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Young adults, particularly university students might be at greater risk of developing psychological distress, and exhibiting symptoms of anxiety and depression during the COVID-19 pandemic. The primary objective of this study was to explore and compare the determinants and predictors of mental health (anxiety and depression) during and after the COVID-19 lockdown among university students. This was an observational, cross-sectional study with a sample size of 417 students. An online survey utilizing International Physical Activity Questionnaire-Short Form (IPAQ-SF), General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) was distributed to Universiti Tunku Abdul Rahman students via Google forms. During lockdown, family income [χ2 (1, n = 124) = 5.155, p = 0.023], and physical activity (PA) [χ2 (1, n = 134) = 6.366, p = 0.012] were associated with anxiety, while depression was associated with gender [χ2 (1, n = 75) = 4.655, p = 0.031]. After lockdown, family income was associated with both anxiety [χ2 (1, n = 111) = 8.089, p = 0.004], and depression [χ2 (1, n = 115) = 9.305, p = 0.002]. During lockdown, family income (OR = 1.60, p = 0.018), and PA (OR = 0.59, p = 0.011) were predictors for anxiety, while gender (OR = 0.65, p = 0.046) was a predictor for depression. After lockdown, family income was a predictor for both anxiety (OR = 1.67, p = 0.011), and depression (OR = 1.70, p = 0.009). Significant negative effects attributed to the COVID-19 lockdown, and certain factors predisposed to the worsening of mental health status in university students. Low family income, PA, and female gender were the major determinants and predictors linked to anxiety and depression.

Hypertension is a leading contributor to cardiovascular disorders globally. There has been a recent upsurge in non-pharmacological management involving mindfulness-based meditation (MBM) in lowering blood pressure (BP) among the hypertensive population; however, the level of supportive evidence among patients primarily diagnosed with hypertension remain limited. Therefore, this systematic review aimed to synthesize the evidence of randomized controlled trials (RCTs) on the effect of MBM on BP explicitly in adults primarily diagnosed with elevated blood pressure or hypertension. A database search of RCTs was conducted in PubMed, Scopus, Cochrane Central Register of Controlled Trials, and Web of Science until December 2023. The effect size score was calculated for variables of interest followed by qualitative analysis. Nine studies with 543 participants (mean age 54.9±9.0) met the pre-specified eligibility criteria. Eight trials reported MBM convincing in lowering the systolic BP (p=0.001–0.020) and 6 in reducing the diastolic BP (p=0.001–0.01) among this target population. There was a disparity of gender in 7 studies and 4 trials did not report the ethnicity of participants. The methodological quality of the trials was gratifying, however, most studies presented with absence of allocation concealment and blinding of outcome assessors, fragmentary reporting of data, and high attrition rate that potentially affected the validity of trials. MBM interventions may serve as an early preventive and supportive measure for adults with elevated BP or hypertension. However, more robust and rigorous trials with a larger, homogeneous sample and long-term follow-up are necessary to quantify the magnitude of this intervention. Moreover, the methodological issues may affect the overall quality and reliability of MBM interventions; hence, future studies must also address the risk of bias due to inadequate blinding and high attrition through treatment concealment and personalized engagement measures. •MBM is beneficial in lowering both SBP and DBP among adults with elevated BP or hypertension.•Eight studies reported MBM to be helpful in reducing SBP and 7 trials indicated MBM useful in alleviating DBP.•Trials examining the effect of MBM exhibited a noticeable selection and publication bias.•Limitations included a small sample size, discrepancies in type, duration, and dosage of MBM and lack of long-term follow-up.

Literature suggests a common pathophysiological ground between carotid atherosclerosis (CAS) and white matter alterations in the brain. However, the association between carotid intima-media thickness (CIMT) and white matter hyperintensities (WMH) has not been conclusively reported. The current systematic review explores and reports the relationship between CIMT and WMH among asymptomatic/non-stroke adults. A recent literature search on PubMed, SCOPUS, and Web of Science databases was conducted in compliance with the PRISMA protocol. The pre-defined Population-Intervention-Comparison-Outcome-Study (PICOS) criteria included observational studies investigating the CIMT-WMH association among non-stroke adults undergoing magnetic resonance imaging and carotid ultrasound. Out of 255 potential results, 32 studies were critically assessed for selection, and finally, 10 articles were included, comprising 5,116 patients (females = 60.2%; males = 39.8%) aged between 36-71 years. The included studies earned high quality ratings (6-9) based on the Newcastle-Ottawa-Scale criteria. Qualitative synthesis showed a significantly parallel relationship between increased CIMT and greater WMH burden in 50% of the studies. In addition, significant risk factors related to the CIMT-WMH association included older age, hypertension, depression, migraine, Hispanic ethnicity, and apolipoprotein E (ɛ4) in postmenopausal women. Overall, the cumulative evidence showed a consistent CIMT-WMH association in asymptomatic middle-aged and older non-stroke adults, indicating that CAS may contribute to the progression of pathologically hyperintense white matter in the brain. However, further research is warranted to infer the plausible relationship between CIMT and WMH in the absence of stroke.

Background The benefits of strength training on shooting accuracy in football players and other athletes are well known, but its effectiveness in improving shooting accuracy among basketball players remains unclear. Therefore, this study aimed to determine the effect of partial range of motion (PROM) and full range of motion (FROM) triceps strength training on stationary three-point shooting test (S3P) among recreational basketball players. Methods This was a single-blinded randomized controlled trial. 30 participants were randomly assigned into 3 equal groups; FROM, PROM, and control (CON). Triceps strength training was carried out using an adjustable overhead cable crossover machine. With shoulders over-head flexed to 160–180° for both experimental groups, the FROM group performed strength training from full elbow flexion to full extension. In contrast, the PROM group worked at a restricted range, between 60°-110° elbow flexion/extension. Both groups engaged in 4 sets of 10 repetitions, 2 sessions/week for 4-weeks at 67% of 1 repetition maximum, while the CON group did not participate in any exercise program. S3P was assessed at baseline and at the end of 4-weeks intervention. Results Participants mean age (20.20 ± 1.54 years), height (1.74 ± 0.61 m), and body mass index (22.55 ± 3.31) were descriptively analysed. Within group analysis showed a significant improvement of S3P in both FROM ( p  = 0.0345, 95% CI = -1.50 to -0.07, ES  = 0.81) and PROM ( p  = 0.005, 95% CI = -2.44 to -0.97, ES  = 2.40) compared to CON group ( p  = 0.8995, 95% CI = -0.61 to 0.68, ES  = 0.05). Group-by-time interaction demonstrated PROM to be more promising ( p  = 0.0102, 95% CI = -1.70 to 0.21) than the FROM and CON groups. Conclusions PROM triceps strength training improves shooting accuracy and is a time-efficient technique highly recommended for basketball players. Trial registration clinicaltrials.gov, NCT04128826, registered on 14/10/2019 - retrospectively, https://clinicaltrials.gov/study/NCT04128826 .

PurposeThe ownership structure in Japanese firms has experienced a significant change recently, fueled primarily by regulatory changes. This has important repercussions on corporate performance and risk. This paper examines the impact of insider ownership on the default risk of Japanese firms.Design/methodology/approachWe collected data from the Nikkei Corporate Governance Evaluation System (CGES) database for the period 2004–2019. Our final dataset yields 36,116 firm-year observations. We apply a firm fixed effect model for baseline regression. Endogeneity was checked by applying propensity score matching (PSM) and two-stage least squares (2SLS) techniques. Furthermore, the robustness of baseline regression results was checked using alternative estimation techniques.FindingsResults show a significant positive influence of insider ownership on default risk. Furthermore, ROA volatility and stock price volatility appear to be the major channels through which insider ownership affects a firm’s default risk. We further document that external monitoring mechanisms, including traditional main bank ties, institutional ownership and analyst coverage, are the key risk-mitigating factors.Research limitations/implicationsOur research deals with Japanese firms only. Future research may attempt to analyze the cases of emerging economies. Furthermore, future research might examine the ownership-default risk relationship for financial institutions to see if this relationship differs between financial and nonfinancial firms.Practical implicationsInsider ownership enhances the probability of default. Hence, policymakers may consider instituting a ceiling for insider ownership in Japanese firms. Moreover, we highlight various risk-mediating channels that would help policymakers adopt guidelines for mitigating corporate risk.Originality/valueOur study is the first to investigate the effect of insider ownership on default risk in Japanese settings. Prior studies identified various determinants that affect firms’ default risk. Our study contributes to this stream of literature by examining the impact of insider ownership on default risk and extending the limited literature related to insider ownership.

The likelihood of pre-hypertensive young adults developing hypertension has been steadily increasing in recent years. Despite the fact that aerobic exercise training (AET) has demonstrated positive results in lowering high blood pressure, the efficacy of different types of AET among pre-hypertensive young adults has not been well-established. The objective of this study was to evaluate the effectiveness of high-intensity interval training (HIIT) and continuous moderate-intensity training (CMT) on the blood pressure (BP) of physically inactive pre-hypertensive young adults. In total, 32 adults (age 20.0 ± 1.1 years and BMI 21.5 ± 1.8) were randomly assigned to three groups: HIIT, CMT and control (CON). The HIIT and CMT groups participated in 5 weeks of AET, while the CON group followed a DASH diet plan only. The HIIT protocol consisted of a 1:4 min work to rest ratio of participants, at an 80–85% heart rate reserve (HR-reserve) and a 40–60% HR-reserve, respectively, for 20 min; the CMT group exercised at 40–60% of their HR-reserve continuously for 20 min. In both the HIIT and CMT groups, systolic blood pressure (SBP) (3.8 ± 2.8 mmHg, p = 0.002 vs. 1.6 ± 1.5 mmHg, p = 0.011) was significantly reduced, while significant reductions in the diastolic blood pressure (DBP) (2.9 ± 2.2 mmHg, p = 0.002) and mean arterial pressure (MAP) (3.1 ± 1.6 mmHg, p < 0.0005) were noted only in the HIIT group. No significant differences in SBP (−0.4 ± 3.7 mmHg, p = 0.718), DBP (0.4 ± 3.4 mmHg, p = 0.714), or MAP (0.1 ± 2.5 mmHg, p = 0.892) were observed in the CON group. Both HIIT and CMT decreased BP in physically inactive pre-hypertensive young adults; however, HIIT yielded more beneficial results in terms of reducing the SPB, DBP and MAP.

This study investigates the impact of corporate governance on corporate environmental performance among Japanese companies listed on the Tokyo Stock Exchange for the period 2006–2019. Using fixed-effects modelling for 4617 firm-year observations from 2006–2019, we demonstrate that board independence, board diversity, and the presence of environmental management committees are significantly associated with improved environmental performance. However, a large board reduces the environmental performance, and CEO duality does not appear to be a significant factor affecting a firm’s environmental performance. Additionally, we show a consistent result when we proxy environmental performance by total carbon emissions.

Using the Ordinary Least Square (OLS) estimation technique based on a sample of 180 listed firms from 2008 to 2018, this study investigates the impact of institutional ownership on firm performance in the Bangladeshi setting. Consistent with the \"active monitoring\" view, the results indicate that both domestic and foreign institutional investors have a positive effect on firm performance measured by Tobin's Q and Return on Asset (ROA). In addition, this study explores whether the other corporate governance attributes-board size and board independence-operate as mediators between institutional ownership and firm performance. Our findings indicate that both board size and board independence have a significant positive impact on the relationship between institutional ownership and firm performance.

Objective: This study evaluates physicians’ adherence to Malaysian Clinical Practice Guidelines for Hypertension 2013 (MCPGs-HPT-2013) and the factors influencing patients’ adherence to antihypertensive medications. Materials and Methods: Among a cohort of randomly selected 170 hypertensive patients, the prescribing trends of physicians were compared with MCPGs-HPT 2013. Univariate and multivariate analyses (odds ratio [OR], 95% CI) were done to investigate the physician’s adherence to MCPGs-HPT-2013. Results: Patients that had three concurrent clinical conditions and prescribed with angiotensin-converting enzyme inhibitors (P < 0.05, OR = 2.989) were affected the most with physicians’ non-adherence with MCPGs-HPT-2013. Conclusion: Surprisingly, <50% of the total patients received guidelines compliant pharmacotherapy that emphasizes the need for strict adherence to MCPGs-HPT-2013 in Malaysia.