher frailty levels are associated with executive dysfunction, which was partially mediated by cardiovascular health. Strategies to improve frailty and better cardiovascular health may be useful for combatting the age-related decline in executive function.

Association Between Insomnia and Cognitive Frailty Among Older Patients With Chronic Heart Failure: Multiple Mediating Effects of Depressive Symptoms and Social Support.

Older patients with chronic heart failure (CHF) are prone to insomnia. Studies have shown that insomnia affects the onset of cognitive frailty and is also strongly associated with depressive symptoms and social support. However, information on how these factors interact to influence cognitive frailty remains underexplored. Our aim in this study was to explore the multiple mediating roles of depressive symptoms and social support in the relationship between insomnia and cognitive frailty. We recruited 300 hospitalized older patients with CHF to participate in this study. The participants completed the Athens Insomnia Scale, Geriatric Depression Scale, Montreal Cognitive Assessment, FRAIL Scale, and Social Support Rating Scale. The mediation hypothesis was tested using a multiple mediation model and bootstrapping method. In this study, 44% of the patients experienced insomnia, and 51.3% were in a state of cognitive frailty. Our main findings suggest that insomnia has an indirect effect on cognitive frailty through 2 pathways: the multiple mediating effects of depressive symptoms and social support, and a single mediating effect of depressive symptoms. The direct effect of insomnia on cognitive frailty is also significant. Older patients with CHF who experience insomnia tend to have more severe depressive symptoms, cognitive frailty, and poor social support. Thus, interventions to recognize insomnia early, improve depressive symptoms, and provide social support may reduce cognitive frailty in older patients with CHF. Longitudinal studies are necessary to further refine our findings and address the limitations of the current study.

Investigating the Relationship Between Mood and Driver Behaviors

Abstract: Introduction: Mood and emotion variously affect our behaviors. The present study examined the relationship between positive and negative affect and driver behaviors as well as the mediating role of perceived stress and driving anger. Method: A total of 369 drivers (age: M = 35.52, SD = 10.61) participated in the study by completing the Positive and Negative Affect Schedule, the Perceived Stress Scale, the Driver Anger Scale, the Driver Behaviour Questionnaire, and the Positive Driver Behaviour Scale. Results: Six serial mediation analyses revealed multiple mediations explaining violations the most and positive behaviors the least. Both positive and negative affects were associated with greater anger, leading to more violations. Moreover, positive affect was negative and negative affect was positively related to perceived stress, which in turn was related to increased violations. For positive behaviors, positive affect was associated with less perceived stress, which was associated with more positive behaviors. Conclusion: Moods and emotions reveal a tendency to behave in ways that can be dangerous to drivers and other road users. The study was particularly important because it was the first in the literature to examine positive and negative affect on driver behaviors, perceived stress, and driving anger.

Mechanisms of the influence of proactive personality on nurses' sense of social responsibility: A structural equation modelling study.

To explore the mechanism of proactive personality influence on nurses' sense of social responsibility through a serial multiple mediation model of volunteering motivation and self-efficacy. Further analysis of a cross-sectional and survey-based study. In June 2023, a study was conducted with 722 Chinese nurses from four hospitals. Data were collected using the Proactive Personality Scale, the Self-Efficacy Scale, the Motivation to Volunteer Scale and the Nurses' Sense of Social Responsibility Scale. Structural equation modelling was used to analyse the relationship between nurses' sense of social responsibility and its correlative factors. Structural equation modelling showed a good model fit. Proactive personality, self-efficacy and motivation to volunteer can directly influence nurses' sense of social responsibility (β = .12, β = .04, β = .50, p < .05). According to the test of chained mediation effects, proactive personality was significant through a single mediation path of self-efficacy (Z = 2.33, p < .05) and motivation to volunteer (Z = 7.32, p < .05) and through successive mediation paths of both variables (Z = 3.33, p < .05). A proactive personality can motivate nurses' social responsibility. Therefore, prompting nurses to be more proactive can effectively enhance nurses' sense of social responsibility. This study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist for cross-sectional studies. This study explored the mechanisms influencing nurses' sense of social responsibility at the end of the epidemic. The results may inform the maintenance of high levels of long-term effects of nurses' social responsibility and shed light on building a standing workforce for public health emergencies.

Predictors of emotional engagement in doctoral education

ABSTRACT The study of learning/research engagement in doctoral education has aroused increasing interest among education researchers, given its influence on PhD candidates’ experiences and outcomes. However, even if doctoral education has been recognised as emotionally intense, there is still a gap in the literature regarding the emotional dimension of engagement. This study aims to analyse the predictors of emotional engagement of PhD candidates enrolled in Portuguese higher education institutions. Data was collected through a survey and analysed using multiple linear regression and mediation analysis. Results showed that emotional engagement was fostered by autonomy-focused supervision, perceived relevance of the research project, personal development motivation, and inclusive academic context; and was hindered by professional motivation. Furthermore, our results showed that autonomy-focused supervision mediated the relationship between inclusive or competitive context and emotional engagement. This study reinforces that doctoral education has a strong emotional component and that promoting positive experiences should be an ethical imperative. As such, developing supervisors’ competencies and practices that nurture the autonomy of PhD candidates requires inclusive research contexts and working conditions that allow supervisors to dedicate the necessary time and effort to support their supervisees. It also draws attention to the need to choose research topics perceived as relevant by PhD candidates and manage motivations and expectancies.

Association Between education and walking speed: counterfactual mediation analysis in favor of a motor reserve hypothesis.

We quantified the extent to which the association between education and fast walking speed (FWS) is explained by 17 mediators (cardiovascular risk factors/diseases, comorbidities, health behaviours, socio-professional characteristics, cognition), and examined whether mediators interact with education, in favor of a reserve hypothesis. Cross-sectional analyses are based on Constances (population-based study of French adults 45-69y). 3m-FWS was measured using photoelectric cells. Education was categorized as lower/higher. After multiple imputation of missing values, we used counterfactual mediation models for multiple mediators allowing for education×mediator interactions, to estimate the total effect (TE), total indirect effect (TIE), and mediated interaction (IMD) of lower education on FWS. Analyses are based on 71,222 participants (52.6% women; mean age=57.2y; 27.2% higher education; mean FWS=180.2cm/s). In joint mediation analyses, the TE of lower education was -8.19cm/s (95% confidence interval [CI]=-8.87;-7.51), with a TIE of -5.76cm/s (95%CI=-6.10;-5.41; proportion mediated=70.3%, 95%CI=65.6;75.0). The IMD was negative (-2.52, 95%CI=-3.31;-1.72); 30.8% of the TE and 43.8% of the TIE were attributable to the IMD. Several mediators explain a large part of the association between lower education and slower FWS. The detrimental effect of mediators was more pronounced in participants with lower than in those with higher education, in agreement with a reserve hypothesis.

Resting-state brain activity as a biomarker of chronic pain impairment and a mediator of its association with pain resilience.

Past cross-sectional chronic pain studies have revealed aberrant resting-state brain activity in regions involved in pain processing and affect regulation. However, there is a paucity of longitudinal research examining links of resting-state activity and pain resilience with changes in chronic pain outcomes over time. In this prospective study, we assessed the status of baseline (T1) resting-state brain activity as a biomarker of later impairment from chronic pain and a mediator of the relation between pain resilience and impairment at follow-up. One hundred forty-two adults with chronic musculoskeletal pain completed a T1 assessment comprising a resting-state functional magnetic resonance imaging scan based on regional homogeneity (ReHo) and self-report measures of demographics, pain characteristics, psychological status, pain resilience, pain severity, and pain impairment. Subsequently, pain impairment was reassessed at a 6-month follow-up (T2). Hierarchical multiple regression and mediation analyses assessed relations of T1 ReHo and pain resilience scores with changes in pain impairment. Higher T1 ReHo values in the right caudate nucleus were associated with increased pain impairment at T2, after controlling for all other statistically significant self-report measures. ReHo also partially mediated associations of T1 pain resilience dimensions with T2 pain impairment. T1 right caudate nucleus ReHo emerged as a possible biomarker of later impairment from chronic musculoskeletal pain and a neural mechanism that may help to explain why pain resilience is related to lower levels of later chronic pain impairment. Findings provide empirical foundations for prospective extensions that assess the status of ReHo activity and self-reported pain resilience as markers for later impairment from chronic pain and targets for interventions to reduce impairment. PRACTITIONER POINTS: Resting-state markers of impairment: Higher baseline (T1) regional homogeneity (ReHo) values, localized in the right caudate nucleus, were associated with exacerbations in impairment from chronic musculoskeletal pain at a 6-month follow-up, independent of T1 demographics, pain experiences, and psychological factors. Mediating role of ReHo values: ReHo values in the right caudate nucleus also mediated the relationship between baseline pain resilience levels and later pain impairment among participants. Therapeutic implications: Findings provide empirical foundations for research extensions that evaluate (1) the use of resting-state activity in assessment to identify people at risk for later impairment from pain and (2) changes in resting-state activity as biomarkers for the efficacy of treatments designed to improve resilience and reduce impairment among those in need.

Control beliefs as mediators between education and quality of life in patients with breast, prostate, colorectal, and lung cancer: a large register based study

ObjectiveControl beliefs have been found to influence adaption to a cancer diagnosis. This study explored interrelationships among education, control beliefs, and health-related quality of life (HRQoL) in patients with breast, prostate, colorectal, and lung cancer and tested weather control beliefs act as mediators.MethodsSix hundred and five patients with breast (n = 205), prostate (n = 205), colorectal (n = 124), and lung (n = 71) cancer from two German cancer registries answered standardized questionnaires. Response rate was 54%. HRQoL was assessed with the EORTC QLQ-C30 core questionnaire and control beliefs (internal, external, and fatalistic) were evaluated using the IPC-questionnaire. Education was measured on a scale ranging from 1 to 8. Data were analyzed using multiple mediation models.ResultsThere was a positive correlation between education and HRQoL. Internal beliefs were positive and external beliefs were negative correlated with HRQoL. Internal control beliefs mediated the relationship between education and global health-related quality of life (.299, CI .122, .531), physical functioning (.272, CI .110, .486), emotional functioning (.325, CI .120, .578), and pain (-.288, CI − .558, − .094). External and fatalistic control beliefs did not act as mediators.ConclusionPatients with low education feel they have less control over their cancer disease and consequently a poorer health-related quality of life.

SEM Approach to the Mediation Analysis of the Two-Condition Within-Subject Design

The effects of the two-condition within-subject (TCWS) conditional mediation model are developed using the SEM approach. The structural equation model for the within-subject mediator and the within-subject outcome with the specification of a between-subject moderator is developed to derive the indirect effects. Formulas are derived for the indirect effects of two conditions in the TCWS conditional mediation model. These effects are calculated on the rotated outcomes, which are the difference and sum of the outcomes, through two mediators. The derivation is done under both natural and rotated condition approaches. The rotated outcome is expressed as a linear function of the two natural mediators in the natural condition approach, whereas in the rotated condition approach, it is expressed as a function of the two rotated mediators. The total indirect effect on each rotated outcome in both natural and rotated condition approaches consists of two individual indirect effects: one through the within-condition mediator and the other through the crossed-condition mediator. Comparison of two individual indirect effects can reveal the nature of causal relations between conditions and outcomes. The TCWS conditional mediation model is generalized by considering multiple within-subject mediators and multiple between-subject moderators as well as the multiple conditions case. The bootstrapping confidence intervals are used to estimate and test the conditional indirect effects. The total and individual conditional indirect effects are probed by overlaying their bootstrap confidence intervals for given moderator values, and this multi-plot helps the understanding of magnitudes and mechanisms of the moderator on the indirect effects.

Spatial adaptation of eosinophils and their emerging roles in homeostasis, infection and disease.

Eosinophils are bone marrow-derived granulocytes that are traditionally associated with type 2 immune responses, such as those that occur during parasite infections and allergy. Emerging evidence demonstrates the remarkable functional plasticity of this elusive cell type and its pleiotropic functions in diverse settings. Eosinophils broadly contribute to tissue homeostasis, host defence and immune regulation, predominantly at mucosal sites. The scope of their activities primarily reflects the breadth of their portfolio of secreted mediators, which range from cytotoxic cationic proteins and reactive oxygen species to multiple cytokines, chemokines and lipid mediators. Here, we comprehensively review basic eosinophil biology that is directly related to their activities in homeostasis, protective immunity, regeneration and cancer. We examine how dysregulation of these functions contributes to the physiopathology of a broad range of inflammatory diseases. Furthermore, we discuss recent findings regarding the tissue compartmentalization and adaptation of eosinophils, shedding light on the factors that likely drive their functional diversification within tissues.

Cohabitation Attitudes and Behaviours of Undergraduate Students in Taraba State, Nigeria: The Mediating Role of Social Media and Peer Pressure

This study examines the impact of social-media and peer pressure on attitudes and behavior of undergraduate students towards cohabitation. The study sampled 1,970 undergraduate students from three universities in Taraba State, Nigeria. Data was collected with an online questionnaire. The study adopts social learning theory and Berger and Luckman’s social construction of reality. The data was analyzed using multiple regression and mediation analysis. The results reveal significant positive effects of attitudes towards cohabitation, social media use, and peer pressure on behaviours towards cohabitation. The finding revealed that a one-unit increase in attitudes towards cohabitation corresponds to a 0.41-unit increase in cohabitation behaviours. It also revealed that, a one-unit increase in social media use and peer pressure leads to a 0.21-unit and 0.25-unit increase, respectively, in cohabitation behaviours. Furthermore, the study shows that age negatively affects cohabitation behaviours, indicating a decrease in behaviours as age increases. The mediation analysis reveals that attitudes towards cohabitation significantly predict behaviors towards cohabitation (coefficient = 0.26 P &lt;0.001). The study further revealed that social media use and peer pressure partially mediate the relationship between attitudes and behaviours towards cohabitation (0.19 (P&lt; 0.001) with a 95% confidence interval of 0.14, 0.24). The study concludes that social media use and peer pressure play essential roles in shaping attitudes towards cohabitation and cohabiting behaviour among undergraduates in Taraba State.

Tourism Constraints and Subjective Well-Being for Senior: A Serial Multiple Mediation Model

ABSTRACT This study targets seniors aged 60 and above, exploring the impact of tourism constraints on their subjective well-being through the lens of Activity Theory, as well as the mediating and serial mediating roles played by constraint negotiation and tourism participation. Conducted through a questionnaire survey, the empirical research reveals that tourism constraints negatively impact the subjective well-being of seniors. Conversely, tourism constraints positively influence constraint negotiation, which in turn positively affects tourism participation. Tourism participation enhances subjective well-being. Furthermore, constraint negotiation acts as a mediator in the relationship between tourism constraints and tourism participation, while tourism participation mediates the relationship between tourism constraints and subjective well-being. Serial mediating effect is found between tourism constraints and subjective well-being through constraint negotiation and tourism participation. This paper enriches the study of outcome variables and mechanisms of elderly tourism constraints, offering targeted suggestions to improve the tourism participation of seniors, thereby enhancing their sense of achievement and well-being.

Associations between parent and child latent eating profiles and the role of parental feeding practices

Previous research employing the person-centred approach of Latent Profile Analysis (LPA) with parent-reported data of their child's eating behaviour identified four distinct eating profiles in 3-6-year-old children: typical, avid, happy, and avoidant eating (Pickard et al., 2023). In this follow-up study, the same parents were asked to self-report their own eating behaviour (N = 785) and LPA was conducted to determine the latent eating profiles of the parents/caregivers. The LPA showed that a four-profile solution best represented the sample of parents, termed: typical eating (n = 325, 41.4%), avid eating (n = 293, 37.3%), emotional eating (n = 123, 15.7%) and avoidant eating (n = 44, 5.6%). Multiple mediation analysis was then conducted to examine both the direct associations between parents' eating profiles and the child's probability of eating profile membership, as well as the indirect associations through the mediatory role of specific parental feeding practices. The results suggested direct links between parent and child eating profiles, with the 'avid eating' and 'avoidant eating' profiles in parents predicting similar profiles in their children. Feeding practices, such as using food for emotional regulation, providing balanced and varied food, and promoting a healthy home food environment, mediated associations between parent and child eating profiles. This research provides novel evidence to reinforce the need for interventions to be specifically tailored to both the parent's and child's eating profiles. The work also provides an interesting avenue for future longitudinal examination of whether the parents' provision of a healthy home food environment could protect against intergenerational transmission of less favourable eating behaviours.

Supramolecular prodrug inspiring from Rhizoma Coptidis - Fructus Mume herbal pair alleviated inflammatory diseases by inhibiting pyroptosis

Sustained inflammatory responses are closely related to various severe diseases, and inhibiting the excessive activation of inflammasomes and pyroptosis has significant implications for clinical treatment. Natural products have garnered considerable concern for the treatment of inflammation. Huanglian-Wumei decoction (HLWMD) is a classic prescription used for treating inflammatory diseases, but the necessity of their combination and the exact underlying anti-inflammatory mechanism have not yet been elucidated. Inspired by the supramolecular self-assembly strategy and natural drug compatibility theory, we successfully obtained berberine (BBR)-chlorogenic acid (CGA) supramolecular (BCS), which is an herbal pair from HLWMD. Using a series of characterization methods, we confirmed the self-assembly mechanism of BCS. BBR and CGA were self-assembled and stacked into amphiphilic spherical supramolecules in a 2:1 ratio, driven by electrostatic interactions, hydrophobic interactions and π-π stacking; the hydrophilic fragments of CGA were outside, and the hydrophobic fragments of BBR were inside. This stacking pattern significantly improved the anti-inflammatory performance of BCS compared with that of single free molecules. Compared with free molecules, BCS significantly attenuated the release of multiple inflammatory mediators and Lipopolysaccharide (LPS)-induced pyroptosis. Its anti-inflammatory mechanism is closely related to the inhibition of intracellular nuclear factor-kappaB (NF-κB) p65 phosphorylation and the noncanonical pyroptosis signalling pathway mediated by caspase11.

Intra-articular injection of modified citrus pectin and hyaluronate gel induces synergistic effects in treating osteoarthritis

We previously found that modified citrus pectin (MCP), an inhibitor of pro-inflammatory factor Galectin-3 (Gal-3), has significant anti-inflammatory and chondroprotective effects. In this study, a hyaluronate (HA) gel-based sustained release system of MCP (MCP-HA) was developed as an anti-inflammatory agent for chronic inflammation for osteoarthritis (OA) treatment. The MCP-HA gel was injected into the knee joint cavities of OA rabbit models induced by anterior cruciate ligament transection (ACLT) or modified Hulth method once a week for five weeks. We found that MCP-HA could improve the symptoms and signs of OA, protect articular cartilage from degeneration, suppress synovial inflammation, and therefore alleviate OA progression. Proteomic analysis of the synovial fluid obtained from the knee joints of OA rabbits revealed that MCP-HA synergistically regulated the levels of multiple inflammatory mediators and proteins involved in metabolic pathways. Taken together, our results demonstrate that the MCP-HA shows a synergistic effect of HA and MCP by modulating both inflammation and metabolic processes, thereby alleviating OA progression. The MCP-HA sustained release system has promising potential for long-term use in OA treatment.

Operational Stress and Psychological Well-Being Among Police Officers in Benue State Police Command: The Mediating Role of Coping Strategies

Psychological Well-being is an important concept used in behaviour sciences to evaluate the state of an individual in terms of perception, feelings, cognition and internal experience. This study investigated Operational Stress and Psychological Well-being among Police Officers in Benue State Police Command: The Mediating Role of Coping Strategies. The study employed a Cross-Sectional Survey Design, where three hundred and fifty seven (357) Police Officers consisting of 219 (61.3%) Males and 134 (37.5%) Females were used for the study. Their ages ranged from 19 to 59 years with the Mean of 38.13 (SD=9.54128). The Operational Police Stress Questionnaire (PSQ-Op), Brief-COPE Inventory and Psychological General Well-Being Index (PGWB) were used for data collection. Statistical analysis involved the use of Multiple Regression and PROCESS Mediation Analyses. Findings from the hypotheses indicated that, Operational Stress has made an independent significant contribution to Psychological Wellbeing of Police Officers in Benue State Police Command. Coping Strategies significantly influenced Psychological Well-being among Police Officers in Benue State Police Command. The result further showed that, Operational Stress and Coping Strategies jointly influenced Psychological Well-being of Police Officers in Benue State Police Command. Finally, Selfdistraction, Denial, Active Coping, Substance Use, Instrumental Support, Venting, Planning, Acceptance and Religion did not significantly mediate the relationship between Operational Stress and Psychological Well-being among Police Officers; while Emotional Support, Behavioral Disengagement, Positive Reframing, Humor, and Self-blame significantly mediated the relationship between Operational Stress and Psychological Well-being among Police Officers in Benue State Police Command. Based on the findings, it was recommended that, Police Officers should be enlightened on how to manage Operational Stress and develop good coping strategies. On policy basis, it was recommended that, Government should evolve policies that are aimed at training and retraining Police Officers on appropriate Coping Strategies; which will help in reducing Operational Stress and on the other hand increase high level of Psychological Well-being among Police Officers. Also, Non-governmental organizations with caring mind should support Police with logistics that will help reduce Operational Stress. This will help to achieve high state of Psychological Well-being and enhance better policing among Police Officers. Finally, more researches should be encouraged on the subject matter for further identification of long term solutions to problems affecting Psychological Well-being of Police Officers in Benue State Police Command in particular, and Nigeria at large.

The impact of digital economy on China’s green-oriented transition of energy: multiple mediation effects from a spatial perspective

With the continuous advancement of the new generation of information technology revolution, digital economy is gradually becoming an important driving force for energy transition while restructuring the new form of the economy. This paper selects panel data of 30 provinces in China from 2011 to 2021, empirically verifies the special impacts of digital economy on green-oriented transition of energy by using the spatial Durbin model, and further constructs a multi-intermediary model to verify its transition pathways. The main findings are as follows: First, the overall level of green-oriented transition of energy in China’s eastern coastal areas is relatively high, and the western regions have been more capable of catching up in recent years. Second, digital economy has played a significant role in promoting green-oriented transition of energy, and there is a positive spatial spillover effect. Third, digital economy could indirectly promote the green-oriented transition of energy by promoting the upgrading of industrial structure, improving the level of technological innovation and strengthening environmental regulations. This study provides empirical insights and reference for policymakers in accelerating the comprehensive green-oriented transition of energy.

Associations between oral health and depression and anxiety: A cross-sectional and prospective cohort study from the UK Biobank.

To investigate the associations between oral health and depression, anxiety and their comorbidity in the UK Biobank cohort. Oral health problems were self-reported at baseline. Symptoms of depression and anxiety were assessed using the Mental Health Questionnaire (PHQ-4) in a cross-sectional study. In the cohort study, diagnoses of depression and anxiety disorders were based on hospital records. Logistic regression and Cox regression models were used to analyse the association between oral health and depression/anxiety. A total of 305,188 participants were included in the cross-sectional study, and multivariate analysis showed that periodontal disease was associated with depression and/or anxiety (odds ratio [OR]: 1.79, 95% confidence interval [CI]: 1.73-1.86). In the prospective cohort study involving 264,706 participants, periodontal disease was significantly associated with an increased risk of depression and/or anxiety (hazard ratio [HR]: 1.14, 95% CI: 1.10-1.19), depression (HR: 1.19, 95% CI: 1.13-1.25) and anxiety (HR: 1.13, 95% CI: 1.07-1.19). Periodontal disease was also significantly associated with comorbid depression and anxiety (HR: 1.27, 95% CI: 1.16-1.38). Multiple mediation analysis using baseline inflammatory factors showed that white blood cell count and C-reactive protein explained 3.07% and 3.15% of the association between periodontal disease and depression and anxiety, respectively. However, the results of longitudinal multiple mediation analysis of inflammatory factors at first follow-up (N = 10,673) were not significant. Periodontal disease was found to be consistently associated with an increased risk of depression, anxiety and their comorbidity.

노인의 차별경험과 인권감수성의 관계에 대한 연구:사회적지지와 자아존중감의 다중매개효과 분석

The purpose of this study is to enhance the human rights sensitivity to older people by confirming the effect of discrimination experiences of the elderly on human rights sensitivity, and the multiple mediation effects of social support and self-esteem. For the study, a questionnaire survey was conducted on 502 senior citizens aged 65 or older. To analyze the data, multiple mediation effect analysis was conducted using SPSS macro PROCESS v.4.2, and the significance of the mediation effect was confirmed through bootstrapping. The main research results are as follows. First, it was found that the discrimination experience of the elderly affected negatively on their self-esteem and social support, so it is confirmed the need for intervention to lower the negative perceptions by discrimination experience. Second, among the mediation variables, social support completely mediated the relationship between the discrimination experience of the elderly and human rights sensitivity. It is argued that the role of the elderly group that can offset the experience of discrimination should be strengthened. Based on the study results, the researchers suggested practical and policy suggestions such as revitalizing human rights education for the elderly and developing a campaign to improve awareness of the elderly

A data-driven analysis on the mediation effect of compartment models between control measures and COVID-19 epidemics

By collecting various control policies taken by 127 countries/territories during the first wave of COVID-19 pandemic until July 2nd, 2020, we evaluate their impacts on the epidemic dynamics quantitatively through a combination of the multiple linear regression, neural-network-based nonlinear regression and sensitivity analysis. Remarkable differences in the public health policies are observed across these countries, which affect the spreading rate and infected population size to a great extent. Several key dynamical features, like the normalized cumulative numbers of confirmed/cured/death cases on the 100th day and the half time, show statistically significant linear correlations with the control measures, which thereby confirms their dramatic impacts. Most importantly, we perform the mediation analysis on the SEIR-QD model, a representative of general compartment models, by using the structure equation modeling for multiple mediators operating in parallel. This, to the best of our knowledge, is the first of its kind in the field of epidemiology. The infection rate and the protection rate of the SEIR-QD model are confirmed to exhibit a statistically significant mediation effect between the control measures and dynamical features of epidemics. The mediation effect along the pathway from control measures in Category 2 to four dynamical features through the infection rate, highlights the crucial role of nucleic acid testing and suspected cases tracing in containing the spread of the epidemic. Our data-driven analysis offers a deeper insight into the inherent correlations between the effectiveness of public health policies and the dynamic features of COVID-19 epidemics.