Background: A certain percentage of the vaccinated population initially did not want to get vaccinated but changed their minds (from 30% to 70%). By October 2022, World Bank reported that the Philippines had 77.8% COVID-19 vaccination rate. Knowing the factors that changed their decision can help improve the vaccination rate. Objective: This survey aimed to identify the factors that influence positive change in vaccination decisions. Methods: This survey was conducted in the Philippines among Filipinos aged 18-80 years old between March to April 2022. The dependent variable in the study was decision change, a binary variable coded as 1 for a vaccinated person who changed their decision from no to yes and 0 for an unvaccinated person who did not change their decision from yes to no. Results: Age (adjusted odds ratio [aOR] = 0.92, 95% CI = 0.89-0.96) and having a college degree (aOR=11.707, 95% CI=3.23-42.41) are related to changing decisions. Young and college degree holders are likely to change their decisions positively about getting vaccinated. Employer requirement also influences decision change because it affects a person's livelihood. High scores on vaccine confidence (aOR = 1.181, 95% CI = 1.12-1.25) and awareness (aOR = 1.318, 95% CI = 1.08-1.61) are associated with decision change. Conclusion Being young, educated, employed with a requirement to vaccinate, and having high vaccine awareness and confidence are strongly associated with a positive change in the decision to get vaccinated.
Vaccines ; Vaccination ; Philippines ; Awareness ; Covid-19

BACKGROUND AND OBJECTIVE

Self-assessment and metacognition can be practiced with an exam wrapper (EW). EW is a structured, metacognitive, and self-regulated learning strategy that involves guided self-reflection on an exam already taken to improve study habits. This research describes how internal medicine (IM) residents at two tertiary private hospitals performed in written examinations using an EW. The relationship between the residents' metacognition, the exam wrapper, and exam performance was also determined.

METHODS

This study employed a pre-experimental pre- and post-test design. The EW was constructed and tested for validity and reliability. It included (1) a description of study habits, (2) accuracy in self-efficacy perception and exam score prediction, (3) perceived reasons for exam mistakes, and (4) future study plans of residents. A complete enumeration of 24 IM residents was conducted. Respondents completed the Metacognitive Awareness Inventory (MAI) at the beginning of the study. The intervention consisted of (1) residents taking Exam 1: Gastroenterology, followed by EW; (2) Exam 2: Endocrinology and EW; then (3) Exam 3: Oncology, EW, and MAI. Scores were compared using a paired t-test or analysis of variance (ANOVA). The relationships between metacognition scores, the EW, and exam performance were determined using the Pearson correlation coefficient. The level of significance was set at p < 0.05.

RESULTS

The final EW comprises 16 items, with overall indices of content validity ratio of 0.72 and item-rated content validity of 0.8. The internal consistency coefficient is 0.65 (Kuder-Richardson 20). Nineteen out of 24 residents (79.17%) completed the study. Mean exam percentage scores were 57.97%, 42%, and 51.16% for Exams 1, 2, and 3, respectively. Exam 2 differed significantly from the other two exams (p = 0 and p = 0.04). EWs for the first two exams were not significantly different and revealed: (1) top study habits included studying right before an exam and skimming the textbook; (2) 68.42% vs. 63.16% accuracy of selfefficacy perception; (3) 26.32% vs. 31.58% accuracy of grade estimation; (4) 31.58% vs. 26.32% accuracy of error analysis; (5) most errors were due to not reading about the topic, and (6) most planned to “read more." Mean MAI scores were 36.79 ± 9.10 (pretest) and 36.05 ± 9.44 (post-test) (p = 0.81). All correlations were not statistically significant.

CONCLUSION

Residents performed poorly during exams, crammed their studies, preferred low-impact learning strategies, and lacked self-reflection skills and metacognition monitoring. Time issues related to reading or studying were common. There is no significant relationship between metacognition score and exam wrapper use or exam performance in IM residency trainees.

Human ; Metacognition ; Self-control ; Self-regulation

BACKGROUND

Stunting remains a major public health issue in Indonesia, particularly in regions like Pandeglang Regency, where prevalence rates are high. Understanding the contributing factors is essential for targeted interventions.

OBJECTIVE

This study aimed to analyze factors associated with stunting among toddlers using a mixed-methods approach.

METHODS

A cross-sectional mixed-methods study was conducted in two health centers in Banten Province from December 2021 to January 2022. Quantitative data were collected using a structured questionnaire and analyzed using chi-square tests (pRESULTS

There is a relationship between maternal knowledge, history of exclusive breastfeeding, history of supplementary feeding, support from health workers, and socio-economic status with the prevalence of stunting. However, the pattern of exclusive breastfeeding and seeking health services in the working areas of Bangkonol Health Center and Kaduhejo Health Center, Pandeglang Regency, is not good enough and needs to be improved. Health workers need to educate mothers with toddlers about patterns of providing complementary feeding, food preparation, and storage, and basic health practices to prevent stunting.

RESULTS

There is a relationship between maternal knowledge, history of exclusive breastfeeding, history of supplementary feeding, support from health workers, and socio-economic status with the prevalence of stunting. However, the pattern of exclusive breastfeeding and seeking health services in the working areas of Bangkonol Health Center and Kaduhejo Health Center, Pandeglang Regency, is not good enough and needs to be improved. Health workers need to educate mothers with toddlers about patterns of providing complementary feeding, food preparation, and storage, and basic health practices to prevent stunting.

Human ; Infant: 1-23 Months ; Child Preschool: 2-5 Yrs Old ; Public Health ; Prevalence ; Methods ; Indonesia ; Health ; Growth Disorders ; Comprehension

OBJECTIVES: To investigate the impact of prenatal fear stress on placental amino acid transport and emotion and cognition development in offspring rats. METHODS: Thirty pregnant Wistar rats were randomized equally into control and fear stress (induced using an observational foot shock model) groups. In each group, placental and serum samples were collected from 6 dams on gestational day 20, and the remaining rats delivered naturally and the offspring rats were raised under the same conditions until 8 weeks of age. Emotional and cognitive outcomes of the offspring rats were assessed with behavioral tests, and placental structure was examined using HE staining. Bioinformatics analysis was used to identify differentially expressed placental transporter genes under fear stress. The expressions of system A and system L amino acid transporters, along with other specialized transporters, were detected using qRT-PCR and Western blotting. Fetal serum amino acid concentrations were determined by HPLC. The correlations between fetal amino acid levels and behavioral outcomes of the offspring rats were analyzed. RESULTS: The dams with fear stress showed reduced open-field activity and increased freezing behavior with significantly decreased placental weight, fetal weight, and fetal-to-placental ratio. Bioinformatics analysis revealed 28 differentially expressed transporter genes involved mainly in amino acid transport. In the fear stress group, fetal serum amino acid levels were significantly lowered and Slc38a1, Slc43a1, Slc43a2, Slc7a8, Slc6a6, Slc1a1 and Slc6a9 mRNA and protein expressions were all downregulated. The offspring rats in fear stress group exhibited decreased novel object preference and spontaneous alternation with reduced open arm exploration and increased immobility in emotional tests. Lower early-life amino acid levels was found to correlate with impaired adult cognition. CONCLUSIONS Prenatal fear stress in rats impairs placental amino acid transporter expression and reduces fetal serum amino acid levels, potentially contributing to long-term cognitive deficits in the offspring rats.
Animals ; Female ; Pregnancy ; Placenta/metabolism* ; Fear ; Rats ; Rats, Wistar ; Cognition ; Prenatal Exposure Delayed Effects ; Stress, Psychological ; Amino Acids/blood* ; Amino Acid Transport Systems/metabolism*

OBJECTIVES: To explore the mechanisms of Qingre Lidan Jiedu Recipe (QLJR) for improving cognitive dysfunction in rats with high copper load. METHODS: Seventy-five male SD rats were randomized into normal control group, model group, QLJR group, penicillamine (PCA) group, and QLJR+ PCA group. Except for those in the control group, all the rats were fed a high-copper diet for 12 weeks. The effects of the treatments on cognitive function of the rats were assessed using the Barnes maze and passive avoidance tests. Hippocampal expressions of NIX, FUNDC1 and LC3 of the rats were detected using Western blotting and immunofluorescence staining, and changes in mitochondrial morphology were observed with transmission electron microscopy. RESULTS: Behavioral tests showed prolonged target hole latency, shortened latency to enter the dark chamber, and increased error counts of the rats in the model group, which were significantly improved in QLJR+PCA group; the error counts were significantly lower in QLJR+PCA group than in either QLJR or PCA group. Among all the groups, the hippocampal expressions of NIX and FUNDC1 were the lowest and LC3 I/II expression the highest in the model group; NIX and FUNDC1 expressions were significantly higher and LC3 I expression was lower in QLJR+PCA group than in QLJR group and PCA group. Immunofluorescence staining revealed weakened NIX and FUNDC1 expressions and enhanced LC3 expression in the hippocampus of the rats in the model group as compared with those in the normal control and QLJR+PCA groups, but their expressions did not differ significantly between QLJR and PCA groups. The rats in the model group showed obvious structural disarray of the mitochondria, which were improved in all the treatment groups. CONCLUSIONS QLJR improves cognitive dysfunction in rats with high copper load possibly by regulating mitophagy.
Animals ; Male ; Rats, Sprague-Dawley ; Rats ; Drugs, Chinese Herbal/therapeutic use* ; Copper/toxicity* ; Mitophagy/drug effects* ; Hippocampus/drug effects* ; Cognition Disorders/drug therapy* ; Cognitive Dysfunction/chemically induced*

Within the prefrontal-cingulate cortex, abnormalities in coupling between neuronal networks can disturb the emotion-cognition interactions, contributing to the development of mental disorders such as depression. Despite this understanding, the neural circuit mechanisms underlying this phenomenon remain elusive. In this study, we present a biophysical computational model encompassing three crucial regions, including the dorsolateral prefrontal cortex, subgenual anterior cingulate cortex, and ventromedial prefrontal cortex. The objective is to investigate the role of coupling relationships within the prefrontal-cingulate cortex networks in balancing emotions and cognitive processes. The numerical results confirm that coupled weights play a crucial role in the balance of emotional cognitive networks. Furthermore, our model predicts the pathogenic mechanism of depression resulting from abnormalities in the subgenual cortex, and network functionality was restored through intervention in the dorsolateral prefrontal cortex. This study utilizes computational modeling techniques to provide an insight explanation for the diagnosis and treatment of depression.
Prefrontal Cortex/physiology* ; Humans ; Emotions/physiology* ; Cognition/physiology* ; Gyrus Cinguli/physiology* ; Computer Simulation ; Models, Neurological ; Neural Pathways/physiology* ; Nerve Net/physiology*

A brain-computer interface (BCI) based on motor imagery (MI) provides additional control pathways by decoding the intentions of the brain. MI ability has great intra-individual variability, and the majority of MI-BCI systems are unable to adapt to this variability, leading to poor training effects. Therefore, prediction of MI ability is needed. In this study, we propose an MI ability predictor based on multi-frequency EEG features. To validate the performance of the predictor, a video-guided paradigm and a traditional MI paradigm are designed, and the predictor is applied to both paradigms. The results demonstrate that all subjects achieved > 85% prediction precision in both applications, with a maximum of 96%. This study indicates that the predictor can accurately predict the individuals' MI ability in different states, provide the scientific basis for personalized training, and enhance the effect of MI-BCI training.
Humans ; Imagination/physiology* ; Electroencephalography/methods* ; Brain-Computer Interfaces ; Male ; Female ; Adult ; Young Adult ; Brain/physiology* ; Movement/physiology* ; Motor Activity/physiology* ; Psychomotor Performance/physiology*

Hemorrhagic shock is a common clinical emergency that can aggravate cell injury after resuscitation. Astrocytes are crucial for the survival of neurons because they regulate the surrounding ionic microenvironment of neurons. Although hemorrhagic shock and resuscitation (HSR) injury can impair cognition, it remains unclear how this insult directly affects astrocytes. In this study, we established an HSR model by bleeding and re-transfusion in mice. The social interaction test and new object recognition test were applied to evaluate post-operative cognitive changes, and the results suggest that mice experience cognitive impairment following exposure to HSR. In the HSR group, the power spectral density of β and γ oscillations decreased, and the coupling of the θ oscillation phase and γ oscillation amplitude was abnormal, which indicated abnormal neuronal oscillation and cognitive impairment after HSR exposure. In brief, cognitive impairment in mice is strongly correlated with Ca²⁺ signal strength in lateral septum astrocytes following HSR.
Animals ; Astrocytes/metabolism* ; Shock, Hemorrhagic/metabolism* ; Resuscitation/adverse effects* ; Male ; Mice ; Calcium Signaling/physiology* ; Mice, Inbred C57BL ; Septal Nuclei/metabolism* ; Cognitive Dysfunction/etiology* ; Disease Models, Animal ; Cognition Disorders/etiology*

OBJECTIVE: To explore the relationship between the geriatric nutritional risk index (GNRI) and cognitive function. METHODS: A cross-sectional study method was conducted. People aged ≥ 60 years from the National Health and Nutrition Examination Survey (NHANES) databases from 1999 to 2002 and 2011 to 2014 were included as study subjects. The participants were divided into three groups based on their GNRI scores: a medium-high risk group (82 ≤ GNRI < 92), a low risk group (92 ≤ GNRI < 98), and a no-risk group (GNRI ≥ 98). Demographic characteristics (gender, age, race, education), chronic diseases [chronic bronchitis, emphysema, thyroid problems, coronary heart disease, angina pectoris, stroke, hypertension, diabetes mellitus, and depression score on the patient health questionnaire (PHQ-9)], lifestyle habits (history of smoking, hours of sleep), etc., were collected. Cognitive function was assessed using the consortium to establish a registry for Alzheimer's disease word learning subtest (CERAD-WL), animal fluency test (AFT), and digit symbol substitution test (DSST) for the 2011-2014 data, while only the DSST was used for the 1999-2002 data. Differences in the above information among the GNRI cohorts were compared. Factors affecting cognitive function in the population were analyzed using multifactorial Logistic regression. RESULTS: 2 653 participants from 2011 to 2014 and 2 380 participants from 1999 to 2002 were enrolled, with a total of 5 033 participants in the study. There were statistically significant differences in age, stroke, diabetes mellitus, DSST score, AFT score, CERAD score test 1 recall (Cst1), and CERAD score test 2 recall (Cst2) among the GNRI groups. Multifactorial Logistic regression analysis of data from 2011 to 2014 showed that in model 3 (DSST score, age, gender, race, marriage, education, hours of sleep, history of smoking, emphysema, thyroid problems, chronic bronchitis, coronary heart disease, angina pectoris, hypertension, diabetes mellitus, depression score on the PHQ-9, and stroke) adjusted for all covariates, GNRI was a protective factor for DSST [odds ratio (OR) = 1.03, 95% confidence interval (95%CI) was 1.00 to 1.05, P = 0.03]; Logistic regression analyse for 1999 to 2002 and 2011 to 2014 showed a significant association even after adjustment for covariates (OR = 1.02, 95%CI was 1.00 to 1.03, P = 0.02). Subgroup Logistic regression analyses of the total population from 2011 to 2014 showed a significant association between GNRI and DSST scores (OR = 1.02, 95%CI was 1.01 to 1.03, P < 0.001), with significant associations in the age subgroups of 60 to 64 years old, across gender, non-Hispanic Whites and Blacks, by education, and by marital status associations were significant (all P < 0.05). Subgroup Logistic regression analyse of the total populations from 1999 to 2002 and 2011 to 2014 showed a significant association between the GNRI and DSST score (OR = 1.01, 95%CI was 1.01 to 1.02, P < 0.001), but did not show a significant year difference (interaction P = 0.503), and the newly found in the smoking population the association was also more significant (P < 0.01). CONCLUSION The GNRI correlates with the presence of cognitive functions related to processing speed, sustained attention, and executive function, and may be able to serve as an indicator for the assessment or prediction of related cognitive functions.
Humans ; Cross-Sectional Studies ; Aged ; Middle Aged ; Nutrition Surveys ; Cognition ; Female ; Male ; Nutritional Status ; Risk Factors ; Geriatric Assessment

OBJECTIVES: This cross-sectional study aims to explore the association between oral health status and cognitive function in Chinese elderly individuals. METHODS: The survey participants were composed of elderly people aged≥60 who were admitted to West China Hospital of Stomatology, Sichuan University from August 2022 to March 2024. They were divided into a cognitive impairment (CI) group and a healthy control (HC) group according to the Montreal Cognitive Assessment (MoCA) score. General information and oral health indicators of all elderly people were collected. Independent sample t-test and chi-square test were used for inter-group comparison, and multiple linear regression model was applied for multivariate analysis of MoCA scores. RESULTS: A total of 402 elderly people were included in the study, and the number of remaining teeth in the CI group was significantly lower than that in the HC group. The decayed, missing, filled teeth index, debris index-simplified, gingival index, probing depth (PD), and clinical attachment loss in the CI group were all significantly higher than those in the HC group. There was no difference in denture wearing between the two groups. The results of multiple linear regression showed that there was a correlation between the number of remaining teeth and PD and MoCA scores after correcting for confounding factors. CONCLUSIONS Elderly individuals with CI have more prominent oral health issues compared to those with normal cognitive function. There may be a bidirectional relationship between the number of remaining teeth, PD, and cognitive function in elderly people.
Humans ; Oral Health ; Aged ; Cross-Sectional Studies ; Cognitive Dysfunction/epidemiology* ; Male ; Female ; China/epidemiology* ; Middle Aged ; Linear Models ; Aged, 80 and over ; Periodontal Index ; Cognition