Understanding the predictors of health professionals' intention to use electronic health record system: extend and apply UTAUT3 model.

BACKGROUND: The implementation of Electronic Health Record (EHR) systems is a critical challenge, particularly in low-income countries, where behavioral intention plays a crucial role. To address this issue, we conducted a study to extend and apply the Unified Theory of Acceptance and Use of Technology 3 (UTAUT3) model in predicting health professionals' behavioral intention to use EHR systems. METHODS: A quantitative research approach was employed among 423 health professionals in Southwest Ethiopia. We assessed the validity of the proposed model through measurement and structural model statistics. Analysis was done using SPSS AMOS version 23. Hypotheses were tested using structural equation modeling (SEM) analysis, and mediation and moderation effects were evaluated. The associations between exogenous and endogenous variables were examined using standardized regression coefficients (ß), 95% confidence intervals, and p-values, with a significance level of p-value < 0.05. RESULTS: The proposed model outperformed previous UTAUT models, explaining 84.5% (squared multiple correlations (R2) = 0.845) of the variance in behavioral intention to use EHR systems. Personal innovativeness (ß = 0.215, p-value < 0.018), performance expectancy (ß = 0.245, p-value < 0.001), and attitude (ß = 0.611, p-value < 0.001) showed significant associations to use EHR systems. Mediation analysis revealed that performance expectancy, hedonic motivation, and technology anxiety had significant indirect effects on behavioral intention. Furthermore, moderation analysis indicated that gender moderated the association between social influence, personal innovativeness, and behavioral intention. CONCLUSION: The extended UTAUT3 model accurately predicts health professionals' intention to use EHR systems and provides a valuable framework for understanding technology acceptance in healthcare. We recommend that digital health implementers and concerned bodies consider the comprehensive range of direct, indirect, and moderating effects. By addressing personal innovativeness, performance expectancy, attitude, hedonic motivation, technology anxiety, and the gender-specific impact of social influence, interventions can effectively enhance behavioral intention toward EHR systems. It is crucial to design gender-specific interventions that address the differences in social influence and personal innovativeness between males and females.

Moderated BMI accumulation modified associations between blood benzene, toluene, ethylbenzene and xylene (BTEX) and phenotypic aging: mediating roles of inflammation and oxidative stress.

The associations between blood benzene, toluene, ethylbenzene, and xylenes (BTEX) and biological aging among the general adult population remain elusive. The present study comprised 5,780 participants from the National Health and Nutrition Examination Survey 1999-2010. A novel measure of biological aging, phenotypic age acceleration (PhenoAge.Accel), derived from biochemical markers was calculated. Weighted generalized linear regression and weighted quantile sum regression (WQS) were utilized to assess the associations between BTEX components and mixed exposure, and PhenoAge.Accel. The mediating roles of systemic immune-inflammation index (SII) and oxidative stress indicators (serum bilirubin and gamma-glutamyl transferase, GGT), along with the modifying effects of body mass index (BMI) were also examined. In the single-exposure model, the highest quantile of blood benzene (b = 0.89, 95%CI: 0.58 to 1.20), toluene (b = 0.87, 95%CI: 0.52 to 1.20), and ethylbenzene (b= 0.80, 95%CI: 0.46 to 1.10) was positively associated with PhenoAge.Accel compared to quantile 1. Mixed-exposure analyses revealed a consistent positive association between BTEX mixed exposure and PhenoAge.Accel(b=0.88, 95%CI: 0.56 to 1.20), primarily driven by benzene (92.78%). The association between BTEX and PhenoAge.Accel was found to be partially mediated by inflammation and oxidative stress indicators (ranging from 3.2% to 13.7%). Additionally, BMI negatively modified the association between BTEX mixed exposure and PhenoAge.Accel, with a threshold identified at 36.2 kg/mˆ2. Furthermore, BMI negatively moderated the direct effect of BTEX mixed exposure on PhenoAge.Accel in mediation models, while positively modifying the link between SII and PhenoAge.Accel in the indirect path (b interaction= 0.04, 95%CI: 0.04 to 0.06). Overall, BTEX mixed exposure was associated with PhenoAge.Accel among US adults, with benzene may have reported most contribution, and inflammation and oxidative damage processes may partially explain this underlying mechanism. The study also highlighted the potential benefits of appropriate BMI increased. Additional large-scale cohort studies and experiments were necessary to substantiate these findings.

Moderation Effects of Streetscape Perceptions on the Associations Between Accessibility, Land Use Mix, and Bike-Sharing Use: Cross-Sectional Study.

Background: Cycling is known to be beneficial for human health. Studies have suggested significant associations of physical activity with macroscale built environments and streetscapes. However, whether good streetscapes can amplify the benefits of a favorable built environment on physical activity remains unknown. Objective: This study examines whether streetscape perceptions can modify the associations between accessibility, land use mix, and bike-sharing use. Methods: This cross-sectional study used data from 18,019,266 bike-sharing orders during weekends in Shanghai, China. A 500 × 500 m grid was selected as the analysis unit to allocate data. Bike-sharing use was defined as the number of bike-sharing origins. Street view images and a human-machine adversarial scoring framework were combined to evaluate lively, safety, and wealthy perceptions. Negative binomial regression was developed to examine the independent effects of the three perceptual factors in both the univariate model and fully adjusted model, controlling for population density, average building height, distance to nearest transit, number of bus stations, number of points of interest, distance to the nearest park, and distance to the central business district. The moderation effect was then investigated through the interaction term between streetscape perception and accessibility and land use mix, based on the fully adjusted model. We also tested whether the findings of streetscape moderation effects are robust when examinations are performed at different geographic scales, using a small-sample statistics approach and different operationalizations of land use mix and accessibility. Results: High levels of lively, safety, and wealthy perceptions were correlated with more bike-sharing activities. There were negative effects for the interactions between the land use Herfindahl-Hirschman index with the lively perception (ß=-0.63; P=.01) and safety perception (ß=-0.52; P=.001). The interaction between the lively perception and road intersection density was positively associated with the number of bike-sharing uses (ß=0.43; P=.08). Among these, the lively perception showed the greatest independent effect (ß=1.29; P<.001), followed by the safety perception (ß=1.22; P=.001) and wealthy perception (ß=0.72; P=.001). The findings were robust in the three sensitivity analyses. Conclusions: A safer and livelier streetscape can enhance the benefits of land use mix in promoting bike-sharing use, with a safer streetscape also intensifying the effect of accessibility. Interventions focused on streetscape perceptions can encourage cycling behavior and enhance the benefits of accessibility and land use mix. This study also contributes to the literature on potential moderators of built environment healthy behavior associations from the perspective of microscale environmental perceptions.

Can good neighbourhood perception magnify the positive effect of favourable built environment on recreational walking in China?

BACKGROUND: It remains unknown whether good neighbourhood perception can enhance the benefits of favourable built environment to physical activity. Moreover, the moderation pattern is less understood in developing countries. OBJECTIVES: This work aims to examine the moderation effects of perceived neighbourhood safety and aesthetics on the relationship between built environment and time for recreational walking. METHODS: We performed the examination using a sample of 760 residents in Fuzhou City, China. The Negative Binomial Regression Model was developed to examine the moderation roles of neighbourhood safety and aesthetics on the impact of built environment, adjusting for the effects of location, socioeconomic, personal preferences and social environment factors. Moreover, two sensitivity analyses were performed to test whether the moderators found are robust to the control of residential self-selection, and differential measures of conceptually-comparable aspects of built environment. RESULTS: We found stronger associations of time for recreational walking with road density and proportion of parks and squares POIs for residents with high perception of neighbourhood safety, compared to those with low perception of neighbourhood safety. There was a greater effect of the proportion of parks and squares POIs, when perceived aesthetics was high than when perceived aesthetics was low. The findings of neighbourhood safety and aesthetics as moderator, were robust in the two sensitivity analyses. No significant moderation effect was found for land use diversity. CONCLUSIONS: High perceived neighbourhood safety can magnify the positive effects of road connectivity and accessibility to parks and squares. Neighbourhood aesthetics positively moderates the association of time for recreational walking with accessibility to parks and squares. The findings emphasize the need to consider safety- and aesthetics-specific differences in estimates of built environment effects. Improvements in neighbourhood safety and aesthetics are key to effective interventions in built environment to better promote physical activity.

Personality Traits and Family SES Moderate the Relationship between Media Multitasking and Reasoning Performance.

The prevalence of media multitasking has raised concerns regarding its potential impact on cognitive abilities. Despite increasing attention given to this topic, there remains no consensus on how media multitasking is related to cognitive performance. This study aims to shed light on this issue by examining whether and how personality traits and family socioeconomic status (SES) moderate the relationship between media multitasking and reasoning performance. To this end, a large sample of university students (n = 777) completed a battery of measures, including the Raven's Advanced Progressive Matrices, the Media Multitasking Inventory, the Big Five Inventory, the Barratt Impulsiveness Scale, the Grit Scale, and the Family SES Questionnaire. Results revealed a negative correlation between media multitasking and reasoning performance. However, this relationship was substantially moderated by conscientiousness, extraversion, openness, and family SES. Specifically, media multitasking was more detrimental to reasoning performance among individuals with lower levels of conscientiousness, extraversion, openness, and family SES, whereas it was less detrimental to counterparts with higher levels of these personality traits and family SES. The proposed moderation model, for the first time, not only offers novel insights into the theoretical accounts regarding how media multitasking relates to cognitive abilities, but also identifies the protective factors that may buffer the negative impacts of media multitasking.

The Mediation/Moderation Effects of Gut Microbiota on Sleep Quality and Primary Liver Cancer: A Mendelian Randomization and Case-Control Study.

Background: Primary liver cancer (PLC) is a fatal malignancy, sleep quality and gut microbiota were shown to be associated with PLC. However, the mechanism of how sleep quality affects PLC is unclear. This study aims to investigate the mediation/moderation effects of gut microbiota on sleep quality and the occurrence of PLC. Methods: The causality of sleep quality and the occurrence of PLC was detected through the Mendelian randomization (MR) analysis based on the data including 305,359 individuals (Finland Database) and 456,348 participants (UK Biobank). The primary method used for MR analysis was inverse-variance weighted analysis. Gut microbiota' mediation/moderation effects were uncovered in the case-control study including 254 patients with PLC and 193 people with benign liver diseases through the mediation/moderation effect analyses. People's sleep quality was evaluated through the Pittsburgh sleep quality index (PSQI). Results: Poor sleep quality could lead to PLC through the MR analysis (P = 0.026). The case-control study uncovered that Actinobacteria had mediation effects on the relationship between PSQI score, self-sleep quality, and the occurrence of PLC (P = 0.048, P = 0.046). Actinobacteria and Bifidobacterium could inhibit the development of PLC caused by short night sleep duration (P = 0.021, P = 0.022). Erysipelotrichales could weaken the influence of daytime dysfunction on PLC (P = 0.033). Roseburia modulated the contribution of nocturnal insomnia and poor sleep quality to PLC (P = 0.009, P = 0.017). Conclusion: Poor sleep quality was associated with PLC. Gut microbiota' mediation/moderation effects on poor sleep quality and the occurrence of PLC prompted an insightful idea for the prevention of PLC.

Exploring the nexus between fiscal decentralization and ecological sustainability: a fresh perspective from the moderating role of geopolitical risk and updated international evidence.

Fiscal decentralization has been long employed to enhance the utilization of financial resources for sustainable development. Nevertheless, its effectiveness in limiting ecological degradation is ambiguous, especially when a country faces geopolitical risks. Different from previous works which separately examine the impacts of either fiscal decentralization or geopolitical risks on ecological sustainability, this research examines the moderating role of geopolitical risks on the non-linear relationship between fiscal decentralization and ecological footprints across different levels of environmental condition. An advanced panel quantile regression is applied to a sample of 23 advanced and emerging market economies from 1990 to 2018. The empirical results indicate that the nexus between revenue decentralization and ecological footprint follows an inverted U-shaped pattern at the 20th to 60th quantiles of ecological footprint. Meanwhile, the linkage between expenditure and ecological footprint reflects a U-shaped pattern across all quantiles. Notably, geopolitical risk strongly moderates the connection between fiscal decentralization and ecological footprint with the role being stronger in the case of revenue decentralization. This research provides valuable implementations to tailor policies for transferring revenue and expenditure responsibilities to sub-governmental bodies towards sustainability targets based on their current ecological conditions and contexts of geopolitical instability.

Spatio-temporal effects of digital inclusive finance on the synergy between CO2 and air pollution emissions in 251 Chinese cities.

Achieving the synergistic reduction of CO2 and air pollution emissions (SRCAPEs) holds great significance in promoting the green transformation. However, limited research has been conducted on the spatio-temporal impact of digital inclusive finance (DIF) on the synergy between CO2 and air pollution emissions (SCAPEs). To address this gap, we comprehensively employ the linear regression model, geographically and the temporally weighted regression (GTWR) model, and the ordered probit model to empirically analyze the influence of DIF on SCAPE. Our research reveals the following: (1) The linear regression model demonstrates that, on average, DIF can achieve a weak synergistic emission reduction effect. This result remains robust after a battery of robustness tests. (2) The GTWR model reveals that the impact of DIF on both emissions exhibits evident spatio-temporal characteristics. Its emission reduction effect gradually increases, especially after 2014. (3) On the basis of the estimates from the GTWR model, we can identify four distinct synergy types driven by DIF. The number of cities with the preferred type (i.e., achieving SRCAPE) increases the most, from 59 in 2011 to 233 in 2019. (4) On the basis of the built ordered probit models, green technology innovation is an important path for DIF to achieve synergistic emission reduction. The synergistic emission reduction effect is also significantly moderated by the regional economic level and environmental regulation intensity. Our findings have policy implications for central and local governments in achieving SRCAPE and support efforts to achieve sustainable development.

Nonlinear Moderation Effect of Vagal Regulation on the Link between Childhood Trauma and Adolescent Internalizing and Externalizing Symptoms.

Childhood trauma is a leading early adverse environment that increases psychopathological symptoms. Respiratory sinus arrhythmia (RSA) suppression to challenges as a marker of self-regulation is found to linearly moderate the link between early adverse experiences and psychopathological symptoms, but yielding mixed findings. The present study examined the relationships between childhood trauma and internalizing and externalizing symptoms via a 1.5-year longitudinal design and the quadratic moderation effect of RSA suppression on these relationships among adolescents. In November 2021 (T1), the final sample of 275 Chinese adolescents (Mage = 12.94, SDage = 0.79; 49.82% females) completed the short form of Childhood Trauma Questionnaire and the Achenbach Youth Self-Report-2001 and underwent a speech task during which their baseline RSA and stress exposure RSA were obtained. In June 2023 (T2), 251 adolescents completed the Achenbach Youth Self-Report-2001. Results showed that childhood trauma at T1 was positively correlated with internalizing and externalizing symptoms at T1 and T2. RSA suppression to stress quadratically moderated these associations, such that adolescents with moderate rather than higher or lower RSA suppression had the least internalizing and externalizing symptoms at T1 and T2 when exposed to childhood trauma. The findings suggest that moderate RSA suppression to stress as a marker of optimal vagal regulation buffers the risk of developmental psychopathology from early adverse experiences.

Inflammatory markers and androstenedione modify the effect of serum testosterone on obesity among men: Findings from a Chinese population.

BACKGROUND: Few studies are available on the relationship of androstenedione with inflammation and obesity and the effect of androstenedione and inflammation on the association between testosterone and obesity. This study intended to examine the mediation effect of inflammatory markers on the association of testosterone with obesity and the moderation effect of androstenedione on the association of testosterone with inflammation and obesity in Chinese rural men. MATERIALS AND METHODS: This cross-sectional research enrolled 2536 male rural inhabitants from the Henan Rural Cohort study. The serum concentrations of testosterone and androstenedione were determined by liquid chromatography-tandem mass spectrometry. Linear and logistic regression were used to examine the relationships between testosterone, inflammatory markers, and obesity. Mediation and moderation analyses were carried out to evaluate the potential effects of inflammatory markers on the relationship between testosterone and obesity, as well as androstenedione on the relationships of testosterone with inflammation and obesity. RESULTS: After adjusting for confounding factors, the results showed that testosterone and androstenedione were negatively related to obesity, and inflammatory markers were positively associated with obesity. Besides, testosterone and androstenedione were negatively associated with inflammatory markers. Mediation analysis showed that white blood cell, neutrophil, monocyte, and high-sensitivity C-reactive protein had mediating effects on the association between testosterone and obesity. The most vital mediator was high-sensitivity C-reactive protein, and its proportion of the effect was 11.02% (defined by waist circumference), 11.15% (defined by waist-to-hip ratio), 12.92% (defined by waist-to-height ratio), and full mediating effect (defined by body mass index). Moreover, androstenedione played negative moderation effects on the associations of testosterone with inflammation and obesity. CONCLUSION: Inflammatory markers and androstenedione were first found to have modifying effects on the association of testosterone with obesity. Higher levels of testosterone and androstenedione could reduce the inflammation level and risk of obesity, indicating their potential roles in the prevention and treatment of chronic diseases.

Depressive Symptoms Moderate the Association Between Functional Level at Admission to Intensive Post-Stroke Rehabilitation and Effectiveness of the Intervention.

INTRODUCTION: Previous studies showed that depression acts as an independent factor in functional recovery after stroke. In a prospective cohort of patients admitted to intensive inpatient rehabilitation after a stroke, we aimed to test depression as a moderator of the relationship between the functional level at admission and the effectiveness of rehabilitation at discharge. METHODS: All patients admitted to within 30 days from an ischemic or hemorrhagic stroke to 4 intensive rehabilitation units were prospectively screened for eligibility to a multicenter prospective observational study. Enrolled patients underwent an evidence-based rehabilitation pathway. We used clinical data collected at admission (T0) and discharge (T1). The outcome was the effectiveness of recovery at T1 on the modified Barthel Index (proportion of achieved over potential functional improvement). Moderation analysis was performed by using the PROCESS macro for SPSS using the bootstrapping procedure. RESULTS: Of 278 evaluated patients, 234 were eligible and consented to enrolment; 81 patients were able to answer to the Hospital Anxiety and Depression Scale (HADS) and were included in this analysis. The relationship between the functional status at admission and rehabilitation effectiveness was significant only in persons with fewer depressive symptoms; depression (HADS cut-off score: 5.9) moderated this relationship (P = .047), independent from age and neurological impairment. CONCLUSIONS: Our results suggest that depression moderates between the functional status at admission and the functional recovery after post-stroke rehabilitation. This approach facilitates the identification of subgroups of individuals who may respond differently to stroke rehabilitation based on depression.

The impact of green finance and local regulations on industrial green innovation efficiency in China.

When the incentive mechanism of green finance fails to fully promote green technology innovation in industrial enterprises, local government environmental regulations become an important tool in correcting this market failure. However, due to the "follow the cost" hypothesis, the moderating effect of the local government environmental regulation is heterogeneous. In order to explore the impact mechanism of green finance development on the efficiency of green technology innovation in industrial enterprises, spatial effects as well as the heterogeneous moderating effect of local government environmental regulation, this paper systematically evaluates the development level of green finance in 30 provinces in China from 2009 to 2019. It estimates the efficiency of green technology innovation in industrial enterprises using the super-efficiency SBM model, and empirically analyzes the impact mechanism and moderating effect using the spatial Durbin model. The results show that: (1) green finance not only positively impacts the efficiency improvement of green technology innovation in industrial enterprises but also has significant spatial spillover effects; (2) local government environmental regulation has a nonlinear "inverted U-shaped" moderating effect between the green finance development and the efficiency of green technology innovation in industrial enterprises. Based on the research conclusions, this paper proposes policy recommendations from the perspectives of deepening the regional connectivity of green finance and promoting joint regulation by local governments.

Have pensions reduced the relative poverty? ----- empirical analysis from China CHARLS data.

According to its function as increasing disposable income, pension is believed to reduce absolute poverty of recipients. However, nowadays, researchers haven't reached the consensus on whether pensions reduce the relative poverty or not. Given the data from the China Health and Retirement Longitudinal Study (CHARLS) 2018, this study investigates on if pension has positive effect on the reduction of relative poverty by performing the heteroskedastic probit model with 2SLS and IV estimators. The result shows that: (1) Pension has a noticeable ani-poverty effects. Three relative poverty line charts indicate a decrease by 4.8 %, 4.28 % and 4.39 % in the probability of beneficiaries falling into relative poverty for each 1 % increase in pensions. (2) Pension contributes greatly to relative poverty reduction at the regional level, this contribution appears to have an urban-rural heterogeneity, with features of central > western > eastern and rural > town. (3) Pension increases the effect to improve the relative poverty through the mediating effect of intergenerational support from children. (4) To improve relative poverty situation, individual health status shows a positive moderating effect on pensions. For recipients with good health status, their probability of falling into relative poverty are less likely than the others.

A rising trend in eco-friendly products: A health-conscious approach to green buying.

This study aims to develop and test the hypothesis of the relationship between green perceived value, green perceived risk, green trust, and green purchase intentions especially the moderator effect of gender on relationship of green trust and green intention to clarify their correlation. This study focuses on the interdependence between the four factors mentioned (green perceived value, green perceived risk, green trust, and green purchase intentions) in order to increase green purchase intentions in modern society, which is an important factor to be concerned about in this environmental era. The technique of research applied in this study is nonprobability sampling with snowball sampling method. Structural Equation Modeling (PLS-SEM) was used to test the cause and effect relationships in the research. A survey conducted by 214 respondents who concerned in buying eco-friendly product were asked to fill the questionnaire to analyze the hypothesis. The analyzed results show that the moderator effect of gender on relationship of green trust and green intention, green perceived value has a positive effect on both green trust and green purchase intentions. Then, green perceived risk positively affects green trust but has no impact on green purchase intentions. In comparison, green trust is an important factor that leads to green purchase intentions.

Can environmental tax improve the environmental investment? Evidence from a quasi-natural experiment in China.

The implementation of the Environmental Tax Law is a milestone in promoting China's green tax reform. However, the existence literature has lacked attention to whether it leads enterprises to invest in green environmental protection. To examine the Environmental Tax Law effects and mechanism on the environmental investment of heavy-polluted enterprises, this study used the data of heavy-polluted enterprises listed on the A-share market from 2012 to 2020 and regarded the Environmental Tax Law as a quasi-natural experiment to employ a difference-in-differences model. We found that environmental tax improves the green environmental investment of heavy-polluted enterprises, reflecting the guiding role of policy on enterprise investment allocation. Heterogeneity was found, and the promotion effect of environmental tax reform on enterprise environmental investment is more significant in non-nation-owned, central-western regions, and small-scale enterprises. Further analysis believed that market competition, as an external mechanism, helps strengthen environmental tax reform's implementation effect. The findings of this paper provide a new proof for a comprehensive understanding of the micro-effect of environmental tax reform and provide a reference for the implementation of green development strategies.

ASSESSING TIME-VARYING CAUSAL EFFECT MODERATION IN THE PRESENCE OF CLUSTER-LEVEL TREATMENT EFFECT HETEROGENEITY AND INTERFERENCE.

The micro-randomized trial (MRT) is a sequential randomized experimental design to empirically evaluate the effectiveness of mobile health (mHealth) intervention components that may be delivered at hundreds or thousands of decision points. MRTs have motivated a new class of causal estimands, termed "causal excursion effects", for which semiparametric inference can be conducted via a weighted, centered least squares criterion (Boruvka et al., 2018). Existing methods assume between-subject independence and non-interference. Deviations from these assumptions often occur. In this paper, causal excursion effects are revisited under potential cluster-level treatment effect heterogeneity and interference, where the treatment effect of interest may depend on cluster-level moderators. Utility of the proposed methods is shown by analyzing data from a multi-institution cohort of first year medical residents in the United States.

The moderating role of optimism between social trauma and depression among Chinese college students: a cross-sectional study.

BACKGROUND: Although there is a robust relationship among social trauma, optimism, and depression, the inner mechanism of this correlation remains unclear and need to be further explored. The mainly purpose of the current study was to investigate the relationship between social trauma, optimism, and depression among college students in China. More specifically, examined the moderating role of the optimism between social trauma and depression in Chinese college students. METHODS: A sample of 464 Chinese college students (54.7% female, Mage=19.29) from three universities were selected by the convenient sampling, and the Social Trauma Questionnaire (STQ), the Optimism Questionnaire (OPQ), and the Self-Rating Depression (SDS) were completed by these Chinese undergraduates. The descriptive statistics, Pearson correlations, and hierarchical regression analysis were used to examine the results. RESULTS: (1) The social trauma was positively associated with depression, whereas the optimism was negatively associated with social trauma, and depression; (2) The social trauma had a significant correlation with depression, and the optimism could moderate the relationship between social trauma and depression. More specifically, the further study showed that there was a significant positive relation between social trauma and depression under the low optimism level, however, there was a non-significant relation between social trauma and depression under the high optimism level. CONCLUSION: The optimism is the protective mechanism of college students' mental health (e.g., depression), it could weaken the trauma that associated with social trauma among college students.

The Mediation and Moderation Effect Association among Physical Activity, Body-Fat Percentage, Blood Pressure, and Serum Lipids among Chinese Adults: Findings from the China Health and Nutrition Surveys in 2015.

Physical activity (PA) is of benefit and particularly important for cardiovascular disease risk factors as being sedentary becomes a lifestyle habit. Research into Chinese complex association among physical activity, body-fat percentage (BF%), blood pressure, and serum lipids is limited. The present study is based on an observational study among adults (>18 years old) residing in fifteen provinces in China. Data of 10,148 adult participants in the 2015 China Health and Nutrition Survey (CHNS) were analyzed. The simple mediation effect models with covariates were utilized to assess the association among PA and blood pressure or serum lipids, and BF% was played as a mediator. The serial multiple-mediator models with covariates were constructed to the further analysis of the relationship between PA and blood pressure, and BF% was the mediator 1 and blood lipids were the mediator 2. Based on the above hypothesis, the moderated mediation models with covariates were used to analyze the association among PA, BF%, and blood pressure; in addition, BF% was used as the mediator and blood lipids played as the moderator. In the simple mediation models, the model with a dependent variable was high-density lipoprotein cholesterol (HDL-C) or low-density lipoprotein cholesterol (LDL-C); BF% was played as the partly mediation effect and the proportion of contribution was 0.23 and 0.25, respectively. In the serial multiple-mediator models, blood lipids, as the second mediator, played the mediation effect; however, the effect was smaller than the BF%. In the moderated mediation model, blood lipids had the moderation effect as the moderator variable. HDL-C played a moderating role in the latter pathway of the "PA→BF%→SBP/DBP" mediation model, and LDL-C/TC played a moderating role in the direct effect of the "PA→BF%→DBP". In conclusion, BF% played a mediating role in the relationship between PA and blood pressure. HDL-C, LDL-C, and TC were more likely to act as moderating variables in the mediation model "PA→BF%→SBP/DBP". PA could directly and indirectly benefit to control the CVD risk factors simultaneously.

Effect of English Learning Motivation on Academic Performance Among English Majors in China: The Moderating Role of Certain Personality Traits.

Background: Previous studies have explored the interrelationship among learning motivation, personality traits, and academic performance, but little is known about the role of personality traits in the relationship between foreign language learners' motivation and academic performance, especially in the Chinese setting, where English is taken as a compulsory course in universities. Purpose: This study aimed to fill the gap by investigating the relationship between English learning motivation and academic performance among English majors in China and identifying the moderating role of certain personality traits, sequentially providing some implications for improving college English teaching strategies in China. Methods: English majors (N=273) from different types of universities in China were recruited to complete the revised version of the English learning motivation scale and big five personality traits scales via an online survey platform. Descriptive statistics, correlation analyses and hierarchical regression analyses were performed to explore the relationships among the three variables. Results: Results demonstrated that English learning motivation and openness both significantly influenced academic performance and significant interaction effects were found between English learning motivation and agreeableness. Specifically, agreeableness partially moderated the relationship between English learning motivation and academic performance, and English learning motivation had a positive effect on academic performance only for learners with lower levels of agreeableness. Conclusion: These findings not only addressed the gap of the moderating role of personality traits in the motivation-performance relationship but also extended our knowledge of the roles of English learning motivation and certain personality traits in English learning within the context of China, where English is taken as a foreign language, thus providing practical suggestions for college English teachers and researchers in China to improve students academic performance.

The relationship between perceived teacher support and student engagement among higher vocational students: A moderated mediation model.

Introduction: Student engagement is a best predictor variable of student' development and success. It can be highly influenced by internal and external environmental factors, such as perceived teacher support. Methods: In order to explore the influence of perceived teacher support on student engagement among higher vocational students, this study conducted a questionnaire on 1,136 Chinese higher vocational students using perceived teacher support, basic psychological needs satisfaction, learning drive, student engagement and Optimistic attributional styles for explaining positive events (OAS_P) five scales. Results: The results show that: (1) Perceived teacher support can't indirectly predict the student engagement among higher vocational students through basic psychological needs satisfaction; (2) Perceived teacher support can indirectly predict student engagement through learning drive; (3) Perceived teacher support can indirectly predict student engagement through basic psychological needs satisfaction and learning drive; (4) OAS_P has a significant moderation effect on both learning drive and student engagement. Discussion: The finding of this study stated that perceived teacher support has a significant influence on student engagement. So in the teaching process, teachers should pay attention to their learning psychology, provide them with various support and encouragement and beneficial guidance, stimulate their learning drive, help them form a positive and optimistic attribution style, and make them actively participate in learning and school life.