Background: Social anxiety has been shown to affect college students’ academic performance. However, the role of social media addiction and academic engagement in this association is unclear. Methods: A total 2661 college students completed a self-report questionnaire including Liebowitz Social Anxiety Scale, the Bergen Social Media Addiction Scale, the Utrecht Student Work Engagement Scale for Students, and the grade point average. Hayes’ PROCESS macro for SPSS was employed to test the serial mediation effect. Results: Results indicated that social anxiety was negatively related to academic performance, only academic engagement played a single mediating role in the relationship between social anxiety and academic performance, meanwhile social media addiction and academic engagement acted as serial mediators between social anxiety on academic performance. Conclusions: Social media addiction and academic engagement can explain the potential mechanisms of the association between social anxiety and academic performance, which have implications for devising intervention strategies to enhance the mental health and academic outcomes of college students.

Background: Vitamin D deficiency has been associated with type 2 diabetes (T2D) and metabolic syndrome (MS) and its components. However, it is unclear whether a low concentration of vitamin D is the cause or consequence of these health conditions. Thus, this study aimed to evaluate the association of vitamin D concentrations and its genetic risk scores (GRSs) with MS and its component diseases, such as T2D, in middle-aged and elderly participants from rural eastern China. Methods: A subset of 2393 middle-aged and elderly individuals were selected from 70,458 participants of the Nantong Chronic Diseases Study of 2017–2018 in China. We used two 25-hydroxyvitamin D (25[OH]D) synthesis single-nucleotide polymorphisms (SNPs) (DHCR7-rs12785878 and CYP2R1-rs10741657) and two 25(OH) D metabolism SNPs (GC-rs2282679 and CYP24A1-rs6013897) for creating GRSs, which were used as instrumental variables to assess the effect of genetically lowered 25(OH) D concentrations on MS and T2D based on the Wald ratio. F statistics were used to validate that the four SNPs genetically determined 25(OH) D concentrations. Results: Compared to vitamin D sufficient individuals, individuals with vitamin D insufficiency had an odds ratio (OR [95% confidence interval {CI}]) of MS of 1.30 (1.06–1.61) and of T2D of 1.32 (1.08–1.64), individuals with vitamin D deficiency had an ORs (95% CI) of MS of 1.50 (1.24–1.79) and of T2D of 1.47 (1.12–1.80), and those with vitamin D severe deficiency had an ORs (95% CI) of MS of 1.52 (1.29–1.85) and of T2D of 1.54 (1.27–1.85). Mendelian randomization analysis showed a 25-nmol/L decrease in genetically instrumented serum 25(OH) D concentrations using the two synthesis SNPs (DHCR7 and CYP2R1 genes) associated with the risk of T2D and abnormal diastolic blood pressure (DBP) with ORs of 1.10 (95%CI: 1.02–1.45) for T2D and 1.14 (95%CI: 1.03–1.43) for DBP. Conclusions: This one sample Mendelian randomization analysis shows genetic evidence for a causal role of lower 25(OH) D concentrations in promoting of T2D and abnormal DBP in middle-aged and elderly participants from rural China.

Background: Skilled delivery has been a pronounced concern and has been investigated over the years in developing countries. An inclusive understanding of the satisfaction of postpartum mothers is vital in improving the quality of skilled delivery, which is beneath the standard in some parts of developing countries. This study assessed the association between pregnancy-related factors and health status before and after childbirth with satisfaction with skilled delivery in multiple dimensions among postpartum mothers in the Akatsi South District, Ghana.Methods: A community-based, cross-sectional study was conducted among 538 postpartum mothers who participated through the systematic sampling method. Data collection was performed through a pretested and structured questionnaire developed from the WHO responsiveness concept and other prior studies. Questions on satisfaction were categorized into six dimensions. The associations were determined using bivariable and multivariable logistic regression analyses.Results: The overall satisfaction of postpartum mothers with skilled delivery was 80.7%. The highest (89.6%) and the lowest (12.8%) satisfaction with skilled delivery were found in technical quality and financial dimensions. Analysis revealed that autonomously age and delivery procedure were significantly associated with the dimensions of communication and responsiveness. Postpartum mothers who delivered at private healthcare facilities [crude odds ratio (COR) = 1.70; (95% CI 1.00–2.90); p = 0.049] had preterm pregnancy before delivery [COR = 2.08; (95% CI 1.02–4.21); p = 0.043], had cesarean section [COR = 2.73; (95% CI 1.05–7.12); p = 0.040], and presented with complications after childbirth [COR = 2.63; (95% CI 1.09–6.35); p = 0.032] were more likely to be satisfied in the dimension of communication only compared to their counterparts. Regarding responsiveness, multiparous mothers [COR = 1.63; (95% CI 1.06–2.51); p = 0.007] were more likely to be satisfied than primiparous mothers. Overall satisfaction was significantly and positively correlated with the various dimensions of skilled delivery.Conclusions: The majority were satisfied with five dimensions of satisfaction with skilled delivery except for the financial dimension. The District Health Directorate of Akatsi South should take into consideration these findings in their policy development for forward-looking skilled delivery.

Foodborne diseases (FBDs) are a major public health concern, especially in Sub-Saharan African (SSA) countries, such as Ghana, where poor food handling practices (FHPs) are prevalent. To estimate the pooled proportion of good FHPs and the associated factors among Ghanaian food handlers, this systematic review and meta-analysis was conducted to aid scholars, practitioners and policymakers in devising FBD-preventable interventions. The scientific databases PubMed, Google Scholar, Science Direct, African Journals Online, ProQuest, and Directory of Open Access Journals were systematically searched until April 19, 2023, for relevant literature. Observational studies meeting the inclusion criteria of reported good FHPs among food handlers were included. Three authors independently searched the database, assessed the risks of bias and extracted the data from the shortlisted articles. A random-effects model with the DerSimonian and Laird model was used to estimate the pooled effect size of FHPs and the pooled odds ratio (POR) of FHP-associated factors. Out of the 2019 records collated, 33 with a total sample size of 6095 food handlers met the inclusion criteria for meta-analysis. The pooled proportion of good FHPs among Ghanaian food handlers was 55.8% [95% Cl (48.7, 62.8%); I² = 97.4%; p < 0.001]. Lack of food safety training [POR = 0.10; 95% CI (0.03, 0.35); p = 0.001] and inadequate knowledge of food hygiene [POR = 0.36; 95% CI (0.01, 10.19); p < 0.001] were identified as the critical good FHP-associated factors. The study showed that the proportion of good FHPs among Ghanaian food handlers was 55.8%. To increase knowledge of food hygiene among food handlers, the Ghanaian Food and Drugs Authority (FDA) is recommended to provide regular training on food safety for the well-being of the general public.

Objective: To evaluate the therapeutic effect of Traditional Chinese Medicine (TCM), specifically Fuzheng Qingdu (FZQD) therapy, on the survival time of metastatic GC patients. Patients and Methods: Databases of medical records of 6 hospitals showed that 432 patients with stage IV GC were enrolled from March 1, 2012 to October 31, 2020. Propensity score matching (PSM) was used to reduce the bias caused by confounding factors in the comparison between the TCM and the non-TCM users. We used a Cox multivariate regression model to compare the hazard ratio (HR) value for mortality risk, and Kaplan-Meier survival curve for the survival time of GC patients Results: The same number of subjects from the non-TCM group were matched with 122 TCM-treated patients after PSM to evaluate their overall survival (OS) and progression-free survival (PFS). Median time of OS of TCM and non-TCM users were 16.53 and 9.10 months, respectively. TCM and non-TCM groups demonstrated a 1-year survival rate of 68.5% and 34.5%, 2-year survival rate of 28.6% and 3.5%, and 3-year survival rate of 17.8% and 0.0%, respectively. A statistical difference exists in OS between the 2 groups (χ² = 33.39 and P < .0001). The PFS of TCM users was also longer than that of non-TCM users (χ² = 4.95 and P = 0.026). Notably, Chinese herbal decoction, Shenmai and compound Kushen injections were commonly used for FZQD therapy. Conclusion: This propensity-matched study showed that FZQD therapy could improve the survival of metastatic GC patients.