Search Results (1,077)

Background: Physical exercise is known to promote positive psychological functioning among college students; however, its relationship with meaning in life within naturally occurring friendship dyads remains underexplored. This study examined both actor and partner associations between physical exercise, social support, and meaning in life. Methods: A cross-sectional dyadic survey was conducted among 415 friendship dyads (830 Chinese college students, aged 17–23 years). Participants completed validated measures of physical exercise, perceived social support, and meaning in life. Intraclass correlations, Pearson correlations, actor–partner interdependence models (APIMs), and an indistinguishable APIM mediation model were applied to assess within-dyad nonindependence, actor and partner effects, and indirect pathways through social support. Results: Intraclass correlations revealed within-dyad similarities in physical exercise, social support, and meaning in life, with ICCs of 0.101, 0.188, and 0.253, respectively. The constrained indistinguishable mediation model demonstrated acceptable fit: χ²(6) = 12.81, p = 0.046; CFI = 0.973; TLI = 0.933; RMSEA = 0.052; SRMR = 0.028. Physical exercise was positively associated with social support at both the actor level (B = 0.150, p < 0.001) and partner level (B = 0.095, p < 0.001). Social support, in turn, was positively linked to meaning in life at both actor (B = 0.174, p < 0.001) and partner levels (B = 0.206, p < 0.001). Direct effects of physical exercise on meaning in life remained significant for both actor (B = 0.055, p = 0.001) and partner pathways (B = 0.067, p < 0.001). Bootstrap analyses confirmed significant total indirect effects for actors (B = 0.046, 95% CI [0.030, 0.063]) and partners (B = 0.047, 95% CI [0.032, 0.065]). Conclusions: Physical exercise is associated with meaning in life not only via intrapersonal pathways but also through interpersonal pathways within friendship dyads. Social support serves as a key mediating factor in this relationship. Full article

Smoking and central obesity have both been linked to periodontitis, but their combined relationship with periodontal disease may be influenced by demographic and behavioral factors. This cross-sectional study analyzed records of 420 adult dental patients attending the College of Dentistry at the University of Baghdad. Data included demographic characteristics, smoking status, periodontal clinical findings, body mass index (BMI), and waist-to-height ratio (WHtR). Periodontitis was defined according to the 2018 classification framework, and logistic regression models were used to examine the associations of smoking and obesity-related indicators with periodontitis. The overall prevalence of periodontitis was 36.4%. Participants with periodontitis were significantly older than those without periodontitis (46.0 vs. 28.9 years; p < 0.0001). In the fully adjusted model, age remained the strongest factor associated with periodontitis (OR = 1.15 per year; 95% CI: 1.11–1.18; p < 0.001). The apparent association between smoking and periodontitis was substantially influenced by age, as current smoking was more common among younger participants in this sample. The association between smoking status and periodontitis appeared to differ according to WHtR category (interaction term p = 0.016); however, this finding should be interpreted cautiously because of the cross-sectional design and age imbalance across exposure groups. Overall, the findings suggest that age was the dominant factor associated with periodontitis in this dental patient sample, while the relationship between smoking, central obesity, and periodontitis requires further investigation in longitudinal studies with detailed smoking and metabolic data. Full article

Background: Measles remains a significant public health challenge in Ethiopia, and the country has not achieved measles elimination despite the commitments outlined in the Immunization Agenda 2030. This study assessed inequalities in MCV2 vaccination among children aged 24–35 months in Ethiopia. Methods: This study used nationally representative data from the 2022/23 National Health Equity Survey, which employed a two-stage stratified cluster sampling design across all regions and city administrations. A total of 1987 mothers/caregivers of eligible children were interviewed. Descriptive statistics, bivariable analyses, and multivariable logistic regression were conducted using Stata 17 software, and determinants of MCV2 uptake were identified. Wealth-related inequality was assessed using concentration index analysis. Statistical significance was set at p < 0.05. Results: Overall MCV2 coverage was 60.4%. The multivariable analysis identified a significant inequality in second-dose measles vaccination (MCV2) in Ethiopia. Children born in health facilities had higher odds of vaccination (AOR = 1.88; 95% CI: 1.49–2.38), and maternal age of 25–34 years was associated with increased uptake compared to younger mothers (AOR = 2.03; 95% CI: 1.18–3.48). Postnatal care utilization and vitamin A supplementation strongly improved vaccination coverage, with children receiving vitamin A showing markedly higher odds of MCV2 uptake (AOR = 16.74; 95% CI: 9.61–29.14). Female children were more likely to be vaccinated than males (AOR = 1.50; 95% CI: 1.01–2.24), and higher maternal education (college or above) significantly increased uptake (AOR = 2.78; 95% CI: 1.02–7.73). Wealth status also influenced coverage. Conclusion: Improving MCV2 coverage in Ethiopia requires strengthening of maternal and child health services and promotion of integrated care, including PNC, vitamin A supplementation, and routine immunization. Early and consistent contact with the health system, along with addressing gaps in health education and supporting younger mothers, is essential. Persistent inequalities by place of birth, household wealth, and region highlight the need for targeted interventions. Strengthening equitable immunization services remains critical to achieving national and global measles elimination goals. Full article

This study conducts a comparative analysis of surgical outcomes in patients who underwent FSF repair by a plastic surgeon versus an ENT using a national database. A retrospective analysis was conducted on patients who underwent surgical treatment of FSFs by a plastic or ENT surgeon using the de-identified American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. Patients were identified based on surgical CPT codes. Data extracted included primary surgeon specialty and patient demographics, comorbidities, and surgical outcomes. Statistical analysis was performed using Fisher’s Exact test and the Wilcoxon Rank-Sum test, with a p-value < 0.05 representing statistical significance. A total of 111 patients were analyzed, of which 85.6% were male. The mean age was 30.0 years [22.0, 48.0]. There were 70 patients (63.1%) treated by an ENT and 41 (36.9%) by a plastic surgeon. The median operative time was 131.0 min for ENT and 115.0 min for plastic surgery (p = 0.19). The median length of postoperative stay was 1.0 day for both groups. Postoperative complications included surgical site infection (SSI), wound disruption, and sepsis in five patients (4.5%). There was no statistically significant difference in the rate of complications between patients who underwent surgery with an ENT surgeon versus a plastic surgeon (p = 0.16). There were no statistically significant differences in operative time, length of stay, or complications between patients who underwent FSF repair by an ENT or by a plastic surgeon. Surgeon specialty training does not appear to influence intraoperative or postoperative outcomes. Studies with larger sample sizes may demonstrate statistically significant differences in outcomes. Full article

As the first generation in their families to pursue higher education, the mental health of first-generation college students has attracted significant attention from the academic community. Self-esteem and academic performance are significant factors influencing anxiety and mental health among first-generation college students. However, longitudinal research evidence specific to this group in China remains scarce. This study utilized two waves data, selecting a sample of 1024 first-generation college students (mean age 21.73; 55.18% male). Through follow-up surveys conducted at one-year intervals, a cross-lagged model was employed to systematically examine the longitudinal predictive relationships among self-esteem, academic performance, and anxiety. The results indicate significant negative correlations among self-esteem, academic performance, and anxiety. Cross-lagged analysis further indicated that self-esteem at T1 (β = −0.098, p < 0.05) and academic performance at T1 (β = −0.067, p < 0.05) were prospectively associated with lower anxiety at T2. This study reveals the longitudinal predictive associations among self-esteem, academic performance, and anxiety among China’s first-generation college students, providing empirical evidence for universities to improve their mental health support systems by focusing on the self-esteem development of this group and offering targeted academic support. Full article

Background and Objectives: Cervicogenic headaches (CGH) are increasingly common among college students and may negatively affect academic performance and sleep quality. This study aimed to identify the self-reported prevalence of cervicogenic-type head and neck pain in a convenience sample of Saudi college students and to examine its associations with electronic device use, physical activity, and sleep quality among college students in Saudi Arabia. Materials and Methods: A cross-sectional study was conducted among 313 college students from various Saudi university colleges using an online self-administered questionnaire. The questionnaire gathered information on sociodemographic characteristics, electronic device usage, neck pain awareness, physical activity levels, and sleep quality. Descriptive statistics were used to summarize the data, and chi-square tests were used to explore associations between potential predictors and the prevalence of self-reported cervicogenic-type head and neck pain consistent with possible CGH. Results: Most participants were female (84.3%) and aged 18–25 years (95.2%). Cervicogenic-type head and neck pain were reported by 65.2% (n = 204/313), while 56.5% experienced moderate to severe stress. A significant association was found with perceived stress (p = 0.002). Prolonged electronic device use (>4 h/day: 77.9%; p < 0.01), lower physical activity (p = 0.056), medication use (p < 0.01), headache exacerbation with inactivity (p = 0.006), and poor sleep quality (95.1% with PSQI > 10; p = 0.044) were significantly associated. Conclusions: These findings highlight associations between excessive electronic device use, low physical activity, and poor sleep quality with self-reported cervicogenic-type head and neck pain among Saudi college students. Future longitudinal studies and randomized controlled trials are needed to determine whether targeting these factors reduces the prevalence of CGH. Full article

This study investigates the relationship between cardiorespiratory fitness and driving behavior in a highway environment using a driving simulator. A total of 46 young drivers aged 19 to 27 years participated in the experiment. Cardiorespiratory fitness was assessed through the Queen’s College Step Test and heart rate monitoring, allowing participants to be classified into high-fitness and low-fitness groups based on estimated maximum oxygen consumption. Each participant completed three simulated highway driving scenarios under varying traffic and lighting conditions. Driving performance data were continuously recorded, while additional individual and behavioral characteristics were collected through a structured questionnaire. The analysis focused on key performance indicators, including headway distance variability, average speed, and time to collision. Statistical analysis was conducted using regression models. The results indicate that higher physical fitness is associated with greater adaptability in driving behavior, reflected in increased headway variability and slightly higher driving speeds. At the same time, high-fitness drivers exhibited longer time to collision, suggesting improved anticipation and more effective management of traffic conditions. Environmental factors, particularly traffic volume and lighting conditions, remained dominant in shaping driving behavior. Overall, the findings suggest that physical fitness contributes to a more adaptive driving style on highways. By integrating physiological condition into the analysis of driver behavior, this study highlights the importance of considering health-related factors in road safety research and provides insights for developing preventive strategies targeting young drivers. Full article

Research examining risk and protective factors of suicidality among Black students remains limited. This study assessed the effects of psychological inflexibility and emotional resilience on suicidal behaviors among Black college students. We conducted a secondary data analysis of the 2022–2024 Healthy Minds Study. Black students (aged 18–24) who completed the suicidality matrix, psychological inflexibility (Acceptance & Action Questionnaire II) and emotional resilience (Brief Resilience Scale) measures were included in the analysis. Logistic regressions were performed to examine the effect of psychological inflexibility and resilience on suicidal ideation, plans for suicide, and suicide attempts. The students (N = 4557) represented diverse backgrounds, with 61% being African American, 12.2% African, 13.8% Caribbean, and 7% Afro-Latinx. Further, 18.7% endorsed suicidal ideation, 9.2% endorsed suicide plans, and 3.2% reported a suicidal attempt within the past 12 months. Psychological inflexibility was associated with increased risk of suicidal ideation (OR = 1.04, p < 0.001), suicidal plan (OR = 1.05, p < 0.001) and suicide attempt (OR = 1.03, p = 0.011). Emotional resilience was not associated with any suicidal behaviors as a protective or risk factor. The findings support previous research identifying psychological inflexibility as a suicidal risk factor. Prevention and intervention strategies may warrant a focus on promoting psychological flexibility. Full article

Cyberbullying victimization is a public health concern associated with adolescents’ psychological distress symptoms. This cross-sectional study examined whether relative deprivation and moral disengagement were statistically associated with the relationship between cyberbullying victimization and psychological distress symptoms among victim-only five-year higher vocational college students. Among 4290 valid respondents, 1419 students reported at least one cyberbullying victimization experience. Because the present study focused on victimization without concurrent perpetration, 1107 victim-only students were included in the primary analysis. Participants completed self-report measures of cyberbullying victimization, relative deprivation, moral disengagement, and psychological distress symptoms. After controlling for gender and age, cyberbullying victimization was positively associated with psychological distress symptoms. The bootstrap results indicated significant indirect associations through relative deprivation, through moral disengagement, and through the serial pathway from relative deprivation to moral disengagement. These findings suggest that relative deprivation and moral disengagement are statistically linked to the association between cyberbullying victimization and psychological distress symptoms among victim-only vocational students. Given the cross-sectional self-report design, the mediation findings should be interpreted as evidence of statistical associations rather than temporal ordering or causal mechanisms. Full article

College students often maintain poor dietary habits, notably low fruit and vegetable intake. Common barriers include limited time, cost, and lack of nutritional knowledge. This study examined dietary behaviors, barriers, and factors influencing Healthy Eating Scores (HES) among college students. Participants (N = 224; age = 20.3 ± 2.5 years, BMI = 23.9 ± 4.1 kg/m², 78.9% female, and 91.3% white) completed an online survey. Results indicate meat overconsumption with underconsumption of water, fruits, and vegetables. Limited time and healthy options were the primary perceived barriers. Tests of between-subject effects identified gender (F = 4.38, p = 0.04) and living situation (F = 4.42, p < 0.01) as independent HES predictors. Backward stepwise linear regression (adj. R² = 0.22, p < 0.001) further indicated that being male, an athlete, living off-campus, and cooking at home were significantly associated with higher HES. Conversely, non-athlete females living on campus emerged as the most vulnerable group for low HES. These findings suggest that future interventions should target specific demographic vulnerabilities to improve dietary outcomes and mitigate barriers in the college population. Full article

Background/Objectives: Keratoconus is a corneal disorder that causes thinning and bulging of the cornea, resulting in astigmatism and other refractive errors. Mechanical effects and environmental factors are known to exacerbate the disease, and genetic predisposition plays a significant role in its development. Methods: This study investigated the presence of genetic variants in 32 keratoconus patients. We used a next-generation sequencing-based method, and variant interpretation was performed according to the American College of Medical Genetics and Genomics (ACMG) guidelines. Variants were prioritized based on multiple criteria, including population frequency data from the Genome Aggregation Database (gnomAD) (minor allele frequency < 1%), variant type and predicted functional effect, gene–disease association, inheritance pattern, phenotypic relevance, and in silico prediction tools. Results: Thirteen variants were identified in 11 patients (34.3%). Two patients carried variants in two different genes, raising the possibility of oligogenic contributions. Ten variants (76.9%) were novel. The variants were detected in 12 genes, namely ADAMTS18, BEST1, CHST6, COL17A1, CYP1B1, KRT3, PAX6, SLC4A11, TACSTD2, UBIAD1, VSX1, and ZNF469. No association was observed between detected variants and patient age. Conclusions: Our findings demonstrate a substantial proportion of novel variants and support the genetic heterogeneity of keratoconus, while also raising the possibility of oligogenic contributions in a subset of patients. Full article

Sexually transmitted infections (STIs) caused by C. trachomatis and HPV are the most prevalent worldwide. College students are characterized by being young women of reproductive age who may have risky sexual behavior. To describe the prevalence and factors associated with endocervical infection by C. trachomatis and HPV in college women in the Brazilian Amazon. Endocervical secretions were collected. The ompA gene of C. trachomatis and the L1 gene of HPV were detected. The Chi-square test, Fisher’s exact test, G test, Odds Ratio, and Multiple Logistic Regression were used with 95% confidence interval and p ≤ 0.05. The overall prevalence of endocervical infection by C. trachomatis was 8.3% (25/302) and by HPV was 28.9% (87/302). Low income was associated with sexually transmitted infection by C. trachomatis (14.8%, p = 0.0336). Those under 25 years old had twice the chance of HPV infection [39.3%, (OR: 2.6989), 95% CI: 1.6054–4.5371, p = 0.0002], as did women without children [31.8%, (OR: 2.333), CI: 1.1235–4.8461, p = 0.0307]. Women who did not study in a public school had 63% reduced risk of acquiring HPV infection [45.8% (OR: 0.3713), CI: 0.1951–0.7064, p = 0.0035]. C. trachomatis and HPV infections were present in low-income, childless young women who attended public schools, requiring the intensification of STI prevention policies in the Amazon region. Full article

Background: Hypertension is being increasingly observed among young adults in urban India, alongside rapid dietary transitions and rising consumption of ultra-processed foods (UPFs). The current study aimed to assess the frequency and patterns of UPF consumption and examine their association with high blood pressure among urban college students. Methods: A cross-sectional study was conducted among 311 undergraduate students aged 18–24 years from three colleges in Hyderabad, India. Our study used a validated automated device to measure blood pressure. Dietary intake over the previous month was assessed using a 24-item food frequency questionnaire capturing commonly consumed UPFs. After adjusting for age, sex, and socioeconomic variables, multivariable logistic regression was performed to assess the relationships between UPF consumption categories and high blood pressure. Ninety-five percent confidence intervals (CIs) for adjusted odds ratios (AORs) were reported. Results: Overall, 12.5% of participants had high BP (≥140/90 mmHg). The prevalence was higher among males and those aged >20 years. In the adjusted analyses, males had significantly higher odds of having high BP (AOR: 4.96; 95% CI: 1.64–15.01), as did students from higher-income households (AOR: 3.22; 95% CI: 1.07–9.66). Consumption of high-fat and/or high-salt UPFs at or above the median was independently associated with high BP (AOR: 2.85; 95% CI: 1.16–6.99). Taste, availability, and low cost were common drivers of UPF intake. Conclusions: Higher consumption of high-fat and/or high-salt ultra-processed foods was associated with higher odds of elevated blood pressure among urban young adults. These findings warrant further longitudinal investigation and may help inform the development of targeted dietary awareness and food environment interventions in college settings. Full article

Background: Sarcopenic obesity, defined as the coexistence of low muscle mass and excess adiposity, is an emerging public health concern in aging populations. However, longitudinal evidence on the association between socioeconomic status (SES) and incident sarcopenic obesity remains limited, particularly in Asian populations. This study aimed to investigate the association between SES and the long-term incidence of sarcopenic obesity in a large Korean cohort. Methods: We conducted a prospective cohort study using data from the Korean Genome and Epidemiology Study (KoGES). Community-dwelling adults aged ≥ 40 years without sarcopenic obesity at baseline were followed for a mean of 17 years. Sarcopenic obesity was defined as low body mass index (BMI)-adjusted skeletal muscle mass (sex-specific lowest 20th percentile) combined with obesity (BMI ≥ 25 kg/m²). SES indicators included educational attainment, household income, and marital status. Kaplan–Meier methods were used to estimate cumulative incidence, and Cox proportional hazards models were applied to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) with sequential adjustment for demographic, lifestyle, and metabolic factors. Results: In the fully adjusted model, participants with elementary school education showed a higher hazard ratio of incident sarcopenic obesity compared with those with college education or higher (HR 1.39; 95% CI 1.11–1.73; p = 0.003). Similarly, individuals with a household income < 1.0 million KRW per month had a higher hazard ratio compared with those earning ≥4.0 million KRW (HR 1.31; 95% CI 1.02–1.70; p = 0.037). Unmarried participants also showed a higher hazard ratio compared with married individuals (HR 1.31; 95% CI 1.09–1.57; p = 0.003). Conclusions: Lower SES was independently associated with a higher incidence of sarcopenic obesity over long-term follow-up in this population-based cohort. These findings highlight the importance of considering socioeconomic factors in the prevention of sarcopenic obesity. Full article

Background: Cage subsidence (CS) is among the main complications after oblique lumbar interbody fusion (OLIF) and may lead to the failure of indirect decompression. Accurate preoperative bone quality assessment is critical for risk stratification, yet the optimal imaging modality and diagnostic threshold remain unclear. Objectives: This study aimed to determine a quantitative computed tomography (QCT)-derived volumetric bone mineral density (vBMD) threshold for predicting CS after OLIF with posterior fixation. Methods: Patients undergoing OLIF with posterior fixation between July 2017 and March 2020 were retrospectively enrolled. Preoperative vBMD was measured using QCT as the average L2–L4 trabecular volumetric BMD. CS was defined as a loss of more than 2 mm of disk height on sagittal midline CT views between 3 days postoperatively and the last follow-up. Clinical and radiographic parameters including gender, age, body mass index, vBMD, number of operative levels, cage dimensions, disk height, segmental lordosis, intraoperative endplate injury, and fusion status were analyzed. Results: 86 patients (107 operative levels) with a mean follow-up of 20.6 months were included; 25 levels (23.4%) developed CS. Multivariate logistic regression identified vBMD (p < 0.001; OR 0.947; 95% CI 0.923–0.972) and intraoperative endplate injury (p = 0.031; OR 3.640; 95% CI 1.125–11.776) as independent risk factors. The area under the receiver operating characteristic curve (AUC) for vBMD was 0.847 (95% CI, 0.762–0.932), with an optimal threshold of 83.0 mg/cm³ (sensitivity 84.0%, specificity 76.8%). This threshold closely aligns with the American College of Radiology QCT criterion for osteoporosis (80 mg/cm³); however, given that it was derived from a single-center retrospective cohort, external validation in multi-center studies is warranted before broad clinical adoption. Fusion rates differed significantly between CS and non-CS groups (84.0% vs. 96.3%, p = 0.029). Conclusions: QCT-derived vBMD provides a phantom-calibrated, protocol-standardized metric for preoperative risk stratification of cage subsidence after OLIF. Full article