Longitudinal examination of a refined four-factor model of Protective Behavioural Strategies: Psychosocial barriers to their use and protective effects on students' alcohol consumption.

The aim of this study was to investigate the effectiveness of 0.01% topical atropine (ATR) on myopic prevention in a population with different low refractive errors. A retrospective cohort study was conducted on children with low refractive error. They were classified according to the application of 0.01% ATR, and 55 and 67 eyes constituted the ATR and non-ATR groups, respectively. The primary outcomes were changes in spherical equivalent refraction (SER) and axial length (AXL) after a one-year interval. Statistical analysis was carried out using the independent T test and generalized linear model. The SER change and AXL elongation were significantly lower in the ATR group compared to the non-ATR group (P < 0.001 for both). For different initial SERs, SER and AXL progression in the individuals with plus initial SER were significantly lower than those with minus initial SER after ATR treatment (both P < 0.05). High outdoor activity was inversely correlated with myopic progression in the ATR group (P = 0.006). For the non-ATR population, young initial age, minus initial SER, and high near-work activity were related to myopic progression, while high solar exposure and high outdoor activity were inversely correlated with the development of myopic progression (all P < 0.05). Application of 0.01% ATR might relates to myopic prevention effect in a population with low refractive error, especially for plus initial SER.

Because elevated blood pressure during adolescence often persists into adulthood and increases the risk of cardiovascular diseases, early identification of modifiable risk factors for elevated blood pressure is critical for timely prevention. This study compared the predictive performance of body mass index (BMI) and waist-to-height ratio (WHtR) in identifying incident elevated blood pressure among Tianjin adolescents. This longitudinal analysis included 4,694 students aged 11-18 years from the 2023-2024 National Student Common Diseases and Risk Factors Surveillance in Tianjin, China. Modified Poisson regression with false discovery rate (FDR) correction and restricted cubic splines (RCS) were used to assess associations of BMI and WHtR with incident elevated blood pressure, stratified by sex. Predictive performance was evaluated using area under the receiver operating characteristic curves (AUC), integrated discrimination improvement (IDI), calibration plots, and decision curve analysis (DCA). During the one-year interval, 13.2% of girls and 13.5% of boys developed elevated blood pressure. Adjusting for sociodemographic and lifestyle factors, both general and abdominal obesity were significantly associated with incident elevated blood pressure in girls (general obesity: RR 2.25 [95% CI: 1.75-2.88]; abdominal obesity: 1.92 [1.57-2.36]) and boys (general obesity: 2.07 [1.59-2.71]; abdominal obesity: 1.83 [1.48-2.25]). RCS revealed linear associations except for WHtR in girls. AUCs for BMI (girls: 0.640; boys: 0.669) and the combination with WHtR (girls: 0.641; boys: 0.670) were comparable in both sexes; both were similar to WHtR in girls (0.633) but slightly higher than WHtR alone in boys (0.641; DeLong's test p < 0.05). Adding BMI to the basic model improved discrimination more than adding WHtR (IDI: girls 0.0272 vs. 0.0222; boys 0.0242 vs. 0.0179), while including both indices provided no additional improvement. All expanded models showed good calibration and higher net benefits than the basic model, with no additional clinical advantage observed for the combined model. Both BMI and WHtR were associated with incident elevated blood pressure and showed comparable discriminative ability. However, BMI provided a greater incremental improvement in risk prediction than WHtR across sexes, with no additional incremental value from combining both indices.

Ultra-short-echo magnetic resonance imaging (MRI) sequences improve visualization of bone cortex and enable the generation of an MRI-based computed tomography (CT)-like (CT-l) images. To compare the agreement between CT-l images derived from merged fast-field echo (MFFE) sequence with conventional CT (cCT) for detecting sacroiliitis-associated structural lesions. Consecutive MRI and conventional CT examinations (maximum one-year interval) of the sacroiliac joints (SIJ) of patients with suspected sacroiliitis, performed between 2022 and 2023 were retrospectively evaluated by a musculoskeletal radiologist and a third-year resident who evaluated half of the study's images for the presence of erosions, sclerosis, and ankylosis on semicoronal CT-l and cCT-SIJ images. Cohen's kappa was used to compare the results between the two modalities. The diagnostic performance of the CT-l was analyzed using cCT as the reference standard. Inter-reader reliability was assessed using intraclass correlation coefficients (ICCs) between the two readers. Sacroiliitis was detected in 11 patients (21%). Erosions, sclerosis, and ankylosis were detected in 44%/31%, 48%/42%, 4%/4% on CT-l/cCT, respectively. Statistical analysis regarding ankylosis was not feasible due to its low prevalence. Cohen's kappa agreement between modalities was substantial for erosions (0.68) and almost perfect for sclerosis (0.92). Sensitivity and specificity of CT-l were 0.90 and 0.69 for erosions and 0.72 and 0.91 for sclerosis, respectively. The ICC on CT-l/cCT for detecting erosions was 0.72/0.68 and 0.84/0.91 for sclerosis. CT-l MRI sequence is a promising, radiation-free alternative to conventional CT for detecting structural lesions in SIJs, with high diagnostic performance and inter-reader agreement.

While scholars have focused on exploring what predicts subjective career success (SCS), we built on conservation of resources theory to study SCS not only as the ultimate outcome but also as a resource for achieving further valued work outcomes. To this end, we analyzed the gain spiral between SCS, work engagement, and creativity (SCS → work engagement → creativity → SCS) in a four-wave longitudinal design (one-year intervals). Based on a sample of N = 1228 German academic scientists, we conducted a cross-lagged panel model analysis. As expected, SCS showed positive time-lagged effects on work engagement, and work engagement showed positive time-lagged effects on creativity. However, creativity showed no time-lagged effects on SCS. From a series of exploratory multigroup analyses, this pattern of results emerged as robust across sociodemographic and work-related variables. The results help to further our understanding of how SCS functions as a resource.

Gender-specific developmental trajectories of anxiety and depression among college students: Risk of attitudes toward suicide and suicidal behavior.

Age-related hearing loss (ARHL) and dementia are common chronic conditions among the elderly, significantly impacting the quality of life of older adults. Additionally, ARHL is an important and modifiable risk factor for dementia. This study aimed to investigate distinct patterns of cortical atrophy in patients with ARHL and mild cognitive impairment (MCI), comparing those with stable cognition (sMCI) versus those who progressed to dementia (pMCI), using longitudinal MRI data. A total of 93 participants from ADNI were included: 51 sMCI with normal hearing (sMCI+HC, Group 1), 20 sMCI with ARHL (sMCI+ARHL, Group 2), and 22 pMCI with ARHL (pMCI+ARHL, Group 3). All subjects underwent three longitudinal T1-weighted MRI scans at approximately one-year intervals. Cortical thickness was measured using Freesurfer 6.0 in regions including the entorhinal cortex, parahippocampal gyrus, and temporal gyri. Repeated-measures ANOVA was used to compare atrophy rates, and ROC analysis evaluated the predictive value of significant regions. Group 3 showed significantly faster annual atrophy rates in the left entorhinal cortex, left middle temporal gyrus, and bilateral superior temporal gyri compared to Group 1. Group 2 also exhibited faster atrophy in temporal regions than Group 1. ROC analysis demonstrated that combined use of these regions improved predictive accuracy for cognitive progression. ARHL patients with progressive cognitive decline exhibit accelerated atrophy in auditory and early AD-vulnerable regions. Combined cortical thickness measures may serve as a neuroimaging biomarker to predict cognitive progression in ARHL populations.

This study analyzes whether universal health coverage (UHC), treated as an indicator of health-system strength, is associated with labor productivity in ASEAN economies. Framed within the view that health systems may function as economic infrastructure, the study examines the relationship between UHC service coverage and GDP per person employed using panel data from the ten ASEAN member states covering 2000 to 2023. The analysis uses descriptive statistics, correlation analysis, pooled ordinary least squares, and two-way fixed-effects (TWFE) panel regression with country and year effects. Lagged models at one-year, two-year, and three-year intervals are estimated to test temporal persistence, while alternative mediation models using life expectancy and tuberculosis incidence are examined. A controlled lagged TWFE specification further incorporates labor force participation, inflation, trade openness, and urban population share. Descriptive results from the balanced core panel of 240 country-year observations show a mean UHC index of 64.31, mean life expectancy of 71.17 years, and mean GDP per person employed of 54,015.41 constant PPP international dollars. Correlation analysis indicates strong positive associations between UHC and life expectancy (r = 0.9315) and between UHC and logged productivity (r = 0.8817). In the contemporaneous TWFE model, UHC is positively associated with logged GDP per person employed (β = 0.0263, p = 0.0020), implying that a one-point increase in the UHC index is associated with approximately 2.63% higher productivity. The lagged direct models yield highly stable estimates: β = 0.0267 (p = 0.0010) for the one-year lag, β = 0.0273 (p = 0.0006) for the two-year lag, and β = 0.0275 (p = 0.0006) for the three-year lag. In the controlled lagged TWFE models, the coefficients decline but remain statistically significant, at 0.0127 (p = 0.0463), 0.0137 (p = 0.0206), and 0.0142 (p = 0.0076), respectively. UHC also significantly predicts life expectancy and lower tuberculosis incidence, but neither variable emerges as a statistically conclusive mediator of the productivity relationship once UHC is included in the full models. Overall, the findings show that stronger UHC service coverage is robustly associated with higher output per worker in ASEAN, even after lagging the explanatory variable and controlling for key macro-structural conditions. The results support the interpretation that health systems contribute to economic performance not only through welfare improvement but also through the productive conditions that sustain labor efficiency.

The aim of this longitudinal study was to evaluate the repercussions of amyotrophic lateral sclerosis (ALS) on orofacial function, dental health, and the development of malocclusions, in order to assess whether disease progression influences oral and craniofacial outcomes. Thirteen patients diagnosed with ALS according to the Gold Coast criteria were enrolled to be examined at two time points (T1 and T2), with a one-year interval. The ALS Functional Rating Scale-Revised (ALS-FRS-R), the Nordic Orofacial Test Screening (NOT-S), the Decayed Missing and Filled Teeth (DMFT) index, Plaque Index, and standard orthodontic assessments were used to quantify changes in disease progression, orofacial function, dental health, and occlusal parameters, respectively. Statistical evaluation: Paired sample t-tests were performed to evaluate differences between T1 and T2 for continuous variables. Chi-square and Fisher's exact tests were used for categorical data. Multiple linear regression analyses were carried out to assess potential associations between general disease progression, ALS type, and orofacial functional or dental health decline. A significance level of p < 0.05 was adopted for all analyses. Thirteen patients were examined at T1, 10 of whom completed both evaluations. A significant deterioration in the general disease condition was observed (ALS-FRS-R: mean difference -6.0 ± 6.98; p = 0.024). Orofacial function worsened significantly as reflected by an increase in NOT-S total score (+2.3; p = 0.001). Dental health also declined, with a significant increase in DMFT (+1.8; p = 0.014) and Plaque Index (+0.4; p = 0.004). However, occlusal parameters remained stable over the 12-month period, with no significant changes in overjet (p = 0.860) or overbite (p = 0.347). The bulbar type of ALS seems to show worse deterioration of orofacial function over time, and individuals with more significant general disease progression also showed worse orofacial functional decline. ALS has a significant impact on orofacial function and dental health, characterized by neuromuscular deterioration, increased plaque accumulation, and a higher number of affected teeth. Despite this decline, dental occlusion appears to remain stable in the short term. These findings highlight the need for interdisciplinary and preventive oral care strategies in the management of patients with ALS, aiming to preserve oral function and quality of life in a progressively disabling disease.

Radiographic dental age estimation of Brazilian children and adolescents using a national reference sample.

Evaluating bidirectional, longitudinal associations between adolescent executive control and eating behaviors.

Spinal muscular atrophy mainly affects motor neurons in the spinal cord, leading to progressive muscular atrophy and weakness. This study aims to carefully analyse the effect of body parameters on motor function and fine motor skills, measured at one-year intervals, in patients with spinal muscular atrophy. The study included 38 participants diagnosed with SMA. Patients were divided into three groups based on their level of motor function: non-sitters (n = 9), sitters (n = 23), and walkers (n = 6). Anthropometric measurements (weight, height/length) were taken in all participants, and BMI and BMI-z-score were calculated. The motor function was assessed using validated scales: CHOP-INTEND for the non-sitters group and HFMSE scale for the sitters and walkers group. The RULM scale assessed fine motor skills for the sitters and walkers group. At the 12-month follow-up, the CHOP-INTEND scale showed improvement in most non-sitter patients (6/9). The sitter’s group was more heterogeneous on the HFMSE scale, with 10 out of 23 patients showing deterioration in function, 8 showing improvement, while the walker’s group showed the least variability. In the non-sitters group, the dominant category of BMI z-score was underweight, while half of the sitters in the group were underweight, although there were just as many healthy weights. The strongest group, the walkers, was mostly healthy. We have observed a certain tendency that as BMI increases, motor function increases in all groups, while fine motor skill decreases in the most varied sitters group. As BMI increases in SMA patients, motor function improves. Fine motor skill deteriorates as BMI increases in the sitter’s group. The assessment of individual components of motor function and fine motor skills reveals the actual changes that occur over time in patients with SMA.

Muscle strength is a key determinant of health-related physical fitness and has become a significant biological predictor of overall health and lifespan. This study aimed to characterize the development of isometric strength in the lower limbs of Chilean schoolchildren and adolescents aged 7 to 15 years. Specifically, it sought to: (a) determine when sex-based differences in lower limb strength first appear; (b) identify key developmental stages where significant gains in muscle strength occur in boys and girls; and (c) analyze the contribution of individual muscle groups to total lower limb strength while accounting for sex and age differences. This cross-sectional study evaluated the maximum isometric strength of seven lower limb muscle groups in a sample of 302 Chilean children, divided into nine age groups at one-year intervals. Hand-held dynamometry was used for isometric strength assessment. Data analysis included a two-factor analysis of variance (ANOVA) for maximum isometric strength and a stepwise multiple linear regression analysis to the entire sample. Multiple comparisons showed significant differences between the ages of 9 and 12; and sex. The narrowest age range in the progression of maximum isometric strength were: 9-11 years for knee flexors in females (p=0.0201) and 9-12 years for males (p=0.0008). Hip flexors, dorsiflexors, hip extensors and knee extensors explained the highest percentage of variance (R 2=0.897, p<0.0001) in the total lower limb strength. Our findings show that lower limb isometric strength in Chilean schoolchildren and adolescents increases from age 10, with boys outperforming girls by age 15. Hip flexors mainly explain total strength, offering a useful reference to detect within and between subject strength deficits.

Background/Objectives: Human papillomavirus (HPV) infection remains the principal etiologic factor for cervical intraepithelial neoplasia (CIN) and cervical cancer. This longitudinal cohort study aimed to characterize the dynamics of cytological and histopathological changes over a two-year follow-up, focusing on post-treatment reduction in lesion grade, persistence, and progression in relation to HPV genotype distribution and smoking status. Methods: A total of 351 women aged 20-76 years were included, with cervical samples collected at the "Elena Doamna" Clinical Hospital, Iași, Romania. Cytology was categorized according to the Bethesda System, while colposcopy and conization served as diagnostic confirmation methods. HPV genotyping identified both high-risk (HR) and low-risk (LR) viral subtypes. Longitudinal assessments were performed at baseline, one-year, and two-year intervals to evaluate temporal patterns of disease evolution. Results: At baseline, HSIL represented the predominant cytologic category (51.3%, n = 180), followed by ASC-US (19.1%), ASC-H (15.1%), and LSIL (14.5%). Negative cytology increased from 62.4% at one year to 71.8% at two years, indicating substantial post-treatment reduction in lesion grade. Downgrading of lesion severity after treatment occurred in 26.2%, persistence in 11.1%, and progression in 11.1% of cases. Concordance between colposcopy and conization was moderate but statistically significant (κ = 0.345), with the highest agreement observed for HSIL with equivocal features between CIN II and CIN III lesions. Smoking showed a significant association with lesion persistence at two years (OR = 3.07; 95% CI: 1.16-8.08) but no statistically significant association with HR-HPV persistence. HR-HPV genotypes 16, 18, 31, and 33 were most frequently linked to progression, whereas HPV 35, 59, and 68 were associated with persistence. Conclusions: Over two years, most cervical lesions regressed or normalized, demonstrating effective management and follow-up. Persistent infection with HR-HPV types and smoking were the primary determinants of unfavorable outcomes. These findings highlight the clinical relevance of sustained surveillance, HPV genotyping, and smoking cessation as integral components of evidence-based cervical disease prevention and management strategies.

Fire in a Central Amazon forest: Lingering top canopy loss and initial understory regrowth revealed by repeated LiDAR

The Interaction of Person-Affect-Cognition-Execution (I-PACE) model assumes that personal components, such as punishment sensitivity (PS), affect problematic Internet use (PIU) by influencing the way individuals perceive the situation. However, previous studies exploring the relationship between PS and PIU have yielded inconsistent findings. One plausible explanation for this inconsistency is the potential nonlinearity of the relationship between PS and PIU. The purpose of the present study is to examine the curvilinear association between PS and PIU among adolescents. In Study 1, we assessed 7555 participants using Behavioral Inhibition System Scales and Internet Addiction Test to measure PS and PIU. In Study 2, 506 participants were recruited to complete the Mixed Gambles Task and Internet Addiction Test to evaluate PS and PIU respectively. In Study 3, we conducted two waves of surveys within a one-year interval, with 1824 participants completing a battery of scales measuring their PS, anxiety, self-control, and PIU. The results from Study 1 and Study 2 revealed a U-shaped association between PS and PIU. The results in Study 3 indicated that when PS was low, self-control mediated the relationship between PS and PIU. When PS was high, anxiety mediated the association between PS and PIU. These preliminary results emphasize the importance of considering the nonlinear association between PS and PIU, expanding the I-PACE model. Furthermore, this study offers empirical evidence in support of tailored treatment and intervention approaches for PIU, taking into account their varying levels of PS.

The Drug Abuse Screening Test (DAST-10) is one of the most widely used instruments for assessing problematic illicit drug use and its associated consequences, yet little is known about its long-term temporal stability in a longitudinal studies. Although its psychometric properties are well-established, limited evidence exists regarding its long-term temporal stability. This study aimed to evaluate the test–retest reliability and agreement of the DAST-10 in a general community sample across a 12-month interval. A total of 276 adults (mean age = 31.86 years; SD = 9.94; 71% male) from the Australian community completed the DAST-10 at two time points, separated by one year (2022 and 2023). Test–retest reliability was assessed using the intraclass correlation coefficient (ICC), and test–retest agreement was evaluated using the Bland–Altman method. The DAST-10 demonstrated moderate test–retest reliability over the 12-month interval (ICC = 0.39, 95% CI = 0.22–0.52, p < 0.001), suggesting moderate score stability in the context of expected changes in drug use over time. The Bland–Altman analysis indicated a mean difference close to zero, with approximately 5% falling within the 95% limits of agreement, supporting good agreement between time points. These findings provide the first empirical evidence supporting the long-term temporal stability of the DAST-10 in a community-based sample. The results support the use of DAST-10 in longitudinal studies of drug use trajectories in community settings. These results have important implications for clinical assessment, public health surveillance, and research on substance use.

ABSTRACT Moral self-image (MSI) may evoke positive emotions (PE) through several mechanisms, with its benefits extending beyond the initial context to spill over into emotions. Despite this, few studies have comprehensively examined the spillover effects of MSI on emotional health. This study aimed to explore the longitudinal developmental patterns between MSI and emotional health. Using a novel network analysis, this study estimated network models across two waves involving 433 undergraduates (with one-year intervals) and one wave involving 437 community participants. Network analysis showed that MSI may enhance individuals’ PE over time while reducing depression. Furthermore, ‘caring’ in MSI was connected to PE, and ‘hard-working’ was connected to both PE and anxiety. Notably, these associations demonstrate stability across time and across samples. Interventions for emotional health should focus on enhancing ‘caring’ and ‘hard-working.’ This study provides a reference for the development of educational interventions that promote both moral and emotional health.

Background and Objectives: Traumatic injuries are a major public health issue, being the leading cause of death in the U.S. Advancements in medical care, injury prevention, and regional trauma systems have improved survival rates, but there is limited information on outcomes for survivors. Blunt, sharp, and firearm injuries are the primary mechanisms in trauma forensics. This study examines patient outcomes for blunt, sharp, and firearm injuries over 20 years. Materials and Methods: De-identified data were collected from the TriNetX Research network in June 2024. Patients aged 18-90 were categorized by injury type (blunt, sharp, firearm) from 2004 to 2023. Trends were analyzed by stratifying the data into 20 consecutive one-year intervals. Mortality, blood transfusions, traumatic shock, hypovolemic shock, and acute post-hemorrhagic anemia were recorded annually. Statistical analysis was performed using One Way Repeated ANOVA and post hoc Tukey testing, with significance defined as p < 0.05. Results: The study included 1,205,350 blunt, 710,875 sharp, and 144,562 firearm injuries. Firearm injuries predominantly affected males (83%) and African Americans (51%), while blunt and sharp injuries showed more demographic variability. Looking at the 20-year trends, the average age of firearm and sharp injury patients decreased by 21% (48 ± 13 to 38 ± 15, p ≤ 0.0001) and 14% (49 ± 16 to 42 ± 18, p ≤ 0.0001), respectively, while blunt injury patient age did not change significantly. Mortality rates significantly decreased from 12% for firearm, 7% for sharp, and 6% for blunt injuries in 2004 to less than 1% in 2023 for all three injury mechanisms. Blood transfusions increased 450% (2% to 11%) for firearm injuries and increased 100% for sharp and blunt injuries (1% to 2%). Traumatic shock and hypovolemic shock incidences also increased by 100% for firearm injuries (3% to 6% and 1% to 2%, respectively), while sharp and blunt injuries did not change significantly. Acute post-hemorrhagic anemia increased from 3% to 19% for firearm injuries (533% relative increase), while sharp and blunt injuries remained around 3% for the past 20 years. Conclusions: The study reveals that with improved survival rates over the last 20 years, there has been a significant increase in shock-related morbidities and blood transfusion rates, particularly for firearm injuries. These findings can inform trauma care to enhance resuscitation efforts, optimize resource allocation, and improve mortality and outcomes for these injury mechanisms.

Parenting behaviors, including autonomy support and psychological control, have been shown to significantly influence adolescent non-suicidal self-injury (NSSI). However, the underlying mechanisms linking heterogeneous parenting behavior profiles to adolescent NSSI remain unclear. This two-wave longitudinal study (with a one-year interval) of 742 Chinese adolescents (52.7% girls; Mage at Time 1 = 13.40 years) identified four distinct parenting profiles using latent profile analysis (LPA): Supportive (43.6% of the sample), Controlling (17.4%), Moderate Mixed Parenting (33.1%) and High Mixed Parenting (5.9%). Multicategorical serial mediation analysis revealed that adolescent emotion regulation difficulties and depressive symptoms serially mediated the relationship between parenting profiles and NSSI for adolescents in the Controlling, Moderate Mixed Parenting and High Mixed Parenting Profiles. Notably, these mediating effects were significant only for girls. These findings underscore the importance of adopting person-centered and sex-sensitive intervention strategies to mitigate the adverse effects of detrimental parenting behaviors on adolescent NSSI.