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Open Access June 26, 2025

The Relationship Between Lymphocyte Count and Mortality in Patients with Dysphagia

Min Wei, Chengming Ke, Sumin Wu

World Journal of Clinical Medicine Research 2025, 5(1), 40-51. DOI: 10.31586/wjcmr.2025.6128

Abstract Background: Dysphagia is a common functional impairment in elderly populations, often leading to severe complications such as malnutrition and aspiration pneumonia, significantly increasing healthcare burdens. Currently, effective prognostic assessment tools are lacking. The absolute lymphocyte count (ALC), a biomarker reflecting immune-nutritional status, has potential predictive value in this context, though its role in dysphagia prognosis remains unclear. Methods: This retrospective cohort study included 253 dysphagic patients who received percutaneous endoscopic gastrostomy (PEG) or total parenteral nutrition (TPN) between 2014 and 2017. Five patients with missing ALC were excluded. Cox regression models assessed the association between ALC and mortality. ALC was analyzed as both continuous variable (using restriocted cubic splines) and categorical tertiles, with additional threshold analyses to assess non-linearity. Kaplan–Meier survival curves and subgroup analyses were also performed. Results: Lower ALC was associated with poorer nutritional status, higher inflammatory markers, and greater comorbidity burden. Higher ALC was independently associated with reduced mortality (adjusted HR: 0.60; 95% CI: 0.44–0.83; p = 0.002). Patients in the highest tertile had significantly better survival than those in the lowest (HR: 0.37; 95% CI: 0.23–0.59; P < 0.001). A non-linear threshold effect was identified at ALC = 1.899×10⁹/L (p for non-linearity = 0.009). Kaplan–Meier analysis confirmed improved survival with higher ALC (p [...] Read more.

Background: Dysphagia is a common functional impairment in elderly populations, often leading to severe complications such as malnutrition and aspiration pneumonia, significantly increasing healthcare burdens. Currently, effective prognostic assessment tools are lacking. The absolute lymphocyte count (ALC), a biomarker reflecting immune-nutritional status, has potential predictive value in this context, though its role in dysphagia prognosis remains unclear. Methods: This retrospective cohort study included 253 dysphagic patients who received percutaneous endoscopic gastrostomy (PEG) or total parenteral nutrition (TPN) between 2014 and 2017. Five patients with missing ALC were excluded. Cox regression models assessed the association between ALC and mortality. ALC was analyzed as both continuous variable (using restriocted cubic splines) and categorical tertiles, with additional threshold analyses to assess non-linearity. Kaplan–Meier survival curves and subgroup analyses were also performed. Results: Lower ALC was associated with poorer nutritional status, higher inflammatory markers, and greater comorbidity burden. Higher ALC was independently associated with reduced mortality (adjusted HR: 0.60; 95% CI: 0.44–0.83; p = 0.002). Patients in the highest tertile had significantly better survival than those in the lowest (HR: 0.37; 95% CI: 0.23–0.59; P < 0.001). A non-linear threshold effect was identified at ALC = 1.899×10⁹/L (p for non-linearity = 0.009). Kaplan–Meier analysis confirmed improved survival with higher ALC (p < 0.0001). Subgroup analyses showed the protective effect of higher ALC was consistent across age, sex, BMI, PEG use, and comorbidity strata, with no significant interactions. Conclusions: ALC is an independent, non-linear predictor of mortality in older dysphagic patients and may aid clinical risk stratification across diverse patient subgroups.

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Open Access June 25, 2025

Performance and Validity of Knee Function Assessment Tools After Total Knee Arthroplasty: A Systematic Review

Andrei Machado Viegas da Trindade, Helder Rocha da Silva Araújo, Mário Soares Ferreira Júnior, Karine Kelly Rangel de Andrade Monte, Marcos Vinícius Amorim Silva, Rebecca Gomes Moura Bastos, João Gabriel Ventura Bariani, Fernanda Grazielle da Silva Azevedo Nora

Global Journal of Orthopedics 2025, 1(1), 60-69. DOI: 10.31586/gjo.2025.6123

Abstract Objective: To identify and evaluate the main functional assessment tools applied in the postoperative monitoring of patients undergoing total knee arthroplasty (TKA), and to synthesize the functional outcomes reported through these instruments in the current scientific literature. Methodology: A structured review was conducted following PRISMA 2020 guidelines. [...] Read more.

Objective: To identify and evaluate the main functional assessment tools applied in the postoperative monitoring of patients undergoing total knee arthroplasty (TKA), and to synthesize the functional outcomes reported through these instruments in the current scientific literature. Methodology: A structured review was conducted following PRISMA 2020 guidelines. Thirty-one peer-reviewed studies were selected through a targeted manual search based on predefined eligibility criteria. Included studies evaluated functional recovery following TKA using validated outcome measures such as the WOMAC, KSS, KOOS, IKDC, SF-36, and SANE. Data extraction focused on the instruments used, patient population characteristics, and reported outcomes. A descriptive synthesis was compiled in Table 1. Additionally, 15 studies with quantitative data were analyzed using a forest plot to illustrate risk ratios (RR) and 95% confidence intervals (CI) for functional improvement. Risk of bias was assessed qualitatively based on methodological rigor, clarity of reporting, and validation of the outcome tools. Results: All included studies reported improvements in functional status following TKA. Most risk ratios ranged from 0.66 to 0.85, indicating a consistent reduction in the risk of postoperative functional limitation. High-quality studies demonstrated more precise effect estimates and greater internal validity. The SANE scale emerged as a valid and practical tool with high responsiveness, including in its culturally adapted Brazilian version. Despite heterogeneity in study design, the direction of effect remained consistent across all included studies. Conclusion: Validated functional assessment tools are essential for monitoring recovery after total knee arthroplasty. Instruments such as WOMAC and SANE demonstrate strong clinical utility and psychometric validity. Their systematic use enhances outcome comparability, supports individualized rehabilitation planning, and improves decision-making in orthopedic care.

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Systematic Review

Open Access June 19, 2025

Current Status of Legionnaires' Disease and Environmental Factors in Japan

Masafumi Seki

Global Journal of Epidemiology and Infectious Disease 2025, 5(1), 24-27. DOI: 10.31586/gjeid.2025.6129

Abstract Legionnaires' disease became widely known following an outbreak of pneumonia in the United States in 1976. It is often caused by infection from artificial water sources such as cooling towers, water supply and heating systems, and recirculating hot tubs. To effectively implement infection prevention measures for Legionnaires' disease, collaboration among healthcare workers, water supply and [...] Read more.

Legionnaires' disease became widely known following an outbreak of pneumonia in the United States in 1976. It is often caused by infection from artificial water sources such as cooling towers, water supply and heating systems, and recirculating hot tubs. To effectively implement infection prevention measures for Legionnaires' disease, collaboration among healthcare workers, water supply and heating system managers, building hygiene personnel, and other relevant parties is essential. It is important to note that outbreaks of Legionnaires' disease continue to occur frequently both domestically and internationally. While the number of reported cases of Legionnaires' disease in Japan has increased, the mortality rate has decreased but has stabilized at a lower level. Caution is also required as reports have been made in association with disasters and travel, in addition to artificial environmental water.

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Review Article

Open Access June 06, 2025

Food security, dietary diversity, and age as determinants of nutritional status among adolescent girls in coastal Bangladesh

Tanzina Akter, Taslima Akter, Sharmin Shilpy Nokshi, Sujit Kumar Banik, Abu Ansar Md Rizwan

Journal of Biomedical and Life Sciences 2025, 5(2), 110-121. DOI: 10.31586/jbls.2025.6112

Abstract Background: Adolescent girls living in disaster-prone coastal regions of Bangladesh face heightened nutritional vulnerability due to limited food access, poor dietary diversity, and environmental stressors. Despite growing concerns about adolescent malnutrition, few studies have examined the combined influence of food security, dietary diversity, and age on nutritional outcomes in these [...] Read more.

Background: Adolescent girls living in disaster-prone coastal regions of Bangladesh face heightened nutritional vulnerability due to limited food access, poor dietary diversity, and environmental stressors. Despite growing concerns about adolescent malnutrition, few studies have examined the combined influence of food security, dietary diversity, and age on nutritional outcomes in these settings. Objectives: This study aimed to assess the association between dietary diversity, food security, and age with the nutritional status of adolescent girls in coastal Bangladesh. Methods: A cross-sectional survey was conducted among 345 adolescent girls aged 10–19 in Chattogram and Cox’s Bazar. Data on dietary intake were collected using a 24-hour dietary recall and a food frequency questionnaire. Household food security was assessed using a validated scale. Nutritional status was determined using BMI-for-age classifications. Bivariate and multivariate analyses explored associations between dietary diversity, food security, age, and nutritional status. Results: Among participants, 10.14% were underweight, and 29.85% were either overweight or obese. While 17.39% demonstrated high dietary diversity (≥7 food groups), the majority had moderate diversity (5 or 6 food groups) (59.42%). Food-insecure households were significantly more likely to have overweight or obese adolescents (p < 0.05). Although dietary diversity was associated with BMI in bivariate analysis, it was not a significant predictor in the multivariate model. Age showed a significant relationship with both dietary diversity and nutritional status. Conclusion: The findings emphasize the importance of addressing household food security and age-related nutritional vulnerabilities in coastal areas. Interventions should prioritize age-sensitive, culturally appropriate strategies to improve dietary quality and prevent the double burden of malnutrition among adolescent girls.

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Open Access February 24, 2025

Women Hearts on the Line: Exploring the Correlation Between Anthropometric Parameters, Blood Pressure, and Peripartum Cardiomyopathy

Hayatu Umar, Adamu Jibril Bamaiyi, Simeon Alabi Isezuo, Raghu Cherukupalli, Oborien Omokhudu Isa, Abubakar Sadiq Maiyaki, Garba Sanusi, Aminu Abbas, Murtala Audu Ngabea, Nura Maiyadi Ibrahim

World Journal of Clinical Medicine Research 2025, 5(1), 6-19. DOI: 10.31586/wjcmr.2025.1267

Abstract Background: Peripartum cardiomyopathy (PPCM) is a life-threatening heart muscle disease of unknown aetiology that affects women during the peripartum period, particularly in sub-Saharan Africa. While many studies have observed normal blood pressure (BP) in PPCM patients, none have explored whether their BP is appropriate for their body size. This study investigated the correlation between [...] Read more.

Background: Peripartum cardiomyopathy (PPCM) is a life-threatening heart muscle disease of unknown aetiology that affects women during the peripartum period, particularly in sub-Saharan Africa. While many studies have observed normal blood pressure (BP) in PPCM patients, none have explored whether their BP is appropriate for their body size. This study investigated the correlation between body anthropometric parameters and BP in PPCM patients, comparing the findings with those of age-matched normal peripartum controls. Methods: A cohort of 105 women, each from PPCM and matched normal peripartum control groups, were recruited from three healthcare facilities in Sokoto. Blood pressure (BP) parameters were assessed in relation to their anthropometric measurements, and the findings were compared between the two groups. Results: The PPCM patients were significantly smaller in body weight (57.0 ±11.6 Kg vs 66.8 ±13.8 Kg, P <.0001), body mass index (BMI) (21.9 ±4.1 Kg/m2 vs 25.4 ±5.4 Kg/m2, P <.0001, body surface area (BSA) (1.3 ±0.7 m2 vs 1.7 ±0.2 m2, P <.0001), Lean body mass (LBM) (45.3 ±7.0 Kg vs 49.4 ±4.1 Kg, P <.0001) and Percentage body fat (BF) (23.5 ±10.9 % vs 31.2 ±6.9 %, P <.0001). Similarly, PPCM patients had significantly higher systolic BP (SBP), Pulse pressure (PP) and Mean arterial blood pressure (MABP) compared to the normal peripartum PPCM control. Further, linear regression analysis showed that there was higher slope of the relationship between anthropometric indices and SBP and PP in the PPCM cohort, compared to the normal peripartum control group. A similar trend of the slope was seen in the Pearson’s coefficient of the relationship of the anthropometries and BP parameters. Conclusions: This study found that women with peripartum cardiomyopathy (PPCM) exhibited disproportionately higher systolic blood pressure (SBP) and pulse pressure (PP) for each unit increase in anthropometric measurements compared to normal peripartum controls. Notably, PPCM patients had significantly lower anthropometric measures, potentially attributable to poverty and chronic undernutrition. Additionally, the effects of poor antenatal care, lack of immunization and recurrent infection should be considered. These findings suggest an abnormal relationship between anthropometry and blood pressure in PPCM patients, which may have detrimental effects on their cardiovascular health. This abnormal relationship may contribute to the development of heart failure (HF) in PPCM patients and potentially increase the risk in women susceptible to PPCM. Even-though our assumption, yet to be proven. To address this concerning trend in vulnerable populations, improvements in nutritional status, socioeconomic determinants health, adequate antenatal care (ANC), immunization, and infection prevention should be considered.

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Open Access February 14, 2025

A multi-loci time-series descriptive study on noise levels in a pediatric emergency care department

Yuan Luo, Liping Zhao, Yunchen Li

Current Research in Public Health 2025, 5(1), 1-11. DOI: 10.31586/crph.2025.1091

Abstract Objective: To investigate the status of the acoustic environment of a typical Chinese pediatric emergency care department in a time series and identify the relationship between noise levels and factors such as crowd density and movement. Methods: A descriptive study was designed based on a multi-loci time-series method. We measured three loci under three variable settings: the [...] Read more.

Objective: To investigate the status of the acoustic environment of a typical Chinese pediatric emergency care department in a time series and identify the relationship between noise levels and factors such as crowd density and movement. Methods: A descriptive study was designed based on a multi-loci time-series method. We measured three loci under three variable settings: the decibel value, observation volume, and emergency care volume. Results: The noise levels of the three loci were significantly higher than the internationally recommended levels, exceeding rate reached more than 86.3%. The 24-hour mean map of the three loci showed similar fluctuation patterns, all of which had two peaks at approximately 10:00 AM and 16:00 PM. Conclusions: The daytime and nighttime noise levels were well-fitted by cubic functions with different coefficients. It is suggested that crowd density and movement may play important roles in noise mean fluctuations, which can be optimized to ensure a satisfactory environment in a pediatric emergency care department.

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Open Access November 15, 2024

Education Does Not Equally Increase Financial Well-being for All

Shervin Assari, Hossein Zare, Amanda Sonnega

Journal of Social Mathematical & Human Engineering Sciences 2024, 3(1), 62-74. DOI: 10.31586/jsmhes.2024.1113

Abstract Background: Financial well-being is a key domain of overall well-being, encompassing an individual's ability to meet financial obligations, secure their financial future, and maintain a sense of financial freedom. Education is often viewed as a critical pathway to enhancing financial well-being. However, the returns of education on financial well-being are not uniform across racial, ethnic, [...] Read more.

Background: Financial well-being is a key domain of overall well-being, encompassing an individual's ability to meet financial obligations, secure their financial future, and maintain a sense of financial freedom. Education is often viewed as a critical pathway to enhancing financial well-being. However, the returns of education on financial well-being are not uniform across racial, ethnic, and nativity groups. The theory of Minorities’ Diminished Returns (MDRs) suggests that the positive effects of education on outcomes such as income and financial security are weaker for marginalized groups, including Black individuals, Latinos, and immigrants. Objective: This study examines the diminished returns of education on financial well-being among Black, Latino, and immigrant populations in the United States. We aim to investigate how structural inequalities contribute to weaker financial returns on education for these groups compared to their White and native-born counterparts. Methods: We utilized data from the Understanding America Study (UAS 2014) to conduct a cross-sectional analysis of adult respondents. The study assessed financial well-being outcomes (e.g., income, savings, and financial security) and their association with educational attainment across racial, ethnic, and nativity groups. Regression models were employed to test for interaction effects between education and race/ethnicity/nativity, adjusting for sociodemographic factors such as age, gender, employment, and family structure. Results: Our analysis included 8,121 individuals. The mean age of the respondents was 48 years (SD = 16). High education was associated with higher financial well-being (B = 1.284, 95% CI: 1.157, 1.410). The interaction terms between education and immigrant status (B = -0.507, 95% CI: -0.930, -0.084), race (Black) (B = -0.770, 95% CI: -1.208, -0.331), and ethnicity (Hispanic) (B = -0.589, 95% CI: -0.969, -0.210) were all significant, suggesting that immigrant, Black, and Hispanic individuals experience diminished returns on education in terms of financial well-being, relative to US-born non-Hispanic White individuals. The significant negative interactions between education and minority statuses (Black, Hispanic, and immigrant) indicate that while education generally improves financial well-being, the magnitude of this improvement is substantially smaller for these marginalized groups. Conclusion: Understanding how education translates to financial well-being across different racial, ethnic, and nativity groups is critical for addressing persistent financial disparities.

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Open Access April 29, 2024

Predictors of Patient Outcomes Associated with Transfer Status to Definitive Care Hospitals: A Study of Admitted Road Traffic Injured Patients in Two Major Trauma Hospitals in The Gambia

Edrisa Sanyang, Paul Bass, Bakary Ndow, Abubacarr Jagne, Erin M. Reynolds

Current Research in Public Health 2024, 4(1), 13-25. DOI: 10.31586/crph.2024.820

Abstract The Gambia uses the Primary Health Care model with no trauma response system. Trauma patients are transferred through multiple levels of health care facilities before definitive care hospitals. This study was conducted to identify predictors of injury factors associated with transfer. In this study, we examined characteristics of transferred patients compared to those directly admitted in [...] Read more.

The Gambia uses the Primary Health Care model with no trauma response system. Trauma patients are transferred through multiple levels of health care facilities before definitive care hospitals. This study was conducted to identify predictors of injury factors associated with transfer. In this study, we examined characteristics of transferred patients compared to those directly admitted in definitive care hospitals. The study was conducted in two major trauma hospitals in The Gambia. 251 road traffic injury (RTI) patients were either transferred (84%) from lower-level health centers or directly admitted (16%) to one of the study hospitals. Transferred patients were more likely to have been pedestrian/bicyclists (aOR = 1.81; 95% CI = 0.86 – 3.80). Administration of antibiotics was significantly associated with direct admit than transferred patients (aOR = 6.84; 95% CI = 2.38 – 19.68). Transferred patients were more likely to receive intravenous fluid compared to direct admits (aOR = 0.03; 95% CI = 0.01 – 0.08). The study results have implications for policies and planning in the healthcare setting in The Gambia and other LMICs with similar settings. Based on the findings of this study, it is essential that hospital management teams adapt to increasing reliance of RTI patients on lower-level healthcare facilities. The study results suggest increased burden on lower-level health care facilities. Efforts and resources should focus more on supporting lower-level facilities.

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Open Access December 12, 2023

Threatened Wildlife for an Instructional Approach about Biodiversity Conservation

Antonio J. Mendoza-Fernández, Leticia Arnao, Candelaria Carretero, Fabián Martínez-Hernández, José M. Sánchez Robles

Research Journal of Ecology and Environmental Sciences 2023, 3(1), 47-60. DOI: 10.31586/rjees.2023.693

Abstract Biodiversity is related to a global problem: its destruction, a fact supported by scientific authorities. It is not trivial that educational dimension has been contemplated as one of the strategies for its conservation. Since 1992 global initiatives such as the Convention on Biological Diversity postulates concepts that linked education and nature conservation. The main objective of this research work is to test the level of assimilation of extracurricular scientific knowledge by primary school pupils. The method chosen for the content was, on the one hand, a master class intervention with an interactive presentation on a digital whiteboard. Third cases were chosen. Each case consisted of a presentation of the current status of a species of fauna present in Spain. On the second part, students were asked to write an essay and to illustrate the experience during the presentation. Regarding the essays, students showed that they were more attracted to the first species that was presented (Iberian lynx) in a proportion of over 45% of cases. The “Endangered species” concept appeared in more than 77% of the texts reviewed. In terms of drawings, almost 55% of the responses seem to devote more attention to the second species described (Testudo graeca [...] Read more.

Biodiversity is related to a global problem: its destruction, a fact supported by scientific authorities. It is not trivial that educational dimension has been contemplated as one of the strategies for its conservation. Since 1992 global initiatives such as the Convention on Biological Diversity postulates concepts that linked education and nature conservation. The main objective of this research work is to test the level of assimilation of extracurricular scientific knowledge by primary school pupils. The method chosen for the content was, on the one hand, a master class intervention with an interactive presentation on a digital whiteboard. Third cases were chosen. Each case consisted of a presentation of the current status of a species of fauna present in Spain. On the second part, students were asked to write an essay and to illustrate the experience during the presentation. Regarding the essays, students showed that they were more attracted to the first species that was presented (Iberian lynx) in a proportion of over 45% of cases. The “Endangered species” concept appeared in more than 77% of the texts reviewed. In terms of drawings, almost 55% of the responses seem to devote more attention to the second species described (Testudo graeca). An attempt was made to offer rigorous, structured information related to different aspects of natural reality in order to contemplate the broadest possible vision. The example of an instructional intervention presented here aims to be an alternative to other transmissive teaching models. Likewise, the linking of abstract concepts with socio-cultural reality proved to be a successful strategy to reinforce knowledge about natural biodiversity, endangered species or threat factors.

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Open Access October 11, 2023

Quality of Life Assessment of Health Record Professionals Working in a Tertiary Health Facility, during the COVID 19 Pandemic in South Western Nigeria

Oluwaseun Emmanuel ODIPE, Mela DANJIN, Lateef Olabisi OKELEJI, Oluwayemisi Hope ADEWOLE

Current Research in Public Health 2023, 3(2), 128-138. DOI: 10.31586/crph.2023.741

Abstract Background: There is paucity of data on health-related quality of life (HRQoL) among Health Information Managers/Health Record Officers (HROs) in the Nigeria health system. Hence, this study investigated the impact of the COVID-19 pandemic on health-related quality of life (QoL) among HROs in Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Nigeria. Methods: A [...] Read more.

Background: There is paucity of data on health-related quality of life (HRQoL) among Health Information Managers/Health Record Officers (HROs) in the Nigeria health system. Hence, this study investigated the impact of the COVID-19 pandemic on health-related quality of life (QoL) among HROs in Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Nigeria. Methods: A cross-sectional study was conducted in the University Hospital, where a total of 52 health record officers were purposively sampled. Relevant data were collected using the Short Form survey (SF-36v2) questionnaire. One-way ANOVA was used to determine mean group differences across the nine and the two QoL (physical and mental) summary domains based on respondents’ socio-demographics, while level of significance was set at 0.05. Results: All the QoL sections of the instrument used yielded an α-Cronbach’s score of > 0.70. Analysis of some QoL physical component dimensions showed that; Bodily pain (BP) was found to be significantly (P=0.032) associated with marital status, Physical functioning (PF) with gender (P=0.023), and general health (GH) with age group (P=00.025) and highest level of education (P=0.023). On the other hand, mental health component analysis revealed that Social Functioning (SF) was associated with age group (P=014), Role limitation (RE) with marital status (P=0.048), highest level of education (P=0.048) and years of service (P=0.015) etc. Conclusion: The QoL among HROs studied was generally above average, and demographic characteristics such as age, gender and marital status significantly influence QoL. Health managers and stakeholders should consider some of the factors identified in managing HROs.

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Open Access October 07, 2023

A Systematic Review of Observational Studies Focusing on Impact of Telehealth Consultation in Osteoporosis Management during the Pandemic

Samia Amin, Oishi Barua, Farjana Masud ; Sumaiya Monjur, Tahsin Munajja, Ashish Joshi

Current Research in Public Health 2023, 3(2), 119-127. DOI: 10.31586/crph.2023.768

Abstract Background: The COVID-19 pandemic disrupted routine osteoporosis care due to clinic closures and limited in-person consultations. Telehealth emerged as an alternative model enabling remote care delivery and monitoring. However, previous reviews on telehealth either did not include the pandemic period or had a limited focus in scope. Evidence synthesized specifically for osteoporosis care [...] Read more.

Background: The COVID-19 pandemic disrupted routine osteoporosis care due to clinic closures and limited in-person consultations. Telehealth emerged as an alternative model enabling remote care delivery and monitoring. However, previous reviews on telehealth either did not include the pandemic period or had a limited focus in scope. Evidence synthesized specifically for osteoporosis care during the pandemic is needed but lacking. Methods: We systematically searched PubMed, MEDLINE, EMBASE, PsycINFO, Web of Science, and CINAHL for studies on telehealth for osteoporosis published between January 2021 and March 2023. Five studies met the inclusion criteria of: osteoporosis population, telehealth intervention, and COVID-19 pandemic timeframe. Data was extracted on study characteristics, COVID-19 outcomes, osteoporosis status, telehealth purpose, patient satisfaction, and clinical outcomes. Result: The five studies showed telehealth was used for monitoring data, delivering test results, adjusting medications, and assessments. Osteoporosis prevalence among telehealth users ranged 30-100%. High patient satisfaction was reported with telehealth versus in-person care. No major differences occurred in medication delays or fractures between telehealth and in-person groups. Conclusion: This review found telehealth enables effective osteoporosis care and monitoring during the pandemic, with high patient and provider satisfaction. However, more robust randomized controlled trials are needed to establish stronger evidence around telehealth's impacts on clinical osteoporosis outcomes. Implications: Though promising, further high-quality studies will help clarify telehealth's role in improving osteoporosis care and outcomes. Findings inform guidelines on integrating telehealth into routine management. Evidence on user perspectives optimizes telehealth implementation policies.

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Systematic Review

Open Access August 05, 2023

Structural controls mineralization in strike-slip fault terminals, case study: Kaybarkuh region in East of Iran

Vahid Khademi, Mahmoud RezaHeyhat, Mohammad Mahdi Khatib, Mohammad Hossein Zarrinkoub, HosseinHadizadeh Khader

World Journal of Geomatics and Geosciences 2023, 3(1), 13-21. DOI: 10.31586/wjgg.2023.695

Abstract In this study, we have investigated the status of faults in terms of precession and subsequence, and their relationship with vein mineralization in Kaybarkuh intrusive body in East of Iran. At least, three generations of faults are evidenced in Dasht-e-Bayaz (DB) fault terminal. During formation of faults, the stress orientation in the region has changed at least once probably due to DB fault [...] Read more.

In this study, we have investigated the status of faults in terms of precession and subsequence, and their relationship with vein mineralization in Kaybarkuh intrusive body in East of Iran. At least, three generations of faults are evidenced in Dasht-e-Bayaz (DB) fault terminal. During formation of faults, the stress orientation in the region has changed at least once probably due to DB fault evolution. Mineralization, especially gold and copper, is formed along the third-generation faults and sometimes on the fault surfaces. It can be predicted that mineralization also happened in the tensioned area of Kal-Shur covered by salt playa and Quaternary sediments, which requires subsurface and geophysics studies.

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Open Access May 10, 2023

Knowledge of Obstetric Warning Signs and Associated Risks among Saudi Pregnant Women

Najlaa Al-Nayef, Mufareh Asiri, Ahmad Haimour, Marwa Baghdady, Feras Abuerwak

Universal Journal of Obstetrics and Gynecology 2023, 1(1), 22-32. DOI: 10.31586/ujog.2023.680

Abstract Women must be aware of the risk factors of pregnancy complications and the negative maternal and fetal health consequences to take preventative measures and management strategies that will result in a successful pregnancy. This study aimed to assess the Level of Knowledge about obstetric warning signs and the associated factors among pregnant Saudi women attending antenatal care in a tertiary care [...] Read more.

Women must be aware of the risk factors of pregnancy complications and the negative maternal and fetal health consequences to take preventative measures and management strategies that will result in a successful pregnancy. This study aimed to assess the Level of Knowledge about obstetric warning signs and the associated factors among pregnant Saudi women attending antenatal care in a tertiary care maternity set-up in Riyadh City. Data for this cross-sectional study were obtained using a structured questionnaire from eligible pregnant women admitted to King Saud Medical City (KSMC) between August 2020 and March 2021. Data were analyzed using descriptive and inferential statistics. Out of a minimum estimated sample size of 170, researchers recruited 362 participants. As observed, only 92 people, or 25.4%, had enough knowledge about various educational levels. The majority (91.2%) lived in villages, had no history of chronic disease (74.0%), and said that it took them at least 30 minutes to commute from their home to the hospital (69.3%). Two hundred two (55.7%) lacked appropriate knowledge, although most women (76.2%) had one to four pregnancies. Poor psychological health resulted from 37 people's (10.2%) inadequate Awareness. Even though 139 (38.4%) had spent more than 15 minutes receiving education from medical staff and 200 (61.5%) had attended the prenatal care clinic more than four times, most lacked adequate knowledge. The variables education level (P=0.000), working status (P=0.022), and place of residence (P=0.044) showed a statistically significant association with the knowledge level, also only education level statistically significantly affected the likelihood of knowledge gaps. In conclusion, early identification of obstetric warning signs and associated risk factors of pregnancy complications is integral to prevention.

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Open Access June 23, 2022

Priority tree and shrubs for use in Landscape Architecture based on the dynamic states of native vegetation with the highest ecological value in mainland Portugal

Mauro Raposo, Carlos Pinto-Gomes, Ricardo Quinto-Canas

Research Journal of Ecology and Environmental Sciences 2022, 2(1), 46-57. DOI: 10.31586/rjees.2022.234

Abstract The reduction of the native forests coverage in mainland Portugal increased in the past centuries, leading to a marked decrease in biodiversity in general, especially on typical species of mature forest environments. However, urban biodiversity seems to resist more effectively than rural to disturbances due to the lower incidence of fires, as well as to agriculture expansion. Thus, in this work, [...] Read more.

The reduction of the native forests coverage in mainland Portugal increased in the past centuries, leading to a marked decrease in biodiversity in general, especially on typical species of mature forest environments. However, urban biodiversity seems to resist more effectively than rural to disturbances due to the lower incidence of fires, as well as to agriculture expansion. Thus, in this work, we analyzed the dynamics of the natural vegetation potential in each biogeographic sector, and selected, based on the evolutionary stages of the vegetation, a set of priority taxa for conservation. The criteria used are intended to highlight plants with ornamental value, but at the same time, some of them have high patrimonial value, belonging to the Red List of Vascular Flora of Mainland Portugal or protected by Annexes II, IV and V of the Sectorial Plan of the Natura 2000 Network at the European level. Our analysis resulted in the identification of 62 plants that can be increased in public spaces in order to improve their conservation status. For each biogeographic sector, the plants best adapted to the local edaphoclimatic conditions are presented. Forest habitats can now, through micro-reserves in urban areas, ensure their long-term conservation and greater awareness among the population. An integrated planning, where the socio-ecological strategy is designed for the long term, will benefit the quality of life of citizens in an urban environment. Furthermore, the creation of micro-reserves in urban parks (gardens) can prevent the extinction of many botanical values in the landscapes of the western Mediterranean Basin.

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Open Access May 04, 2022

First contribution to the ethnobotanical knowledge in the Peloritani Mounts (NE Sicily)

Gianmarco Tavilla, Alessandro Crisafulli, Veronica Ranno, Rosa Maria Picone, Fatima Zahrae Redouan, Gianpietro Giusso del Galdo

Research Journal of Ecology and Environmental Sciences 2022, 2(3), 1-34. DOI: 10.31586/rjees.2022.201

Abstract This paper presents the results of an ethnobotanical survey carried out in the Peloritani Mounts (NE Sicily). This investigation aims to illustrate the first record known of the traditional uses of plants in this territory through the case study of a small rural suburb named Tipoldo (Messina). The data were collected from 20 informants over the age of 66, who were mainly farmers and shepherds, and were analyzed using two quantitative ethnobotanical indicators. For each plant was reported the Latin name, life form, vernacular name, parts used, ethnobotany category, claimed uses, status, and their relative indexes. Based on semi-structured interviews carried out between February 2017 and May 2018, a listing was compiled of 126 wild plants belonging to 51 families, the most predominant being Asteraceae (19 species) and Fabaceae (15 species). The most common ethnobotanical uses reported are medicinal (30%) and agropastoral use (19%). Among the preparation methods indicated, leaves (39%) were the most commonly used parts of the plants, while the species most mentioned in connection with ethnobotanical applied indexes were: Crepis vesicaria, Dittrichia graveolens, Hypochaeris radicata, Salvia Rosmarinus and Clinopodium nepeta [...] Read more.

This paper presents the results of an ethnobotanical survey carried out in the Peloritani Mounts (NE Sicily). This investigation aims to illustrate the first record known of the traditional uses of plants in this territory through the case study of a small rural suburb named Tipoldo (Messina). The data were collected from 20 informants over the age of 66, who were mainly farmers and shepherds, and were analyzed using two quantitative ethnobotanical indicators. For each plant was reported the Latin name, life form, vernacular name, parts used, ethnobotany category, claimed uses, status, and their relative indexes. Based on semi-structured interviews carried out between February 2017 and May 2018, a listing was compiled of 126 wild plants belonging to 51 families, the most predominant being Asteraceae (19 species) and Fabaceae (15 species). The most common ethnobotanical uses reported are medicinal (30%) and agropastoral use (19%). Among the preparation methods indicated, leaves (39%) were the most commonly used parts of the plants, while the species most mentioned in connection with ethnobotanical applied indexes were: Crepis vesicaria, Dittrichia graveolens, Hypochaeris radicata, Salvia Rosmarinus and Clinopodium nepeta. These practices are presently performed only by a few elderly people, who rely on plants solely for a few activities. Furthermore, ethnobotanical studies are fundamental to clear up the knowledge on the traditional plant uses that are still current in this part of Sicily, to preserve this cultural heritage for future generations.

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Open Access June 16, 2021

Evaluation of the Effect of Azospirillum brasilense and Mycorrhizal Fungi of the Soil in Yacón Grown in a Greenhouse

Di Barbaro Gabriela, Andrada Horacio, Del Valle Eleodoro, Brandan de Weht Celia

Open Journal of Agricultural Research 2021, 1(1), 8-13. DOI: 10.31586/ojar.2021.010102

Abstract In order to evaluate the effect of Azospirillum brasilense and mycorrhizal fungi in the soil on the nutrition of the yacon crop (Smallanthus sonchifolius [(Poeppig & Endlicher) H. Robinson]), determinations of agronomic parameters and the health status of the plants were carried out, under greenhouse conditions. The tests were carried out at the time of the implantation of the culture: the propagules were inoculated with A. brasilense and with native mycorrhizal fungi, generating four treatments, including the control and the co-inoculation of the consortium of the microorganisms under study (T0: control or control without inoculation; T1: inoculation with native A. brasilense; T2: inoculation with native mycorrhizal fungi and T3: joint inoculation with A. brasilense and native mycorrhizal fungi. The results indicate that co-inoculation with A. brasilense [...] Read more.

In order to evaluate the effect of Azospirillum brasilense and mycorrhizal fungi in the soil on the nutrition of the yacon crop (Smallanthus sonchifolius [(Poeppig & Endlicher) H. Robinson]), determinations of agronomic parameters and the health status of the plants were carried out, under greenhouse conditions. The tests were carried out at the time of the implantation of the culture: the propagules were inoculated with A. brasilense and with native mycorrhizal fungi, generating four treatments, including the control and the co-inoculation of the consortium of the microorganisms under study (T0: control or control without inoculation; T1: inoculation with native A. brasilense; T2: inoculation with native mycorrhizal fungi and T3: joint inoculation with A. brasilense and native mycorrhizal fungi. The results indicate that co-inoculation with A. brasilense and native mycorrhizal fungi increased plant growth in height, leaf area, biomass, dry matter and yields significantly in greenhouse production. It was determined that the application of the selected microorganisms has a plant growth promoting effect, increasing growth and productivity, greenhouse grown yacón.

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Article

Open Access November 28, 2025

Determinants of the Carotid Tortuosity Index: Evidence from Digital Subtraction Angiography

Fritz Sumantri Usman, Evlyne Erlyana Suryawijaya, I Made Mahardika Yasa, Hendra Hardiansyah, Merlin Prisilia Kastilong, Leny Kurnia

World Journal of Clinical Medicine Research 2025, 5(1), 80-87. DOI: 10.31586/wjcmr.2025.6216

Abstract Introduction: Stroke remains one of the leading causes of death and disability worldwide, with ischemic stroke accounting for most cases. Structural vascular factors such as carotid artery tortuosity have gained attention as potential markers of vascular aging and cerebrovascular risk. The carotid tortuosity index (CTI), defined as the ratio of actual vessel length to the straight-line [...] Read more.

Introduction: Stroke remains one of the leading causes of death and disability worldwide, with ischemic stroke accounting for most cases. Structural vascular factors such as carotid artery tortuosity have gained attention as potential markers of vascular aging and cerebrovascular risk. The carotid tortuosity index (CTI), defined as the ratio of actual vessel length to the straight-line distance between two fixed points, provides a quantitative measure of arterial curvature. A CTI value of ≥1.2 indicates pathological tortuosity. Although noninvasive modalities such as CTA and MRA are frequently used, digital subtraction angiography (DSA) remains the gold standard for evaluating vessel geometry due to its higher spatial precision. This study aimed to determine the association of age, sex, and hypertension with CTI measured by DSA. Methods: A cross-sectional study was conducted from November to December 2025 at the Neurointervention Clinic, RS Pelni Jakarta, Indonesia, involving 61 adult patients who underwent carotid DSA. CTI was measured bilaterally using digital imaging software and classified as <1.2 (non-tortuous) or ≥1.2 (tortuous). Clinical data, including age, sex, and hypertension status, were collected from medical records and analyzed using bivariate tests. Results: Older age (≥65 years), female sex, and hypertension were significantly associated with higher CTI values on both carotid sides. Tortuosity was more common among hypertensive patients and elderly females, indicating the influence of vascular remodeling and chronic hemodynamic stress. Conclusion: Carotid tortuosity increases with age, hypertension, and female sex. DSA-based CTI measurement provides a reliable and precise approach for evaluating vascular changes associated with cerebrovascular risk.

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Open Access November 06, 2025

Ventral Attention Network Resting State Functional Connectivity: Psychosocial Correlates among US Adolescents

Shervin Assari, Alexandra Donovan, Babak Najand, Golnoush Akhlaghipour, Mario F Mendez

Journal of Biomedical and Life Sciences 2025, 5(2), 122-138. DOI: 10.31586/jbls.2025.6208

Abstract Background: Resting-state functional MRI (rsfMRI) provides insights into large-scale brain network organization associated with cognitive control, emotion regulation, and attentional processes. The ventral attention network (VAN) is a key salience-driven network that supports attentional re-orienting to behaviorally relevant stimuli. However, little is known about how VAN [...] Read more.

Background: Resting-state functional MRI (rsfMRI) provides insights into large-scale brain network organization associated with cognitive control, emotion regulation, and attentional processes. The ventral attention network (VAN) is a key salience-driven network that supports attentional re-orienting to behaviorally relevant stimuli. However, little is known about how VAN resting state functional connectivity varies by demographic, socioeconomic, psychosocial, and behavioral factors during early adolescence. Objective: To examine associations between VAN rsfMRI connectivity and multiple demographic, socioeconomic, psychosocial, and behavioral characteristics. Methods: Data came from the baseline and early follow-up waves of the Adolescent Brain Cognitive Development (ABCD) Study. The analytic sample included youth with high-quality baseline rsfMRI data and complete socioeconomic and psychosocial measures. The primary outcome was mean resting-state functional connectivity within the VAN across subcortical and cortical regions of interest (ROIs). Bivariate correlations were computed between VAN connectivity and demographic (age, sex, puberty, race/ethnicity), socioeconomic (income, parental education, marital status, neighborhood income), psychosocial (trauma, discrimination, financial difficulty), trait (impulsivity), and behavioral variables (body mass index, depression, suicide, prodromal symptoms, and substance use). Unadjusted bivariate correlations and adjusted logistic regressions were used for data analysis. Results: VAN connectivity showed small but significant correlations with multiple contextual factors. Higher household income, parental education, and neighborhood affluence were associated with greater connectivity, whereas Black race and Hispanic ethnicity were related to lower connectivity. Youth reporting higher discrimination and financial difficulty exhibited weaker VAN connectivity. Greater VAN connectivity was negatively associated with impulsive reward-driven trait (drive), prodromal symptoms, BMI, and marijuana and alcohol use. Associations between VAN connectivity and suicide, depression, marijuana use, and alcohol use remained significant in age and sex adjusted models. Conclusions: VAN connectivity reflects subtle neural correlates of socioeconomic and psychosocial context in early adolescence. Our results underscore the importance of integrating structural and contextual factors in interpreting brain-behavior associations across diverse populations. These findings are suggestive of stable socioeconomic and psychosocial correlates of network efficiency.

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Open Access October 29, 2025

Mean Diffusivity of the Left Caudal Anterior Cingulate Cortex and Past Major Depressive Disorder in Adolescents: Evidence from the ABCD Study

Shervin Assari, Alexandra Donovan, Babak Najand, Golnoush Akhlaghipour, Mario F Mendez

Journal of Cellular Neuroscience 2025, 2(1), 52-67. DOI: 10.31586/jcn.2025.6206

Abstract Background: Adolescence is a critical developmental stage for the emergence of major depressive disorder (MDD). Structural and diffusion neuroimaging studies have highlighted the anterior cingulate cortex (ACC) as a key region implicated in emotion regulation, stress reactivity, and mood processing. However, few studies have examined whether microstructural characteristics of the ACC, [...] Read more.

Background: Adolescence is a critical developmental stage for the emergence of major depressive disorder (MDD). Structural and diffusion neuroimaging studies have highlighted the anterior cingulate cortex (ACC) as a key region implicated in emotion regulation, stress reactivity, and mood processing. However, few studies have examined whether microstructural characteristics of the ACC, reflected by mean diffusivity (MD) within gray matter–white matter (GM–WM) contrast regions, are associated with depression in early adolescence. Objective: To examine whether mean diffusivity (MD) within the GM–WM contrast of the left caudal anterior cingulate cortex (ACC) is associated with a past diagnosis of MDD among adolescents in the Adolescent Brain Cognitive Development (ABCD) Study, after accounting for demographic, socioeconomic, and adversity-related factors. Methods: Data were drawn from adolescents with diffusion MRI–derived mean diffusivity measures and diagnostics. The independent variable was mean diffusivity (MD) of the GM–WM contrast in the left caudal ACC. The primary outcome was past MDD diagnosis based on structured psychiatric assessments. Covariates included age, sex, socioeconomic status (SES), and exposure to adverse childhood experiences (ACEs). Logistic regression models tested the association between ACC MD and past MDD. A secondary model evaluated the relationship between ACC MD and past suicide attempt. Results: Mean diffusivity of the left caudal ACC was associated with the odds of past MDD, independent of age, sex, SES, and adversity exposure. In contrast, ACC mean diffusivity was not associated with a history of suicide attempt. Conclusions: Increased mean diffusivity in the caudal ACC may indicate microstructural alterations associated with depressive vulnerability in adolescence. ACC tissue integrity may serve as a sensitive neural correlate of early-onset depression.

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Open Access October 20, 2025

From Subordination to Empowerment: The Journey of Yi Women in Daliangshan

Kam Lo

Universal Journal of Social Sciences and Humanities 2025, 5(1), 18-25. DOI: 10.31586/ujssh.2025.6198

Abstract This paper examines the transformation of Yi women’s social status in Daliangshan, Sichuan Province. It analyzes historical practices—including child marriage (wawaqin [...] Read more.

This paper examines the transformation of Yi women’s social status in Daliangshan, Sichuan Province. It analyzes historical practices—including child marriage (wawaqin) and the tradition of high bridal gifts—along with the role of education, economic modernization, and cultural advocacy initiatives. The study situates these developments within the framework of the United Nations Sustainable Development Goals (SDGs), focusing on gender equality, poverty alleviation, and equitable development. Field interviews, observations, and community-based projects inform this analysis, which highlights both progress and persisting challenges for Yi women.

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Open Access October 17, 2025

Street Foods in Urban Spaces: Analyzing the Determinants of Consumer Patronage in the Koforidua Metropolis

Ernestina Oduro, Gilbert Owiah Sampson, Elizabeth Kafui Senya

Open Journal of Food and Nutrition 2025, 4(1), 12-20. DOI: 10.31586/ojfn.2025.6199

Abstract Eating at home remains very much ingrained in Ghanaian culture but rapid urbanization coupled with busy lifestyle and advancement in technology has greatly changed the way of life of many Ghanaians. These changes have altered the tradition of cooking and eating at home. The study focused on the determinants of consumer patronage of street foods in the Koforidua Metropolis. The target population [...] Read more.

Eating at home remains very much ingrained in Ghanaian culture but rapid urbanization coupled with busy lifestyle and advancement in technology has greatly changed the way of life of many Ghanaians. These changes have altered the tradition of cooking and eating at home. The study focused on the determinants of consumer patronage of street foods in the Koforidua Metropolis. The target population comprised customers that patronize the street foods in Koforidua Metropolis. From the target population, 197 consumers were selected using convenience. A structured self-administered questionnaire was utilized to gather the required data. The data collected were coded and analyzed with the help of SPSS-23. The findings revealed that food characteristics and social status determines consumers patronage of street food. It became evident that age (r=0.261, p<0.01), age (r=-0.318, P<0.01), educational level (r=0.144, P<0.05) and occupation (r=-0.477, P<0.01) of consumers has a significant influence on the decision and patronage of street food. The study concluded that food characteristics and social factors are major determinants of consumers patronage of street foods. It is recommended that Food and Drug Authority (FDA), other stakeholders, and street food vendors work cooperatively to establish laws that capture the distinctive and diverse foods sold on the street and their various preparation, storage, and sale methods in order to ensure that food preparation and sales are safe and hygienic.

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Open Access October 14, 2025

Research Development of Disease Pain in Elderly Patients with Type 2 Diabetes

Wenyang Liu, Hongyang Liu

World Journal of Nursing Research 2025, 4(1), 126-133. DOI: 10.31586/wjnr.2025.6125

Abstract This paper describes the current status of research on disease distress in elderly type 2 diabetic patients at home and abroad, with a view to developing targeted interventions for diabetic patients, improving self-management behavioral ability and quality of life in elderly type 2 diabetic patients, and improving patients' glycemic control.

This paper describes the current status of research on disease distress in elderly type 2 diabetic patients at home and abroad, with a view to developing targeted interventions for diabetic patients, improving self-management behavioral ability and quality of life in elderly type 2 diabetic patients, and improving patients' glycemic control.

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Review Article

Open Access October 06, 2025

The symbolism and cultural significance of “Tuei” beverage among the Fantes in Ghana

Patience Darko, Juliana Opoku Yeboah, Francesca Anowie, Esther Kumea Ashun, Florentina Ajibisa, Manasseh Edison Komla Amu

Open Journal of Food and Nutrition 2025, 4(1), 1-11. DOI: 10.31586/ojfn.2025.6160

Abstract Background: Traditional foods, once carriers of cultural identity and heritage, are being quietly replaced as globalization and modern ideals redefine the choices of younger generations. This ethnographic study investigated the cultural meaning and symbolism of Tuei, an indigenous maize-based beverage, among the Fante people in the Central Region of Ghana. The study aimed to document how Tuei is rooted in Fante social and ceremonial life, exploring its role as a symbol of identity, continuity, and tradition. Methods: A qualitative approach with semi-structured interviews were done with 7 participants involving one cultural expert, three elders, and three local producers. Results: The findings revealed that Tuei has a significant role in rites of passage such as marriages, funerals, and naming ceremonies, where it functions as a marker of status and social cohesion. It was daily used as a gesture of hospitality and symbol of community unity. Additionally, the study found that the nutritional benefits of Tuei was rich in essential nutrients from maize, which contribute to energy provision and digestion. Some participants also reported its traditional use in promoting digestive health and general well-being. Again, Tuei was influenced by modernization which has reduced its consumption among younger generations and elite groups. Conclusions: The study concluded with recommendations to strengthen these preservation efforts through educational initiatives, the integration of Tuei [...] Read more.

Background: Traditional foods, once carriers of cultural identity and heritage, are being quietly replaced as globalization and modern ideals redefine the choices of younger generations. This ethnographic study investigated the cultural meaning and symbolism of Tuei, an indigenous maize-based beverage, among the Fante people in the Central Region of Ghana. The study aimed to document how Tuei is rooted in Fante social and ceremonial life, exploring its role as a symbol of identity, continuity, and tradition. Methods: A qualitative approach with semi-structured interviews were done with 7 participants involving one cultural expert, three elders, and three local producers. Results: The findings revealed that Tuei has a significant role in rites of passage such as marriages, funerals, and naming ceremonies, where it functions as a marker of status and social cohesion. It was daily used as a gesture of hospitality and symbol of community unity. Additionally, the study found that the nutritional benefits of Tuei was rich in essential nutrients from maize, which contribute to energy provision and digestion. Some participants also reported its traditional use in promoting digestive health and general well-being. Again, Tuei was influenced by modernization which has reduced its consumption among younger generations and elite groups. Conclusions: The study concluded with recommendations to strengthen these preservation efforts through educational initiatives, the integration of Tuei into cultural festivals, and ongoing community engagement to ensure the continuity of this cultural practice.

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Open Access October 04, 2025

Unequal Burden of Loss of a Loved One in Non-Hispanic Black and White Californians

Shervin Assari, Sharon Cobb, Mohsen Bazargan

Open Journal of Psychology 2025, 5(1), 52-63. DOI: 10.31586/ojp.2025.6197

Abstract Purpose: Although the effect of loss of a loved one on depression is well established, very limited knowledge exists on racial differences in this effect. Aim: In the current study we compared Non-Hispanic White (NHW) and Non-Hispanic Black (NHB) Californians for the effects of loss of a loved one on depression in a representative sample of adults in California. Methods: This cross-sectional study used data from the Survey of California Adults on Serious Illness and End-of-Life 2019. Overall, 1603 people entered our study. We compared 901 (56.2%) NHB and 702 (43.8%) NHW adults (age 18 and older). Race/ethnicity, demographics (age and gender), socio-economic factors (education, income, employment, and marital status), religiosity, and health (self-rated health and number of chronic medical conditions), and depression were measured. To perform data analysis, we used logistic regression models. Results: In the pooled sample, loss of a loved one was not associated with self-reported depression, net of all covariates. Race, however, interacted with loss of a loved one on depression, suggesting a larger association for NHBs compared to NHWs. In race-specific models, loss of a loved one predicted depression for NHBs (OR = 1.54) but not NHWs (OR [...] Read more.

Purpose: Although the effect of loss of a loved one on depression is well established, very limited knowledge exists on racial differences in this effect. Aim: In the current study we compared Non-Hispanic White (NHW) and Non-Hispanic Black (NHB) Californians for the effects of loss of a loved one on depression in a representative sample of adults in California. Methods: This cross-sectional study used data from the Survey of California Adults on Serious Illness and End-of-Life 2019. Overall, 1603 people entered our study. We compared 901 (56.2%) NHB and 702 (43.8%) NHW adults (age 18 and older). Race/ethnicity, demographics (age and gender), socio-economic factors (education, income, employment, and marital status), religiosity, and health (self-rated health and number of chronic medical conditions), and depression were measured. To perform data analysis, we used logistic regression models. Results: In the pooled sample, loss of a loved one was not associated with self-reported depression, net of all covariates. Race, however, interacted with loss of a loved one on depression, suggesting a larger association for NHBs compared to NHWs. In race-specific models, loss of a loved one predicted depression for NHBs (OR = 1.54) but not NHWs (OR = 0.99). Conclusion: There are differences between NHBs and NHWs in the effect of loss of a loved one on depression. NHBs show a stronger association between loss of a loved one and depression than NHWs. This result is not in line with the NHB mental health paradox or with NHB resilience but is consistent with the notion that social relations may be more salient for NHBs than for NHWs.

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Open Access October 01, 2025

Place-Based Diminished Returns of Economic Resources in Rural America: A Framework for Understanding Geography-Conditioned Inequality

Shervin Assari, John Ashley Pallera, Babak Najand, Mojgan Azadi, Hossein Zare

Journal of Social Mathematical & Human Engineering Sciences 2025, 4(1), 1-14. DOI: 10.31586/jsmhes.2025.6067

Abstract Background: Socioeconomic status (SES) is widely associated with improved health, behavioral, and educational outcomes. However, emerging research suggests that these benefits are not uniformly experienced across populations or contexts. The theory of Marginalization-related Diminished Returns (MDRs) has primarily focused on racial and ethnic disparities, showing that individuals from [...] Read more.

Background: Socioeconomic status (SES) is widely associated with improved health, behavioral, and educational outcomes. However, emerging research suggests that these benefits are not uniformly experienced across populations or contexts. The theory of Marginalization-related Diminished Returns (MDRs) has primarily focused on racial and ethnic disparities, showing that individuals from racially marginalized groups often experience weaker protective effects of SES. There is a lack of evidence on geography—particularly rural residence—as a moderator of SES effects. Objective: This review explores how place, especially rural contexts in the U.S., shapes the extent to which SES translates into improved outcomes. We extend the MDRs framework to include place-based and geography-based marginalization, arguing that even among non-Hispanic White populations, rural residence can lead to diminished returns on education, income, and other forms of capital. Content: Drawing on theoretical models such as Fundamental Cause Theory and Bronfenbrenner’s Ecological Systems Theory, and synthesizing empirical findings from studies of academic achievement, substance use, and educational aspirations, this review highlights how structural disadvantages in rural areas weaken the effectiveness of individual and family-level resources. Conclusion: Rural health and educational disparities are not solely due to a lack of resources but may also reflect systemic conditions that erode the value of existing resources. Policy interventions must be place-aware and address the contextual constraints that limit opportunity. Future research should more explicitly test how geography moderates the effects of SES across a range of outcomes and populations.

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Perspective Article

Open Access September 18, 2025

Does Stress Explain the Effects of Sexual/Gender Minority Status on Children’s Behavioral and Emotional Risk?

Shervin Assari, Alexandra Donovan, John Ashley Pallera, Gandom Assari, Babak Najand, Kamiar Alaei, Arash Alaei

Open Journal of Psychology 2025, 5(1), 38-51. DOI: 10.31586/ojp.2025.6188

Abstract Background: Sexual and gender minority (SGM) youth are at elevated risk for adverse mental health and substance use outcomes. Stressors such as family conflict, discrimination, and trauma have been suggested as possible mediators of these disparities. Aims: This study examined whether family conflict, discrimination, and trauma mediate the associations between SGM identity and [...] Read more.

Background: Sexual and gender minority (SGM) youth are at elevated risk for adverse mental health and substance use outcomes. Stressors such as family conflict, discrimination, and trauma have been suggested as possible mediators of these disparities. Aims: This study examined whether family conflict, discrimination, and trauma mediate the associations between SGM identity and adverse outcomes, including suicide attempt, major depressive disorder (MDD), nicotine use, and marijuana use. Methods: Participants were children from the Adolescent Brain Cognitive Development (ABCD) study. SGM identity was reported at baseline, while outcomes included past MDD and suicide attempts as well as future nicotine and marijuana use. Structural equation modeling (SEM) was used to test both direct and indirect pathways linking SGM identity to mental health and behavioral outcomes. Results: No significant mediation was found through family conflict, discrimination, or trauma. Instead, effects of SGM identity were primarily direct: SGM youth had higher odds of past suicide attempts and MDD, as well as future marijuana use, but not future nicotine use. Stressor variables, however, were independently associated with outcomes. Discrimination predicted all outcomes; trauma was positively associated with suicide, nicotine, and marijuana use but not MDD; and family conflict predicted all outcomes except MDD. Conclusion: Family conflict, discrimination, and trauma did not mediate SGM disparities in mental health and substance use, but each emerged as an independent predictor of risk. These findings highlight the complexity of mechanisms underlying SGM-related disparities and suggest the need for future research to explore additional pathways and contextual influences.

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Open Access August 22, 2025

Status Epilepticus in Sub-Saharan Africa: A Literature Review on Epidemiological Challenges, Socio-Cultural Barriers, and Public Health Impact

Marcellin Bugeme, Olivier Mukuku *, Emmanuel Kiyana Muyumba, Béatrice Koba Bora

Open Journal of Neuroscience 2025, 3(1), 23-40. DOI: 10.31586/ojn.2025.6161

Abstract This literature review delves deeply into the epidemiology, structural and cultural challenges, and management strategies of status epilepticus (SE) in sub-Saharan Africa (SSA). Incidence rates of SE vary significantly between countries, with notable disparities associated with socio-economic contexts, healthcare infrastructures, and cultural perceptions of epilepsy. The management of SE in this [...] Read more.

This literature review delves deeply into the epidemiology, structural and cultural challenges, and management strategies of status epilepticus (SE) in sub-Saharan Africa (SSA). Incidence rates of SE vary significantly between countries, with notable disparities associated with socio-economic contexts, healthcare infrastructures, and cultural perceptions of epilepsy. The management of SE in this region is often hindered by constraints in medical infrastructure, inadequate access to specialist diagnostics such as electroencephalogram, and limited availability of essential anti-epileptic drugs, which are frequently out of reach for rural populations. These challenges are further exacerbated by the social stigma and cultural beliefs surrounding epilepsy, impeding access to care and widening inequalities. Moreover, the scarcity of qualified medical personnel undermines the efficient and prompt management of this neurological emergency. The review underscores the pressing need to enhance healthcare infrastructures, boost the capabilities of healthcare professionals, and conduct community awareness initiatives to destigmatize epilepsy and lessen prejudice. Additionally, practical recommendations are put forward for enhancing local capacity, fostering equity in care access, and mitigating regional health disparities in SSA.

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Literature Review

Open Access May 05, 2025

Persistent Social Welfare Needs Among Educated Caribbean Black Individuals: Evidence of Minorities' Diminished Returns

Shervin Assari, Babak Najand, Hossein Zare, Amanda Sonnega

Journal of Biomedical and Life Sciences 2025, 5(1), 98-109. DOI: 10.31586/jbls.2025.1189

Abstract Background: Educational attainment is strongly linked to increased employment opportunities, higher income, and greater financial security, making its inverse relationship with reliance on social welfare programs well-documented. However, consistent with the Minorities' Diminished Returns (MDRs) theory, the protective effects of education may be weaker for racial and ethnic minority [...] Read more.

Background: Educational attainment is strongly linked to increased employment opportunities, higher income, and greater financial security, making its inverse relationship with reliance on social welfare programs well-documented. However, consistent with the Minorities' Diminished Returns (MDRs) theory, the protective effects of education may be weaker for racial and ethnic minority groups compared to non-Latino Whites. This study examines whether the impact of educational attainment (measured as years of schooling) on social welfare use differs between Caribbean Black and White adults in the United States, focusing on outcomes since age 18 and in the past year. Objective: To investigate the relationship between years of schooling and the likelihood of using social welfare programs, while exploring whether this association varies between Caribbean Black and White adults, in alignment with the MDRs framework. Methods: Data were derived from the National Survey of American Life (NSAL), a nationally representative dataset with a robust sample of Black and White adults in the United States. The study focused on Caribbean Black and White participants aged 18 and older. Structural equation modeling (SEM) was employed to examine the relationship between years of schooling and social welfare use, adjusting for covariates including age, gender, employment status, and marital status. Interaction terms were used to assess potential differences in the returns of education across racial groups. Results: Higher educational attainment was associated with reduced likelihood of using social welfare programs overall. However, consistent with the MDRs framework, the protective effect of education was weaker for Caribbean Black individuals compared to their White counterparts. Caribbean Blacks with similar levels of education as Whites were more likely to report using social welfare programs since age 18 and in the past year, highlighting diminished returns on education for this population. Conclusion: This study extends the MDRs framework to Caribbean Black populations, a group rarely studied in the U.S., revealing significant disparities in the economic benefits of education. The findings underscore the need for policies that address systemic barriers limiting the economic returns of education for racial and ethnic minorities, including Caribbean Blacks, to promote greater equity in social and economic outcomes.

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Open Access May 05, 2025

To Be Twice as Good to Get Half

Shervin Assari, John Ashley Pallera, Hossein Zare

Journal of Biomedical and Life Sciences 2025, 5(1), 67-83. DOI: 10.31586/jbls.2025.1158

Abstract “To Be Twice as Good to Get Half” is a common mindset among high aspiration and ambition Black individuals in the U.S., capturing the lived reality of Minorities’ Diminished Returns (MDRs). This paper explains that MDRs reflect how, even with high levels of ambition, self-efficacy, education, and income, Black individuals and other marginalized groups do not experience the same protective benefits [...] Read more.

“To Be Twice as Good to Get Half” is a common mindset among high aspiration and ambition Black individuals in the U.S., capturing the lived reality of Minorities’ Diminished Returns (MDRs). This paper explains that MDRs reflect how, even with high levels of ambition, self-efficacy, education, and income, Black individuals and other marginalized groups do not experience the same protective benefits for health and well-being as White populations. Systemic obstacles embedded within U.S. society weaken the expected returns on socioeconomic achievements for racialized individuals, creating a reality where “being twice as good” still results in lesser outcomes. High-SES Black individuals, for instance, continue to face significant risks for adverse outcomes, such as depression and chronic disease, due to structural inequities across domains like labor market discrimination, segregation, and accumulated disadvantage from childhood. Our analysis identifies key mechanisms—including interpersonal discrimination, lower-quality education, and structural racism in sectors like banking, policing, and real estate—that erode the protective effects of SES across racial lines. Mediating factors, such as chronic stress, allostatic load, and epigenetic changes over the life course, further compound these diminished returns, weakening the expected physical and mental health benefits. Drawing on extensive evidence from U.S. national and local datasets and corroborated by international studies, this paper underscores the necessity of policies that dismantle structural barriers rather than relying solely on SES improvements. Recommendations include implementing multi-sectoral policies, recognizing the unique challenges of middle-class non-White populations, and approaching policy with humility, acknowledging that achieving equity is a long-term endeavor. By challenging the “bootstraps” narrative, this paper advocates for structural interventions aimed at genuine health and economic equity for all racial and socioeconomic groups. While we provide an in-depth analysis of MDRs’ phenomena, mechanisms, mediators, and policy implications, the experience is often distilled as, “I have to be twice as good to get half.”

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Open Access May 04, 2025

Educational Attainment Better Protects Non-Latino than Latino People Against Diabetes Mellitus

Shervin Assari, Hossein Zare

Global Journal of Cardiovascular Diseases 2025, 4(1), 95-106. DOI: 10.31586/gjcd.2025.1099

Abstract Background: High educational attainment is a well-recognized protective factor against health problems such as diabetes. However, the theory of Minorities' Diminished Returns (MDRs) suggests that this protective effect is weaker for ethnic minorities compared to non-Latino Whites. This diminished effect is thought to result from structural inequalities, such as lower-quality [...] Read more.

Background: High educational attainment is a well-recognized protective factor against health problems such as diabetes. However, the theory of Minorities' Diminished Returns (MDRs) suggests that this protective effect is weaker for ethnic minorities compared to non-Latino Whites. This diminished effect is thought to result from structural inequalities, such as lower-quality education and fewer occupational opportunities, faced by ethnic minorities. Objective: This study examined the protective effect of years of schooling—used as a proxy for educational attainment—on diabetes mellitus (DM), overall and by ethnicity. Based on the MDRs framework, we hypothesized that the protective effect of education would be weaker for Latino individuals compared to non-Latinos. Methods: Data were drawn from the 2012 wave of the Understanding America Study (UAS), a nationally representative, internet-based panel. The outcome of interest was self-reported doctor diagnosis of DM. Logistic regression models were used to assess the association between educational attainment and DM, with an interaction term to explore differences between Latino and non-Latino individuals. Models were adjusted for age, sex, employment, immigration status, and marital status. Findings were presented as adjusted odds ratios (OR), p-values, and 95% confidence intervals (CIs). Results: Higher educational attainment was associated with lower odds of DM in both Latino and non-Latino individuals (p < 0.001). An interaction between education and ethnicity (p < 0.05) indicated that the protective effect of education was weaker for Latino individuals compared to non-Latinos. Conclusion: The findings align with the MDRs framework, which suggests that the health benefits of education are not equally distributed across ethnic groups. For Latino individuals, structural barriers such as lower educational quality and labor market discrimination may limit the protective effect of education against DM. While education is a key determinant of health, its unequal returns contribute to ethnic health disparities. Policymakers must address structural inequalities in education and employment that disproportionately affect ethnic minorities. Tackling these disparities through multi-sector policy interventions will require bipartisan political support.

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Open Access March 25, 2025

Resting-State Sensory-Motor Connectivity between Hand and Mouth as a Neural Marker of Socioeconomic Disadvantage, Psychosocial Stress, Cognitive Difficulties, Impulsivity, Depression, and Substance Use in Children

Shervin Assari, Alexandra Donovan, Babak Najand, Golnoush Akhlaghipour, Mario F Mendez

Journal of Cellular Neuroscience 2025, 2(1), 31-46. DOI: 10.31586/jcn.2025.1280

Abstract Background: The sensory-motor network is essential for integrating sensory input with motor function and higher-order cognition. Resting-state functional connectivity (rsFC) within this network undergoes significant developmental changes, and disruptions in these connections have been linked to behavioral and psychiatric outcomes. However, the relationship between sensory-motor [...] Read more.

Background: The sensory-motor network is essential for integrating sensory input with motor function and higher-order cognition. Resting-state functional connectivity (rsFC) within this network undergoes significant developmental changes, and disruptions in these connections have been linked to behavioral and psychiatric outcomes. However, the relationship between sensory-motor connectivity, early-life adversity, and later health behaviors remains understudied. Objective: This study examines the associations between rsFC within the sensory-motor network (mouth and hand regions) and key social, psychological, and behavioral factors, including baseline and past socioeconomic status (SES), trauma exposure, family conflict, impulsivity, major depressive disorder (MDD), and future substance use. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) Study, a national sample of U.S. children. Resting-state fMRI data were used to assess functional connectivity within the sensory-motor network. Bivariate analyses examined associations between rsFC in the sensory-motor mouth and hand regions and baseline SES, past SES, childhood trauma exposure, family conflict, impulsivity, and MDD. Longitudinal analyses assessed whether baseline rsFC predicted future substance use. Results: Greater rsFC between the sensory-motor mouth and hand regions was significantly associated with lower SES, higher trauma exposure, and greater family conflict. Increased connectivity was also correlated with older age and more advanced puberty status. Higher rsFC between the sensory-motor mouth and hand regions was linked to greater impulsivity, lower cognitive function, an increased likelihood of MDD, and future marijuana use. Conclusion: These findings suggest that sensory-motor connectivity is sensitive to socioeconomic and psychosocial stressors, with potential long-term implications for mental health and substance use risk. The results highlight the importance of early-life environmental factors in shaping neurodevelopmental trajectories and emphasize the need for targeted interventions to mitigate the effects of adversity on brain function and behavior. Future research should further explore the role of sensory-motor network alterations in behavioral health outcomes as a function of environmental stressors.

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Original Article

Open Access March 12, 2025

Academic Aspirations of 12th Grade Students in the United States: Place-Based Diminished Returns of Parental Education in Rural Areas

Shervin Assari, Gandom Assari, Hossein Zare

Open Journal of Educational Research 2025, 5(2), 65-74. DOI: 10.31586/ojer.2025.6040

Abstract Background: The Motivational Theory of Life-Span Development suggests that individual aspirations are shaped by both internal and external resources. Parental education is a key determinant of educational aspirations, yet its effects may vary by geographic location, demonstrating spatial patterns of Minorities’ Diminished Returns (MDRs). Objectives: This [...] Read more.

Background: The Motivational Theory of Life-Span Development suggests that individual aspirations are shaped by both internal and external resources. Parental education is a key determinant of educational aspirations, yet its effects may vary by geographic location, demonstrating spatial patterns of Minorities’ Diminished Returns (MDRs). Objectives: This study examines the association between parental education and aspirations for graduate or professional education among non-Latino White adolescents, with a specific focus on urban-suburban versus rural differences. Methods: Using data from the 12th-grade cohort of the Monitoring the Future (MTF) 2024 survey, we conducted multivariate analyses to assess the relationship between parental education and aspirations for graduate or professional education. We further examined whether this association was moderated by geographic location (urban-suburban vs. rural) to identify place-based MDRs. Results: Higher parental education was associated with greater aspirations for advanced education; however, this effect was weaker in rural areas compared to urban and suburban settings. These findings highlight that even among non-Latino White adolescents, rural residence diminishes the benefits of socioeconomic resources, providing evidence of place-based MDRs. Conclusion: Rural residents face a dual disadvantage—both lower socioeconomic status and weaker returns on those resources—necessitating targeted interventions beyond resource allocation. To address disparities in educational aspirations in rural areas, policymakers should focus on improving equitable access to educational opportunities and ensuring that these resources translate into comparable outcomes across different social and geographic contexts.

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Open Access March 11, 2025

Why High Income Fails to Reduce E-Cigarette Use: The Knowledge-Attitude Paradox in the SMOKES Study

Shervin Assari, Mohammad Mohammadi, Mohammad Pashmchi, Fatemeh Aghaeimeybodi, John Ashley Pallera

Open Journal of Medical Sciences 2025, 5(1), 59-73. DOI: 10.31586/ojms.2025.6037

Abstract Background: Electronic cigarette (e-cigarette) use and vaping tobacco have increased rapidly worldwide, raising concerns about their health effects, social acceptability, and regulatory challenges. In many countries, e-cigarettes are more commonly used by individuals from higher socioeconomic status (SES) backgrounds, who, in theory, should have greater knowledge about e-cigarettes and [...] Read more.

Background: Electronic cigarette (e-cigarette) use and vaping tobacco have increased rapidly worldwide, raising concerns about their health effects, social acceptability, and regulatory challenges. In many countries, e-cigarettes are more commonly used by individuals from higher socioeconomic status (SES) backgrounds, who, in theory, should have greater knowledge about e-cigarettes and their associated risks. However, it remains unclear why a group with more knowledge about e-cigarette risks would also hold more positive attitudes toward vaping and exhibit higher usage rates — a phenomenon that may represent a knowledge-behavior paradox. Understanding this paradox, along with the complex relationships between e-cigarette knowledge, attitudes, and behaviors, is critical for informing effective public health interventions, campaigns, social media messaging, and regulatory policies. Objectives: This study aimed to evaluate the complex relationship between SES, e-cigarette knowledge, pro-vaping attitudes, and e-cigarette use. Methods: The SMOKES Study (Study of Measurement of Knowledge and Examination of Support for Tobacco Control Policies) used a multi-center, cross-sectional design, collecting data from 2,403 college and university students across 15 provinces in Iran (covering nearly half of the country's provinces). The survey measured family income, age, sex, ethnicity, e-cigarette use, knowledge, and attitudes. Structural Equation Modeling (SEM) was employed to examine the interrelations between SES, knowledge, attitudes, and behavior, while adjusting for age, sex, and ethnic minority status. Results: SEM analysis confirmed the hypothesized paradox. Although greater knowledge about e-cigarettes was linked to less favorable attitudes toward vaping and lower use, pro-vaping attitudes emerged as the strongest predictor of vaping behavior, while knowledge played a weaker protective role. Notably, individuals with higher SES simultaneously showed higher knowledge and, paradoxically, more pro-e-cigarette attitudes and greater usage. Female students and ethnic minority students reported higher correct knowledge and lower pro-vaping attitudes and use. Although age and higher family income were associated with more favorable attitudes, they did not directly predict vaping behavior. These results suggest that for higher SES individuals, poor knowledge is not the main driver of e-cigarette use; rather, their pro-e-cigarette attitudes, which seem to outweigh the influence of knowledge, play a key role. Conclusions: Although individuals from higher SES backgrounds report greater correct knowledge about e-cigarettes, this knowledge does not necessarily translate into reduced positive attitudes or lower usage. This study highlights the complexity of these paradoxical effects and suggests that public health strategies need to go beyond simple education and knowledge-based interventions. Targeted approaches should address industry messaging, challenge misconceptions, and strengthen regulatory efforts to reduce e-cigarette use among young adults, including those from higher SES backgrounds.

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Original Article

Open Access March 09, 2025

Gender Differences in Quit Rates in a Tobacco Cessation Program: In Search of Demographic, Socioeconomic, Health, or Behavioral Explanatory Mechanisms

Payam Sheikhattari, Rifath Ara Alam Barsha, Shervin Assari

Journal of Biomedical and Life Sciences 2025, 5(1), 30-41. DOI: 10.31586/jbls.2025.6017

Abstract Background: Women have consistently shown lower quit rates in tobacco cessation programs compared to men. This gender disparity persists despite comprehensive interventions and access to cessation resources. While prior studies suggest that factors such as social support, chronic disease burden, and socioeconomic status may contribute to these differences, there is limited empirical [...] Read more.

Background: Women have consistently shown lower quit rates in tobacco cessation programs compared to men. This gender disparity persists despite comprehensive interventions and access to cessation resources. While prior studies suggest that factors such as social support, chronic disease burden, and socioeconomic status may contribute to these differences, there is limited empirical evidence to confirm these mechanisms. Aims: This study aimed to investigate potential mechanisms underlying gender differences in quit rates in a tobacco cessation program, testing whether demographic, socioeconomic, health, or behavioral factors explain the observed disparities. Methods: Participants were assigned to one of three smoking cessation interventions: an in-person program (CEASE), a self-help approach, or an online/hybrid program. The main outcome measured was smoking abstinence, evaluated three months after the intervention. Secondary analyses explored whether demographic, socioeconomic, health, or tobacco use-related factors mediated the association between gender and quit rates. Results: Women had significantly lower quit rates than men (p < 0.01). This association remained significant after adjusting for demographic, socioeconomic, health, and addiction-related factors. While women reported higher social support and a higher prevalence of chronic cardiometabolic conditions, these factors did not explain the gender disparity in quit rates. Conclusions: Gender differences in quit rates persist despite controlling for known factors that could influence cessation success. Although women had higher social support, they had lower quit rate. Future research should explore unmeasured variables, such as psychological, biological, and structural influences, to develop more effective cessation strategies tailored for women.

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Open Access March 09, 2025

Place-Based Diminished Returns of Parental Education on Adolescents’ Inhalant Use in Rural Areas

Shervin Assari, Hossein Zare

Universal Journal of Pediatrics 2025, 1(1), 16-25. DOI: 10.31586/ujp.2025.6031

Abstract Background Adolescent substance use is often influenced by socioeconomic and geographical factors. While higher parental education is typically associated with lower substance use, these protective effects may be weaker for marginalized groups facing structural disadvantages that limit the utility and returns of their economic and social resources. Rural areas, characterized by fewer [...] Read more.

Background Adolescent substance use is often influenced by socioeconomic and geographical factors. While higher parental education is typically associated with lower substance use, these protective effects may be weaker for marginalized groups facing structural disadvantages that limit the utility and returns of their economic and social resources. Rural areas, characterized by fewer employment opportunities and limited recreational activities, may contribute to marginalization-related diminished returns (MDRs) of parental education on adolescent substance use, including inhalant use. Objectives This study applies the MDRs framework to examine whether the protective effect of higher parental education on current inhalant use (past 30 days) among 12th-grade American adolescents varies by geographic location. Specifically, we assess whether youth from highly educated families in rural areas are at a disproportionate risk of inhalant use compared to their urban and suburban peers. Methods Using data from the 2024 Monitoring the Future (MTF) study, a nationally representative survey of 12th-grade adolescents in the U.S., we tested main effects and statistical interactions between parental education and residence (rural vs. urban/suburban) in predicting the odds of inhalant use over the past 30 days. Logistic regression models, both with and without interaction terms, were applied to evaluate whether the protective effects of parental education varied by residence location, controlling for relevant demographic and socioeconomic factors. Results Findings indicate a significant interaction between parental education and rural residence. While higher parental education was associated with lower odds of inhalant use in urban and suburban areas, this protective effect was substantially weaker in rural settings. Adolescents from highly educated families in rural areas exhibited a higher-than-expected risk of inhalant use, suggesting that geographic marginalization attenuates the benefits of parental socioeconomic resources. Conclusions These results highlight the role of place-based marginalization in shaping adolescent substance use disparities, demonstrating that MDRs extend beyond race and ethnicity to location-based disadvantages. Rural youths from highly educated families may face unique structural and social challenges that counteract the protective effects of parental education. Public health efforts should consider place-based interventions that address the economic, recreational, and social limitations of rural environments to reduce substance use risk among high-SES adolescents residing in rural areas.

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Open Access March 04, 2025

SMOKES: Study of Measurement of Knowledge and Examination of Support for tobacco control policies

Shervin Assari, Mohammad Mohammadi, Mohammad Pashmchi, Fatemeh Aghaeimeybodi, John Ashley Pallera

Global Journal of Cardiovascular Diseases 2025, 4(1), 79-94. DOI: 10.31586/gjcd.2025.6005

Abstract Background: Tobacco use remains a major global health concern, and understanding the factors that influence tobacco-related knowledge and support for tobacco control policies is critical for effective development of tobacco control policies that are accepted by the public. Objectives: This study introduces the rationale, design, methodology, and participants of the SMOKES Study [...] Read more.

Background: Tobacco use remains a major global health concern, and understanding the factors that influence tobacco-related knowledge and support for tobacco control policies is critical for effective development of tobacco control policies that are accepted by the public. Objectives: This study introduces the rationale, design, methodology, and participants of the SMOKES Study (Study of Measurement of Knowledge and Examination of Support for tobacco control policies), which is conducted to evaluate tobacco use, tobacco-related knowledge and attitude, as well as support for tobacco control policies among college and university students. Methods: The SMOKES Study was designed to address significant gaps in literature by focusing on college and university students in a non-Western context. A multi-center, cross-sectional design was employed to collect data from a diverse sample of college and university students across different geographical provinces in Iran. The survey instrument incorporated a range of measures covering socio-demographic characteristics, university-related variables, family tobacco use status, personal tobacco consumption behaviors (including detailed assessments of cigarette, hookah, and electronic cigarette use), and attitudinal as well as knowledge-based assessments related to vaping. Support for tobacco control policies is also measured. Data were collected using an online survey that included self-administered questionnaires, enabling access to a large diverse sample. This study may be used to determine the prevalence of ever and current use of cigarettes, electronic cigarettes, and hookah, as well as examining the correlates of single, dual, and poly-tobacco use. The study also aims to assess the role of social determinants, attitudes, and ethnic/geographic differences in shaping these outcomes. Results: The study sample consisted of 2403 college and university students, including undergraduates enrolled in different academic programs from all faculties and disciplines. Participants were drawn from universities across 15 provinces, and 11 ethnic groups, ensuring a heterogeneous sample with respect to socio-demographic background, ethnicity, and institutional affiliation. This diversity enhances the generalizability of the findings and allows for the exploration of subgroup differences in tobacco use patterns and policy support. Conclusions: The SMOKES Study offers a framework for examining tobacco-related knowledge and the acceptability of tobacco control policies among a key part of the population, being college and university students. By providing detailed insights into the prevalence and correlates of tobacco knowledge, attitude, use, as well as the tobacco control policy support, the study lays the groundwork for tailored public health interventions and more effective tobacco regulation strategies particularly for college campuses in a non-Western setting.

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Open Access February 27, 2025

Hopelessness and Smoking among Black Adults

Shervin Assari, Babak Najand, Payam Sheikhattari

Open Journal of Medical Sciences 2025, 5(1), 51-58. DOI: 10.31586/ojms.2025.1191

Abstract Background: While the link between depression and smoking is known, less is known about the relationship between hopelessness and smoking in large national community-based sample of Black people. Aims: This study investigates the association between hopelessness and smoking status, using data from the National Survey of American Life (NSAL), which is the only ethnically [...] Read more.

Background: While the link between depression and smoking is known, less is known about the relationship between hopelessness and smoking in large national community-based sample of Black people. Aims: This study investigates the association between hopelessness and smoking status, using data from the National Survey of American Life (NSAL), which is the only ethnically diverse nationally representative sample of Black adults. Methods: Data from the NSAL were analyzed. Hopelessness and smoking status were assessed using structured interviews. Logistic regression was employed to assess the link between hopelessness and smoking status, controlling for potential confounders such as demographic factors and socioeconomic indicators as well as depression. Results: 4,939 participants entered our analysis. Hopelessness was significantly associated with higher odds of smoking status. This association remained robust after adjusting for confounders such as demographic factors, socioeconomic status, and depression. Conclusions: Hopelessness may be a critical risk factor for smoking in Black adults. Promoting hope as a component of targeted tobacco cessation programs may help reduce tobacco use of Black populations.

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Open Access February 25, 2025

Nucleus Accumbens Resting State Functional Connectivity is Linked to Family Income, Reward Salience, and Substance Use

Shervin Assari, Alexandra Donovan

Journal of Cellular Neuroscience 2025, 2(1), 12-22. DOI: 10.31586/jcn.2025.1244

Abstract Background: As a central component of the brain's reward system, nucleus accumbens (NAcc) plays a crucial role in reward salience and substance use behaviors. Changes in the NAcc are also relevant to higher rates of substance use of youth and adults from low-income backgrounds. Although resting-state functional connectivity (rsFC) of the NAcc provides valuable insights into the neural [...] Read more.

Background: As a central component of the brain's reward system, nucleus accumbens (NAcc) plays a crucial role in reward salience and substance use behaviors. Changes in the NAcc are also relevant to higher rates of substance use of youth and adults from low-income backgrounds. Although resting-state functional connectivity (rsFC) of the NAcc provides valuable insights into the neural mechanisms underlying reward processing and the propensity for self-reported reward salience and substance use, research exploring the association between NAcc rsFC and brain networks beyond the default mode network (DMN) and prefrontal cortex (PFC) is limited. Objective: To investigate the role of the resting-state functional connectivity of the NAcc with the cingulo-opercular network, sensorimotor mouth network, and sensorimotor hand network in the association between socioeconomic status, self-reported reward salience, and future substance use. Methods: Data were obtained from the Adolescent Brain Cognitive Development (ABCD) study. NAcc rsFC with the cingulo-opercular network, sensorimotor mouth network, and sensorimotor hand network was assessed at baseline. Socioeconomic status was measured using family income. Self-reported reward salience was assessed using validated psychometric scales. Substance use outcomes were tracked longitudinally over the study period. Structural Equation Modeling was employed to examine the covariances between family income, NAcc rsFC, reward salience, and subsequent substance use. Results: Higher baseline family income was positively associated with baseline NAcc rsFC (B = 0.092, p < 0.001) and negatively associated with baseline reward salience (B = -0.040, p = 0.036) and future substance use (B = -0.081, p < 0.001). Baseline NAcc rsFC was strongly and positively associated with reward salience (B = 0.734, p < 0.001) and future substance use up to age 13 (B = 0.124, p < 0.001). Additionally, baseline reward salience was positively associated with future substance use (Covariance = 0.176, p < 0.001). Conclusion: The findings suggest that NAcc rsFC with brain networks beyond the DMN or PFC may contribute to the links between low parental socioeconomic status, reward salience, and substance use risk. Expanding the understanding of NAcc rsFC provides new insights into the neural mechanisms underlying these associations. These results have important implications for developing targeted interventions aimed at preventing substance use, particularly among low-income youth with heightened reward salience. Further research is needed to explore causal pathways and moderating factors influencing these relationships.

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Open Access February 24, 2025

Socioeconomic Status, Trauma, Cognitive Function, Impulsivity, Reward Salience, and Future Substance Use: Role of Left Caudate Connectivity with the Cingulo-Opercular Network

Shervin Assari, Hossein Zare, Golnoush Akhlaghipour, Mario F Mendez

Journal of Cellular Neuroscience 2025, 1(1), 46-61. DOI: 10.31586/jcn.2025.1264

Abstract Background: While understanding how corticostriatal connectivity is associated with socioeconomic status (SES), trauma exposure, cognitive function, reward salience, impulsivity, and future substance use is essential to identifying neurobiological pathways that contribute to health disparities and behavioral outcomes, very few studies have tested the role of left caudate resting-state [...] Read more.

Background: While understanding how corticostriatal connectivity is associated with socioeconomic status (SES), trauma exposure, cognitive function, reward salience, impulsivity, and future substance use is essential to identifying neurobiological pathways that contribute to health disparities and behavioral outcomes, very few studies have tested the role of left caudate resting-state functional connectivity (rsFC) with the cingulo-opercular network as a proxy of corticostriatal connectivity in social, cognitive, and behavioral processes. Objective: This study investigates the associations between left caudate-cingulo-opercular connectivity and multiple biopsychosocial domains, including low SES, high trauma exposure (financial and life events), cognitive function, reward salience, impulsivity, depression, and future substance use (tobacco and marijuana use). Methods: Resting-state functional magnetic resonance imaging (rs-fMRI) data were analyzed to assess connectivity between the left caudate and the cingulo-opercular network. Data on socioeconomic status, trauma exposure, cognitive performance, and mental health were collected from participants. Future substance use behaviors were evaluated through longitudinal follow-ups. Correlation and regression analyses were conducted to examine relationships between corticostriatal connectivity and the targeted domains. Results: Corticostriatal hypoconnectivity was associated with lower SES, higher trauma exposure, poorer cognitive function, heightened reward salience, higher impulsivity, and history of depression. Additionally, corticostriatal hypoconnectivity at baseline predicted future tobacco and marijuana use during follow-up years. Conclusion: Corticostriatal hypoconnectivity, particularly the rsFC between the left caudate and the cingulo-opercular network, may represent a potential mechanism linking a wide range of social, emotional, and behavioral problems in youth. These findings suggest that corticostriatal hypoconnectivity could serve as a neurobiological marker for identifying individuals at risk for depression, low cognitive function, high reward salience, impulsivity, and substance use, emphasizing the interplay between socioeconomic and neurocognitive factors in shaping behavioral health trajectories.

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Open Access February 19, 2025

The CEASE Tobacco Cessation Controlled Trial for Low-Income Racial and Ethnic Minority Participants: Key Predictors of Success

Shervin Assari, Rifath Ara Alam Barsha, Chidubem Egboluche, Payam Sheikhattari

Global Journal of Cardiovascular Diseases 2025, 4(1), 59-69. DOI: 10.31586/gjcd.2025.1246

Abstract Background: Tobacco use remains disproportionately high among low-income and racial-ethnic minority populations. The CEASE program, with its self-help, hybrid/online, and in-person modalities, has demonstrated efficacy in promoting tobacco cessation. However, predictors of successful cessation among participants in these groups remain unclear. Objective: To identify baseline predictors of successful tobacco cessation among low-income and racial-ethnic minority participants in the CEASE program, with a focus on demographic, socioeconomic, behavioral, and psychosocial factors. Methods: Participants were allocated into three intervention arms: self-help, CEASE hybrid/online, and CEASE in-person. Baseline characteristics, including demographics (e.g., age, gender), socioeconomic status (e.g., education, employment), substance use profiles (e.g., cigarette packs per week, use of other tobacco products, menthol tobacco use), physical health (e.g., general health, number of cardiometabolic risk conditions), mental health (e.g., depressive symptoms, perceived stress), perceived social support, and nicotine dependence, were analyzed as potential predictors of cessation success. Multivariable logistic regression models were used to identify factors associated with successful quitting, controlling for the study arm. Results: In addition to the study arm, gender, baseline depression, cardiometabolic conditions, tobacco flavor, and the use of other tobacco products were significant predictors of quit success. Individuals receiving in-person interventions had significantly higher odds of quitting (AOR = 3.79, p < 0.05). Women were significantly less likely to quit compared to men (AOR = 0.24, p < 0.01). Participants with a greater number of cardiometabolic risk conditions were more likely to quit (AOR = 1.93, p < 0.05), while those with higher levels of depression had lower odds of quitting (AOR = 0.61, p < 0.05). Menthol tobacco users were also less likely to quit (AOR = 0.10, p < 0.05). Interestingly, individuals who used other forms of tobacco in addition to cigarettes had increased odds of quitting (AOR = 2.86, p [...] Read more.

Background: Tobacco use remains disproportionately high among low-income and racial-ethnic minority populations. The CEASE program, with its self-help, hybrid/online, and in-person modalities, has demonstrated efficacy in promoting tobacco cessation. However, predictors of successful cessation among participants in these groups remain unclear. Objective: To identify baseline predictors of successful tobacco cessation among low-income and racial-ethnic minority participants in the CEASE program, with a focus on demographic, socioeconomic, behavioral, and psychosocial factors. Methods: Participants were allocated into three intervention arms: self-help, CEASE hybrid/online, and CEASE in-person. Baseline characteristics, including demographics (e.g., age, gender), socioeconomic status (e.g., education, employment), substance use profiles (e.g., cigarette packs per week, use of other tobacco products, menthol tobacco use), physical health (e.g., general health, number of cardiometabolic risk conditions), mental health (e.g., depressive symptoms, perceived stress), perceived social support, and nicotine dependence, were analyzed as potential predictors of cessation success. Multivariable logistic regression models were used to identify factors associated with successful quitting, controlling for the study arm. Results: In addition to the study arm, gender, baseline depression, cardiometabolic conditions, tobacco flavor, and the use of other tobacco products were significant predictors of quit success. Individuals receiving in-person interventions had significantly higher odds of quitting (AOR = 3.79, p < 0.05). Women were significantly less likely to quit compared to men (AOR = 0.24, p < 0.01). Participants with a greater number of cardiometabolic risk conditions were more likely to quit (AOR = 1.93, p < 0.05), while those with higher levels of depression had lower odds of quitting (AOR = 0.61, p < 0.05). Menthol tobacco users were also less likely to quit (AOR = 0.10, p < 0.05). Interestingly, individuals who used other forms of tobacco in addition to cigarettes had increased odds of quitting (AOR = 2.86, p < 0.05). No other factors, including demographic variables (e.g., age), socioeconomic status (e.g., education, marital status), substance use profiles (e.g., cigarette packs per week, NRT use), or nicotine dependence, were significant predictors of cessation success. Conclusion: Baseline self-reported anxiety/depression and depressive symptoms play a critical role in reducing the likelihood of successful tobacco cessation among low-income and racial-ethnic minority participants in the CEASE program. These findings underscore the importance of addressing mental health challenges as part of tobacco cessation interventions to enhance their efficacy. Future research should explore targeted strategies for integrating mental health support into cessation programs to improve outcomes for underserved populations.

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Open Access February 17, 2025

Gender Differences in the Association Between Socioeconomic Status and Cardiometabolic Health: National Health and Nutrition Examination Survey

Shervin Assari, Hossein Zare

Global Journal of Cardiovascular Diseases 2025, 4(1), 50-58. DOI: 10.31586/gjcd.2025.1198

Abstract Background: Socioeconomic status (SES) is a well-established determinant of health, often associated with lower risk of cardiometabolic diseases (CMD). However, the extent to which SES influences CMD may vary by gender due to differences in social roles, health behaviors, and biological susceptibilities. This study examined the relationship between SES, measured by the [...] Read more.

Background: Socioeconomic status (SES) is a well-established determinant of health, often associated with lower risk of cardiometabolic diseases (CMD). However, the extent to which SES influences CMD may vary by gender due to differences in social roles, health behaviors, and biological susceptibilities. This study examined the relationship between SES, measured by the poverty-to-income ratio (PIR), and CMD indicators—including obesity, diabetes, and cardiovascular disease (CVD)—among men and women using data from the National Health and Nutrition Examination Survey (NHANES). Methods: This cross-sectional study utilized NHANES data (1999-2018), adjusting for race/ethnicity and age. SES was operationalized using PIR, with CMD outcomes (obesity, diabetes, and CVD) as dependent variables. Generalized linear models (GLM) were employed to evaluate the main effects of SES on CMD, with gender included as a moderator. Results: Higher SES was associated with lower overall CMD risk. However, the protective effects of SES were more pronounced in women than in men for all outcomes. These findings suggest that gender-specific pathways may mediate the relationship between SES and CMD. Women may derive greater health benefits from higher SES due to factors such as reduced stress exposure, healthier behaviors, and increased healthcare utilization. Conversely, the weaker association observed in men may reflect differences in social hierarchy sensitivity, responses to unemployment, or other contextual factors. Conclusion: The findings highlight the importance of gender-specific considerations when addressing SES-related disparities in CMD outcomes. Policies and interventions aimed at reducing CMD burden should account for these gender differences to promote equitable improvements in cardiometabolic health. Further research is needed to unravel the mechanisms driving these differences and to inform targeted strategies.

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Open Access February 13, 2025

Psychosocial Correlates of Childhood Body Mass Index: Racial and Ethnic Differences

Shervin Assari, Hossein Zare

Global Journal of Cardiovascular Diseases 2025, 4(1), 34-49. DOI: 10.31586/gjcd.2025.1180

Abstract Objective: To examine racial/ethnic differences in the associations of family socioeconomic status (SES), neighborhood SES, and inhibitory control with body mass index (BMI) in 9-10-year-old children using data from the Adolescent Brain Cognitive Development (ABCD) study. Methods: This cross-sectional study included a diverse sample of children aged 9-10 years, representing [...] Read more.

Objective: To examine racial/ethnic differences in the associations of family socioeconomic status (SES), neighborhood SES, and inhibitory control with body mass index (BMI) in 9-10-year-old children using data from the Adolescent Brain Cognitive Development (ABCD) study. Methods: This cross-sectional study included a diverse sample of children aged 9-10 years, representing non-Latino White, Black, Latino, Asian, and Other racial/ethnic groups. BMI was the primary outcome. Key predictors were family SES, neighborhood SES, and inhibitory control. Multivariable regression models were stratified by race/ethnicity to identify group-specific associations. Results: Race/ethnic groups differed in psychosocial correlates of childhood BMI at age 9 and 10. Among non-Latino White children, higher family income (B = -0.086, p < 0.001), higher parental education (B = -0.069, p < 0.001), and living in a married household (B = -0.079, p < 0.001) were associated with lower BMI. Additionally, the presence of healthy food options in the zip code (B = -0.030, p = 0.032) was linked to lower BMI, while lack of planning (B = 0.032, p = 0.030) was associated with higher BMI. For non-Latino Black children, positive urgency (B = -0.068, p = 0.022) was negatively associated with BMI, while other factors such as family SES and neighborhood SES did not show significant associations. For Latino children, higher family income (B = -0.093, p = 0.001) and parental education (B = -0.099, p < 0.001) were associated with lower BMI. In this group, male gender (B = 0.043, p = 0.033) was associated with higher BMI. Among Asian children, higher family income (B = -0.199, p = 0.006) and parental education (B = -0.144, p = 0.037) were significantly associated with lower BMI. For children in the "Other" racial/ethnic category, higher family income (B = -0.101, p = 0.023), living in a married household (B = -0.076, p = 0.026), and higher median income in the zip code (B = -0.083, p = 0.013) were associated with lower BMI. In this group, male children had lower BMI compared to females (B = -0.089, p = 0.001). Conclusion: The findings highlight substantial racial/ethnic differences in the psychosocial and socioeconomic correlates of BMI in children. There is a need for tailored interventions that target social determinants of childhood high BMI. One size does not fit all.

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Open Access February 11, 2025

Childhood Depression, Hopelessness, and Suicidal Attempt Predict Earlier Tobacco and Marijuana Use Initiation During Adolescence

Shervin Assari, Babak Najand, Payam Sheikhattari

Open Journal of Medical Sciences 2025, 5(1), 18-31. DOI: 10.31586/ojms.2025.1181

Abstract Background: Emotional problems have been associated with substance use, yet longitudinal research examining this relationship during childhood and adolescence in large, diverse, community-based samples remains limited. Aims: This study investigates the prospective associations between three emotional problems—hopelessness, depression, and suicide attempts—before ages 9–10 and [...] Read more.

Background: Emotional problems have been associated with substance use, yet longitudinal research examining this relationship during childhood and adolescence in large, diverse, community-based samples remains limited. Aims: This study investigates the prospective associations between three emotional problems—hopelessness, depression, and suicide attempts—before ages 9–10 and the subsequent initiation of tobacco and marijuana use before ages 14–15, using data from the Adolescent Brain Cognitive Development (ABCD) study. Methods: Data from the ABCD study were analyzed. Baseline emotional problems, including hopelessness, depression, and suicide attempts, were assessed at ages 9–10 through structured parent interviews. Substance use outcomes (tobacco and marijuana initiation) were tracked from baseline to follow-up at ages 14–15 using structured self-report measures. Structural Equation Modeling (SEM) was employed to assess the predictive roles of these early-life emotional problems, controlling for potential confounders such as demographic factors and family and neighborhood socioeconomic status. Results: Baseline hopelessness, depression, and suicide attempts at ages 9–10 were significant predictors of tobacco and marijuana use initiation at ages 14–15. These associations remained robust after adjusting for confounders, indicating the independent effects of early emotional problems on adolescent substance use initiation. Conclusions: Emotional problems in early childhood, including hopelessness, depression, and suicidal behavior, are critical predictors of substance use initiation during adolescence. These findings underscore the importance of early identification and targeted mental health interventions to reduce the risk of substance use among vulnerable youth.

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Open Access January 10, 2025

Extreme Heat Exposure is Associated with Lower Learning, General Cognitive Ability, and Memory among US Children

Shervin Assari, Hossein Zare

Open Journal of Neuroscience 2025, 3(1), 10-22. DOI: 10.31586/ojn.2025.1277

Abstract Background: The increasing frequency and intensity of extreme heat exposure is a significant consequence of climate change, with broad public health implications. While many health risks associated with heat exposure are well-documented, less research has focused on its impact on children’s cognitive function. Objectives: This study examines the [...] Read more.

Background: The increasing frequency and intensity of extreme heat exposure is a significant consequence of climate change, with broad public health implications. While many health risks associated with heat exposure are well-documented, less research has focused on its impact on children’s cognitive function. Objectives: This study examines the relationship between extreme heat exposure and various domains of cognitive function in children. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study. Key variables included race/ethnicity, age, gender, family socioeconomic status (SES), heatwave exposure, and multiple cognitive domains: total composite score, fluid composite score, crystallized intelligence, reading ability, picture vocabulary, pattern recognition, card sorting, and list recall. Structural equation modeling (SEM) was used for data analysis. Results: A total of 11,878 children were included in the analysis. Findings revealed significant associations between extreme heat exposure and lower cognitive performance across multiple domains. The strongest adjusted effects were observed in pattern recognition (B = −0.064, p < 0.001) and reading ability (B = −0.050, p < 0.001), both within the learning domain, as well as total composite cognitive ability (B = −0.067, p < 0.001), fluid composite (B = −0.053, p < 0.001), and crystallized intelligence (B = −0.061, p < 0.001), all within general cognitive ability. Weaker but still significant associations were found for list recall (B = −0.025, p = 0.006) and card sorting (B = −0.043, p < 0.001) within the memory domain, as well as picture vocabulary (B = −0.025, p = 0.008) within general cognitive ability. These associations remained significant after controlling for demographic factors, race/ethnicity, family SES, and neighborhood SES. Conclusions: This study underscores the impact of climate change on cognitive function disparities, particularly in learning and general cognitive ability among children exposed to extreme heat. Findings highlight the need for targeted interventions to mitigate the cognitive risks associated with heat exposure in vulnerable populations.

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Open Access January 24, 2025

High Socioeconomic Status Black Adolescents Attend Worse Schools than Whites

Shervin Assari, Hossein Zare

Open Journal of Educational Research 2025, 5(1), 1-12. DOI: 10.31586/ojer.2025.1160

Abstract Background: School characteristics — including poverty levels, teacher experience, graduation rates, and college enrollment — are essential determinants of students’ academic outcomes and long-term success. Families often use their socioeconomic resources, such as parental education and household income, to secure access to high-quality schools with favorable attributes. However, [...] Read more.

Background: School characteristics — including poverty levels, teacher experience, graduation rates, and college enrollment — are essential determinants of students’ academic outcomes and long-term success. Families often use their socioeconomic resources, such as parental education and household income, to secure access to high-quality schools with favorable attributes. However, Minorities’ Diminished Returns (MDRs) theory suggests that Black families may not experience the same benefits of high family SES due to structural barriers. This study examines the association between family SES and school characteristics, focusing on racial disparities in access to high-quality educational environments. Objective: To investigate the relationship between family SES (parental education and household income) and multiple school characteristics (poverty, teacher experience, graduation rates, and college enrollment), and to assess racial differences in these associations. Methods: Data from the Adolescent Brain Cognitive Development (ABCD) study, a national sample of US adolescents, was analyzed. We used multivariate regression models to examine associations between family SES and school characteristics and to test for interactions by race, specifically comparing Black and White adolescents. Results: Higher family SES was associated with positive school characteristics overall, including lower school poverty, greater teacher experience, and increased graduation and college enrollment rates. However, these positive effects of high family SES on school characteristics were significantly weaker for Black adolescents than for White adolescents. Black adolescents from high-income families were more likely than White adolescents from similar backgrounds to attend schools with higher poverty rates, less experienced teachers, and reduced graduation and college enrollment rates. Conclusion: Our findings highlight persistent racial inequities in access to educational opportunities, even among families with comparable socioeconomic resources. The diminished returns of family SES for Black adolescents underscore the role of structural barriers in limiting access to high-quality schools. These findings emphasize the need for policy interventions to address systemic inequalities that hinder Black families from fully leveraging their SES to access favorable educational environments.

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Open Access January 24, 2025

Neurocognitive, Emotional, and Behavioral Costs for Adolescents Due to Diminished Returns of Parental Employment on Trauma

Shervin Assari, Hossein Zare

Open Journal of Neuroscience 2025, 3(1), 1-9. DOI: 10.31586/ojn.2025.1263

Abstract Background: Parental employment is a significant social determinant of children's developmental outcomes, shaping their cognitive and behavioral trajectories. However, the effects of parental employment may not be equally protective across racial groups. The Minority Diminished Returns (MDRs) framework suggests that socioeconomic status (SES) factors, such as employment, yield fewer [...] Read more.

Background: Parental employment is a significant social determinant of children's developmental outcomes, shaping their cognitive and behavioral trajectories. However, the effects of parental employment may not be equally protective across racial groups. The Minority Diminished Returns (MDRs) framework suggests that socioeconomic status (SES) factors, such as employment, yield fewer protective benefits for Black families compared to White families. Objective: This study investigates the diminished returns of parental employment on trauma and associated neurocognitive and behavioral outcomes in children, with a focus on racial variation in these effects. Methods: Using data from the Adolescent Brain Cognitive Development (ABCD) study, a large and diverse sample of children was analyzed. We applied MDRs theory and social determinants of health frameworks to examine the association between parental employment, trauma, and children's cognitive and behavioral outcomes. The analysis controlled for family SES, neighborhood factors, and racial group differences. Results: Preliminary findings suggest that while parental employment is generally protective against trauma, the strength of this association is diminished for Black children. Black families with employed parents experience higher levels of trauma and stress compared to their White counterparts, which may contribute to racial disparities in cognitive and behavioral outcomes. Conclusion: Parental employment may not equally buffer against trauma-related risks for Black children, reflecting the broader pattern of diminished returns for racially disadvantaged groups. These findings highlight the need for policies addressing the unequal benefits of SES across racial groups.

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Open Access January 24, 2025

Pallidum Functional Hypoconnectivity and Inhibitory Control as Partial Mediators of Environmental Influences on Tobacco and Marijuana Initiation

Shervin Assari, Hossein Zare

Journal of Cellular Neuroscience 2025, 1(1), 33-45. DOI: 10.31586/jcn.2025.1140

Abstract Background: Low socioeconomic status (SES) has been linked to higher rates of tobacco and marijuana use initiation; however, the contributions of environmental and neurocognitive factors remain underexplored. This study investigates a potential pathway connecting low SES, fine particulate matter (PM2.5) exposure, brain functional connectivity, and inhibitory control to increased [...] Read more.

Background: Low socioeconomic status (SES) has been linked to higher rates of tobacco and marijuana use initiation; however, the contributions of environmental and neurocognitive factors remain underexplored. This study investigates a potential pathway connecting low SES, fine particulate matter (PM2.5) exposure, brain functional connectivity, and inhibitory control to increased tobacco and marijuana use initiation among adolescents. Objectives: To examine the mediating roles of PM2.5 exposure, resting-state functional connectivity between the right pallidum and the ventral attention network (P-VAN rsFC), and inhibitory control in the relationship between low SES and tobacco and marijuana use initiation. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study to assess associations between baseline SES, baseline PM2.5 exposure (based on zip code), baseline P-VAN rsFC, baseline inhibitory control, and subsequent tobacco and marijuana use initiation. Mediation models were used to determine whether PM2.5 exposure and changes in P-VAN rsFC act as pathways linking low SES to diminished inhibitory control and subsequent substance use initiation. Results: Low SES was associated with higher PM2.5 exposure, which, in turn, was linked to alterations in P-VAN rsFC. These alterations were correlated with lower inhibitory control, which significantly predicted tobacco and marijuana use initiation over time. Inhibitory control partially mediated the relationship between low SES and substance use initiation, indicating a complex pathway influenced by environmental and neurocognitive factors. Conclusions: This study identifies a potential mechanism linking low SES to tobacco and marijuana use initiation through environmental and neurobiological pathways. Understanding how PM2.5 exposure and neurofunctional connectivity impact inhibitory control can provide valuable insights for developing targeted interventions to reduce substance use among adolescents in low SES environments.

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Open Access January 24, 2025

Cingulate Gyrus Volume as a Mediator of the Social Gradient in Cognitive Function

Shervin Assari, Hossein Zare

Journal of Cellular Neuroscience 2025, 1(1), 24-32. DOI: 10.31586/jcn.2025.1139

Abstract Background: Socioeconomic status (SES) is a well-established predictor of cognitive function in children, but the neurobiological pathways through which SES influences cognitive outcomes remain underexplored. This study examines the role of the cingulate gyrus (region of the brain that is involved in emotion regulation, decision-making, error detection, and cognitive control) in mediating [...] Read more.

Background: Socioeconomic status (SES) is a well-established predictor of cognitive function in children, but the neurobiological pathways through which SES influences cognitive outcomes remain underexplored. This study examines the role of the cingulate gyrus (region of the brain that is involved in emotion regulation, decision-making, error detection, and cognitive control) in mediating the relationship between SES and cognitive performance, with a focus on whether these effects vary by sex. Objective: To investigate the role of the cingulate gyrus in mediating the association between social gradients (family SES) and cognitive function in children and assess potential sex differences in these pathways. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study. Cognitive function was assessed using a composite measure of executive function and general cognitive ability. Structural MRI data were used to measure the volume of the cingulate gyrus. Path analysis was conducted to examine the mediating role of the cingulate gyrus in the association between SES and cognitive function. Interaction terms were included to test for sex differences. Results: Higher SES was significantly associated with a larger cingulate gyrus volume and better cognitive function. The volume of the left cingulate gyrus partially mediated the relationship between family and neighborhood SES and cognitive function, explaining a portion of the social gradient in cognitive outcomes. No significant sex differences were found in these mediating effects. Conclusions: The cingulate gyrus partially mediates the link between SES and cognitive function in children. These findings suggest that social disparities in cognitive function may operate, in part, through neurobiological changes such as those in the cingulate gyrus, without significant variation by sex.

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Open Access January 23, 2025

Population Diversity Matters: Heterogeneity of Biopsychosocial Pathways from Socioeconomic Status to Tobacco Use via Cerebral Cortical Volume in the ABCD Study

Shervin Assari, Hossein Zare

Journal of Cellular Neuroscience 2025, 1(1), 12-23. DOI: 10.31586/jcn.2025.1132

Abstract Background: Most neuroscience research has predominantly focused on White, middle-class populations, leading to gaps in understanding how socioeconomic status (SES) influences brain development and health behaviors in racially diverse groups. Tobacco use, a major public health concern, is influenced by both family and neighborhood SES, with early initiation during adolescence predicting [...] Read more.

Background: Most neuroscience research has predominantly focused on White, middle-class populations, leading to gaps in understanding how socioeconomic status (SES) influences brain development and health behaviors in racially diverse groups. Tobacco use, a major public health concern, is influenced by both family and neighborhood SES, with early initiation during adolescence predicting long-term health outcomes. The Adolescent Brain Cognitive Development (ABCD) study provides a unique opportunity to examine racial disparities in the pathways from SES to brain development and behavior, especially through the lens of Marginalization-Related Diminished Returns (MDRs), where the effects of SES are attenuated for minority groups. Objective: This study investigates racial variation in the associations between SES, cerebral cortical volume, and tobacco use initiation, comparing Black and White youth over 4-6 years of follow-up. Methods: Data from the ABCD study were analyzed to assess pathways from family income to adolescents’ cortical volume via the needs-to-income ratio, and from cortical volume to tobacco use initiation. Structural equation modeling was used to evaluate these pathways, stratified by race, with a focus on comparing Black and White participants. Covariates included family and neighborhood SES, demographic factors, and baseline behavioral measures. Results: We found that the positive association between income (via the needs-to-income ratio) and total cortical volume was significantly weaker for Black youth compared to White youth. Additionally, the link between larger total cortical volume and reduced risk of tobacco initiation was also weaker in Black adolescents. These findings were consistent over 4-6 years of follow-up, suggesting that Black youth experience diminished returns from higher SES in terms of brain development and behavioral outcomes. Conclusions: Our findings highlight significant racial disparities in the pathways from SES to brain development and tobacco use initiation, supporting the Marginalization-Related Diminished Returns (MDRs) framework. While higher SES is associated with larger cortical volumes and lower tobacco use risk in White youth, these associations are attenuated in Black adolescents.

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Open Access January 23, 2025

Weaker Effects of Educational Attainment on Chronic Medical Conditions in American Indian Alaska Native, Black, and Latino Adults: National Health Interview Survey 2023

Shervin Assari, Hossein Zare

Open Journal of Medical Sciences 2025, 5(1), 1-12. DOI: 10.31586/ojms.2025.1150

Abstract Background: Chronic medical conditions are major drivers of healthcare spending, morbidity, and mortality in the United States, as well as critical indicators of health disparities. The disproportionately high rates of chronic medical conditions among Black, Latino, and American Indian and Alaska Native adults compared to non-Latino Whites highlight the urgent need to examine the factors [...] Read more.

Background: Chronic medical conditions are major drivers of healthcare spending, morbidity, and mortality in the United States, as well as critical indicators of health disparities. The disproportionately high rates of chronic medical conditions among Black, Latino, and American Indian and Alaska Native adults compared to non-Latino Whites highlight the urgent need to examine the factors contributing to these disparities. While higher socioeconomic status is generally associated with better health outcomes, this benefit may be diminished for racialized and minoritized populations. Objective: This study investigates the protective effects of educational attainment and income-to-poverty ratio on the prevalence of chronic medical conditions and examines whether these effects vary across racial and ethnic groups, specifically among Black, Latino, and American Indian and Alaska Native adults compared to non-Latino White adults. Methods: Using data from the 2023 National Health Interview Survey (NHIS), this cross-sectional study analyzed the association between educational attainment and chronic medical conditions across racial and ethnic groups. Logistic regression models were employed to assess whether the strength of the relationship between education and chronic medical conditions differed by racial/ethnic group, controlling for key demographic and socioeconomic covariates. Sample size was 29,373 which was reflective of 256,566,689 US population. Results: Consistent with the theory of Minorities' Diminished Returns, findings showed that the protective effects of higher educational attainment on chronic medical conditions were significantly weaker for Black, Latino, and American Indian and Alaska Native adults than for their non-Latino White counterparts. Even among individuals with higher education, Black, Latino, and American Indian and Alaska Native adults faced elevated risks of chronic medical conditions. Conclusion: While educational attainment generally reduces the prevalence of chronic medical conditions, this protective effect is moderated by racial and ethnic background. Structural barriers limit the health benefits of educational attainment. This underscores the need for policies that address structural inequities—such as low-quality education and occupational segregation—that constrain the protective health effects of educational attainment for minoritized groups.

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Open Access January 23, 2025

Diminished Returns of Educational Attainment on Hypertension Prevalence among American Indian and Alaska Native Adults: National Health Interview Survey 2023

Shervin Assari, Hossein Zare

Global Journal of Cardiovascular Diseases 2025, 4(1), 11-21. DOI: 10.31586/gjcd.2025.1148

Abstract Background: Research on Minorities’ Diminished Returns (MDRs) consistently reveals that social determinants of health, especially educational attainment, do not yield equal health benefits across racial and ethnic groups in the United States. MDRs suggest that social stratification, segregation, lower education quality, and labor market discrimination contribute to diminished health returns [...] Read more.

Background: Research on Minorities’ Diminished Returns (MDRs) consistently reveals that social determinants of health, especially educational attainment, do not yield equal health benefits across racial and ethnic groups in the United States. MDRs suggest that social stratification, segregation, lower education quality, and labor market discrimination contribute to diminished health returns of education among minoritized groups. However, few studies have tested the relevance of MDRs in American Indian and Alaska Native (AIAN) populations compared to non-Hispanic White adults. Objectives: This study aimed to examine the strength of the inverse association between educational attainment and hypertension prevalence, hypothesizing that the protective effect of education on hypertension risk is reduced among AIAN adults relative to non-Hispanic Whites. Methods: Using data from the 2023 National Health Interview Survey (NHIS), we analyzed a nationally representative sample of adults aged 18 and older. Logistic regression models examined the association between educational attainment and self-reported hypertension diagnosis, stratified by racial/ethnic group (AIAN vs. non-Hispanic White). Models were adjusted for key covariates, including age, gender, income, and insurance status. Results: Higher educational attainment was associated with a lower prevalence of hypertension in the combined sample of AIAN and non-Hispanic White adults. However, this protective association was significantly weaker among AIAN adults compared to non-Hispanic White adults, as evidenced by a significant interaction between race and education. Conclusion: AIAN adults exhibit a higher prevalence of hypertension even at higher levels of educational attainment compared to non-Hispanic White adults, supporting the relevance of MDRs for AIAN populations. This finding underscores the need for public health interventions that address structural barriers and contextual factors unique to AIAN populations. Policies focused solely on educational access may be insufficient to reduce hypertension risk among AIAN adults without addressing broader social and structural inequities.

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Open Access January 23, 2025

Trauma and Early Puberty May Be Stronger Predictors of Early Tobacco Initiation in Girls Compared to Boys

Shervin Assari, Hossein Zare

Journal of Biomedical and Life Sciences 2025, 5(1), 1-13. DOI: 10.31586/jbls.2025.1135

Abstract Objective: This study investigates the pathways linking socioeconomic status (SES), trauma, early puberty, and tobacco use, with a focus on how these relationships differ by sex. Using data from the Adolescent Brain Cognitive Development (ABCD) study, we explore how SES and race contribute to trauma exposure, which in turn may influence early puberty and tobacco use. The study also examines [...] Read more.

Objective: This study investigates the pathways linking socioeconomic status (SES), trauma, early puberty, and tobacco use, with a focus on how these relationships differ by sex. Using data from the Adolescent Brain Cognitive Development (ABCD) study, we explore how SES and race contribute to trauma exposure, which in turn may influence early puberty and tobacco use. The study also examines potential mediating effects of trauma and early puberty on the association between SES and tobacco use, while comparing these pathways for males and females. Methods: Data were drawn from the ABCD study, and structural equation modeling (SEM) was employed to test direct and indirect pathways between SES, trauma, early puberty, and tobacco use. The sample was stratified by sex to assess differences in these relationships for males and females. Key predictors included SES, race, and age, while outcomes were trauma, early puberty, and tobacco use. The model assessed mediating effects of trauma and early puberty on tobacco use. Results: Trauma was a significant predictor of early puberty for females (B = 0.032, SE = 0.015, p = 0.039) but not males. Early puberty was significantly linked to tobacco use for females (B = 0.048, SE = 0.015, p = 0.001) but not for males. Additionally, trauma had an effect on tobacco use among females (B = 0.048, SE = 0.014, p < 0.001) but not males. Lower SES was significantly associated with higher trauma exposure for both males (B = -0.109, SE = 0.014, p < 0.001) and females (B = -0.110, SE = 0.015, p < 0.001). Conclusions: The findings suggest that trauma and early puberty play more significant roles in the pathways from SES to tobacco use for females than for males. While trauma and early puberty are crucial mediators for females, these factors are less predictive for males. These results highlight the importance of sex-specific interventions targeting trauma and early puberty as pathways to early tobacco use.

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Open Access January 23, 2025

Brain-Wide Resting-State Functional Connectivity Partially Mediates Socioeconomic Disparities in Children's Cardiometabolic Health

Shervin Assari, Hossein Zare, Golnoush Akhlaghipour, Mario F Mendez

Journal of Cellular Neuroscience 2025, 1(1), 1-11. DOI: 10.31586/jcn.2025.1143

Abstract Background: Although some neural mechanisms underlying socioeconomic status (SES) disparities are known, the role of brain-wide resting-state functional connectivity in these effects remains less understood. Aim: This study aims to identify brain-wide resting-state functional connectivity signatures that may mediate the effects of SES on body mass index (BMI) and blood pressure in [...] Read more.

Background: Although some neural mechanisms underlying socioeconomic status (SES) disparities are known, the role of brain-wide resting-state functional connectivity in these effects remains less understood. Aim: This study aims to identify brain-wide resting-state functional connectivity signatures that may mediate the effects of SES on body mass index (BMI) and blood pressure in children, using data from the Adolescent Brain Cognitive Development (ABCD) study. Methods: Data were drawn from the ABCD study, a large, diverse cohort of children aged 9-10. Pre-processed resting-state functional MRI data were used, and factor analysis was conducted to extract a whole-brain connectivity factor. The first factor, capturing the greatest variance in brain-wide resting-state connectivity, was selected for further analysis in a structural equation model (SEM). This connectivity factor was tested as a potential mediator of the relationship between SES (measured by parental education, family income, and neighborhood characteristics) and two indicators of cardiometabolic health: BMI and systolic blood pressure. Results: Factor analysis revealed a robust first factor that accounted for a significant proportion of variance in brain-wide resting-state functional connectivity. This factor was significantly associated with SES, indicating that children from lower SES backgrounds exhibited distinct connectivity patterns. Additionally, the factor was linked to both BMI and systolic blood pressure, suggesting its relevance to cardiometabolic health. Mediation analysis showed that this connectivity factor partially mediated the relationship between SES and both BMI and systolic blood pressure. Conclusions: Brain-wide functional connectivity may be a mediator of SES effects on BMI and blood pressure in children. The first connectivity factor provides a promising neural signature linking SES with cardiometabolic risk. Comprehensive brain-wide approaches to functional connectivity may offer valuable insights into how social determinants of health shape neural and physical development in childhood.

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Open Access January 16, 2025

Extreme Heat Exposure and Adolescent Cognitive Function

Shervin Assari, Hossein Zare

Open Journal of Neuroscience 2025, 3(1), 1-9. DOI: 10.31586/ojn.2025.1247

Abstract Background: Extreme heat exposure is an increasing public health concern, particularly in the context of climate change. Limited research has explored its impact on children's cognitive outcomes. This study investigates the association between extreme heat exposure and cognitive function in 9–10-year-old children, using data from the Adolescent Brain Cognitive Development (ABCD) study. [...] Read more.

Background: Extreme heat exposure is an increasing public health concern, particularly in the context of climate change. Limited research has explored its impact on children's cognitive outcomes. This study investigates the association between extreme heat exposure and cognitive function in 9–10-year-old children, using data from the Adolescent Brain Cognitive Development (ABCD) study. Additionally, we assess whether this effect is independent of socio-demographic factors such as race, family socioeconomic status (SES), and neighborhood SES. Methods: Data were drawn from the ABCD study, comprising over 10,000 children aged 9–10 years. Cognitive function was assessed through standardized cognitive tests, while extreme heat exposure was estimated using geographic and climate data. Structural equation modeling (SEM) was employed to examine the direct effects of heat exposure on cognitive outcomes and to account for potential confounding variables, including race, family SES, and neighborhood SES. Results: Black families, low SES households, and children from low SES neighborhoods were disproportionately exposed to extreme heat. Extreme heat exposure was significantly associated with lower cognitive function in children, and this association remained robust even after adjusting for socio-demographic factors. Conclusions: Extreme heat exposure is linked to diminished cognitive function in children, particularly among socio-economically disadvantaged and marginalized populations. Given the increasing frequency of extreme heat events due to climate change, future research should further explore these implications for children’s cognitive outcomes. Policy interventions that improve access to cooling infrastructure, expand green spaces, and prioritize at-risk populations are critical to mitigating the adverse cognitive effects of extreme heat in low SES communities.

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Open Access January 16, 2025

Heat Exposure Predicts Earlier Childhood Pubertal Initiation, Behavioral Problems, and Tobacco Use

Shervin Assari, Babak Najand, Hossein Zare

Global Journal of Epidemiology and Infectious Disease 2025, 5(1), 1-11. DOI: 10.31586/gjeid.2025.1176

Abstract Background: Climate change has raised significant concerns about its impact on health, particularly for vulnerable populations such as children and adolescents. While extensive research has examined physical health effects, limited attention has been given to the influence of extreme heat on developmental and behavioral outcomes. Objectives: This study investigates the association [...] Read more.

Background: Climate change has raised significant concerns about its impact on health, particularly for vulnerable populations such as children and adolescents. While extensive research has examined physical health effects, limited attention has been given to the influence of extreme heat on developmental and behavioral outcomes. Objectives: This study investigates the association between extreme heat exposure and early puberty initiation (ages 9-10), using data from the Adolescent Brain Cognitive Development (ABCD) study. It further explores how early puberty correlates with behavioral problems and tobacco use initiation. Methods: Data from 11,878 participants in the ABCD study were analyzed to examine the relationship between extreme heat exposure (independent variable) and puberty initiation (outcome). Behavioral problems and tobacco use initiation were evaluated as downstream outcomes of early puberty. Covariates included age, sex, and race/ethnicity, and behavioral problems were assessed using the Child Behavior Checklist (CBCL). Structural equation modeling (SEM) was employed for analysis. Results: Extreme heat exposure was significantly associated with earlier puberty initiation at ages 9-10. Early puberty, in turn, correlated with higher levels of behavioral problems and an increased likelihood of tobacco use initiation. Conclusions: These findings underscore the importance of addressing environmental factors such as extreme heat to reduce risks associated with early maturation, including behavioral and substance use challenges. Targeted interventions and policies are needed to mitigate the impact of extreme heat on child development, and longitudinal studies are essential to confirm these results and inform effective prevention strategies.

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Open Access January 16, 2025

Puberty Onset and Positive Urgency Explain Diminished Returns of Family Income on Tobacco and Marijuana Use

Shervin Assari, Babak Najand, Hossein Zare

Open Journal of Psychology 2025, 5(1), 1-11. DOI: 10.31586/ojp.2025.1141

Abstract Background: Puberty is a crucial developmental milestone that involves significant physiological, emotional, and behavioral changes. Early puberty onset, influenced by both biological and social factors, is associated with an increased risk of engaging in substance use, such as tobacco and marijuana. While high family income is generally linked to delayed puberty onset and lower behavioral [...] Read more.

Background: Puberty is a crucial developmental milestone that involves significant physiological, emotional, and behavioral changes. Early puberty onset, influenced by both biological and social factors, is associated with an increased risk of engaging in substance use, such as tobacco and marijuana. While high family income is generally linked to delayed puberty onset and lower behavioral risks, these benefits may not be equally protective for Black youth due to the phenomenon of Minorities' Diminished Returns (MDRs). MDRs suggest that higher family income does not offer the same protective effects for Black youth as it does for White youth, potentially leading to earlier puberty and increased substance use among high-income Black adolescents. Objective: This study aimed to investigate whether early puberty onset and associated positive urgency (impulsivity) mediate the relationship between family income and the initiation of tobacco and marijuana use over a six-year follow-up period among adolescents. Additionally, the study examined whether the effects of family income on early puberty onset differ by race, testing the hypothesis that high-income Black youth would experience earlier puberty onset compared to their high-income White peers. Methods: Data were sourced from the Adolescent Brain Cognitive Development (ABCD) Study. Participants were 9-10-year-old adolescents at baseline, followed over a period of six years. Structural equation modeling (SEM) was used to assess whether early puberty onset mediated the effects of family income on substance use behaviors. Interaction terms between race and family income were included to test whether the impact of family income varies by race. Results: Early puberty onset and associated positive urgency partially explained the relationship between family income and the initiation of tobacco and marijuana use. High-income Black youth showed earlier puberty onset compared to their White counterparts. Earlier puberty onset then predicted higher positive urgency. These factors, in turn, were linked to higher rates of tobacco and marijuana initiation. Conclusions: This study provides additional evidence that the benefits of high family income do not extend equally to Black adolescents, particularly regarding delaying puberty onset and its consequences for substance use.

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Open Access January 15, 2025

Too Much Heat May Make You Smoke

Shervin Assari, Babak Najand, Hossein Zare

Global Journal of Cardiovascular Diseases 2025, 4(1), 1-10. DOI: 10.31586/gjcd.2025.1175

Abstract Background: The rising concerns surrounding climate change have drawn attention to its potential impact on health, particularly among vulnerable groups such as children and older adults. Despite extensive research on health consequences, limited studies have explored the connection between extreme heat exposure and tobacco use initiation among adolescents in the United States. [...] Read more.

Background: The rising concerns surrounding climate change have drawn attention to its potential impact on health, particularly among vulnerable groups such as children and older adults. Despite extensive research on health consequences, limited studies have explored the connection between extreme heat exposure and tobacco use initiation among adolescents in the United States. Objectives: This study examines the relationship between extreme heat exposure and the initiation of tobacco use in adolescents, using data from the Adolescent Brain Cognitive Development (ABCD) study. It also evaluates the mediating roles of major depressive disorder (MDD) and childhood behavioral problems. Methods: Data from 11,878 participants in the ABCD study were analyzed to explore the link between extreme heat exposure (independent variable) and tobacco use initiation (dependent variable). Covariates included age, sex, and race/ethnicity, while MDD and behavioral problems (measured using the Child Behavior Checklist, CBCL) were assessed as potential mediators. Structural equation modeling (SEM) was applied for analysis. Results: The findings indicated a significant association between extreme heat exposure and an increased likelihood of tobacco use initiation in adolescents aged 9 to 15. MDD and behavioral problems partially mediated this relationship. Conclusions: These results underscore the importance of targeted interventions aimed at mitigating the impact of extreme heat on adolescent health, including its influence on tobacco use initiation. Addressing mental health and behavioral challenges could help reduce these risks. Future longitudinal research is needed to confirm these findings and evaluate the efficacy of strategies to protect vulnerable youth populations.

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Open Access November 21, 2024

Financial Strain Partially Explains Diminished Returns of Parental Education in the ABCD Study

Shervin Assari, Hossein Zare

Open Journal of Neuroscience 2024, 2(1), 25-34. DOI: 10.31586/ojn.2024.1129

Abstract Background: Previous research shows that socioeconomic status (SES) positively impacts children's development, yet the benefits are not equally distributed across racial groups. According to the Minorities’ Diminished Returns (MDRs) framework, Black children tend to experience smaller gains from parental education compared to White children. Objective: Building on the MDRs framework, [...] Read more.

Background: Previous research shows that socioeconomic status (SES) positively impacts children's development, yet the benefits are not equally distributed across racial groups. According to the Minorities’ Diminished Returns (MDRs) framework, Black children tend to experience smaller gains from parental education compared to White children. Objective: Building on the MDRs framework, this study examines whether high financial strain contributes to the diminished returns of parental education for Black children, using data from the Adolescent Brain Cognitive Development (ABCD) Study. We hypothesized that: (1) there would be a positive effect of parental education on total cortical volume, (2) this effect would be weaker for Black than White children, and (3) higher household financial strain in Black families would mediate the diminished returns of parental education on total cortical volume for Black children. Methods: Data were drawn from the baseline ABCD Study, focusing on 7,936 9- and 10-year-old children identified as either Black (n = 1,775) or White (n = 6,161). Parental education was the key independent variable, covariates included age, sex, household income, and marital status, race was the moderator, financial strain was the mediator, and total cortical volume was the outcome. Structural Equation Models (SEMs) were employed to examine the associations between parental education and cortical volume, with financial strain as a mediator and race as a moderator. Results: Higher parental education was associated with greater cortical volume in the pooled sample. However, this effect was significantly weaker for Black children. Financial strain partially mediated the observed diminished returns of parental education. Conclusion: High financial strain experienced by middle-class Black families partially explains why the association between parental education and child development is weaker in Black than White families. Interventions aimed at enhancing educational quality, increasing employability, expanding access to higher-paying jobs, and reducing labor market discrimination against Black individuals may help address racial inequities in child development in the U.S. Efforts to reduce financial strain should extend beyond low-income populations to also support higher-educated minority families.

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Open Access November 21, 2024

Diminished Returns of Educational Attainment on Body Mass Index Among Latino Populations: Insights from UAS Data

Shervin Assari, Hossein Zare

Global Journal of Epidemiology and Infectious Disease 2024, 4(1), 92-104. DOI: 10.31586/gjeid.2024.1096

Abstract Background: Educational attainment is a well-established predictor of physical health outcomes, including body mass index (BMI). However, according to the theory of Minorities' Diminished Returns (MDRs), the health benefits of education tend to be weaker for ethnic minorities compared to non-Latino Whites, due to structural inequalities and social disadvantages. Objective: [...] Read more.
Background: Educational attainment is a well-established predictor of physical health outcomes, including body mass index (BMI). However, according to the theory of Minorities' Diminished Returns (MDRs), the health benefits of education tend to be weaker for ethnic minorities compared to non-Latino Whites, due to structural inequalities and social disadvantages. Objective: This study examines whether the association between educational attainment and BMI is weaker among Latino individuals compared to non-Latino individuals, in line with the MDRs framework. Methods: Data were drawn from the 2014 wave of the Understanding America Study (UAS), a nationally representative internet-based panel. Body mass index (BMI) was the outcome of interest. Linear regression models were used to analyze the association between educational attainment and BMI, with an interaction term for ethnicity to explore differences in the relationship between Latino and non-Latino people. Models were adjusted for age, sex, marital status, and labor market participation and results were presented as beta coefficients, p-values, and 95% confidence intervals (CIs). Results: Higher educational attainment was associated with lower BMI for both Latino and non-Latino participants (p < 0.001). However, the interaction between educational attainment and ethnicity was significant (p < 0.05), indicating that Latino individuals experienced smaller reductions in BMI because of higher education compared to non-Latino people. Conclusion: This study provides evidence of diminished returns from educational attainment on BMI among Latino individuals. These findings support the MDRs framework, suggesting that structural barriers may limit the health benefits of education for Latino populations. While education is a key determinant of physical and mental health, its benefits are not equitably distributed across ethnic groups. Structural inequalities, chronic stress, poor neighborhood environments, and adverse educational and occupational conditions likely contribute to this disparity. Addressing these underlying factors through targeted policy interventions is necessary to promote health equity for Latino populations.

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Open Access November 21, 2024

Unequal Returns: Education Fails to Fully Prepare Black and Latino Americans for Retirement

Shervin Assari, Babak Najand, Hossein Zare, Amanda Sonnega

Open Journal of Educational Research 2024, 4(6), 392-401. DOI: 10.31586/ojer.2024.1104

Abstract Background: Retirement is a universal life stage, marking the culmination of an individual's working years. However, many people face financial challenges during retirement due to insufficient financial planning. Retirement preparedness is essential for ensuring economic security and maintaining a high quality of life in later years. Education is often viewed as a key driver of retirement [...] Read more.
Background: Retirement is a universal life stage, marking the culmination of an individual's working years. However, many people face financial challenges during retirement due to insufficient financial planning. Retirement preparedness is essential for ensuring economic security and maintaining a high quality of life in later years. Education is often viewed as a key driver of retirement preparedness, as it is linked to higher earnings, better financial literacy, and improved decision-making. However, the Minorities' Diminished Returns (MDRs) theory suggests that the economic, cognitive, and behavioral benefits of education are weaker for racial and ethnic minorities compared to non-Latino Whites. Objective: This study aims to examine the relationship between educational attainment and retirement preparedness, focusing on whether this association differs among Black, Latino, and non-Latino White individuals, using data from the Understanding America Study (UAS). Methods: Data were drawn from the UAS, a nationally representative internet-based panel survey. The sample included participants from diverse racial and ethnic backgrounds. Linear regression models were used to evaluate the association between educational attainment, measured in years of schooling, and retirement preparedness. Interaction terms were included to test whether the association varied by race and ethnicity. Models were adjusted for potential confounders, including age, sex, marital status, employment status, and immigration. Results: In the overall sample, higher educational attainment was significantly and positively associated with better retirement preparedness (p < 0.001). However, consistent with the MDRs framework, the strength of this association was significantly weaker for Black and Latino participants compared to non-Latino White participants (p < 0.05). Non-Latino Whites with higher education levels reported substantially better retirement preparedness, while the same level of education yielded smaller gains in retirement preparedness for Black and Latino individuals. Conclusion: The findings support the Minorities' Diminished Returns theory, showing that although educational attainment enhances retirement preparedness for all groups, Black and Latino individuals derive fewer benefits compared to their non-Latino White counterparts. These disparities point to persistent structural inequalities and systemic barriers within the education system and labor market, as well as the effects of segregation and discrimination, which undermine the economic benefits of education for marginalized populations. Addressing these disparities requires targeted policy interventions aimed at eliminating racial and ethnic inequalities in retirement outcomes and ensuring equitable benefits from educational attainment for all groups.

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Open Access November 19, 2024

The Cost of Opportunity: Anti-Black Discrimination in High Resource Settings

Shervin Assari, Hossein Zare

Journal of Biomedical and Life Sciences 2024, 4(2), 92-110. DOI: 10.31586/jbls.2024.1128

Abstract Objective: Inequalities exist in children’s educational outcomes—including reading proficiency, school discrimination, and school disciplinary actions—across zip codes with different levels of educational childhood opportunity index (COI). This study examines the interaction between race and educational environment on children’s educational outcomes. We hypothesize that race, parental [...] Read more.
Objective: Inequalities exist in children’s educational outcomes—including reading proficiency, school discrimination, and school disciplinary actions—across zip codes with different levels of educational childhood opportunity index (COI). This study examines the interaction between race and educational environment on children’s educational outcomes. We hypothesize that race, parental education, and their interaction are associated with perceived school discrimination, which in turn reduces their cognitive, academic, and emotional wellbeing. We also hypothesize that Black children with high socioeconomic status (SES) report high perceived school discrimination in high-COI settings. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) study, which measures a wide range of educational, cognitive, and emotional outcomes. At the same time, the ABCD children are sampled across areas with vast differences in COI rankings, that can be classified into these five categories: very high, high, average, low, and very low educational COIs. Our structural equation models (SEM) tested the additive and interactive effects of race and educational attainment on perceived school discrimination, and the effects of school discrimination on various cognitive abilities (reading proficiency, picture vocabulary, and list sorting working memory), school suspension, as well as depressed mood. Our multi-group SEM assessed how these relationships vary across educational COI levels. Results: Our findings showed that high SES Black children report highest school discrimination in residential areas with highest COIs. This is based on the observation that the interaction between race and parental education on experiences of school discrimination were only significant in areas with highest COI. Across residential areas with different COI levels, students who experienced higher school discrimination had higher suspension, worse depression, and worse cognitive performance. Conclusion: While higher COIs are associated with better academic outcomes, Black-White gaps exist in the role of increased COI through increased racial bias that children perceive. These findings underscore the complexity of educational equity, suggesting that improving COI alone is insufficient for eliminating racial disparities in school experiences. Policies should be in place to reduce school-based discrimination against Black students in high COI settings.

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Open Access November 09, 2024

Educated but Unhealthy? Examining Minorities' Diminished Returns

Shervin Assari, Hossein Zare

Global Journal of Epidemiology and Infectious Disease 2024, 4(1), 82-91. DOI: 10.31586/gjeid.2024.1105

Abstract Background: Educational attainment is known to improve self-rated health; however, research suggests that these benefits may be less pronounced for racial and ethnic minority groups. The Minorities' Diminished Returns (MDRs) theory posits that the protective effects of resources such as education are weaker for marginalized populations, such as Black and Latino individuals, compared to [...] Read more.
Background: Educational attainment is known to improve self-rated health; however, research suggests that these benefits may be less pronounced for racial and ethnic minority groups. The Minorities' Diminished Returns (MDRs) theory posits that the protective effects of resources such as education are weaker for marginalized populations, such as Black and Latino individuals, compared to their White counterparts. Objective: This study aims to investigate racial and ethnic disparities in the association between years of schooling and self-rated health among U.S. adults, with a focus on understanding the reduced health benefits of education for Black and Latino individuals. Methods: Using data from the Understanding America Study (UAS; 2014), we conducted a cross-sectional analysis of adults aged 18 and older (N = 6,785). Self-rated health was the outcome, and years of schooling was the primary independent variable. We controlled for sociodemographic factors including age, gender, employment status, immigration status, and marital status. Stratified analyses were conducted by race/ethnicity (Non-Latino White, Non-Latino Black, and Latino). Linear regression models were used to examine the association between years of schooling and self-rated health, and interaction terms were included to assess variation in this relationship across racial/ethnic groups. Results: While years of schooling was positively associated with better self-rated health overall, the magnitude of this effect was weaker for Black and Latino individuals compared to White individuals. After adjusting for sociodemographic factors, Black and Latino adults reported worse self-rated health for each additional year of schooling, compared to their White counterparts, supporting the MDRs hypothesis. Conclusion: The findings suggest that while higher educational attainment is protective against worse self-rated health, this protection is not equally distributed across racial and ethnic groups. Black and Latino individuals experience diminished returns from their years of schooling in terms of self-rated health, likely due to structural barriers and social inequalities. Policies addressing health disparities must consider these diminished returns and aim to reduce structural racism and discrimination that undermine the benefits of education for minoritized populations.

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Open Access November 09, 2024

Educated but on Social Security Disability Insurance: Minorities’ Diminished Returns

Shervin Assari, Babak Najand, Hossein Zare, Amanda Sonnega

Journal of Biomedical and Life Sciences 2024, 4(2), 81-91. DOI: 10.31586/jbls.2024.1108

Abstract Background: Educational attainment is widely regarded as a key predictor of economic and social outcomes in later life, including the likelihood of receiving Social Security Disability Insurance (SSDI). According to the Minorities' Diminished Returns (MDRs) theory, however, the benefits of education may be less pronounced for racial and ethnic minorities compared to non-Latino [...] Read more.
Background: Educational attainment is widely regarded as a key predictor of economic and social outcomes in later life, including the likelihood of receiving Social Security Disability Insurance (SSDI). According to the Minorities' Diminished Returns (MDRs) theory, however, the benefits of education may be less pronounced for racial and ethnic minorities compared to non-Latino Whites. This study investigates whether the effects of education on the likelihood of receiving SSDI differ by race and ethnicity, focusing on Black and Latino Americans. Objective: The primary aim of this study was to examine the relationship between educational attainment (measured in years of schooling) and the likelihood of receiving SSDI, with a specific focus on exploring how this relationship varies by race and ethnicity, in line with the MDRs framework. Methods: Data were drawn from the Understanding America Study (UAS), a nationally representative, internet-based panel survey. The sample included Black, Latino, and non-Latino White U.S. adults. Our sample size was 12,975 adults over the age of 18. Logistic regression models were used to assess the association between educational attainment and receiving SSDI, adjusting for demographic variables such as age, sex, employment status, and marital status. Interaction terms between race/ethnicity and educational attainment were included to explore whether the returns on education varied across racial and ethnic groups. Results: Higher educational attainment was significantly associated with a lower likelihood of receiving SSDI in the overall sample. However, consistent with the MDRs framework, the protective effect of education was significantly weaker for both Black and Latino individuals compared to non-Latino Whites. Black and Latino participants with similar levels of education as their non-Latino White counterparts were more likely to receive SSDI, reflecting diminished returns on educational attainment for these groups. Conclusion: This study provides strong evidence supporting the MDRs theory, demonstrating that the protective effects of education on the likelihood of receiving SSDI are not equally distributed across racial and ethnic groups. Black and Latino Americans experience weaker returns on their education when it comes to avoiding SSDI, likely due to structural inequalities and systemic barriers. These findings highlight the need for policies that address not only educational disparities but also the broader societal factors that limit the benefits of education for racial and ethnic minorities.

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Open Access November 05, 2024

Diminished Returns of Educational Attainment on Numeracy Score of Latino Populations: Insights from UAS Data

Shervin Assari, Hossein Zare, Golnoush Akhlaghipour, Mario F Mendez

Open Journal of Neuroscience 2024, 2(1), 14-24. DOI: 10.31586/ojn.2024.1098

Abstract Background: Educational attainment is a well-established social determinant of various domains of cognitive function across the lifespan. However, the theory of Minorities' Diminished Returns (MDRs) suggests that the health benefits of educational attainment tend to be weaker for ethnic minorities compared to non-Latino Whites. This phenomenon may reflect the impact of structural [...] Read more.
Background: Educational attainment is a well-established social determinant of various domains of cognitive function across the lifespan. However, the theory of Minorities' Diminished Returns (MDRs) suggests that the health benefits of educational attainment tend to be weaker for ethnic minorities compared to non-Latino Whites. This phenomenon may reflect the impact of structural inequalities, social stratification, and historical disadvantage. Objective: This study examines whether the association between educational attainment and numeracy score, one domain of cognitive function, is weaker in Latino individuals compared to non-Latino individuals, as predicted by the MDRs framework. Methods: Data were drawn from the 2014 wave of the Understanding America Study (UAS), a national internet-based panel. Numeracy score, a domain of the cognitive function was measured using an 8-item measure. Linear regression models were used to analyze the association between educational attainment and numeracy score, with an interaction term for ethnicity x educational attainment to explore differences between Latino and non-Latino participants. Models were adjusted for age, gender, marital status, immigration, and employment, and results were presented as beta coefficients, p-values, and 95% confidence intervals (CIs). Results: Overall, 5,659 participants entered our analysis. Higher educational attainment was positively associated with higher numeracy score for both Latino and non-Latino participants (p < 0.001). However, the interaction between education and ethnicity was significant (p < 0.05), indicating that Latino individuals experienced smaller numeracy benefits from education compared to non-Latino individuals. These results support the MDRs framework, suggesting that structural barriers may reduce the numeracy returns of education for Latino individuals. Conclusion: This study provides evidence of diminished returns of educational attainment in terms of numeracy scores among Latino individuals. While education is a key determinant of cognitive abilities such as numeracy, its benefits are not equitably distributed across ethnic groups. Structural inequalities particularly in educational opportunities likely contribute to this disparity. Addressing these underlying factors through targeted policy interventions is necessary to promote cognitive equity for Latino populations.

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Open Access November 03, 2024

School Poverty Partially Mediates the Effects of Structural Racism on Youth Tobacco Use Initiation

Shervin Assari, Hossein Zare

Global Journal of Epidemiology and Infectious Disease 2024, 4(1), 69-81. DOI: 10.31586/gjeid.2024.1062

Abstract Background. Although youth from high socioeconomic status (SES) backgrounds are generally protected against tobacco use, this protection is weaker for racialized and marginalized families, particularly Black youth. While Minorities' Diminished Returns (MDRs) of household income on tobacco use have been documented for Black youth, the mechanisms underlying these effects are not well understood. [...] Read more.

Background. Although youth from high socioeconomic status (SES) backgrounds are generally protected against tobacco use, this protection is weaker for racialized and marginalized families, particularly Black youth. While Minorities' Diminished Returns (MDRs) of household income on tobacco use have been documented for Black youth, the mechanisms underlying these effects are not well understood. Objective. This study investigates whether school poverty and associated peer deviance and delinquent behaviors explain the disproportionately higher tobacco use among Black youth from high-income backgrounds, using data from the Adolescent Brain Cognitive Development (ABCD) study. Methods. We conducted a longitudinal analysis of Black youth from high-income families within the Adolescent Brain Cognitive Development (ABCD) study. A total of 8,777 youth was included in our analysis. We examined the associations between household income and tobacco use, with school poverty and associated peer deviance and delinquent behaviors as mediators. Race was considered as a moderator. Results. Compared to their high-income White counterparts, Black youth from high-income backgrounds were more likely to live in areas with higher school poverty, which exposed them to increased levels of peer deviance and delinquent behaviors compared to their White counterparts. These exposures, in turn, were associated with higher rates of tobacco use among Black youth. Thus, higher school poverty, along with the related peer deviance and delinquent behaviors, contributed to the elevated tobacco use observed among Black adolescents from high-income backgrounds. Conclusion. The study suggests that residing in areas with school poverty, peer deviance, and youth delinquency may explain Minorities' Diminished Returns, which are defined as the weaker protective effects of socioeconomic status on tobacco use among Black youth. Interventions aiming to prevent tobacco use need to include structural components addressing these broader social determinants of health.

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Open Access October 30, 2024

Social Determinants of Successful Smoking Cessation: An Eight-Year Analysis of Population Assessment of Tobacco and Health (PATH) Data

Shervin Assari, Payam Sheikhattari

Journal of Biomedical and Life Sciences 2024, 4(2), 60-70. DOI: 10.31586/jbls.2024.1070

Abstract Background: Smoking cessation is a crucial public health goal due to its substantial impact on reducing the morbidity and mortality associated with tobacco use. However, significant disparities in smoking cessation success persist across socioeconomic groups in the United States. Objectives: This study aimed to examine differences in smoking cessation rates among daily smokers [...] Read more.

Background: Smoking cessation is a crucial public health goal due to its substantial impact on reducing the morbidity and mortality associated with tobacco use. However, significant disparities in smoking cessation success persist across socioeconomic groups in the United States. Objectives: This study aimed to examine differences in smoking cessation rates among daily smokers based on race, ethnicity, and socioeconomic status (SES) using data from the Population Assessment of Tobacco and Health (PATH) study, spanning waves 1 to 6 (eight years). Methods: Longitudinal data from PATH were analyzed, focusing on baseline daily cigarette smokers followed over an eight-year period to assess cessation outcomes. SES was measured by education and poverty status. Successful smoking cessation was defined as sustained abstinence from cigarettes for 12 months or more at the final wave. Logistic regression models identified predictors of successful cessation, adjusting for potential confounders, including age, nicotine dependence, and access to cessation resources. Results: The analysis revealed significant disparities in cessation success across racial, ethnic, and SES groups. Smokers living in poverty and those with lower educational attainment were less likely to achieve cessation success than their counterparts. Race (Black) and ethnicity (Latino) were also significantly associated with lower cessation success. Conclusions: This study highlights the social determinants of smoking cessation success among U.S. adult smokers, with lower success rates observed among those in poverty and with less educational attainment. These findings emphasize the need for targeted interventions that address the unique barriers to cessation faced by low-SES groups. Public health strategies should prioritize equitable access to cessation resources and culturally tailored interventions to reduce these disparities and improve cessation outcomes among all smokers.

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Open Access October 30, 2024

Smokers with Multiple Chronic Disease Are More Likely to Quit Cigarette

Shervin Assari, Payam Sheikhattari

Global Journal of Epidemiology and Infectious Disease 2024, 4(1), 60-68. DOI: 10.31586/gjeid.2024.1068

Abstract Objective: This study aims to investigate the relationship between the presence of chronic medical conditions and cessation among U.S. adults who use combustible tobacco. We hypothesized that having chronic medical conditions would be associated with a higher likelihood of successfully quitting combustible tobacco. Methods: We utilized longitudinal data from the Population [...] Read more.

Objective: This study aims to investigate the relationship between the presence of chronic medical conditions and cessation among U.S. adults who use combustible tobacco. We hypothesized that having chronic medical conditions would be associated with a higher likelihood of successfully quitting combustible tobacco. Methods: We utilized longitudinal data from the Population Assessment of Tobacco and Health (PATH) Study, using data from Waves 1 to 6. Only current daily smokers were included in our analysis. The independent variable was the number of chronic medical conditions, defined as zero, one, or two or more. The outcome was becoming a former smoker (quitting smoking). Using multivariate regression analyses, we assessed the association between the number of chronic conditions and tobacco cessation over the six waves. We controlled for potential confounding variables, including demographic factors and socioeconomic status. Results: Our analysis revealed a significant association between the number of chronic medical conditions and the likelihood of quitting smoking. Specifically, individuals with two or more chronic conditions exhibited a greater probability of quitting smoking compared to those with no chronic conditions. The results remained significant after adjusting for potential confounders. Conclusions: Multiple chronic medical conditions may act as a catalyst for smoking cessation among U.S. adults. This suggests that the presence of multimorbidity, defined as multiple chronic disease diagnoses, may serve as “teachable moments,” prompting significant health behavior changes. These findings highlight the potential for leveraging chronic disease management and healthcare interventions to promote tobacco cessation, particularly among individuals with multiple chronic conditions.

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Open Access September 12, 2024

Assessment of Coping Strategies Among Nursing Students: Basis for Psychological First Aid

Kenneth Dwight Espulgar, Zyrill Jovelle Faeldan, Christian Joy Ferre, Julie Ann Frago, Andrea Fatima Galanao, Roison Andro Narvaez, Emmy Macaraeg, Rolando Antonio

World Journal of Nursing Research 2024, 3(1), 64-72. DOI: 10.31586/wjnr.2024.1072

Abstract Background: Telomere length is a critical biomarker of cellular aging and overall health. While childhood socioeconomic status (SES) indicators such as education and poverty can have long-lasting effects on biological aging, research has shown contradictory results regarding the impact of adulthood SES on future telomere length, particularly in racially and ethnically diverse individuals. [...] Read more.

Background: Telomere length is a critical biomarker of cellular aging and overall health. While childhood socioeconomic status (SES) indicators such as education and poverty can have long-lasting effects on biological aging, research has shown contradictory results regarding the impact of adulthood SES on future telomere length, particularly in racially and ethnically diverse individuals. This study investigates the effects of baseline adulthood SES indicators such as education and poverty on telomere length nine years later in women, using data from the Future of Families and Child Wellbeing Study (FFCWS). Methods: We analyzed data from the FFCWS, a longitudinal cohort study. The sample included baseline adulthood SES and follow-up telomere length measure of women (n = 2,421) with varying socioeconomic conditions. Telomere length was measured from saliva samples nine years after the baseline measure of adulthood SES. Education, poverty, and marital status at baseline were assessed. Multivariate linear regression models were used to examine the association between adulthood SES indicators at baseline and future telomere length, controlling for potential confounders. Results: From the total 2,421 women, 675 were Latino White, 1,158 were non-Latino Black, and 588 were non-Latino White. Our findings indicate that for non-Latino White women poverty at certain level, and childbirth weight, and for non-Latino Black maternal age were predictors of telomere lengths nine years later. Conclusion: Poverty at a specific level, maternal age and childbirth weight serve as predictors of telomere lengths nine years later in some women. These findings underscore the importance of socioeconomic factors and early-life influences in understanding telomere dynamics and aging processes among women from varied racial and ethnic backgrounds.

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Open Access September 10, 2024

Does Adulthood Socioeconomic Status Predict Subsequent Telomere Length in Racially and Ethnically Diverse Women?

Shervin Assari, Mohammad Dezfuli, Amirreza Peyrovinasab, Hossein Zare

Journal of Biomedical and Life Sciences 2024, 4(1), 47-59. DOI: 10.31586/jbls.2024.1023

Abstract Background: Telomere length is a critical biomarker of cellular aging and overall health. While childhood socioeconomic status (SES) indicators such as education and poverty can have long-lasting effects on biological aging, research has shown contradictory results regarding the impact of adulthood SES on future telomere length, particularly in racially and ethnically diverse individuals. [...] Read more.

Background: Telomere length is a critical biomarker of cellular aging and overall health. While childhood socioeconomic status (SES) indicators such as education and poverty can have long-lasting effects on biological aging, research has shown contradictory results regarding the impact of adulthood SES on future telomere length, particularly in racially and ethnically diverse individuals. This study investigates the effects of baseline adulthood SES indicators such as education and poverty on telomere length nine years later in women, using data from the Future of Families and Child Wellbeing Study (FFCWS). Methods: We analyzed data from the FFCWS, a longitudinal cohort study. The sample included baseline adulthood SES and follow-up telomere length measure of women (n = 2,421) with varying socioeconomic conditions. Telomere length was measured from saliva samples nine years after the baseline measure of adulthood SES. Education, poverty, and marital status at baseline were assessed. Multivariate linear regression models were used to examine the association between adulthood SES indicators at baseline and future telomere length, controlling for potential confounders. Results: From the total 2,421 women, 675 were Latino White, 1,158 were non-Latino Black, and 588 were non-Latino White. Our findings indicate that for women in our study, no adulthood SES indicators such as poverty status, education, or marital status at baseline were predictive of telomere lengths nine years later. Conclusion: Our observations challenge that expected longitudinal association between adulthood SES indicators and subsequent telomere length almost a decade later in racially and ethnically diverse group of women. These findings underscore the need for additional research on the validity of TL as a mediator of the effects of adulthood SES on future rate of biological aging.

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Open Access September 05, 2024

Caste-based Diminished Returns of Educational Attainment on Wealth Accumulation in India

Shervin Assari, Hossein Zare

Open Journal of Educational Research 2024, 4(5), 243-255. DOI: 10.31586/ojer.2024.1056

Abstract Background: Education is widely recognized as a key driver of wealth generation, providing individuals with the opportunity to enhance their socioeconomic status. However, the effectiveness of education in generating wealth varies significantly across different social groups. In the United States, research has shown that Black individuals experience weaker economic returns on education [...] Read more.

Background: Education is widely recognized as a key driver of wealth generation, providing individuals with the opportunity to enhance their socioeconomic status. However, the effectiveness of education in generating wealth varies significantly across different social groups. In the United States, research has shown that Black individuals experience weaker economic returns on education compared to their White counterparts, a phenomenon explained by the theory of Minorities' Diminished Returns (MDRs). Although MDRs have been documented in various countries, their relevance to caste-based disparities in India remains unexplored. Objective: This study aims to investigate the caste-based diminished returns of education on wealth in India. We hypothesize that the returns on educational attainment, in terms of wealth generation, will be weaker for individuals from Scheduled Castes (SCs) compared to those from higher castes, using data from the India Demographic and Health Surveys (DHS). Methods: This study was a cross-sectional analysis of DHS -2019/2021 data from India, examining the relationship between educational attainment and wealth across different caste groups (scheduled castes and non-scheduled castes). Multivariate regression models will be employed to assess the interaction between caste and education in predicting wealth outcomes, controlling for relevant covariates such as age, gender, and region. Results: The study is expected to find that the returns on education, in terms of wealth, are significantly weaker for individuals from Scheduled Castes compared to those from higher castes. This would indicate that caste-based discrimination continues to hinder the economic progress of Scheduled Castes, even when they achieve similar levels of education as their upper-caste counterparts. Conclusion: The findings of this study will extend the MDR framework to the Indian context, demonstrating that caste-based disparities result in diminished returns on education for wealth generation. This study underscores the need for targeted policies that address the specific barriers faced by Scheduled Castes in translating educational attainment into economic success and highlights the ongoing impact of caste-based discrimination in India.

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Open Access September 04, 2024

Cognitive and Psychological Mediators of the Social Gradient in Tobacco Use Initiation Among Adolescents: Evidence from the ABCD Study

Shervin Assari, Hossein Zare

Journal of Biomedical and Life Sciences 2024, 4(1), 36-46. DOI: 10.31586/jbls.2024.1035

Abstract Background: Tobacco use among adolescents is a significant public health concern, with early initiation leading to long-term health risks. Understanding the factors that contribute to the initiation of tobacco use is crucial for developing effective prevention strategies. This study investigates the roles of substance use harm knowledge and tobacco susceptibility in mediating the [...] Read more.

Background: Tobacco use among adolescents is a significant public health concern, with early initiation leading to long-term health risks. Understanding the factors that contribute to the initiation of tobacco use is crucial for developing effective prevention strategies. This study investigates the roles of substance use harm knowledge and tobacco susceptibility in mediating the relationship between social gradients (race, ethnicity, and socioeconomic status) and tobacco use initiation among adolescents. Methods: Data from the Adolescent Brain Cognitive Development (ABCD) study, comprising a racially, ethnically, and economically diverse sample of tobacco-naive adolescents aged 9 to 16, were analyzed. Structural equation modeling (SEM) was used to test whether substance use harm knowledge and tobacco susceptibility mediate the effects of socioeconomic status (SES) on the initiation of tobacco use. Results: Findings indicated that both substance use harm knowledge and tobacco susceptibility partially mediate the relationship between SES and tobacco use initiation. Adolescents from lower SES backgrounds exhibited lower levels of harm knowledge and higher levels of tobacco susceptibility, which increased their likelihood of initiating tobacco use. Conclusion: This study highlights the complex interplay between social determinants and individual cognitive and psychological factors in influencing tobacco use initiation among adolescents. Public health interventions that enhance harm knowledge and reduce susceptibility to tobacco use are crucial for preventing initiation, particularly among racially, ethnically, and economically diverse adolescents. These efforts can help reduce health disparities and promote health equity.

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Original Research

Open Access September 04, 2024

Social Epidemiology of Early Initiation of Electronic and Conventional Cigarette Use in Early to Middle Adolescents

Shervin Assari, Hossein Zare, Payam Sheikhattari

Journal of Biomedical and Life Sciences 2024, 4(1), 27-35. DOI: 10.31586/jbls.2024.1038

Abstract Background: Early initiation of tobacco use among adolescents is a significant public health concern. While there is extensive research on overall tobacco use, much of it focuses on initiation in late adolescence, uses cross-sectional designs, and lacks specific exploration of electronic versus conventional cigarette use. This study aims to investigate social determinants influencing the [...] Read more.

Background: Early initiation of tobacco use among adolescents is a significant public health concern. While there is extensive research on overall tobacco use, much of it focuses on initiation in late adolescence, uses cross-sectional designs, and lacks specific exploration of electronic versus conventional cigarette use. This study aims to investigate social determinants influencing the early initiation of electronic and conventional cigarette use among U.S. adolescents. Methods: We utilized data from the Adolescent Brain Cognitive Development (ABCD) study, which follows a cohort of tobacco-naïve children from age nine through age 16. The social determinants examined included household income, parental education, financial difficulties, racial/ethnic minority status, family structure, neighborhood income, and gender minority status. Structural equation models were employed to assess associations between these determinants and early initiation of electronic and conventional cigarette use. Results: Male gender was associated with a higher likelihood of conventional cigarette use, while the risk of early initiation of electronic cigarette use was similar across genders. White adolescents were at a higher risk of conventional cigarette use; however, the risk for electronic cigarette use was comparable across White and non-White groups. Financial difficulties were linked to an increased likelihood of early initiation of conventional cigarette use but not electronic cigarette use. Higher household income was associated with a reduced risk of initiating conventional cigarettes but did not significantly impact electronic cigarette use. Adolescents from married families were less likely to initiate electronic cigarette use. No significant effects were found for parental education or neighborhood income on the initiation of either type of cigarette use. Age did not significantly affect the initiation of either cigarette type, and gender minority status was marginally associated with early initiation of conventional cigarette use. Conclusions: The social patterning of electronic cigarette use differs from that of conventional cigarette use, suggesting that distinct tobacco products do not pose a uniform risk across all adolescents. This study underscores the importance of tailored prevention efforts that address the unique challenges associated with early initiation of electronic and conventional cigarette use among adolescents. The differential risk factors identified suggest targeted prevention strategies for conventional cigarette use, focusing on financial difficulties, household income, and gender-specific interventions. In contrast, prevention efforts for electronic cigarette use may require broader, more inclusive approaches that address all adolescents, regardless of their background. Comprehensive universal screening for electronic cigarette use and targeted screening for conventional cigarette use among adolescents are recommended.

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Open Access August 27, 2024

Role of Impulsivity in Explaining Social Gradient in Youth Tobacco Use Initiation: Does Race Matter?

Shervin Assari, Payam Sheikhattari

Open Journal of Neuroscience 2024, 2(1), 1-13. DOI: 10.31586/ojn.2024.1052

Abstract Background: Socioeconomic status (SES) is traditionally viewed as a protective factor against impulsivity and subsequent tobacco use in youth. The prevailing model suggests that higher SES is associated with lower impulsivity, which in turn reduces the likelihood of future tobacco use. However, this pathway may not hold uniformly across racial groups due to differences in impulsivity and [...] Read more.

Background: Socioeconomic status (SES) is traditionally viewed as a protective factor against impulsivity and subsequent tobacco use in youth. The prevailing model suggests that higher SES is associated with lower impulsivity, which in turn reduces the likelihood of future tobacco use. However, this pathway may not hold uniformly across racial groups due to differences in impulsivity and the phenomenon of Minorities' Diminished Returns (MDRs), where the protective effects of SES, such as educational attainment, tend to be weaker or even reversed for Black youth compared to their White counterparts. Objectives: This study aims to examine the racial heterogeneity in the pathway from childhood SES to impulsivity and subsequent tobacco use initiation during adolescence, focusing on differences between Black and White youth. Methods: Data were drawn from the Adolescent Brain Cognitive Development (ABCD) Study, which includes a diverse sample of youth aged 9 to 16 years. The analysis examined the relationship between baseline family SES (age 9), impulsivity (age 9), and subsequent tobacco use (ages 9 to 16). Impulsivity was measured using the Urgency, Premeditation (lack of), Perseverance (lack of), Sensation Seeking, and Positive Urgency Impulsive Behavior Scale (UPPS-P). Structural equation modeling (SEM) was employed, with analyses stratified by race to explore potential differences in these associations. Results: Overall, 6,161 non-Latino White and 1,775 non-Latino Black adolescents entered our analysis. In the full sample, higher family SES was linked to lower childhood impulsivity and, consequently, less tobacco uses in adolescence. However, racial differences emerged upon stratification. Among White youth, higher SES was associated with lower impulsivity, leading to reduced tobacco use, consistent with the expected model. In contrast, among Black youth, higher SES was not associated with lower impulsivity, thereby disrupting the protective effect of SES on tobacco use through this pathway. These findings suggest that racial heterogeneity exists in the SES-impulsivity-tobacco use pathway, aligning with the MDRs framework, which highlights how structural factors may weaken the protective effects of high SES among Black youth. Conclusions: These findings underscore the importance of considering racial heterogeneity in the relationships between SES, impulsivity, and tobacco use. The observed disparities suggest a need for targeted interventions that address the unique challenges faced by Black youth, who may not experience the same protective benefits of high SES as their White peers. These results carry significant implications for public health strategies aimed at reducing tobacco use in racially diverse populations.

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Open Access August 18, 2024

Extreme Heat Exposure Is Associated with Higher Socioeconomic Disadvantage and Elevated Youth Delinquency

Shervin Assari, Hossein Zare

Journal of Social Mathematical & Human Engineering Sciences 2024, 3(1), 15-28. DOI: 10.31586/jsmhes.2024.1044

Abstract Background: Climate change has led to an increase in the frequency and intensity of extreme heat events, a trend expected to continue. This poses significant health risks, particularly for vulnerable populations like children. While previous research has largely concentrated on the physical health impacts of extreme heat, less attention has been given to behavioral outcomes, such as [...] Read more.

Background: Climate change has led to an increase in the frequency and intensity of extreme heat events, a trend expected to continue. This poses significant health risks, particularly for vulnerable populations like children. While previous research has largely concentrated on the physical health impacts of extreme heat, less attention has been given to behavioral outcomes, such as delinquency. Objectives: This study investigates the association between extreme heat exposure and delinquency among children, utilizing data from the Adolescent Brain Cognitive Development (ABCD) study. It also explores the potential mediating roles of neighborhood socioeconomic status (SES; measured by median home value), puberty, peer deviance, and financial difficulties. Methods: Data from the national ABCD study were analyzed to assess the relationship between extreme heat exposure (exposure) and delinquency (outcome). Covariates included race/ethnicity, sex, and age. Mediators examined were neighborhood SES, puberty, peer deviance, and financial difficulties. Structural equation modeling (SEM) was employed for data analysis. Results: Overall, 11,878 children entered our analysis. The analysis revealed a significant association between extreme heat exposure and higher levels of delinquency among children. Children more exposed to extreme heat were more likely to be Black, reside in lower SES neighborhoods, experience greater financial difficulties, and have more advanced puberty status. The group facing the highest heat exposure was also economically disadvantaged. Conclusions: The findings suggest that children already disadvantaged by socio-economic factors are disproportionately affected by extreme heat, leading to increased delinquency. This highlights the need for targeted interventions to protect these vulnerable populations and address the mediators of extreme heat exposure. Future research should focus on longitudinal studies and evaluate the effectiveness of various mitigation strategies to address these disparities.

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Open Access August 17, 2024

Socioeconomic Status Partially Mediates the Effects of Structural Racism on Youth Tobacco Use Initiation

Shervin Assari, Hossein Zare

Global Journal of Epidemiology and Infectious Disease 2024, 4(1), 44-59. DOI: 10.31586/gjeid.2024.1032

Abstract Background: Recent research has identified structural racism—systemic policies and practices that perpetuate racial inequalities—as a significant social determinant of population health. Studies utilizing data from the Adolescent Brain Cognitive Development (ABCD) study have shown an association between higher levels of state-level structural racism and increased tobacco use among youth in [...] Read more.

Background: Recent research has identified structural racism—systemic policies and practices that perpetuate racial inequalities—as a significant social determinant of population health. Studies utilizing data from the Adolescent Brain Cognitive Development (ABCD) study have shown an association between higher levels of state-level structural racism and increased tobacco use among youth in the United States. However, there has been limited exploration of the psychosocial mediators of this relationship, particularly in the context of youth aged 10-16 years. Objective: This study aimed to assess the roles of socioeconomic status (SES), tobacco susceptibility, and perceived discrimination as potential mediators in the relationship between state-level structural racism and youth tobacco initiation rates. Methods: We analyzed data from the ABCD study, a nationally representative longitudinal survey of 11,698 youth followed from ages 9/10 to 15/16. These data were combined with state-level indicators of structural racism. We employed structural equation modeling (SEM) to investigate the mediators of the association between structural racism and self-reported initiation of tobacco use, while controlling for individual and state-level covariates. Results: Our findings indicate that higher levels of structural racism were associated with increased rates of tobacco initiation among youth. This relationship was partially mediated by lower SES, but not by perceived discrimination or tobacco susceptibility. Conclusion: The association between structural racism and youth tobacco initiation appears to be influenced in part by the lower SES prevalent in states with higher levels of racism. These results highlight the need for addressing both racism and SES inequalities as key strategies for reducing tobacco disparities among youth.

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Open Access August 14, 2024

Handing Money to the Poor Is Never Enough: The Impact of Marginalization-Related Diminished Returns

Shervin Assari, Hossein Zare

Global Journal of Epidemiology and Infectious Disease 2024, 4(1), 34-43. DOI: 10.31586/gjeid.2024.1026

Abstract Recent US studies such as Baby’s First Years have again demonstrated that unconditional cash transfers and guaranteed income do not lead to significant improvements in the health, economic status, and well-being of individuals living in poverty. In this perspective article we review the emerging literature on this topic and offer explanations for the observed outcomes. We then apply the theory and [...] Read more.

Recent US studies such as Baby’s First Years have again demonstrated that unconditional cash transfers and guaranteed income do not lead to significant improvements in the health, economic status, and well-being of individuals living in poverty. In this perspective article we review the emerging literature on this topic and offer explanations for the observed outcomes. We then apply the theory and empirical evidence on marginalization-related diminished returns (MDRs) also called minorities diminished returns (MDRs) to elucidate the weak or null effects of cash transfers in the lives of marginalized populations. According to the MDR theory, marginalization not only reduces access to resources but also reduces their utility. Individuals who experience long-term poverty and marginalization exhibit smaller than expected benefits from new resources, such as cash, in adulthood. This is due to the deeply entrenched structural barriers and systemic discrimination that persist throughout their lives. The existing literature suggests that socioeconomic changes in adulthood have limited impact on the health and well-being of populations that have been raised in poverty. This is because the advantages of increased socioeconomic status (SES) are often undermined by ongoing marginalization and limited access to supportive resources and opportunities. As a result, simply providing cash transfers is insufficient to create substantial and lasting improvements in the lives of those living in poverty. To address these challenges, we recommend a multifaceted approach that includes childhood poverty prevention, interventions aimed at reducing marginalization, and comprehensive multi-sector strategies. By focusing on early intervention and addressing the root causes of poverty and marginalization, we can create more effective and sustainable solutions to improve health and well-being among disadvantaged populations. This holistic approach recognizes the complexity of poverty and the necessity of addressing both immediate needs and long-term structural barriers to achieve meaningful change.

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Perspective

Open Access July 24, 2024

Race by Sex Intersectional Differences in the Association between Allostatic Load and Depression in US Adults: 2005-2018

Shervin Assari, Mahbube Askari Azad, Hossein Zare

Global Journal of Epidemiology and Infectious Disease 2024, 4(1), 20-33. DOI: 10.31586/gjeid.2024.1014

Abstract Objective: Previous research has underscored the link between allostatic load—a comprehensive indicator of the cumulative physiological burden of chronic stress—and depression. However, there remains a significant gap in understanding how this relationship may differ across race and sex intersectional groups. This study aimed to investigate variations in the association between elevated [...] Read more.

Objective: Previous research has underscored the link between allostatic load—a comprehensive indicator of the cumulative physiological burden of chronic stress—and depression. However, there remains a significant gap in understanding how this relationship may differ across race and sex intersectional groups. This study aimed to investigate variations in the association between elevated allostatic load (AL>4) and depression among different race-sex intersectional groups within the general population. Methods: This cross-sectional secondary analysis utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 2005-2018. The analysis included variables such as race, sex, age, socioeconomic status, depression (measured via the Patient Health Questionnaire - PHQ), and allostatic load. Linear regression analyses were conducted to examine the interactions between race and sex with allostatic load, focusing on the likelihood of high depression as the outcome. Results: Across the pooled sample, an allostatic load greater than 4 was significantly associated with increased depression. Notably, an interaction effect was observed between race and AL>4 on depression among women, indicating that non-Hispanic Black women with a high allostatic load exhibited more pronounced depressive symptoms (Beta: 1.09, CI: 0.02-2.61). Conversely, among men, allostatic load greater than 4 neither correlated with nor interacted with race to influence depression levels. Conclusion: The study highlights the critical need to consider allostatic load as a key target for interventions that aim to reduce depression among Black women. These findings underscore the necessity for customized intervention strategies that address the nuanced race-sex disparities in the impact of allostatic load on mental health across populations.

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Open Access July 16, 2024

Poverty Status at Birth Predicts Epigenetic Changes at Age 15

Shervin Assari, Hossein Zare

Journal of Biomedical and Life Sciences 2024, 4(1), 1-14. DOI: 10.31586/jbls.2024.989

Abstract We used 15 years of follow up of 854 racially and ethnically diverse birth cohort who were followed from birth to age 15. Structural equation modeling (SEM) was used to examine the effects of race/ethnicity, maternal education, and family structure on poverty at birth, as well as the effects of poverty at birth on epigenetic changes at age 15. We also explored variations by sex. Results: [...] Read more.
We used 15 years of follow up of 854 racially and ethnically diverse birth cohort who were followed from birth to age 15. Structural equation modeling (SEM) was used to examine the effects of race/ethnicity, maternal education, and family structure on poverty at birth, as well as the effects of poverty at birth on epigenetic changes at age 15. We also explored variations by sex. Results: Our findings indicate that Black and Latino families had lower maternal education and married family structure which in turn predicted poverty at birth. Poverty at birth then was predictive of epigenetic changes 15 years later when the index child was 15. This suggested that poverty at birth partially mediates the effects of race/ethnicity, maternal education, and family structure on epigenetic changes of youth at age 15. There was an effect of poverty status at birth on DNA methylation of male but not female youth at age 15. Thus, poverty at birth may have a more salient effect on long term epigenetic changes of male than female youth. Conclusions: Further studies are needed to understand the mechanisms underlying the observed sex differences in the effects of poverty as a mechanism that connects race/ethnicity, maternal education, and family structure to epigenetic changes later in life.

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Open Access July 12, 2024

Race, Poverty Status at Birth, and DNA Methylation of Youth at Age 15

Shervin Assari, Hossein Zare

Global Journal of Epidemiology and Infectious Disease 2024, 4(1), 8-19. DOI: 10.31586/gjeid.2024.988

Abstract Epigenetic studies, which can reflect biological aging, have shown that measuring DNA methylation (DNAm) levels provides new insights into the biological effects of social environment and socioeconomic position (SEP). This study explores how race, family structure, and SEP (income to poverty ratio) at birth influence youth epigenetic aging at age 15. Data were obtained from the Future [...] Read more.

Epigenetic studies, which can reflect biological aging, have shown that measuring DNA methylation (DNAm) levels provides new insights into the biological effects of social environment and socioeconomic position (SEP). This study explores how race, family structure, and SEP (income to poverty ratio) at birth influence youth epigenetic aging at age 15. Data were obtained from the Future of Families and Child Wellbeing Study (FFCWS) cohort, with GrimAge used as a measure of DNAm levels and epigenetic aging. Our analysis included 854 racially and ethnically diverse participants followed from birth to age 15. Structural equation modeling (SEM) examined the relationships among race, SEP at birth, and epigenetic aging at age 15, controlling for sex, ethnicity, and family structure at birth. Findings indicate that race was associated with lower SEP at birth and faster epigenetic aging. Specifically, income to poverty ratio at birth partially mediated the effects of race on accelerated aging by age 15. The effect of income to poverty ratio at birth on DNAm was observed in male but not female youth at age 15. Thus, SEP partially mediated the effect of race on epigenetic aging in male but not female youth. These results suggest that income to poverty ratio at birth partially mediates the effects of race on biological aging into adolescence. These findings highlight the long-term biological impact of early-life poverty in explaining racial disparities in epigenetic aging and underscore the importance of addressing economic inequalities to mitigate these disparities. Policymakers should focus on poverty prevention in Black communities to prevent accelerated biological aging and associated health risks later in life. Interventions aimed at eliminating poverty and addressing racial inequities could have significant long-term benefits for public health. Future research should explore additional factors contributing to epigenetic aging and investigate potential interventions to slow down the aging process. Further studies are needed to understand the mechanisms underlying these associations and to identify effective strategies for mitigating the impact of SEP and racial disparities on biological aging.

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Open Access June 01, 2024

An Assessment of Off-Season Vegetable Farming on Farmers in Savelugu Municipality in the Northern Region

Yakubu Jacob Fuseini

Open Journal of Agricultural Research 2024, 4(1), 1-11. DOI: 10.31586/ojar.2024.933

Abstract The study aimed to assess the impact of off-season vegetable farming on farmers in the Savelugu Municipality in the Northern Region. The study population consisted of all respondents to off-season vegetable farming in the Savelugu Municipality in the five selected communities in the Northern Region. A purposive sampling technique was used for a sample size of fifty (50) off-season farmers in the [...] Read more.

The study aimed to assess the impact of off-season vegetable farming on farmers in the Savelugu Municipality in the Northern Region. The study population consisted of all respondents to off-season vegetable farming in the Savelugu Municipality in the five selected communities in the Northern Region. A purposive sampling technique was used for a sample size of fifty (50) off-season farmers in the selected communities. An interview guide and questionnaire were used to solicit data to conclude the findings. The data derived from the questionnaire were analysed in a step-by-step thematic analysis that included reading the transcriptions several times, coding, generating codes, and reviewing and naming themes. Afterwards, the questionnaire and interview guide responses were transferred into Microsoft Excel under assigned variable names. Descriptive statistics, namely frequency, means, and percentages, were used to analyse the data. Off-season vegetable production technology can be gained by using different agro-climatic regions, maintaining or adjusting planting time, selecting varieties, and creating artificial and controlled environments through tunnels, polytene houses, glass houses, hotbeds, etc. Moreover, Off-Season vegetables helped earn income and ranked highest with an overall mean score of 1. Nearly all the trained farmers said their primary constraint was the high incidence of pests and diseases. It is evident that off-season cultivation is profitable and significantly impacts the farmers' consumption expenditure and food security status. Therefore, providing improved and modern agricultural inputs to off-season farmers is essential for rural agricultural development.

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Review Article

Open Access May 12, 2024

Socio-Demographic Factors Influencing Work-Family Conflict Among Hotel Managers

Samuel Otoo

Universal Journal of Business and Management 2024, 4(1), 15-27. DOI: 10.31586/ujbm.2024.946

Abstract This study examines the influence of socio-demographic factors on work-family conflict among management staff in star-rated hotels in the Accra Metropolis. The research aims to explore how variables such as gender, age, marital status, and educational background impact the experiences of work-family conflict among hotel managers. A quantitative research design was employed, and data were collected [...] Read more.

This study examines the influence of socio-demographic factors on work-family conflict among management staff in star-rated hotels in the Accra Metropolis. The research aims to explore how variables such as gender, age, marital status, and educational background impact the experiences of work-family conflict among hotel managers. A quantitative research design was employed, and data were collected through structured questionnaires distributed to a purposive sample of hotel managers. The findings reveal significant associations between socio-demographic characteristics and work-family conflict, highlighting the complexities of balancing work responsibilities with family obligations in the hospitality industry. The implications of the study underscore the importance of tailored interventions to support the well-being of hotel managers, while the recommendations emphasise the implementation of work-life balance programs, support for family obligations, promotion of diversity and inclusion, and continuous training and development. It is recommended that hotel organisations create a supportive work environment that enhances the job satisfaction and productivity of their management staff. This study contributes valuable insights to the existing literature on work-family conflict in the hospitality sector and provides a foundation for future research endeavours in this area.

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Open Access November 22, 2023

Pregnancy outcome in patients with previous infection with COVID-19 and the health of newborns

Romir Kadriu, Ilir Demiri, Goran Dimitrov, Pajtim Asani, Ardita Demiri-Kadriu

Open Journal of Medical Sciences 2023, 3(1), 46-52. DOI: 10.31586/ojms.2023.823

Abstract The study is a follow-up of the study "Coronavirus in pregnant patients and their clinical outcomes – results of a case-control study" conducted by R.Kadriu et al (2023) in which,in addition to the pregnant patients whose outcome is now being investigated,a control group of patients who were not pregnant,conducted with pregnant patients and a control group that were non-pregnant patients.This [...] Read more.

The study is a follow-up of the study "Coronavirus in pregnant patients and their clinical outcomes – results of a case-control study" conducted by R.Kadriu et al (2023) in which,in addition to the pregnant patients whose outcome is now being investigated,a control group of patients who were not pregnant,conducted with pregnant patients and a control group that were non-pregnant patients.This study was conducted 6 months after the discharge of the patients and their newborns,and highlights the impact of COVID-19 on their health as well as the health of the newborns. The aim of the study is to follow up the patients after 6 months of their hospitalization as COVID-19 patients and after their delivery.In the COVID study, none of the health indicators showed statistically significant differences between the population before and after hospitalization.Patient data were collected at the case level summarized in their respective groups.For secondary objectives, several comparative analyzes were performed regarding comorbidity-related parameters and available risk factors.A significance level (α) of 0.05 was used for statistical significance. While these results may be reassuring regarding the stability of health status, one should be aware of the limitations of the study, including sample size and specific population characteristics.

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Open Access October 20, 2023

Factors Influencing Fertility Control among Highly-Educated Urban Women in the Cape Coast Metropolis of Ghana

Joseph Boateng, Liyab John Tachin

Universal Journal of Social Sciences and Humanities 2023, 3(2), 80-90. DOI: 10.31586/ujssh.2023.799

Abstract Fertility control is crucial to achieving improved health and socio-economic status of women. The main objective of the study was to explore fertility control behaviours among educated urban women in the Cape Coast Metropolis. The study adopted the interpretivist (qualitative) philosophy in social research. The population for the study comprised women who have at least secondary-level education, are married or in a stable union and are between the ages of 18 and 49 years. A snowball sampling technique was used to select thirty-two (32) respondents for the study. The respondents constituted the number that provided the required information at saturation. The main instrument for data collection was a semi-structured interview guide. Data was collected from educated women within the Cape Coast Metropolis. Five items open-ended questions under the heading Factors influencing fertility control among highly-educated urban women in the Cape Coast Metropolis [...] Read more.

Fertility control is crucial to achieving improved health and socio-economic status of women. The main objective of the study was to explore fertility control behaviours among educated urban women in the Cape Coast Metropolis. The study adopted the interpretivist (qualitative) philosophy in social research. The population for the study comprised women who have at least secondary-level education, are married or in a stable union and are between the ages of 18 and 49 years. A snowball sampling technique was used to select thirty-two (32) respondents for the study. The respondents constituted the number that provided the required information at saturation. The main instrument for data collection was a semi-structured interview guide. Data was collected from educated women within the Cape Coast Metropolis. Five items open-ended questions under the heading Factors influencing fertility control among highly-educated urban women in the Cape Coast Metropolis. All transcribed data were then imported into NVivo 11, a computer-aided qualitative data analysis package with each transcript coded sentence by sentence. The codes were determined and constructed based on the content of the data. After the coding process, each code was described and memos attached as ideas about the themes emerged from social-cultural, economic to educational factors. The study underscores the adequate involvement of male partners in women’s fertility control practices, especially women’s contraceptive preferences. This demonstrates the authority of men over women in the domain of the family. Recognising that men have enormous powers regarding fertility issues tend to appreciate the need to promote and advance family needs and welfare. Also, the results indicate that other close associates or relatives are involved in women’s contraceptive lives. These close relations are what describes as a social network in Bronfenbrenner social-ecological framework. Besides, there are multiple socio-cultural and economic obstacles that could work against achieving desired fertility levels. It is recommended that family planning programmes should not focus on only women, but include male partners to enhance a change in behaviour and norms regarding power and gender roles that do not make them supportive partners. There is a need for a high-level promotion through civil society to encourage men to get involved in family planning matters. This will help women or couples to freely adopt their desired fertility control methods without hindrance.

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Open Access February 04, 2023

Microbial Quality of Home Prepared Complementary Foods in Slum Households with Children of Age 6-24 Months in Addis Ababa: A Community Based Cross-sectional Study

Abiyot Tenna, Esubalew Tesfahun, Dejene Derseh, Gebremedhin Yenehun, Teshome Nigussie

Open Journal of Food and Nutrition 2022, 1(1), 40-50. DOI: 10.31586/ojfn.2023.595

Abstract Background: Foodborne disease is a worldwide challenge. It causes a huge burden of diarrhea in children mostly in developing countries and this is common during the complementary feeding periods. As home serve as the proliferation ground for microbial pathogens, home- prepared complementary foods, coupled with unhygienic feeding practice and contamination, it is the cause of child morbidity and poor nutritional status. This is worse in slum households. However, recent evidence is very scarce and further study is very necessary. Objective: To investigate the microbiological quality of home-prepared complementary foods in slum households with children of 6-24 months in Addis Ababa, 2021. Methods: A community-based cross-sectional study design was used and a total of 91 households were included. Three sub-cities in Addis Ababa and slum settlements within each sub-city were randomly selected by lottery method. Households with children of age from 6-24 months were selected by systematic random sampling. Laboratory investigation was used for microbial identification and excel sheet was used for data entry and cleaning. SPSS V. 23 was used for data analysis. Result: The median and interquartile range of aerobic plate count, S.aureus, yeast, molds and total coliforms are log5.75cfu/ml, Log1.84cfu/ml; Log4.7cfu/ml, Log5.46cfu/ml; Log5.29 cfu/ml, Log3.68cfu/ml; Log4.17cfu/ml, Log4.70cfu/ml; and Log0, Log3.5cfu/ml, respectively. Fecal coliform and E.coli were observed in 19% and 10% of complementary food samples. Conclusion: The load of aerobic plate count, S.aureus [...] Read more.

Background: Foodborne disease is a worldwide challenge. It causes a huge burden of diarrhea in children mostly in developing countries and this is common during the complementary feeding periods. As home serve as the proliferation ground for microbial pathogens, home- prepared complementary foods, coupled with unhygienic feeding practice and contamination, it is the cause of child morbidity and poor nutritional status. This is worse in slum households. However, recent evidence is very scarce and further study is very necessary. Objective: To investigate the microbiological quality of home-prepared complementary foods in slum households with children of 6-24 months in Addis Ababa, 2021. Methods: A community-based cross-sectional study design was used and a total of 91 households were included. Three sub-cities in Addis Ababa and slum settlements within each sub-city were randomly selected by lottery method. Households with children of age from 6-24 months were selected by systematic random sampling. Laboratory investigation was used for microbial identification and excel sheet was used for data entry and cleaning. SPSS V. 23 was used for data analysis. Result: The median and interquartile range of aerobic plate count, S.aureus, yeast, molds and total coliforms are log5.75cfu/ml, Log1.84cfu/ml; Log4.7cfu/ml, Log5.46cfu/ml; Log5.29 cfu/ml, Log3.68cfu/ml; Log4.17cfu/ml, Log4.70cfu/ml; and Log0, Log3.5cfu/ml, respectively. Fecal coliform and E.coli were observed in 19% and 10% of complementary food samples. Conclusion: The load of aerobic plate count, S.aureus, yeast, molds, and total coliform are high in samples of complementary foods. Therefore, intervention studies for further identification of contamination sources should be made in order to minimize contamination of complementary foods and associated infections.

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Article

Open Access January 28, 2023

Participation in the National Campaign on Viral Hepatitis C and Non-Communicable Diseases among Administrative Workers of Ain Shams University, Egypt

Nashwa I. Basyoni, Nourhan B. Abd-ElSamad, Mohamed F. Allam, Samia I. El-Damaty

World Journal of Medical Microbiology 2023, 2(1), 14-21. DOI: 10.31586/wjmm.2023.584

Abstract Background: On the first of October 2018, the Egyptian Ministry of Health and Population (MOHP) launched an initiative; named “100 Million Healthy Lives”, for nationwide screening of hepatitis c virus (HCV) and non-communicable diseases (NCDs). Egypt has the highest prevalence of HCV infection in the world where about 10% of the Egyptian population is affected by the disease. NCDs are the [...] Read more.

Background: On the first of October 2018, the Egyptian Ministry of Health and Population (MOHP) launched an initiative; named “100 Million Healthy Lives”, for nationwide screening of hepatitis c virus (HCV) and non-communicable diseases (NCDs). Egypt has the highest prevalence of HCV infection in the world where about 10% of the Egyptian population is affected by the disease. NCDs are the leading cause of mortality in Egypt and account for about 84% of all deaths. This study was conducted to a) Estimate the prevalence of participation in the national campaign on viral hepatitis C and non-communicable diseases among administrative workers in Ain shams University (ASU), b) Estimate the self-reported satisfaction of these participants with the campaign. Subjects and Methods: A cross-sectional study was conducted on 400 administrative workers of ASU faculties between March and August 2019 in Cairo, Egypt. A multistage random sample was done. Results: The study showed that 96% of the study group participated in the campaign. “Evaluating health status” was considered the main reason for participation at 92%, followed by "desire to obtain follow-up card", at 36%. Non-participation rate was about 4% and the main cause of non-participation was “fear of needle prick". About 91% of the participants were satisfied with the provided services. Mass media played a major role in awareness about the campaign for 91% of participants. Conclusions: The majority of the study group participated and was satisfied with the campaign. Mass media played a major role in participant awareness of the campaign.

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Open Access November 25, 2022

Knowledge for a Better Conservation: Syntaxonomic Review of Caribbean Pine Forests (Cuba, Hispaniola)

Ana Cano-Ortiz, Ricardo Quinto Canas, José Carlos Piñar Fuentes, Sara del Río, Carlos José Pinto Gomes, Eusebio Cano

Research Journal of Ecology and Environmental Sciences 2022, 2(4), 118-181. DOI: 10.31586/rjees.2022.284

Abstract A phytosociological review is carried out of the pine forest formations on the islands of Cuba and Hispaniola (Caribbean), due to the diversity of soils and environments. We collected 10 plant associations belonging to the class Byrsonimo-Pinetea caribaea growing on siliceous, calcareous and sandy substrates and 21 associations on special, serpentine and ophite substrates and on ultramafic rocks belonging to the class Caseario crassinervis-Pinetea cubensis, exclusive to Cuba; while the association of pine forests on serpentines in Hispaniola is included in the class Phyllantho orbicularis-Neobracetea valenzuelanae with a Caribbean distribution. The comparative phytosociological and statistical study reveals phytosociological anomalies in the inclusion of various syntaxa, and in the description of other syntaxa according to the International Code of Phytosociological Nomenclature (ICPN). We therefore propose a change in status for several of the subassociations described: subass. ilicetosum repandae: syn. var. con Ilex repanda; subass. schmidtottietosum shaferi: syn. var. with Schmidtottia shaferi; subass. acrosynanthetosum trachyphylli: syn. var. with Acrosynanthus trachyphyllus; subass. psychotrietosum grandis: var. con Psychotria grandis; subass. notodonetosum roigii: syn. var. with Notodon roigii. We also propose a nomen novum: jaquinietosum oxhyphyllae Reyes & Acosta 2012 ex Cano et al. hoc loco [...] Read more.

A phytosociological review is carried out of the pine forest formations on the islands of Cuba and Hispaniola (Caribbean), due to the diversity of soils and environments. We collected 10 plant associations belonging to the class Byrsonimo-Pinetea caribaea growing on siliceous, calcareous and sandy substrates and 21 associations on special, serpentine and ophite substrates and on ultramafic rocks belonging to the class Caseario crassinervis-Pinetea cubensis, exclusive to Cuba; while the association of pine forests on serpentines in Hispaniola is included in the class Phyllantho orbicularis-Neobracetea valenzuelanae with a Caribbean distribution. The comparative phytosociological and statistical study reveals phytosociological anomalies in the inclusion of various syntaxa, and in the description of other syntaxa according to the International Code of Phytosociological Nomenclature (ICPN). We therefore propose a change in status for several of the subassociations described: subass. ilicetosum repandae: syn. var. con Ilex repanda; subass. schmidtottietosum shaferi: syn. var. with Schmidtottia shaferi; subass. acrosynanthetosum trachyphylli: syn. var. with Acrosynanthus trachyphyllus; subass. psychotrietosum grandis: var. con Psychotria grandis; subass. notodonetosum roigii: syn. var. with Notodon roigii. We also propose a nomen novum: jaquinietosum oxhyphyllae Reyes & Acosta 2012 ex Cano et al. hoc loco.

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Open Access November 13, 2022

Effects of Impacted Third Molars Extraction on Periodontal Status of Second Molar and Oral Health-Related Quality of Life

Tie-lou Chen, Pei Wang, Shi-feng Wang, Yan-en Wang, Xin-hai Zhang, Wen-jing Chen, An-xin Yue, Dao Xiang, Xu Feng

Universal Journal of Stomatology 2022, 1(1), 1-11. DOI: 10.31586/ujs.2022.473

Abstract Objective: The study investigated the impacts of third molar (M3) extraction on periodontal status of adjacent second molar (M2) and oral health-related Quality of life (QoL). Methods: 272 cases with M3 were randomly divided into treatment group and control group, each of 136 cases. Questionnaire survey evaluated demographic features of the subjects. Gingival index (GI), [...] Read more.

Objective: The study investigated the impacts of third molar (M3) extraction on periodontal status of adjacent second molar (M2) and oral health-related Quality of life (QoL). Methods: 272 cases with M3 were randomly divided into treatment group and control group, each of 136 cases. Questionnaire survey evaluated demographic features of the subjects. Gingival index (GI), plaque index (PLI) and conscious symptoms of adjacent teeth of the M3 were detected in both groups at baseline (T0), 1 week (T1), 1 month (T2) and 6 months (T3) after treatment. The impacts of QoL were evaluated using OHIP-14 to measure total scores and various items of OHIP-14 at different observation point. Results: The percentage of swelling and toothache in the treatment group was significantly lower than that in the control group at T1, T2 and T3. Significant differences could be seen in GI and PLI between the treatment and control groups at T2 and T3. The total score of OHIP-14 in T2 and T3 was significantly lower than that in T0 and T1 in the treatment group. The 14 items scores and the percentage of positive reaction in the treatment group were significantly lower than those in the control group at T2 and T3. Conclusion: M3 extraction had significant impacts on the periodontal status of the second molar and quality of life. This study would provide an important basis for the prophylactic removal of M3 in clinical work.

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Open Access November 09, 2022

Economic Consequences of Covid-19 in Western Ethiopia: Challenges and Opportunities

Isubalew Daba Ayana, Firdisa Birru Goshu, Desalegn Eticha Deressa, Melkamu Wolde Geleta, Tarekegn Tariku Ebissa, Tesfaye Eresso Gofe, Dugasa Rafisa Olana

Universal Journal of Finance and Economics 2022, 2(1), 52-70. DOI: 10.31586/ujfe.2022.502

Abstract This research is conducted with main aim of assessing the economic consequences of Covid-19 pandemic in Western Ethiopia. Primary data is collected through questionnaire and interview from 320 respondents living in three zones of Western Ethiopia. The study areas (zones) are selected purposively from Oromia region; however, the respondents are sampled by employing random sampling technique. The [...] Read more.

This research is conducted with main aim of assessing the economic consequences of Covid-19 pandemic in Western Ethiopia. Primary data is collected through questionnaire and interview from 320 respondents living in three zones of Western Ethiopia. The study areas (zones) are selected purposively from Oromia region; however, the respondents are sampled by employing random sampling technique. The respondents were stratified as community members, daily laborer, business owners, government sector and NGOs employees. Exploratory research design was adopted to achieve the research objectives. Simple descriptive statistics and ordinary least square regression model are used to analyze and interpret the collected data. The study results disclose that majority of community have good awareness about the pandemic and social interaction is reduced due to social distancing. Majority of respondents realize the negative impact of Covid-19 on their economy; reduction of office services; and reduced access to market; and absence of strong support from the government. The great severity of Covid-19 impacts is failed on daily laborers. The regression result shows that sales, experience in business, education level in years, employment status of the respondent, number of workers in the business and work hours per week are positively and significantly influencing daily income of business owner before and after the pandemic outbreak. It is advised the stakeholders to give frequent follow-up and support particularly for daily laborers and small business holders to reduce the future socio-economic impacts of Covid-19 pandemic.

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Open Access November 08, 2022

An evaluation of Eating Pattern and Nutritional Status of Police Personnel in the Tamale Metropolis in Ghana

Gifty Selorm Bansah

Open Journal of Food and Nutrition 2022, 1(1), 27-39. DOI: 10.31586/ojfn.2022.517

Abstract Police work is mentally demanding and stressful, which takes a heavy toll on the health of police personnel. This study was conducted to assess the eating pattern, physical activity and nutritional status of police personnel in the Tamale Metropolis. A cross-sectional research design was adopted for the study. The population of this study involved all the 1590 police personnel with two years [...] Read more.

Police work is mentally demanding and stressful, which takes a heavy toll on the health of police personnel. This study was conducted to assess the eating pattern, physical activity and nutritional status of police personnel in the Tamale Metropolis. A cross-sectional research design was adopted for the study. The population of this study involved all the 1590 police personnel with two years working experience within the Tamale Metropolis in the Northern Region of Ghana. Simple random sampling technique was used to select three hundred and eighty-four (384) respondents for the study. The main instrument for data collection was questionnaire. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 21.0. Chi-square and Fisher’s exact tests were used to test associations. Logistic modeling was used to test the strength of the associations. P<0.05 was used to denote significance. The study revealed that the police eat two main meals, skip breakfast or eat in between meals, consume alcohol, ate foods belonging to the meat, soft drinks, fish, grain and eggs groups and their diet were more moderately diverse. The study also concluded the police personnel had normal BMI while was overweight and obese respectively. It is recommended that the police department should institute health education programs on the benefits of good dietary practices to achieve optimal health, to avoid the practice of police eating two main meals, skipping breakfast, consuming more alcohol but rather consumes diet that is moderately diverse to sustain him or her. It is also recommended that police department should institute a health education and screening exercise policy to examine the personals periodically to warrant their good health in the service.

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Open Access November 03, 2022

5-fluorouracil Improves the Testicular Antioxidant Status and Alleviates Oxidative Stress in Male Albino Rats Treated with Cyclophosphamide

Rabia A M Yahya, Azab Elsayed Azab, Karema El.M.Shkal, Ahmed M. Attia, Mona A. Yehia

World Journal of Cancer and Oncology Research 2022, 1(1), 29-38. DOI: 10.31586/wjcor.2022.492

Abstract The therapeutic effect of Cyclophosphamide (CPA) is thus attributed to phosphoramide mustard and acrolein leads to the formation of high levels of reactive oxygen species (ROS), which results in decreased antioxidant activity. Excessive production of ROS could also culminate in oxidative stress. Objectives: This study aims to evaluate the effect of sub-lethal dose of the [...] Read more.

The therapeutic effect of Cyclophosphamide (CPA) is thus attributed to phosphoramide mustard and acrolein leads to the formation of high levels of reactive oxygen species (ROS), which results in decreased antioxidant activity. Excessive production of ROS could also culminate in oxidative stress. Objectives: This study aims to evaluate the effect of sub-lethal dose of the cyclophosphamide, 5-FU, combination of 5-FU, and CPA on testicular antioxidant status, and oxidative stress in male albino rats. Materials and Methods: Twenty-eight male adult rats were grouped randomly into four groups (n=5 each group). Group I (control): Rats were injected with saline intraperitoneally and at a dose of 1.0 ml/kg b.w. for 14 days. Group II cyclophosphamide (CPA): Cyclophosphamide at a dose of 10 mg/kg day by day through i.p. to rats for 14 days. Group III Fluorouracil (5-FU): 5-Fluorouracil at a dose of 10 mg/kg day by day in saline was given through i.p. to rats for 14 days. Group IV (CPA+5-FU): Rats were given CPA followed by 5-FU at a dose of 10 mg/kg per day (day by day) through i.p. to rats for 14 days. At the end of the experimental period, rats were anesthetized using light ether. Blood and testes tissue samples were taken and prepared for biochemical measurements. Biochemical parameters in rat serum and tissues were evaluated. Results: Individual injection of CPA and 5-FU to rats were reduced testes TAC, GSH concentration, GR, and CAT activities compared to control. However, the combination treatment of rats with 5-FU and CPA increased the levels of these non-enzymatic and enzymatic antioxidant compared with those treated with CPA alone. Also, results showed significantly increased TBARS and NO concentration in the testes of CPA treated rats when compared to normal ones, while 5-FU increased NO only compared with the control. Conclusion: It can be concluded that treatment of rats with CPA is associated with the production of free radicals that leads to hazardous alterations in certain non-enzymatic, and enzymatic functions. The increase in lipid peroxidation probably leads to the intracellular accumulation of ROS with the subsequent development of testes tissue injury. However, 5-FU and CPA combination could produce a significant amelioration in most cases for these changes, and it may be considered as a potentially useful candidate in the combination chemotherapy with CPA to combat oxidative stress mediated non target organs injury even if it was not a complete protection. Future work should consider combined chemotherapy regimens, as two or more mechanisms of action of chemotherapeutic drugs could be more powerful than one mechanism.

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Open Access October 30, 2022

Prevalence of Oral Health Problems and Distribution According to Socio-demographic Variables and Blood Groups among Patients in the Tripoli Region

Azab Elsayed Azab, Hanan M. M. Aljefari

World Journal of Dental Sciences and Research 2022, 1(1), 1-15. DOI: 10.31586/wjdsr.2022.485

Abstract Background: Oral health plays an important role in maintaining life functions and quality of life. Periodontal disease can vary with respect to bacterial etiology, host response, and clinical disease progression. A key role of genetic effects has suggested distribution of lesions and severity of destruction in each individual. Many diseases, particularly digestive disorders, cancer, and infection, show preferences among the ABO blood types. Knowledge of blood groups and their association with oral diseases is very important, as it may help in early diagnosis and treatment strategies‏. Objectives: The study aimed to investigate the distribution of patients with oral and dental health problems according to age, regions, Socio-demographic Variables, and blood groups in the Tripoli region. Material and Methods: The present study was conducted on 200 patients with oral and dental health problems attending six medical centers in Tripoli region from the 01^st March 2022 to the 01^st June 2022. Also, 100 healthy individuals without any oral and dental health problems or any other diseases were recruited as a control group. This study was approved by the Research and Ethical Committee of the medical centers and Libyan Academy of graduate studies. One ml of venous blood was withdrawn from each participant in the study for determination of blood groups. The data were compared using Chi-Square using SPSS Statistics for Windows, Version 25. Results: The results showed that the mean age of the patients was 43.03±13.82 years. The higher distribution of patients was 58 patients (29%) in the age group (26-35) years while the lower distribution was 10 patients (5%) in the age group (66-75) years. The distribution of patients according to the region were 81.5%, 13%, 4%, and 1.5% in Tripoli, South Tripoli, West Tripoli, and East Tripoli, respectively. The Distribution of patients according to occupation were 4.5% Students, 30% Housewives, 10.5% Employers, 12.5% Teachers, 14% Nurses, 7.5% Doctors, 12.5% Laboratory Technicians and 8.5% Freelance workers. The distribution of patients according to levels of education were 23.5% Pre-Secondary, 19% Secondary, 46% Bachelor's or equivalent, and 11.5% Master's or equivalent. The distribution of patients according to marital status were 26% single and 74% married. The distribution of patients according to oral and dental problems were 5% with bridge, 8% with missing teeth, 86% with dental caries, 63.5% with bleeding of gum, and 25.5% with swelling of gum. The degrees of gingival erythema among patients were 36.5% mild, 38% moderate, and 25.5% severe. The degrees of gingival inflammation among patients were 36% mild, 38.5% moderate, and 25.5% severe. The distribution of A, B, AB, and O blood groups showed a significant (P=0.000) difference between healthy individuals and oral and dental health problems among patients that, were 54%, 12%, 4%& 30%, and 21.5%, 9%, 3.5% & 66%, respectively. Also, the distribution of A⁺, A^-, B⁺, B^-, AB⁺, O⁺, and O^- blood groups showed a significant (P=0.000) difference between healthy individuals and patients with oral and dental health problems that, were 49%, 5%, 10%, 2%, 4%, 25%, & 5%, and 18%, 3.5%, 8%, 1%, 3.5%, 60%& 6%, respectively. But, the distribution of Rh⁺ and Rh^- blood groups showed a non-significant (P=0.695 [...] Read more.

Background: Oral health plays an important role in maintaining life functions and quality of life. Periodontal disease can vary with respect to bacterial etiology, host response, and clinical disease progression. A key role of genetic effects has suggested distribution of lesions and severity of destruction in each individual. Many diseases, particularly digestive disorders, cancer, and infection, show preferences among the ABO blood types. Knowledge of blood groups and their association with oral diseases is very important, as it may help in early diagnosis and treatment strategies‏. Objectives: The study aimed to investigate the distribution of patients with oral and dental health problems according to age, regions, Socio-demographic Variables, and blood groups in the Tripoli region. Material and Methods: The present study was conducted on 200 patients with oral and dental health problems attending six medical centers in Tripoli region from the 01^st March 2022 to the 01^st June 2022. Also, 100 healthy individuals without any oral and dental health problems or any other diseases were recruited as a control group. This study was approved by the Research and Ethical Committee of the medical centers and Libyan Academy of graduate studies. One ml of venous blood was withdrawn from each participant in the study for determination of blood groups. The data were compared using Chi-Square using SPSS Statistics for Windows, Version 25. Results: The results showed that the mean age of the patients was 43.03±13.82 years. The higher distribution of patients was 58 patients (29%) in the age group (26-35) years while the lower distribution was 10 patients (5%) in the age group (66-75) years. The distribution of patients according to the region were 81.5%, 13%, 4%, and 1.5% in Tripoli, South Tripoli, West Tripoli, and East Tripoli, respectively. The Distribution of patients according to occupation were 4.5% Students, 30% Housewives, 10.5% Employers, 12.5% Teachers, 14% Nurses, 7.5% Doctors, 12.5% Laboratory Technicians and 8.5% Freelance workers. The distribution of patients according to levels of education were 23.5% Pre-Secondary, 19% Secondary, 46% Bachelor's or equivalent, and 11.5% Master's or equivalent. The distribution of patients according to marital status were 26% single and 74% married. The distribution of patients according to oral and dental problems were 5% with bridge, 8% with missing teeth, 86% with dental caries, 63.5% with bleeding of gum, and 25.5% with swelling of gum. The degrees of gingival erythema among patients were 36.5% mild, 38% moderate, and 25.5% severe. The degrees of gingival inflammation among patients were 36% mild, 38.5% moderate, and 25.5% severe. The distribution of A, B, AB, and O blood groups showed a significant (P=0.000) difference between healthy individuals and oral and dental health problems among patients that, were 54%, 12%, 4%& 30%, and 21.5%, 9%, 3.5% & 66%, respectively. Also, the distribution of A⁺, A^-, B⁺, B^-, AB⁺, O⁺, and O^- blood groups showed a significant (P=0.000) difference between healthy individuals and patients with oral and dental health problems that, were 49%, 5%, 10%, 2%, 4%, 25%, & 5%, and 18%, 3.5%, 8%, 1%, 3.5%, 60%& 6%, respectively. But, the distribution of Rh⁺ and Rh^- blood groups showed a non-significant (P=0.695) difference between healthy individuals and patients that, were 88% & 12%, and 89.5%& 10.5%, respectively. Conclusion: It can be concluded that the mean age of the patients with oral and dental health problems was 43.03 years and the higher distribution of patients was in the age group (26-35) years. The higher distribution of ABO blood groups was O blood group among patients especially O⁺blood groups. The distribution of Rh+ and Rh- blood groups were showed a non-significant difference between healthy individuals and patients with oral and dental health problems. Further studies are needed to confirm these results.

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Open Access August 19, 2022

COVID-19 and Central Nervous System Diseases

Jiaxia Li, Yuan Feng, Mingwu Xia, Li Wan

World Journal of Clinical Medicine Research 2022, 1(1), 9-13. DOI: 10.31586/wjcmr.2022.386

Abstract We reviewed the influence of coronavirus disease 2019 (COVID-19) on the central nervous system reported in the literature since its prevalence. Common neurological symptoms of COVID-19 include altered or impaired consciousness, headache, dizziness, cerebrovascular accidents, and seizures, etc. Encephalopathy caused by or related to COVID-19 includes stroke, acute encephalitis, and Guillain-Barre [...] Read more.

We reviewed the influence of coronavirus disease 2019 (COVID-19) on the central nervous system reported in the literature since its prevalence. Common neurological symptoms of COVID-19 include altered or impaired consciousness, headache, dizziness, cerebrovascular accidents, and seizures, etc. Encephalopathy caused by or related to COVID-19 includes stroke, acute encephalitis, and Guillain-Barre syndrome. Concomitant COVID-19 in patients with vascular risk factors increased the risk of stroke; the hypercoagulable state and vascular dysfunction caused by COVID-19 also led to stroke. Acute encephalitis was usually accompanied by a history of headache, fever, and altered mental status, and shown hemorrhagic lesions or high signal on MRI. In Guillain-Barre syndrome, there was a time lag between infection with the primary pathogen and the onset of neurological symptoms, which generally manifest as limb paralysis and various sensory abnormalities. The review illustrated that COVID-19 lead to serious consequences of brain and brought difficulties to the treatment. Exploring the neural mechanisms of COVID-19 to better understand the activity of the virus in the brain and to prevent further viral damage to the brain is an urgent issue.

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Open Access July 01, 2022

Effect of Rainfall on Yield Related Traits and Total Carotenoids Contents of 42 Accessions of Provitamin A Cassava at Two Cropping Seasons in Ibadan

Olusegun David Badewa, Elizabeth Parkes, Eli Kolo Tsado, Andrew Saba Gana, Kehinde Dele Tolorunse, Patrick Akpotuzor, Peter Iluebbey, Toye Ayankanmi

Open Journal of Agricultural Research 2022, 2(1), 37-49. DOI: 10.31586/ojar.2022.314

Abstract Cassava crop improvement is a function of selecting superior genotypes that meets the end-users needs and preference. This is done via genotype testing at different environments thereby subjecting the materials to the elements of climate and other environmental factors. In pro-vitamin a cassava genotypes, dry matter (DM), total carotenoids (TC), and fresh root yield (FYLD) are important traits for [...] Read more.

Cassava crop improvement is a function of selecting superior genotypes that meets the end-users needs and preference. This is done via genotype testing at different environments thereby subjecting the materials to the elements of climate and other environmental factors. In pro-vitamin a cassava genotypes, dry matter (DM), total carotenoids (TC), and fresh root yield (FYLD) are important traits for improving economic status, nutritional health and livelihoods of farmers and processors. This study evaluated the effect of rainfall patterns on 42 provitamin A Cassava accessions for FYLD, DM, TC at different months (6,9&12 months after planting) and for two seasons (2019/2020 and 2020/2021) in Ibadan. The study shows that the relationship between TC and FYLD were more variable at second season than in the first season. The relationships between TC & DM and FYLD & DM at both seasons showed similar variability. The rainfall pattern shows that higher rainfall trend was noticed at the first cropping season (2019/2020) than 2020/2021 cropping seasons. At different months categories and across cropping season, rainfall recorded the least value of 4.58mm at 6 Months After Planting (MAP) which was in the month of December, increased at 9 MAP (Mar) and all through the 12 MAP (107.05mm). Traits relationship with rainfall shows that yield increased with rainfall, DM (25.70%) was highest during the months of least rainfall (4.58mm) and decreased (16.40%) as rainfall (52.09mm) starts during the 9 MAP and at 12 MAP, when the rainfall was 107mm, the DM was 18.76%. Total carotenoids were highest at 6 MAP with 13.76 µg/g when the rainfall was least and decreased (13.04 µg/g) with increased rainfall. During the first cropping season, DM and TC were higher with higher rainfall but with reduced fresh root yield while at second season, when the rainfall was lower, fresh root yield was higher.

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Open Access May 18, 2022

Parental Involvement in the Academic Performance of Students in Ghana: Socio-Economic Status

Patrick Kwarteng, Frank Asiamah, Anderson Oppong Twumasi, Jacob Oppong Nkansah, Jacob Issaka, Simon Kweku Afetorgbor

Open Journal of Educational Research 2022, 2(3), 114-125. DOI: 10.31586/ojer.2022.305

Abstract The purpose of the study was to assess the socioeconomic status and levels of parental involvement on the academic performance of Junior High School Students in the Upper West Akim District in Ghana. The study adopted the quantitative approach and specifically used the descriptive survey design. Simple random sampling and purposive sampling techniques were used for the selection of schools and [...] Read more.

The purpose of the study was to assess the socioeconomic status and levels of parental involvement on the academic performance of Junior High School Students in the Upper West Akim District in Ghana. The study adopted the quantitative approach and specifically used the descriptive survey design. Simple random sampling and purposive sampling techniques were used for the selection of schools and respondents for the study. The main instrument used for data collection was questionnaire. The Statistical Product and Service Solutions (SPSS) software version 22 was used for analysis of data gathered. The study concluded that, parents’ socioeconomic status specifically; education, occupation and income levels, is an important factor that determines the academic performance of students in the Upper West Akim District. The educational and income statuses have a positive relationship with the academic performance of students. The findings from the study also revealed that, parents who ensure that their children study at home, provide their educational needs, discuss their progress with their teachers and attend PTA meetings regularly have children who perform better academically as compared to children whose parents do not see to it that their children study at home, provide the educational needs of their children, discuss their children’s learning with teachers and attend PTA meeting regularly. It is recommended that, Considering the strong positive relationship between parental involvement and academic performance, it is recommended that government through the National Commission for Civic Education (NCCE) should educate parents, teachers and school managers on the relevance of parental involvement in the education of the child and the need for the school to create an atmosphere that would involve parents in the education of their wards. It is also recommended that, adult literacy should be enhanced by government to improve the level of education of parents in the Upper West Akim District which will go a long way to improve participation of parents in children’s education and hence improve their academic performance.

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Article

Open Access May 17, 2022

Academic Achievement of Low- Social-Economic-Status (SES) of Junior High School Students

Esther Aba Quansah, Lovedale Adzo Tsotovor, Cyril Ababio Titty, Benjamin Kwabena Ochour, Janet Dansoah Oppong, Kingsley Opoku, Frank Acheampong

Open Journal of Educational Research 2022, 2(3), 102-114. DOI: 10.31586/ojer.2022.298

Abstract The purpose of the study was to assess Academic achievement of Low- Social-Economic-Status (SES) of Junior High School Students in Ghana. The study employed a descriptive, cross-sectional survey design. The population for the study comprised all JHS students and teachers in the Aboom Circuit of the Cape Coast Metropolis. Krejcie and Morgan (1970) sampling table, Purposive and randomly sampling [...] Read more.

The purpose of the study was to assess Academic achievement of Low- Social-Economic-Status (SES) of Junior High School Students in Ghana. The study employed a descriptive, cross-sectional survey design. The population for the study comprised all JHS students and teachers in the Aboom Circuit of the Cape Coast Metropolis. Krejcie and Morgan (1970) sampling table, Purposive and randomly sampling techniques were used to select schools, teachers and students for the study. The sample frame for the study was all students and teachers in the five selected JHS of the Aboom Circuit of the Cape Coast Metropolis. The sample size for the study was 350 for students and 30 for teachers. The main instrument for data collection for the study as questionnaire. Research question was analysed using mean and standard deviation; hypothesis was analysed using Pearson Product Moment Correlation. The study revealed that continued, consistent and persistent presence of these student-related factors such as hunger, lack of self-motivation, poor study habit, watching TV, laziness, and students’ truancy or absenteeism negatively affect students’ academic achievement. The results of the study also indicated that there was a moderate, negative correlation between student-related factors and students’ academic achievement with high levels of perceived student-related factors with low levels of students’ academic achievement. It is recommended that, the role of guidance and counseling session in schools is to assists students to be focused on their studies. Therefore, guidance and counseling sessions in various schools should be effectively organised to prevent students’ truancy. It is also recommended that School administrators in partnership with PTA leadership and NGOs should educate students on the relevance of education and give social support to students from low socio-economic backgrounds and motivate them in their studies.

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Article

Open Access May 11, 2022

An Appraisal of School-Related Factors that Contribute to the Academic Achievements of Low Social-Economic-Status of Students in Ghana

Esther Aba Quansah

Open Journal of Educational Research 2022, 2(2), 93-101. DOI: 10.31586/ojer.2022.286

Abstract The objective of the study was to examine the school-related factors that contribute to the academic achievements of low- social economic – status of students in the Aboom Circuit of the Cape Coast Metropolis during 2015-2016 academic years. The study adopted descriptive survey research design. Purposive and random sampling techniques were used to select teachers, schools and students. The five [...] Read more.

The objective of the study was to examine the school-related factors that contribute to the academic achievements of low- social economic – status of students in the Aboom Circuit of the Cape Coast Metropolis during 2015-2016 academic years. The study adopted descriptive survey research design. Purposive and random sampling techniques were used to select teachers, schools and students. The five junior high schools (St Nicholas, St. Monica, Aboom Methodist B, Aboom Zion A and Aboom Zion C) were randomly selected from the ten schools in the circuit. A proportional allocation was used to determine and allocate the total number of students from the population to each school. The main instrument for data collection was questionnaire. The data were entered in a pre-designed template in the Statistical Package for Social Science (SPSS) software, version 21. The data were analysed using descriptive (frequency and percentages, mean and standard deviation) and inferential statistics (correlation). The research hypothesis was also analysed using Pearson Product Moment Correlation. The hypothesis was tested at 0.05 level of significance. The study indicated that school-related factors such as school time schedule, resources, school climate, guidance and counselling, school-parents’ relationship may significantly contribute to students’ academic achievement. It is also concluded that when the right atmosphere or conditions are created, students can perform well irrespective of their socio-economic statuses or backgrounds. It is recommended that the Ministry of Education (MOE)/Ghana Education Service (GES) in partnership with school administrators should provide adequate teaching and learning resources and facilities for effective teaching and learning at the school. It is also recommended that in other to ensure effective teaching and learning, the Ministry of Education (MOE) and the Ghana Education Service (GES) should collaborate to implement a class size reduction policy effectively as expected. This means that the student-to-teacher ratio should strictly be adhered to.

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Article

Open Access March 26, 2022

Healthcare Workers Should Receive Seasonal Influenza Vaccine during COVID-19 Pandemic?

Hadir Fathy Abdel-Rahman Ibrahim, Aisha Aboul Fotouh, Mohamed Farouk Allam

Global Journal of Epidemiology and Infectious Disease 2022, 2(1), 33-35. DOI: 10.31586/gjeid.2022.215

Abstract It is known that seasonal influenza virus vaccination is important to be taken every year among healthcare workers (HCWs) to avoid transmission of influenza virus and its complications inside the workplace. The reason behind the importance of vaccination is that HCWs are at high risk to be infected with influenza virus. Among the studies addressing the rates of influenza vaccine status among HCWs, [...] Read more.

It is known that seasonal influenza virus vaccination is important to be taken every year among healthcare workers (HCWs) to avoid transmission of influenza virus and its complications inside the workplace. The reason behind the importance of vaccination is that HCWs are at high risk to be infected with influenza virus. Among the studies addressing the rates of influenza vaccine status among HCWs, a study was conducted in three Middle East countries where the vaccination rates were 24.7%, 67.2%, and 46.4% in United Arab Emirates, Kuwait, and Oman, respectively. Now, after the pandemic of COVID-19 there are beliefs that vaccination with influenza virus could decrease the deaths from COVID-19. A recent retrospective cohort study to detect the effect of seasonal influenza vaccine on the deaths among COVID-19 patients showed that the individuals who didn’t take the influenza vaccine in the last year before being infected with COVID-19 had a higher risk of being hospitalized when compared with patients who took the vaccine. In conclusion, seasonal influenza vaccine could have an important role in the prevention of COVID-19. Seasonal influenza vaccine coverage should be improved among HCWs. New tailored health education programs to improve the attitudes and beliefs of HCWs towards seasonal influenza vaccine during the era of COVID-19 are strongly and urgently needed.

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Mini Review

Open Access February 25, 2022

Claiming the Place; Informal Placemaking, Power and Territorial Identity in Heliopolis, Cairo

Sadek Saad

Journal of Art and Design 2022, 1(1), 46-60. DOI: 10.31586/jad.2022.246

Abstract The bottom-up or informal placemaking process is “illegal”, practised only by the “poor” and “unintellectual” classes. The author argues that various classes practise informal placemaking regardless of their economic status or educational level. Studying the spatial manifestation of informal placemaking helps to understand the concrete needs of the residents and reconsider their role in [...] Read more.

The bottom-up or informal placemaking process is “illegal”, practised only by the “poor” and “unintellectual” classes. The author argues that various classes practise informal placemaking regardless of their economic status or educational level. Studying the spatial manifestation of informal placemaking helps to understand the concrete needs of the residents and reconsider their role in identifying places. Aiming to comprehend informal placemaking and its importance, this study investigates informal placemaking in Sheraton Residence, Heliopolis, Cairo. The area is chosen for its formality, socio-economic and cultural patterns. Cases of informal placemaking in Sheraton Residence are described and analysed to pinpoint their role in creating a sense of place, territorial identity and comprehending their meaning. A comparison with cases in informal low-income housing is conducted to construct diversities and similarities. The study encourages the re-thinking of the public role in placemaking as a place of negotiation and belonging. We can improve their urban quality by re-thinking informal placemaking and looking at how people use the place. The general impression that only informal housing and low-educated classes practise informal placemaking is incorrect.

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Article

Open Access February 21, 2022

Anthropometric diagnosis of 6-59 months Children with Severe Acute Malnutrition: Weight for Height-Z scores Versus Mid Upper Arm Circumference

N Prabhat, G Sarika, Nimmathota Arlappa

Current Research in Public Health 2022, 1(1), 40-48. DOI: 10.31586/crph.2022.220

Abstract An unhealthy dietary habit leads to excess calorie consumption (overnutrition) or inadequate supply of one or more essential micronutrients (undernutrition).This nutritional imbalance is assessed by Anthropometric measurements, Biochemical estimations, Clinical examination and assessment of Dietary intakes. Anthropometry is an inexpensive, rapid and non-invasive method that provides details on [...] Read more.

An unhealthy dietary habit leads to excess calorie consumption (overnutrition) or inadequate supply of one or more essential micronutrients (undernutrition).This nutritional imbalance is assessed by Anthropometric measurements, Biochemical estimations, Clinical examination and assessment of Dietary intakes. Anthropometry is an inexpensive, rapid and non-invasive method that provides details on different components of body structure and is highly sensitive to the broad spectrum of nutritional status. Hence, it has always been an important tool for screening and early diagnosis of malnutrition. Undernutrition in below 5 year children is life-threatening epidemic contributing to about 45% of under 5 child deaths. Children with Severe Acute Malnutrition (SAM) are nine times more likely to die, compared to their healthy counterparts. Therefore, early and accurate diagnosis of children with SAM is crucial for its management and prevention of morbidity and mortality from the same. SAM is defined as weight-for-height Z scores (WHZ) below -3SD of the median or a mid upper arm circumference (MUAC) of <115mm in children of 6-59 months age. The cut-offs for MUAC and WHZ are scientifically approximated to each other and both are used to diagnose children with SAM (Severe Wasting). However, the research findings from various countries revealed that the agreement between WHZ and MUAC is poor as both indices classify the children with SAM differently, with a small overlap, which varies greatly among countries. These discrepancies have an implication when using either one alone for measuring the prevalence of acute malnutrition. Therefore, it is pertinent to adopt both WHZ and MUAC indices to assess the burden of severe acute malnutrition (SAM) in the community.

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Review Article

Open Access January 29, 2022

COVID-19 and the Non-Repayment of Agricultural Loans in West Cameroon: A major Challenge for the Small Farmer in an Individual Loan Situation

Yannick Tamo Fogue, Ibrahim Manu

Open Journal of Agricultural Research 2022, 2(1), 1-13. DOI: 10.31586/ojar.2022.181

Abstract This study raises the problem of the non-repayment of agricultural credits by producers who are members of the Community Growth Mutual (MC²), in this period of COVID-19. It questions the economic mores in force in most member countries of the Organization for the Harmonization of Business Law in Africa (OHADA), where credit has become difficult for small rural farmers; And refers to the [...] Read more.

This study raises the problem of the non-repayment of agricultural credits by producers who are members of the Community Growth Mutual (MC²), in this period of COVID-19. It questions the economic mores in force in most member countries of the Organization for the Harmonization of Business Law in Africa (OHADA), where credit has become difficult for small rural farmers; And refers to the theory of the vicious circle of poverty, which advocates an indispensable recourse to foreign capital in the event of financial breakdown, as a means of increasing capital. Since the capital of rural producers remains insufficient and their possibility of reinvestment decreases, then becomes zero because of agricultural credit. To understand the factors of the non-repayment of these credits, data were collected from 100 agro-sylvo-pastoral producers of the Bayangam group (West-Cameroon) of both sexes, aged at least 18 years, having obtained an unpaid credit from the MC² since 2019, and a manager of this microfinance institution. After analysis, it appears that beyond overproduction and anti-COVID-19 measures that lead to the missale or fall in prices on the market, the conditions of access to credit, the non-possession of acceptable guarantees, the misuse of the object of credit and the practice of financial cavalry by the borrower, as well as the rigidity of the procedures for prosecuting debtors significantly explain this non-repayment. It is associated with determinants such as age, level of education, marital status, type of agricultural activity of the debtor. Hence the need for flexibility of microfinance institutions vis-à-vis rural agro-sylvo-pastoral producers, who are severely affected by the economic shock of the COVID-19.

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Article

Open Access November 22, 2021

Epidemiological and Clinical Profiles of Acute Diarrhea Due Rotavirus or Associated Rotavirus and Other Pathogens in Children Aged 0-71 Months Hospitalized at Kalembe-lembe Pediatric Hospital in Kinshasa, Democratic Republic of the Congo

Clément M. Mbadiko, D. Mutambel Hity S.N, Gracia K. Mbuyi, Erick Bukaka, Ruth Claudine Tshiama, Gédéon Ngiala Bongo

Global Journal of Epidemiology and Infectious Disease 2021, 1(1), 66-80. DOI: 10.31586/gjeid.2021.165

Abstract This research is based on a retrospective analysis of medical records filed in the archives of the emergency departments of Kalembe-lembe Hospital in Kinshasa city in the Democratic Republic of the Congo. The study involved 324 records of patients aged 0-71 months admitted to the emergency departments and hospitalized for acute diarrhea from January 1 to December 31, 2015. The aim was to inventory [...] Read more.

This research is based on a retrospective analysis of medical records filed in the archives of the emergency departments of Kalembe-lembe Hospital in Kinshasa city in the Democratic Republic of the Congo. The study involved 324 records of patients aged 0-71 months admitted to the emergency departments and hospitalized for acute diarrhea from January 1 to December 31, 2015. The aim was to inventory the cases of rotavirus diarrhea and/or other germs (individually or in combination) to study their epidemiological and clinical aspects. Thus, the epidemiological and clinical parameters (age, sex, season, symptoms, frequency and physical aspects of stools, dehydration status and duration of hospitalization) of diarrheic children diagnosed as positive for rotavirus were compared with those infected with other germs (individually or in combination with rotavirus or other viruses). The search for the etiological agents of the diarrhea was performed in 56.48% of the cases. The results of this work allowed us to show: (i) a predominance of infections by viruses (69.94%) including rotavirus (48.08%), (ii) high rates of infections by etiological agents of diarrhea including rotavirus in children under 12 months, (iii) a high proportion of vomiting, fever, physical asthenia and restlessness or frequent and liquid stools or moderate dehydration in children infected with rotavirus, (iv) specific clinical pictures according to the etiological agents of diarrhea or their combinations.

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Article

Open Access August 21, 2021

E-cigarette Purchase Intention through Facebook Social Media: A Cross-Sectional Study

Nusrat Parvin, Sayaka Zaman, Samia Amin

Universal Journal of Business and Management 2021, 1(2), 72-78. DOI: 10.31586/ujbm.2021.091

Abstract Online shopping is a growing phenomenon and social media namely Facebook has radically changed consumers online purchase behaviour; especially the interactive information system of consumers, peers, and vendors. Similar to other online purchasing products or services, e-cigarette marketing in Facebook has potential. This study aims to determine the association between individual’s online [...] Read more.

Online shopping is a growing phenomenon and social media namely Facebook has radically changed consumers online purchase behaviour; especially the interactive information system of consumers, peers, and vendors. Similar to other online purchasing products or services, e-cigarette marketing in Facebook has potential. This study aims to determine the association between individual’s online interaction and e-cigarette purchase intention from Facebook vape groups. A cross-sectional study was conducted among 214 respondents using the Facebook platform from September to December 2019. Data were collected via a self-administered questionnaire. The Chi-square test was used for data analyses using SPSS (version 25.0). Most of the participants were male; the mean age of the respondents was 27.41 ± 2.1. Total 93.9% (201 of 214) and 56.1% (120 of 214) respondents were vaper and smoker respectively. Among the non-smokers, most of the respondents were vaper (84 of 94, 89.4%). Consumers smoking and vaping status were associated with each other (χ2 = 6.11, P=0.01). There was an association between vaping status and purchase intention of e-cigarettes from the Facebook vape group (χ2 = 5.06, P=0.02). Online interactions, namely like (χ2 = 5.88, P <0.01), post (χ2 = 7.16, P <0.01) and sharing (χ2 = 10.14, P <0.01) of the e-cigarette related information or advertisements in social media were associated with purchase intention of e-cigarettes from Facebook vape group. This study revealed individuals vaping and online interactions were associated with an online purchase the intention of e-cigarette in Facebook. Public health researchers and policymakers might contemplate the regulatory environment of online marketing of e-cigarettes to curtail the uptake of e-cigarettes among non-smokers.

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Article

Open Access July 30, 2021

Air of Uncertainty from Pollution Profiteers: Status of Ambient Air Quality of Sawmill Industry in Ilorin Metropolis, Kwara State, Nigeria

Olalekan Morufu Raimi, Timothy Kayode Samson, Ajayi Bankole Sunday, Adio Zulkarnaini Olalekan, Odipe Oluwaseun Emmanuel, Ogunleye Temitope Jide

Research Journal of Ecology and Environmental Sciences 2021, 1(1), 17-38. DOI: 10.31586/rjees.2021.010102

Abstract We can’t stop breathing, but we can do something about the quality of air that we breathe. Clean fresh air is indispensable ingredient for a good life quality. Individuals poses the right towards expecting that the breathed air will not harm people. Thus, fighting air pollution will not only improve health outcomes, productivity, and well-being, it’s also essential toward reducing the emissions of [...] Read more.

We can’t stop breathing, but we can do something about the quality of air that we breathe. Clean fresh air is indispensable ingredient for a good life quality. Individuals poses the right towards expecting that the breathed air will not harm people. Thus, fighting air pollution will not only improve health outcomes, productivity, and well-being, it’s also essential toward reducing the emissions of greenhouse gas as well as fighting climate change. For examples, a third of the global population is at risk from unhealthy of ambient air pollutants concentrations, with the loss of approximately 6.4 million healthy-life-years attributed specifically to chronic exposure to ambient particulate matter. Expert panels have consistently rated air pollution as a greater health hazard than water pollution. Pollution of air is the leading source of unexplained and undiagnosed diseases, besides have remained associated with a variety of serious human health risks, and in fact, a threshold has not been established under which these pollutants exert no adverse effects. This study evaluates ambient air quality at major sawmill sites in Ilorin Metropolis, Kwara State, Nigeria. “Measurements of Air pollution were accurately carried out using direct reading, automatic in situ gas monitors; Hand held mobile multi-gas monitor with model AS8900 [Combustible (LEL), and Oxygen (O₂)], BLATN with model BR – Smart Series air quality monitor (PM₁₀, Formaldehyde) and air quality multimeter with model B SIDE EET100 (Dust (PM_2.5), VOC, Temperature and Relative Humidity)”. The outcomes disclosed among others, the average concentrations of CO, O₂ as well as other measured parameters for instance formaldehyde (HcHo) etc., they are also consistently low as well as within acceptable range in terms of National as well as Global monitoring standards for air quality indices. However, there are few exceptions for instance the average volatile organic compounds (VOCs) concentrations, PM_2.5, PM₁₀ as well as Combustible (LEL) respectively, which are higher when compared to National and Global standards. This high figure is due to pollutant amount existing in the sawmills air environment resulting from input of influents from activities of the sawmill. However, as a result, air pollution in the city of Ilorin is found to be increasingly polluted and are of major health concern because of their synergistic action. Due to the high evidences and values, it can lead to a remarkable rise in over-all figure of hospital visits/ patients’ admissions with acute respiratory illnesses as soon as air pollutants level remained high. Hence, there is the need for an aggressive control of ambient air pollution.

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Article

Open Access November 16, 2023

Zero Carbon Manufacturing in the Automotive Industry: Integrating Predictive Analytics to Achieve Sustainable Production

Shakir Syed

Journal of Artificial Intelligence and Big Data 2023, 3(1), 17-28. DOI: 10.31586/jaibd.2023.1179

Abstract This charge-ahead paper suggests that transitioning the automotive industry towards a zero-carbon ecosystem from material to end-of-life can be accomplished through disruptive zero-carbon manufacturing in the broad area of all-electric vehicle production technology. To accomplish zero carbon emission automotive manufacturing in the vehicle assembly domain, future paradigms must converge on the [...] Read more.

This charge-ahead paper suggests that transitioning the automotive industry towards a zero-carbon ecosystem from material to end-of-life can be accomplished through disruptive zero-carbon manufacturing in the broad area of all-electric vehicle production technology. To accomplish zero carbon emission automotive manufacturing in the vehicle assembly domain, future paradigms must converge on the decoupling of carbon dioxide emissions from automobile manufacturing and use the design, processing, and manufacturing conditions. The envisioned zero carbon emission vehicle manufacturing domain consists of two complementary components: (a) making more efficient use of energy and (b) reducing carbon in energy use. This paper presents the status of key scientific and technological advancements to bring the manufacturing model of today to a zero-carbon ecosystem for the entire automotive industry of tomorrow. This paper suggests the groundbreaking application of dynamic and distributed predictive scheduling algorithms and open sensing and visualization technology to meet the zero carbon emission vehicle manufacturing goals. Power-aware high-performance computing clusters have recently become a viable solution for sustainable production. Advances in scalable and self-adaptive monitoring, predictive analytics, timeline-based machine learning, and digital replica of cyber-physical systems are also seen co-evolving in the zero carbon manufacturing future. These methods are inspired by initiatives to decouple gross domestic product growth and energy-related carbon dioxide emissions. Stakeholders could co-design and implement shared roadmaps to transition the automotive manufacturing sector with relevant societal and environmental benefits. The automated mobility sector offers a program, an industry-leading example of transforming an automotive production facility to carbon neutrality status. The conclusions from this paper challenge automotive manufacturers to engage in industry offsetting and carbon tax programs to drive continuous improvement and circular vehicle flows via a multi-directional zero-carbon smart grid.

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Review Article

Open Access December 24, 2022

Web-Centric Cloud Framework for Real-Time Monitoring and Risk Prediction in Clinical Trials Using Machine Learning

Ravi Shankar Garapati

Current Research in Public Health 2022, 2(1), 22-40. DOI: 10.31586/crph.2022.1346

Abstract Advances in web-centric cloud computing have facilitated the establishment of an integrated cloud environment connecting a wide variety of clinical trial stakeholders. A web-centric cloud framework is proposed for real-time monitoring and risk prediction during clinical trials. The framework focuses on identifying relevant datasets, developing a data-management interface, and implementing [...] Read more.

Advances in web-centric cloud computing have facilitated the establishment of an integrated cloud environment connecting a wide variety of clinical trial stakeholders. A web-centric cloud framework is proposed for real-time monitoring and risk prediction during clinical trials. The framework focuses on identifying relevant datasets, developing a data-management interface, and implementing machine-learning algorithms for data analysis. Detailed descriptions of the data-management interface and the machine-learning processes are provided, targeting active clinical trials with therapeutic uses in cancer. Demonstrations utilize publicly available clinical-trial data from the ClinicalTrials.gov repository. The real-time monitoring and risk prediction systems were assessed by developing five supervised-classification-machine-learning models for trial-status prediction and six unsupervised models for patient-safety-profile assessment, each representing a different phase of the clinical-trial process. All supervised models yielded high accuracy and area-under-the-curve values at the testing stage, while the unsupervised models demonstrated practical applicability. The results underscore the advantages of using the trial-status algorithm, the patient-safety-profile model, and the proposed framework for performing real-time monitoring and risk prediction of clinical trials.

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