Patients with comorbid neurotic and anxiety disorders are more receptive of the discomfort accompanying continuous positive airway pressure therapy than average obstructive sleep apnea patients. The purpose of the study was to analyze short-term and long-term continuous positive airway pressure therapy adherence data of patients with obstructive sleep apnea and comorbid anxiety and stress-related dyssomnias, as this group of disorders is expected to rise in the post-covid era. Study retrospectively analyzed clinical outcomes of obstructive sleep apnea patients. All subjects with obstructive sleep apnea were diagnosed based on in-lab video polysomnography, further referred to CPAP titration and were invited for regular follow-up visits. The results showed that subjects with comorbid obstructive sleep apnea and anxiety-related disorders used ventilation therapy more hours per day (6,690 hours/day vs. 5,000 hours/day, ****p<0,0001, anxiety (n=19) vs. controls (n=60)). Patients from the anxiety group remained longer in our therapy program (7,086 years vs. 2,905 years, ****p<0,0001) and had markedly better control over their weight, as the body-mass index of the control group increased by +1,065 kg/m2 per year and the body-mass index in the examination group increased only by +0,296 kg/m2 every year. Our data document that obstructive sleep apnea patients on ventilation therapy, who do not have enough control over their increasing body weight might highly benefit from therapy approaches similar to patients with anxiety-related dyssomnias and that management of obstructive sleep apnea is not an obstacle in concomitant treatment of neurotic and anxiety-related dyssomnias.

This study proposes an integrated approach combining geographic information systems (GIS) and geotechnical analyses to assess the stability of the Oued Ayda mountain lake dam, located in the Siliana Governorate, northwestern Tunisia. The mechanical properties of the embankment and foundation materials were integrated into a Mohr-Coulomb geomechanical model, while the pore water pressure distribution was simulated for various representative hydromechanical scenarios: end of construction, normal operation, rapid drainage, and short- and long-term empty reservoir conditions. The stability analysis, performed using the Morgenstern-Price method with the SLOPE/W software (GeoStudio), reveals high safety factors on the upstream side (SF > 3 in the short term and SF ≥ 2 in the long term), indicating good resistance of this slope to hydraulic and mechanical stresses. Conversely, the results show that the downstream slope exhibits significantly lower safety factors, ranging from 1.335 to 1.338 under long-term conditions, particularly during normal operating and rapid drainage scenarios. These reduced values indicate a high vulnerability of this slope to persistent saturation and adverse hydraulic gradients. In conclusion, although the dam exhibits satisfactory overall stability, the downstream slope remains the most vulnerable area of the structure. The results underscore the need for rigorous management of water level fluctuations and suggest reinforcing the drainage system or implementing targeted stabilization measures to ensure the long-term safety and durability of the structure.

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.

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.

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.

Simulation-based learning (SBL) is widely recognized as an effective educational approach that bridges theory and practice in nursing education. Despite its global adoption, limited research has examined the experiences of Filipino nursing students with SBL, particularly in resource-constrained settings. This study explored the perspectives of Bachelor of Science in Nursing students from a university in Metro Manila, Philippines, on the impact of SBL on their skills, emotional responses, and challenges encountered. A descriptive qualitative design was employed using purposive sampling of ten students who had participated in at least one SBL activity. Data were collected through semi-structured interviews and short written reflections and analyzed thematically following Braun and Clarke’s framework to capture nuanced experiences. Three major themes emerged from the analysis. First, students reported initial anxiety, nervousness, and stress during their early SBL experiences, which gradually transformed into confidence, adaptability, and resilience as they gained familiarity and competence. Second, SBL enhanced technical and cognitive skills such as clinical judgment, decision-making, teamwork, and patient-centered care, supporting students’ readiness for real-world practice. Third, students identified resource limitations, insufficient equipment, and time constraints as significant barriers to optimal learning, though these challenges also fostered creativity and perseverance. The findings demonstrate that SBL fosters technical competence, critical thinking, and professional growth but requires institutional support to address resource constraints and faculty development needs. This study underscores the importance of expanding SBL in Philippine nursing curricula to align with international best practices and to contribute to Sustainable Development Goals 3 (good health and well-being), 4 (quality education), and 5 (gender equality).

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.

Early-onset neurodegenerative diseases (EO-NDs), such as early-onset Alzheimer’s disease (EOAD), Parkinson’s disease (EOPD), and familial amyotrophic lateral sclerosis (fALS), often stem from monogenic causes and manifest before typical age thresholds. These disorders frequently feature disrupted mitochondrial function and heightened oxidative stress, which together accelerate neuronal damage and degeneration. In this work, the author performs a comprehensive analysis of the literature and data related to mitochondrial dysfunction and redox imbalance in EO-NDs. Bibliometric trends were assessed using R-based tools on PubMed datasets, highlighting keyword networks and publication surges in recent years. Publicly available RNA-seq datasets from GEO and SRA were examined, with example DESeq2 analysis illustrating altered mitochondrial gene expression in EO-ND patient-derived samples. Network modeling of redox pathways using Python’s networkx demonstrates how oxidative stress can propagate through metabolic networks. Together, these computational approaches reinforce that mitochondrial DNA mutations, impaired electron transport chain (ETC) function, and reactive oxygen species (ROS) accumulation play central roles in EO-ND pathogenesis. The discussion further evaluates why antioxidant clinical trials have largely failed and how emerging therapies such as gene replacement, antisense oligonucleotides, and mitochondrial biogenesis modulators may provide more effective interventions.

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.

This systematic review aimed to evaluate the biomechanical properties, functional performance, and clinical outcomes of different hip prosthesis materials and designs used in total hip arthroplasty (THA). A comprehensive search strategy identified 34 peer-reviewed studies published between 2015 and 2024. The materials investigated included cobalt-chromium-molybdenum (CoCrMo), titanium alloys, PEEK, ceramics, and advanced surface coatings such as polycrystalline diamond (PCD). In addition, dual mobility systems, lattice structures, and additively manufactured and patient-specific implants were assessed. The studies utilized clinical trials, finite element analysis, and biomechanical testing to compare outcomes such as wear resistance, stress distribution, osseointegration, and range of motion. The findings demonstrated that titanium alloys and porous lattice structures reduce stress shielding, while ceramics and CoCrMo provide superior wear resistance. Dual mobility implants improved joint stability and range of motion, particularly in high-risk patients. PEEK and PCD showed promising properties but lacked robust long-term data. The integration of advanced manufacturing technologies and material innovations has led to more personalized and biomechanically efficient solutions for THA. Further longitudinal studies are needed to validate these developments. This review provides a critical synthesis of the biomechanical, functional, and clinical implications of contemporary hip prosthetic systems.

“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.”

Stigma surrounding drug addiction remains a critical barrier to effective treatment, significantly influencing healthcare access, patient engagement, and recovery outcomes. This study explores the multifaceted impact of stigma on individuals seeking help for substance use disorders (SUDs), with a focus on healthcare-related discrimination, internalized stigma, and structural barriers. Research indicates that negative perceptions among healthcare providers contribute to delayed treatment-seeking behaviors, reduced adherence to medication-assisted treatment (MAT), and increased relapse rates. Additionally, patients internalizing these societal judgments experience heightened psychological distress, social isolation, and decreased self-efficacy, further hindering their recovery process. To address these challenges, evidence-based strategies such as addiction medicine education, trauma-informed care, harm reduction approaches, and peer support models have been shown to effectively reduce stigma and improve treatment outcomes. Hospital administrators and nursing leaders play a critical role in fostering a culture of empathy, advocating for the reframing of addiction as a neuro-psycho-biological disease rather than a moral failing. Future research should explore digital mental health interventions, motivational interviewing techniques, and interdisciplinary collaboration to further dismantle stigma and enhance the effectiveness of addiction treatment programs. This study highlights the urgent need for systemic policy changes, targeted educational programs, and a shift in clinical attitudes to create a more inclusive and stigma-free healthcare environment. Through implementing these approaches, healthcare providers can ensure equitable access to treatment and improve long-term health outcomes for individuals with opioid use disorder (OUD) and other substance-related conditions.

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.

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.

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.

Background: Educational attainment is often regarded as a pathway to economic stability and social mobility. However, the Minorities’ Diminished Returns (MDRs) framework has demonstrated that the effects of educational attainment on various economic, behavioral, and health outcomes are weaker for marginalized populations, including racial/ethnic minorities, immigrants, LGBTQ+ individuals, and those living in disadvantaged areas. While MDRs have been documented for various marginalized demographic groups, the role of trauma in moderating socioeconomic outcomes remains underexplored. Objective: This study examines whether lifetime trauma exposure diminishes the positive association between educational attainment and poverty-to-income ratio (PIR), a key indicator of economic well-being. Methods: Using data from the National Survey of American Life (NSAL), we analyzed a nationally representative sample of 6,008 adults, including Black, White, Latino, and Other racial/ethnic groups. We employed linear regression models to evaluate the association between the independent variable educational attainment and the outcome PIR. We then tested lifetime trauma as a moderator of this association. Models controlled for age, gender, employment, and race/ethnicity. Results: Educational attainment was positively associated with PIR across all groups, but the strength of this association was significantly attenuated for individuals with a history of lifetime trauma. These effects were independent of covariates. Conclusions: These findings extend the MDRs framework by highlighting trauma as a potential contributor to diminished returns of education on socioeconomic wellbeing. Structural inequities that increase trauma exposure in minoritized populations may also limit the economic benefits of education, particularly for groups with multiple trauma exposures. Policies aimed at addressing economic inequality must integrate social policies that reduce trauma and stress.

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.

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.

Background: Social determinants of health (SDOH) significantly influence health behaviors, including tobacco use among youth. Adversities such as perceived discrimination, perceived neighborhood stress, life trauma, and financial strain are stressors that may mediate the relationship between various SDOH and youth tobacco use. This study aims to investigate whether multidimensional adversities mediate the effects of SDOH on tobacco use among youth. Methods: Data from the Adolescent Brain Cognitive Development (ABCD) study were used to test our hypotheses. The sample included a diverse cohort of youth aged 9-10 years old followed until they were 15-16 years old. We examined the effects of baseline parental education, household income, neighborhood income, and family structure on subsequent youth tobacco use. Structural equation models were used to test if adversities (perceived discrimination, life trauma, financial strain) operate as potential mediators. Results: All ABCD participants were eligible for our analysis, regardless of race, ethnicity, or SDOHs (n = 11,878). The findings indicated that the effects of parental education, household income, neighborhood income, and family structure on youth tobacco use were partially mediated by adversities. Higher levels of parental education and household income were associated with lower tobacco use, and this relationship was weakened when accounting for adversities. Similarly, stable family structures and higher neighborhood income were linked to reduced tobacco use, with adversities playing a mediating role. Conclusions: Multidimensional adversities partially mediate the relationship between SDOH at baseline and subsequent youth tobacco use. Interventions aimed at reducing youth tobacco use should address both the social determinants and multiple adversities experienced by adolescents. Policies to improve the educational and economic situations of families, enhance neighborhood environments, and support stable family structures all reduce youth tobacco use, with lower exposure to adversities explaining this effect.

The role and contribution of women in modern organisations have been phenomenal. However, societal norms and other patriarchal values continue to stifle the progress of women leaders. The study's overall purpose was to examine the leadership styles of female leaders in managing senior high schools in the Central Region of Ghana. The study adopted non-numerical data and used a purely qualitative research approach. A phenomenological design supported the study framework, and the required data was collected through interviews. The target population for the study were female headmistresses and assistant headmistresses in the various Senior High Schools in the Metropolis. The study involved all six female headmistresses and eight assistant headmistresses in the Metropolis. The participants were sampled using the census to meet the study objectives. The data were analysed thematically. The study revealed that married couples use the participatory leadership style, but those who are single use the assertive style. The study also concluded that women leaders who are single and are farther from 60 years old are more likely to have problems in the discharge of their duties as leaders since men, per societal influence, will always try to resist the control of women leaders. The Ghana education service should package special incentives for women who aspire to achieve the utmost leadership role of becoming heads of senior high schools. It will motivate the young women generation. It is also recommended that women in leadership positions in the Ghana Education Service are advised to learn by updating their skills and competencies to grow in confidence and share ideas with colleagues in the same field to adopt and adapt leadership styles that have worked in other institutions to handle institutional challenges.

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.

The purpose of this study was to assess the structural attributes of black and white Printed Printex Textile Fabrics in Ghana. The study adopted a factorial experimental research design. The three fabrics with black prints and white as base colours were purchased from the market. These three fabrics had the same designs but two had different fabric finishes and the third one had no finish (plain, embossed and plisse). Key soap purchased from the Ghanaian market and standard soap from Ghana Standard Authority were used for the study. A purposive sampling procedure was used in choosing the fabrics and soap for the study. Specimens totalling 219 were cut randomly from along the warp and weft directions of the Printex black and white cotton fabric with finishes (plain, embossed and plisse). The use of laboratory experiments and the apparatus used to experiment. The data obtained were presented using both descriptive and inferential statistics. The descriptive statistics (frequencies, percentages, means and standard deviation) were used as summary statistics of variables of the study. The one-way analysis of variance (ANOVA) was used to test for significant differences among three variables (three washing cycles), whereas the independent samples t-test was used to test for statistically significant differences between the performance of the fabric finishes under Key soap and the standard soap. The study indicated that differences in the attributes of the finishes caused differences in the structural attributes of the fabrics. This was because some of the finishes required certain structural attributes to bond well with the fabrics. The implication is that continuous washing weakens the structural attributes of fabrics which causes them to fail or weakens their resistance to stress tests. The study, however, found that differences in the structural attributes of the fabric finishes caused differences in the effects of washing on the selected fabric finishes. It is recommended that Printex Textile Limited should place critical emphasis on the weight of the fibres used in the construction of the fabrics. This was necessary since the study found that the fabric finish with the greatest weight performed better in tensile strength than those with the lowest weight. As a result, the use of fibres with high weight is expected to improve the use and care of the fabric finishes in terms of their ability to resist stress or tension during washing.

Nutrition plays a key role in regulating the autonomic nervous system (ANS), which is responsible for controlling involuntary bodily functions such as heart rate, breathing, digestion and body temperature. Some nutrients, such as amino acids, vitamins and minerals, have a specific role in the ANS. For example, amino acids are necessary for the synthesis of neurotransmitters, such as serotonin and dopamine, which regulate mood and anxiety. Vitamins and minerals are important for the proper functioning of the ANS, such as vitamin B12, magnesium and zinc. A balanced diet can help reduce oxidative stress and inflammation, which can negatively affect ANS functioning. On the other hand, a nutrient-poor diet can lead to dysfunctions in the ANS, such as hypertension, changes in heart rate and digestive disorders. Digestive problems such as constipation, diarrhea, irritable bowel syndrome (IBS) and functional dyspepsia can occur when the ANS is not working properly. It is important to maintain a healthy and balanced diet to ensure the proper functioning of the autonomic nervous system.

The purpose of this study was to examine coping strategies for managing the effects of work-family conflict on the management staff of hotels in the Accra metropolis of Ghana. The study adopted a Convergent parallel mixed methods research technique. The population of the study is all-star-rated management staff of star-rated hotels in the Accra metropolis. multi-stage sampling. The estimation of the sample size for the hotel managers was based on Krejcie and Morgan’s table for the determination of the sample size for a given population. The population of 100 managers were stratified and randomly sampled out of the 182 managers. The main instruments for data collection were questionnaires and an interview. Statistical Package for Social Sciences (SPSS) version 22.0 was used to determine simple percentages and frequencies of responses. Pearson product-moment Correlation and structural equation model were used to determine the consequences of work-family conflict as well as coping strategies adopted by managers. Amos PLS was used to determine the moderating effect of coping strategies on work-family conflict and job performance. Hotel managers in the Accra metropolis combine the strategies of structural role redefinition, personal role redefinition, cognitive restructuring and reactive role redefinition to curb work-family conflict. The study demonstrated a positive relationship between coping strategies and job performance. Coping strategies had a moderating effect on the relationship between work-family conflict and the job performance of hotel managers. Thus, to improve the job performance of hotel managers, there should be the application of coping interventions to help them perform on the job. The study also determined that work-family conflict had a significant positive relationship with job performance. Similarly, the study established that coping strategies significantly moderate the relationship between work-family conflict and job performance among hotel managers in the Accra metropolis. Although coping strategies were employed by hotel managers in the Accra metropolis, it is recommended that training sessions on the use of coping strategies and stress management techniques should be considered by management to address psychological and emotional work environment stressors since they have been proven to reduce stress and WFC. It is also recommended that there should be an inter-hotel collaboration to offer smaller hotels which do not have the resources some leverage the impact of work-family conflict. This platform can be provided by the Ghana hotels association to impact knowledge of coping strategies in smaller hotels. The government must be encouraged to liaise with the Ghana hotels association to enforce the mandatory eight-hour work per day to avoid overworking of hotel managers.

Oncology nurses are more likely to get compassion fatigue (CF) than nurses in other fields because of the emotional stress and poor outlook of cancer patients. Because of this, the care might not be very good, the job might not be very satisfying, and there is a good chance that the patient's pain won't be noticed. Aim. To synthesize empirical evidence on compassion fatigue in order to extract the common, central, and fundamental elements that may improve nursing care. Design. An integrative review Results. Fifteen (15) studies met the eligibility criteria wherein five themes emerged. These are the level of compassion fatigue among oncology nurses, the oncology nurses' perspectives on compassion fatigue, precipitating factors leading to CF with 2 subthemes (work environment and a feeling of lack of support), the influence of compassion fatigue on the personal lives and general well-being of cancer nurses, and the consequences on the quality of oncology nurses' professional lives at work. Conclusion. CF is a significant problem for nurses who work in specialized areas such as cancer units, demonstrated as a basic incapacity to nurture others. The integration of studies provides evidence of clinical practice application which can provide better outcomes and improve nursing care. Implications for Practice. The findings provide understanding into healthcare practice on how to avoid compassion fatigue. Clinical management approaches that can mitigate compassion fatigue and its negative repercussions are presented, as well as the formation of peer support groups that have the ability to ameliorate CF.

The present article seeks to provoke a discussion into how video games can be used in anxiety treatments and social stimulation tools among middle-year students and children of that same age. To do so, we initially start this article by reflecting on how the covid-19 pandemic disparate all anxiety alerts in our society including mental health issues such as depression and special anxiety disorders. Then we compare how the numbers of anxiety among children and young adults were already alarming before the lockdowns imposition and the social distance measures, especially in urban centers. This rising anxiety condition can be felt especially in the years that followed the social isolation of children especially because their social connection and recognition were just starting to grow and to establish important connections between their peers in-person and in virtual environments, throwing light on how to screen media and children`s homes are related with the anxiety increase and how we can investigate that phenomenon without succumbing to excessive positivism to today`s technology or to a deconstructive pessimism that leads us to distrust those media that are already in contact with middle-year students and children`s in that same age. To do so, we will resort to philosophical tools such as Edusemiotics and Cultural Studies to understand how games such as Minecraft and Roblox can be used in school environments to help students and teachers manage anxiety levels and surpass socialization issues past covid-19 lockdowns. To finish our reflection we also bring some data related to how those same media and games helped middle-year students to surpass social isolation and family disconnection during the pandemic while their kept exercising school content in those games, sharing and debating with their peers on virtual platforms.

Background: Sexuality is considered to be one of the most significant markers of quality of life. This is due to the fact that sexuality is linked to ideas, feelings, behaviors, social integration, and therefore, a person's physical and mental health and well-being but with patients who have gynecologic cancers, there are significant challenges when it comes to matters of sexuality and intimacy. Aim: To find out how gynecological cancer affects women's sexual experiences and how they express sexuality in the context of their sickness Design: A qualitative synthesis, thematic approach Result: Nineteen (19) eligible studies centered with gynecologic cancers on sexual functioning were included with two (2) main themes emerged: (1) Issues with Sexual Experiences and (2) Physical and Emotional Burden. Many individuals were found to have one or more sexual dysfunctions, which commonly caused distress. Conclusion: Changes in the women’s quality of life in the sexual aspect due to their disease takes a toll not just on the physical but in other facets as well. Better knowledge and patient-centered approaches would improve gynecologic cancer patients' capacity to cope in terms of sexual functioning. Implications: Healthcare professionals such as oncology nurses and doctors should better understand ways to address the sexual problems of their patients following the myriad of events following their diagnosis and treatment of their gynecologic cancers.

Water is essential for food security and animal agricultural productivity, but it is becoming more scarce due to climate change. The interaction between climate change and livestock water resources has received little attention from researchers, despite the significance of small-scale animal husbandry for the rural poor in Africa and the size of the changes that are anticipated to have an impact on smallholder livestock systems. Threats to livestock water are undoubtedly one of the most significant environmental issues that have impacted food security on the continent, given their links to small-scale animal husbandry and the detrimental impacts on productivity. In order to balance the negative effects of climate change scenarios for sustainable animal productivity and contribute to food security through small-scale animal agriculture, the most climate-smart and resilient agricultural water practices and technologies must be used. Changes in rainfall and a decline in the biomass available for grazing and rangelands as a result of water stress brought on by the climate would have the most severe effects. This is due to the rain-fed nature of small-scale livestock farming. The local animal genetic resources are essential for animal productivity and food security in Africa, particularly in areas where livestock water is becoming scarce owing to climate change. Research and development goals on the effects of climate change on livestock water, animal productivity, and food security may need to be reviewed if demands of vulnerable small-scale animal producers are to be successfully addressed in the future decades. It is best to use an interdisciplinary approach to comprehend the relationships between small-scale animal husbandry, food security, and climate change. By navigating the complexities of climate adaptation, small-scale livestock farmers can manage livestock water scarcity by taking adaptation measures that are in line with evolving climate impacts and associated means of implementation based on pertinent and useful knowledge that takes into account a blend of traditional and modern water science. In this paper, an effort is made to close some significant information gaps and shed light on how water-induced stress impacts small-scale animal production, which has an effect on food security.

The purpose of the study was to assess teachers’ use of field trips in evaluating Social Studies lessons in Winneba Senior High School in Effutu Municipality in the Central Region of Ghana. Qualitatively, a case study research design was employed for the study. The population of this study comprised all the four (4) Social Studies teachers and Social Studies Association president in Winneba Senior High School. Convenient and purposive sampling techniques were used to select the municipality, Winneba Senior High School and Social Studies teachers and Social Studies Association president for the study. The main instrument for data collection was semi-structured interview guide. The data was analysed through the use of the interpretative method on the themes identified during the data collection. The study indicated that the use of field trips in the teaching and learning of Social Studies has the potential to influence the understanding levels of students and teachers. Therefore, field trips have the potential to help students and teachers to gain new knowledge that may not have been obtained through theoretical learning in the classroom. The study also revealed that organisation of field a trip has some challenges, such as, time as the main factor, financial problems, inadequate support from School Management, Parents and some teachers, nature of the curriculum, the behaviour of students outdoor were related to the research questions and interpreted on the number of issues raised by respondents. It is recommended that procedures for seeking permission be outlined by the Ghana Education Service to facilitate easy permission processes and to reduce the stress associated with seeking permission for organizing field trips for teachers and students in Senior High Schools. It is also recommended that students should be educated more and more by their Social Studies teachers on the importance of embarking on field trips to eliminate the lukewarm attitudes of some of the students. It is recommended that the Regional and District directors of education should ensure constant and effective supervision of teachers to encourage the use of field trips as a teaching strategy for the evaluate Social Studies lessons.

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.

The tensile strength is an imperative properties and essential indications consumers’ look out for in purchasing a quality fabric. The objective of this study was to examine key soap on tensile strength in three washing cycles of selected Printex fabrics in Ghana. Quantitatively, the study adopted both experimental and factorial research designs. Materials for the study consisted of three fabrics with black prints and white as base colour were purchased from the market. These three fabrics had the same designs but two had different fabric finishes and the third one had no finish (plain, embossed and plisse). Six yards each of the Printex black and white fabrics with embossed, plisse and a third one which did not have any special fabric finish were used for the study. Key soap purchased from the Ghanaian market, and standard soap from Ghana Standard Authority was used for the study. Purposive and simple random techniques were used to select materials for the study. The main research instrument for the testing tensile strength was Universal tensile testing machine. Data were analysed with both descriptive and inferential statistics. The one-way analysis of variance (ANOVA) was used to test the hypothesis formulated to guide the study. The study revealed that continuous washing had degrading effects on the tensile strength. The implication is that continuous washing weakens the internal strengths of fabrics which cause them to fail or weakens their resistance to stress test. The study also found that continuous washing had degrading effects on the tensile strength of the selected fabrics. It is recommended that the Ghana Standards Authority should encourage soap producers to get their chemical compositions as close to those of the standardised soap as possible.

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.