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The correct specification of covariance structures in linear mixed models (LMMs) is critical for accurate longitudinal data analysis. These data, characterised by repeated measurements on subjects over time, demand careful handling of inherent correlations to avoid biased estimates and invalid inferences. Incorrect covariance structure specification can lead to inflated type I error rates, reduced statistical power, and inefficient estimation, ultimately compromising the reliability of statistical inferences. Traditional methods for selecting appropriate covariance structures, such as AIC and BIC, often fall short, particularly as model complexity increases or sample sizes decrease. Studies have shown that these criteria can misidentify the correct structure, resulting in suboptimal parameter estimates and poor assessment of standard errors for fixed effects. Additionally, relying on trial-and-error comparisons in LMMs can lead to overfitting and arbitrary decisions, further undermining the robustness of model selection and inference. To address this challenge, we introduce LiMMCov, an interactive app that uniquely integrates time-series concepts into the process of covariance structure selection. Unlike existing tools, LiMMCov allows researchers to explore and model complex structures using autoregressive models, a novel feature that enhances the accuracy of model specification. The app provides interactive visualisations of residuals, offering insights into underlying patterns that traditional methods may overlook. LiMMCov facilitates a systematic approach to covariance structure selection with a user-friendly interface and integrated theoretical guidance. This paper details the development and features of LiMMCov, demonstrates its application with an example dataset, and discusses its potential impact on research. The app is freely accessible at https://zq9mvv-vub0square.shinyapps.io/LiMMCov-research-tool/ .

Social support, family functioning and family health are essential elements in the treatment of heart failure, yet most heart failure studies focus on the pharmacological interventions. This study aimed to examine whether perceived social support from nurses is associated with better family functioning of patients with heart failure and their nearest relatives and to examine whether family health mediates this relationship. A sample of 312 patients with heart failure and 312 of their nearest relatives were included in the study. The Family Functioning, Health and Social Support questionnaire was used to collect the data. Dyadic data were analysed by the Actor-Partner Interdependence Mediation Model with distinguishable dyads using structural equation modelling. Patients and nearest relatives who perceived more social support had a higher level of family health and functioned better within the family. One partner effect was found, indicating that the higher the level of family health of the nearest relative, the better the family functioning of the patient (p <0.001). Family health partially (in the patient) and completely (in the nearest relative) mediated the association between social support and family functioning. This study indicated that patients with heart failure and their nearest relatives who perceived more social support from nurses were more likely to have high level of family health and function better within the family. The interdependent relationships found in our study highlight a dyadic and family-oriented approach to improve family functioning in patients with heart failure.

In China, debates on achieving work-family balance have intensified with the rise of the dual-earner model. Balancing paid and unpaid work is stressful for dual-earner couples resulting in poor mental well-being outcomes for both partners. While prior mental well-being research mainly focused on individual associations, our study investigates associations of paid and unpaid workloads on spousal mental well-being within married dyads. Moreover, given that family support is an important resource in accordance with Chinese cultural and social norms, we investigate the mitigating role of family support within this dyadic relationship. Using coupled data from the Chinese Family Panel Study (CFPS) Wave 5, we employed Actor-Partner Interdependence Model (APIM) to explore crossover mechanisms of multiple workloads (total, paid, and unpaid) and spousal mental well-being. Mental well-being was evaluated by utilizing a scale for depressive symptoms and for subjective well-being. We found that both genders’ higher levels of depression were border-significantly related to their own total workload (i.e. the sum of paid and unpaid labour), yet spousal associations were unobserved. For women, paid workload is negatively associated with subjective well-being while controlling for unpaid workload. The moderation models revealed, for men, that family support received from their wives’ family attenuates the positive association between workloads and depression. Our study advances our knowledge of the gender dynamics influencing work-family balance and strengthens the rationale for the adoption of family-friendly workplace regulations in China.

Background Mid-March 2020, Belgium went in lockdown to combat the COVID-19-pandemic. Having to provide school-based day care and adapt to online teaching, while all social, cultural and sports events and activities were cancelled, secondary school teachers’ physical activity (PA) and sedentary behaviour (SB) may have been affected considerably. This study investigates the impact of the first Belgian lockdown on PA and SB in Flemish secondary school teachers. Methods This prospective cohort study was conducted throughout the 2019–2020 school year. PA and SB measured in March/April 2020 were compared with a pre-lockdown measurement in January/February 2020. Other pre-lockdown measurements (September/October 2019 and November/December 2019) and one other during-lockdown measurement (May/June 2020) allowed us to control for confounding. Validated questionnaires were used to assess participants’ PA and SB. Generalized linear mixed models were applied in R. Results Among 624 participants (77·2% females, 43·3 ± 10·3 years), increases were observed for total PA (+ 108 min/week;  p  = 0·047), moderate PA (+ 217 min/week;  p  = 0·001), domestic and garden PA (+ 308 min/week;  p  < 0·0001) and leisure-time PA (+ 131 min/week;  p  < 0·0001), whereas work-related PA (-289 min/week;  p  < 0·0001) and active transportation (-38 min/week;  p  =0·005) decreased. No differences were observed for walking ( p  = 1·0) and vigorous PA ( p  = 0·570). Increases were found for total SB (+ 972 min/week;  p  < 0·0001), work-related SB (+ 662 min/week;  p  < 0·0001) and leisure-time SB (+ 592 min/week;  p  = 0·0004), whereas transport-related SB (-290 min/week;  p  < 0·0001) decreased. Conclusion During the lockdown, we found in our sample that Flemish secondary school teachers showed an increase in SB that was 9 times as high as their PA increase. As a government, education network or school, it is crucial to sensitize, promote, and facilitate sufficient MVPA and/or walking, but likewise to discourage SB during pandemic-induced lockdowns.

Background: Cancer-related cognitive impairment (CRCI) affects quality of life, daily functioning and return-to-work. However, CRCI remains under-addressed in cancer care. Since cognitive complaints often co-occur with fatigue and psychological distress, a multimodal approach is warranted. We developed Integrative Neuro-Cognitive Remediation Therapy (INCRT), a multidisciplinary survivorship program combining personalized cognitive function and strategy training with group-based psychoeducation, cognitive–behavioral therapy and Acceptance and Commitment Therapy, and onco-yoga. Methods: Cancer survivors suffering from CRCI were eligible. Assessments included neuropsychological testing, patient-reported outcomes, and daily functioning at baseline (T0), post-intervention (T1), and 6-month follow-up (T2). Primary outcomes were objective and subjective neurocognitive functioning (NCF); secondary outcomes were psychological distress, fatigue, metacognition, and daily functioning. Changes were analyzed using linear mixed models. Results: Between November 2022 and January 2025, 44 of 56 eligible survivors enrolled; 38 completed the program (71.1% female; median age 53.5). Objective and subjective NCF improved significantly at T1 and T2 (ps < 0.001). Psychological distress, fatigue, and unhelpful metacognitions decreased over time (ps < 0.05). Participants reported greater emotional and cognitive insight and improved daily functioning. Conclusions: INCRT improves cognitive functioning, reduces psychological distress and fatigue, and enhances daily functioning, with benefits maintained at follow-up. The integrative design supports sustained effects by promoting internalization and daily application of learned strategies.

The phytolith (plant silica) morphotype, Elongate dendritic, is used to indicate the presence of domesticated grasses (cereals) from the Pooideae subfamily, such as wheat and barley, in the archaeological record, but related wild taxa also produce Elongate dendritic that closely resemble those of cereals. By examining the morphometric traits of Elongate dendritic in a diverse set of extant Pooideae taxa, we evaluate its effectiveness as a proxy for cereal domestication and identification. We investigated the occurrence of Elongate dendritic across a wide range of Pooideae taxa and generated 3D meshes of phytoliths using confocal microscopy. From these meshes, we extracted geometric morphometric and topological traits, which served as input for machine learning (ML) models to assess the taxonomic resolution of Elongate dendritic. Regression models and linear discriminant analyses (LDAs) were applied to test for links between morphometric traits, domestication status, and ploidy level. Our results show that Elongate dendritic occurrence is likely an ancestral trait within Pooideae, with high levels largely confined to Triticeae (wheat, barley, rye) and Avena (oats). Machine learning applied to 3D phytolith traits captured meaningful taxonomic patterns, with more reliable identification at broader taxonomic levels than at finer ones. However, the approach requires further refinement before it can be robustly applied to archaeological samples. Regression models and LDA demonstrated that while domestication significantly influences morphometric variation, ploidy level does not, although further study is warranted. These findings offer important guidance for archaeologists and biologists studying crop domestication. By integrating 3D morphometrics, topological data analysis, and ML, this study introduces a new approach to quantitative phytolith identification. Continued expansion of reference datasets, coupled with methodological refinement, will be essential for improving identification at finer taxonomic levels and unlocking the full potential of Elongate dendritic in the study of domestication and 168 cultivation practices.

COVID-19 can induce neurological sequelae, negatively affecting the quality of life. Unravelling this illness's impact on structural brain connectivity, white-matter microstructure (WMM), and cognitive performance may help elucidate its implications. This cross-sectional study aimed to investigate differences in these factors between former hospitalised COVID-19 patients (COV) and healthy controls. Group differences in structural brain connectivity were explored using Welch-two sample t-tests and two-sample Mann–Whitney U tests. Multivariate linear models were constructed (one per region) to examine fixel-based group differences. Differences in cognitive performance between groups were investigated using Wilcoxon Rank Sum tests. Possible effects of bundle-specific FD measures on cognitive performance were explored using a two-group path model. No differences in whole-brain structural organisation were found. Bundle-specific metrics showed reduced fiber density (p = 0.012, Hedges’ g = 0.884) and fiber density cross-section (p = 0.007, Hedges’ g = 0.945) in the motor segment of the corpus callosum in COV compared to healthy controls. Cognitive performance on the motor praxis and digit symbol substitution tests was worse in COV than healthy controls (p < 0.001, r = 0.688; p = 0.013, r = 422, respectively). Associations between the cognitive performance and bundle-specific FD measures differed significantly between groups. WMM and cognitive performance differences were observed between COV and healthy controls.

The Central Sensitization Inventory (CSI) measurement properties in patients having nonspecific, noncancer pain are well-established. However, studies examining the reliability and validity of either the CSI or the Central Sensitization Inventory short-form version (CSI-9) in breast cancer survivors (BCS) are scarce. The purpose was to evaluate convergent validity and internal consistency of the CSI and CSI-9. Additionally, the relevance of a new cluster calculator using the CSI was explored. The cross-sectional multi-center study included 65 BCS and 37 healthy volunteers. Patients filled out multiple questionnaires assessing pain, number of painful areas, anxiety, depression and quality of life. The relevance of a cluster calculator was explored by known-group comparisons and boxplot description. All hypotheses were formulated before data analysis. The majority of hypotheses on the correlations between the CSI or CSI-9 and other health outcomes were confirmed (22 out of 27). The CSI and CSI-9 have excellent (α = 0.92) and good (α = 0.86) internal consistency, respectively. The CSI cluster calculator might be an interesting tool to use to have a patient’s overall condition snapshot. Generally, the study findings support the construct validity and internal consistency of the CSI, which underline the use of this self-reported instrument in BCS. The CSI-9 shows promising results, but should be further evaluated.

This study investigates the association between precarious employment (PE) and mental well-being and examines the mediating role of five intrinsic quality of work (IQW) dimensions: autonomy, physical demands, work intensity, skill discretion, and social support. We distinguish between main (>24 hours/week) and supplementary (≤24 hours/week) gig workers. Survey data from 397 Belgian gig workers were used to construct a multidimensional, gig-specific measure of PE (the Employment Precariousness Scale for gig work: 'EPRES-gw'). Structural equation modeling was applied to test mediation by IQW dimensions and examine differences between main and supplementary gig workers. PE was positively associated with poor mental well-being among main but not supplementary workers. Among main gig workers, the relationship was mediated by high work intensity, physical demands, and low social support. For supplementary workers, low autonomy mediated the association. PE is particularly relevant for the mental well-being of main gig workers. The role of IQW is important, though the key dimensions differ by time spent in in gig work. These findings highlight the need for policy interventions and research addressing both employment rights and IQW-related psychosocial risks, with approaches tailored to the distinct challenges of main versus supplementary gig workers.