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Development and validation of the Health Segment Classification of Population Encompassed within Singapore (HealthSCOPES) framework

Introduction The population is heterogeneous with varying levels of healthcare needs. Clustering individuals into health segments with more homogeneous healthcare needs allows for better understanding and monitoring of health profiles in the population, which can support data-driven resource allocation. Methods Using the developed criteria, data from several of Singapore’s national administrative datasets were used to classify individuals into the various health segments. Cross-sectional analysis of healthcare utilization charges was conducted. Validation was done for the framework’s prognostic ability of clinically relevant outcomes measured in the following year. Results The framework is comprised of twelve segments classed within four broad groups. The segments comprising individuals with cancer, with transitional care needs, and in the last year of their lives had the highest mean per resident healthcare charges. The segments comprising adults and seniors with complex chronic conditions and with transitional care needs had the highest percentage of individuals historically diagnosed with obesity. The framework was able to distinguish varying tiers of healthcare utilization charges and relative risk of death in the following year. Discussion The framework was developed using a hybrid approach, with expert input and comprehensive national data that extended beyond the usual hospital patient population. The framework can be directly applied for use in program or policy design, evaluation, and cost-effectiveness analyses. Conclusion The HealthSCOPES framework was developed to segment the entire population in Singapore with similar healthcare needs.

July effect in hospitalized cirrhosis patients: A US nationwide study using difference-in-differences analysis

Background The July effect in US teaching hospitals has been studied with conflicting results. We aimed to evaluate the effect of physician turnover in July on the clinical outcomes of patients hospitalized with cirrhosis. Methods We utilized the Nationwide Inpatient Sample database (2016–2019) to identify patients hospitalized with cirrhosis and liver-related complications (variceal bleeding, hepatorenal syndrome, acute-on-chronic liver failure). We used difference-in-differences analysis to compare teaching and non-teaching hospital differences in mortality and length of stay (LOS) in May and July, and trends in outcomes in other months before and after July. Results We included 78,371 hospitalizations in teaching and 23,518 in non-teaching hospitals in May and July. Teaching hospital admissions had overall higher complication rates and mortality compared to non-teaching hospitals. We did not find a difference in mortality between teaching and non-teaching hospitals in all cirrhotic patients (adjusted odds ratio 1.01, 95%CI [0.88–1.16]) or in those with severe complications (0.87, [0.72–1.06]). There was greater LOS in July vs. May in teaching hospitals relative to non-teaching hospitals for all patients with cirrhosis (adjusted rate ratio 1.03, 95%CI [1.02–1.05]) and for those with severe complications (1.19, [1.17–1.21]). The months after July were associated with longer LOS in teaching hospitals, with the effect gradually diminishing over the subsequent months. Conclusions Our study suggests trainee turnover in July did not affect mortality, but lengthened hospital stays for patients with cirrhosis, highlighting the need for effective supervision of new trainees and strategies to mitigate operational disruptions for improved clinical management.

Sociodemographic and behavioral factors associated with diet quality among low-income community health center patients with hypertension

Objective Identify the most important sociodemographic and behavioral factors related to the diet of low-income adults with hypertension in order to guide the development of a community health worker (CHW) healthy eating intervention for low-income populations with hypertension. Design In this cross-sectional analysis, dietary recalls were used to assess Healthy Eating Index-2020 (HEI-2020) total (range: 0 to 100 [best diet quality]) and component scores and sodium intake. Self-reported sociodemographic and behavioral data were entered into a Least Absolute Shrinkage and Selection Operator (LASSO) regression model to determine the relative importance of factors related to diet quality. Setting Five community health centers in Boston, Massachusetts. Participants Adults (>20 years old) with a hypertension diagnosis. Results Participants (N = 291) were mostly female (65.0%), on Medicaid (82.8%), food insecure (59.5%), and Hispanic (52.2%). The mean (95% CI) HEI-2020 score was 63.0 (62.3, 65.7) Component scores were low for sodium and whole grains; mean (SE) sodium intake was 2676.9 (45.5) mg/day. The most important factors associated with lower HEI-2020 scores were: not having own housing, male gender, tobacco use, marijuana use, and skipping meals; the most important factors associated with higher HEI-2020 scores were Hispanic ethnicity and receipt of community food resources (5-fold cross-validated R 2 = 0.17). Conclusions In this population of low-income adults with hypertension, diet quality would be improved by reducing sodium and increasing whole grain intake. Healthy eating interventions among low-income populations should consider providing dietary guidance in the context of behavioral factors (e.g., meal skipping) and substance use (e.g., marijuana) and should address barriers to health eating through referral to community food resources (e.g., food pantries).

Measurement and evaluation of low-carbon tourism development on islands: A case study in Changdao, China

China’s island tourism is still in the exploratory stage, and the carbon emissions due to island tourism development are still prominent. This study assesses the development of low-carbon tourism on Changdao Island in China. We constructed an evaluation model for low-carbon tourism on islands based on the driver-pressure-state-impact-response model, and the Entropy Weight Method-Analytical Hierarchy Process Method was combined with the weighting method to determine the index weights of ench evaluation-indicator. The annual changes in the development level of low-carbon tourism, the weights of the indicators, the characteristics of the scores, the low-carbon development mode, and key factors of island tourism were analyzed. The results of the study showed that the indicator “impact” was the most influential element of the island’s low-carbon tourism, and the ecological environment value was higher than that of the economic value. Moreover, energy saving and consumption reduction helped tourists to have a better experience, which further enabled island tourism to have a larger market size. The “response” also occupied a crucial position, where the weighted value of government planning was twice as high as that of corporate practice. The other elements were “pressure”, “state”, and “driving forces”, which showed that low carbon emissions are an important criterion for the island tourism environment and economic factors have the greatest effect in terms of the “driving forces”. The study evaluated the level of low-carbon development in island regionals across multiple dimensions, filled the literature gap, and provided a reference for the study of regional low-carbon and sustainable development of tourism.

A Hexavalent Tellurium-Based Chalcogen Bonding Catalysis Platform: High Catalytic Activity and Controlling of Selectivity

An enhanced Transformer framework with incremental learning for online stock price prediction

To address the limitations of existing stock price prediction models in handling real-time data streams—such as poor scalability, declining predictive performance due to dynamic changes in data distribution, and difficulties in accurately forecasting non-stationary stock prices—this paper proposes an incremental learning-based enhanced Transformer framework (IL-ETransformer) for online stock price prediction. This method leverages a multi-head self-attention mechanism to deeply explore the complex temporal dependencies between stock prices and feature factors. Additionally, a continual normalization mechanism is employed to stabilize the data stream, enhancing the model’s adaptability to dynamic changes. To ensure that the model retains prior knowledge while integrating new information, a time series elastic weight consolidation (TSEWC) algorithm is introduced to enable efficient incremental training with incoming data. Experiments conducted on five publicly available datasets demonstrate that the proposed method not only effectively captures the temporal information in the data but also fully exploits the correlations among multi-dimensional features, significantly improving stock price prediction accuracy. Notably, the method shows robust performance in coping with non-stationary and frequently changing financial market data.

Scale-up of Microdroplet Reactors for Efficient CO₂ Resource Utilization

Retrospective exploratory evaluation of individual pigs’ behaviour involved in tail biting during rearing and fattening

Tail biting is one of the biggest welfare problems in pigs. However, depending on the individuals involved (e.g., tail biter/victim), pigs seem to change their behaviour prior to tail biting events, which raises the possibility of early detection and thus prediction and prevention of tail biting. In this retrospective explorative study, we used datasets from four different studies with 9 trials of rearing (4 pens/trial with 24 pigs/pen) and fattening (8 pens/trial with 12 pigs/pen) that focused on the exploration behaviour of undocked pigs towards plant-based enrichment materials. From this dataset, we identified 8 pens from rearing (n = 192 pigs) and 6 pens from fattening (n = 72 pigs) in which individual tail biters were identified. From this dataset, we investigated whether any a priori behavioural changes in exploration or feeding could be identified with respect to tail biting. Furthermore, the effects of weight parameters from suckling to fattening were examined. Using linear mixed effects models, we found that exploration duration was linked to days prior to tail biting in rearing, depending on CatPig (category of pigs: biter, victim, neutral pig) (P = 0.001), in fattening independent of CatPig (P<0.0001), and by duration, amount and frequency of feed consumption in fattening (P<0.0001). Some weight parameters covaried with CatPig in rearing (weight-gain suckling: P = 0.0018; weaning weight: P = 0.019) and fattening (weaning weight: P = 0.07; start weight at fattening: P = 0.03; weight-gain rearing: P = 0.02). Suitable indicators for future early detection trials of tail biting could be exploration duration in rearing and fattening and feeding data in fattening. Moreover, weight parameters in rearing and fattening and exploration duration in rearing may be used to identify individual pigs that might become tail biters in an upcoming tail biting event. The retrospective explorative nature of our analysis revealed interesting patterns; however, further studies are needed to confirm our findings.

What makes a city breastfeeding friendly? A qualitative analysis of interviews with breastfeeding women from Europe and Asia

Background The warm chain of support is the continuous enabling environment from the mother’s first contact with healthcare professionals during early pregnancy, birth and immediate post-partum period, her transition from healthcare facility to home, through to work and the community at large. A breastfeeding-friendly city should be able to support a breastfeeding journey across the warm chain. Objective To determine breastfeeding women’s perspective of an ideal breastfeeding-friendly city. Methods Between September 2021 and January 2022, twenty-two women who were breastfeeding or had ever breastfed in the last 5 years from Ireland and Malaysia were interviewed. A set of selection criteria was applied to ensure representation of a range of the characteristics known to be associated with breastfeeding success: diverse age groups, birth and breastfeeding experiences, culture and socioeconomical background. One-on-one semi-structured online interviews were conducted by the first author. Data were analysed using Braun and Clarke’s Thematic Analysis framework. Results One overarching theme of breastfeeding at the front and centre of the city, and three major themes were developed: 1. mothers feel supported when breastfeeding is prioritised; 2. when breastfeeding is visible in the environment, it becomes normalized; 3. there is a need to have seamless breastfeeding support across the continuum of the warm chain, and at all levels of society. Conclusions The findings demonstrated the importance of prioritized, and continuous support throughout the breastfeeding journey. The hopes and aspirations of a breastfeeding-friendly city expressed here would be useful for cities to consider when developing or implementing breastfeeding support programmes as well as guide development of indicators of a breastfeeding-friendly city.

Drug-Drug interactions prediction calculations between cardiovascular drugs and antidepressants for discovering the potential co-medication risks

Predicting Drug-Drug Interactions (DDIs) enables cost reduction and time savings in the drug discovery process, while effectively screening and optimizing drugs. The intensification of societal aging and the increase in life stress have led to a growing number of patients suffering from both heart disease and depression. These patients often need to use cardiovascular drugs and antidepressants for polypharmacy, but potential DDIs may compromise treatment effectiveness and patient safety. To predict interactions between drugs used to treat these two diseases, we propose a method named Multi-Drug Features Learning with Drug Relation Regularization (MDFLDRR). First, we map feature vectors representing drugs in different feature spaces to the same. Second, we propose drug relation regularization to determine drug pair relationships in the interaction space. Experimental results demonstrate that MDFLDRR can be effectively applied to two DDI prediction goals: predicting unobserved interactions among drugs within the drug network and predicting interactions between drugs inside and outside the network. Publicly available evidence confirms that MDFLDRR can accurately identify DDIs between cardiovascular drugs and antidepressants. Lastly, by utilizing drug structure calculations, we ascertained the severity of newly discovered DDIs to mine the potential co-medication risks and aid in the smart management of pharmaceuticals.

How much time to figure out how to get where? Route planning and subjective stress under time pressure

From a daily commute to military operations in hostile territory and natural disaster responses, people frequently move from place to place. Cognition (e.g., wayfinding) occurs in conjunction with behavior (e.g., locomotion) to facilitate spatial navigation–intentional movement through space. People often use maps to plan routes, which is part of wayfinding. Time pressure is common during navigation, even during route planning, for example from time constraints (e.g., a deadline), waiting periods (e.g., technological problems), or imposed urgency (e.g., someone tells you to hurry up). Route planning requires knowing where to go, determining how to get there, and managing transient stressors that can influence performance. Across cognitive and behavioral domains, time pressure is often conceptualized as a stressor and examined with a single operationalization. As a result, we do not know to what extent time constraints, waiting periods, and imposed urgency independently or interactively a) contribute to the sense of subjective stress, and b) impact spatial performance. Our work addressed these knowledge gaps using a computerized spatial task that centrally involved planning and tracing routes on maps. We describe this new methodology for studying route planning and demonstrate experimental effects of urgency messaging on increased subjective stress and decreased time between map presentation and first click (planning time). When participants took longer to plan or drew longer routes, they reported greater subjective stress. Results carry implications for the design and implementation of time pressure manipulations, route planning in stressful conditions, and mitigating or optimizing stress effects on performance.

Trends in the levels, causes, and risk factors of maternal mortality in Pakistan: A comparative analysis of national surveys of 2007 and 2019

Background Maternal mortality ratio (MMR) has decreased worldwide but Pakistan is still striving towards achieving the SDG targets for maternal health. This study highlights the trends in maternal mortality levels and risk factors in Pakistan between 2007 and 2019. Methods This study compares the results of secondary data analysis of the Pakistan Maternal Mortality Survey 2019 with the Pakistan Demographic and Health Survey 2007. A nested case-control study was carved to compare maternal deaths with the women who survived a pregnancy, in the same sampling clusters during the same period. Logistic regression was used to estimate odds ratios (OR) for major risk factors of maternal mortality after adjusting for the women’s age, parity, education, and wealth quintile. Results In 2019, Pakistan’s MMR was 186 per 100,000 live births, registering a 33% decline from 2007 (rural 42% vs. urban 11%). The leading causes of maternal mortality were postpartum hemorrhage, hypertensive disease of pregnancy, postpartum infection, and post-abortion complications. Women > 35 years and those expecting their first child were more likely to die from childbirth, while those who had ever used family planning had a lower risk according to the data for both years. In 2007, a distance of > 40 kilometers to a hospital significantly increased the risk of mortality but this association was not significant in 2019. In 2019, women who died were more likely to receive antenatal care than those who survived (adjusted OR 9.3); this association was not significant in 2007. Conclusion The modest reduction in MMR can be attributed to improved access to maternal health services in rural areas with increased antenatal care and institutional deliveries. However, most maternal deaths were caused by poor accessibility to quality emergency obstetric care. Lack of family planning remains a major risk factor for high maternal mortality in Pakistan.

Supervised exercise-based rehabilitation for people with intermittent claudication–Study protocol for a Danish implementation process (StRiDE)

Introduction Intermittent claudication is a peripheral artery disease caused by arteriosclerosis. People with intermittent claudication experience leg cramping during walking, with relief of symptoms during rest. Evidence shows that by participating in supervised exercise therapy and smoking cessation programs, people with intermittent claudication can reduce those symptoms and improve health-related quality of life and maximal walking distance while minimizing the need for an operation. However, implementation of such health-promoting initiatives in clinical practice in Denmark and other countries is limited. This is a protocol presenting the implementation process of supervised exercise therapy and smoking cessation in a region of Denmark. Methods and analysis The implementation process is a collaboration between the municipalities in the Region of Zealand and the Department of Vascular Surgery at University Hospital Zealand. The study uses a convergent mixed-methods prospective clinical cohort design, and the theoretical frame of this implementation process follows the framework for Adapting an existing intervention to a new context (ADAPT). The process involves stakeholder engagement, ongoing evaluation through key performance indicators and relevant outcomes that will inform the implementation process across and within each municipality. Dissemination Dissemination will happen throughout the process through continued meetings with stakeholders and dissemination of performance indicators and outcome results obtained through a database. All information about the study and material will be freely available. The project is registred on Clinicalgov (NCT06299956).

Hypoxia-Initiated Supramolecular Free Radicals Induce Intracellular Polymerization for Precision Tumor Therapy

Changes in life satisfaction over six years in the general population: A longitudinal study with the Satisfaction With Life Scale (SWLS)

Background Satisfaction with life is a key concept for most individuals. The Satisfaction With Life Scale (SWLS) for measuring general life satisfaction has been widely analyzed in terms of cross-sectional associations. However, the knowledge about long-term changes in life satisfaction and the associations between such changes and changes in other variables of physical and mental health is limited. Methods A community-based representative sample of the general population has been examined twice with a time interval of six years (n = 4,999), using the SWLS and several other scales. Results Over the six years, the mean SWLS score of the total sample remained nearly unchanged (M = 27.0, SD = 5.2, both at t1 and at t2). The test-retest correlation was rtt = 0.66 for the total sample, and there were only marginal differences in temporal stability between male and female respondents. Changes in the SWLS over the six years were correlated with changes in optimism (r = 0.23), mental health (r = 0.26), social functioning (r = 0.22), perceived social support (r = 0.21), anxiety (r = -0.30), and physical complaints (r = -0.18). These change score correlations were lower than the corresponding coefficients under the cross-sectional perspective. Measurement invariance across sex, age, and time was established. Conclusion The SWLS proved to be an appropriate tool for assessing changes in life satisfaction, and correlations between change scores of life satisfaction and health-related variables complement the knowledge about these associations from a cross-sectional perspective.

Trazodone, dibenzoylmethane and tauroursodeoxycholic acid do not prevent motor dysfunction and neurodegeneration in Marinesco-Sjögren syndrome mice

There is no cure for Marinesco-Sjögren syndrome (MSS), a genetic multisystem disease linked to loss-of-function mutations in the SIL1 gene, encoding a BiP co-chaperone. Previously, we showed that the PERK kinase inhibitor GSK2606414 delays cerebellar Purkinje cell (PC) degeneration and the onset of ataxia in the woozy mouse model of MSS. However, GSK2606414 is toxic to the pancreas and does not completely rescue the woozy phenotype. The present study tested trazodone and dibenzoylmethane (DBM), which partially inhibit PERK signaling with neuroprotective effects and no pancreatic toxicity. We also tested the chemical chaperone tauroursodeoxycholic acid (TUDCA), which protects MSS patients’ cells from stress-induced apoptosis. Mice were chronically treated for five weeks, starting from a presymptomatic stage. Trazodone was given 40 mg/kg daily by intraperitoneal (ip) injection. DBM was given 0.5% in the diet ad libitum. TUDCA was given either 0.4% in the diet, or 500 mg/kg ip every three days. None of the treatments prevented motor dysfunction or PC degeneration in woozy mice, as assessed by beam walking, rotarod test, and calbindin immunohistochemistry. Only trazodone slightly boosted beam walking performance, but this effect was not related to inhibition of PERK signaling. Pharmacokinetic studies excluded that the lack of effect was due to altered drug metabolism in woozy mice. These results indicate that trazodone, DBM and TUDCA, at dosing regimens active in other neurodegenerative disease mouse models, have no disease-modifying effect in a preclinical model of MSS. This underscores the difficulty of translating neuroprotective strategies from other conditions to MSS, highlighting the need for more targeted therapeutic approaches.

Specialty palliative care use among cancer patients: A population-based study

Background Rigorous population-based assessments of the use of specialty palliative care (SPC) in the US are rare. Settings/subjects This study examined SPC use among cancer patients in a mid-sized metropolitan area in Southeast US. Measurements In this cancer decedent cohort study, data were acquired and linked from the state-wide cancer registry; state-wide hospital discharge dataset; and local SPC providers. Results 12,030 individuals with cancer were included in this study; only 2,958 (24.6%) used SPC. Of the 9,072 persons who did not use SPC, 3,877 (42.7%) went only to hospitals that did not offer SPC; and 3,517 (38.8%) went to hospitals that offered SPC but did not use it. About half of SPC recipients (1493; 50.5%) first received SPC in the final 30 days of life, including 768 (26.0%) in the final week of life. Characteristics associated with using SPC use included being in an socio-economic status quintile other than the lowest; being younger; being Black; having a solid (versus hematological) cancer; having a shorter survival with cancer; dying in the latter two years of the study; being from an area of low or complete rurality; having a hospital admission in the final 60 days prior to initiation of PC or death; having more days in hospital; and living within 15 miles of a hospital offering SPC. Conclusions In this population-based study, only one-quarter of cancer patients used SPC, and for half who did so, it came in the final 30 days of life.

Clinical course and neurological outcomes of cerebral venous sinus thrombosis: A single center retrospective observational study

Background Cerebral venous sinus thrombosis (CVST) is a rare type of thrombosis that affects the cerebral venous system. The data on neurological outcomes are limited. Objectives This study aimed to investigate the neurological outcomes of CVST, contributing factors, clinical presentation, treatment and mortality. Methods This was a single-center, retrospective study at a university-based referral hospital in Thailand. Consecutive patients diagnosed with CVST between January 2010 and December 2020 were included. Outcomes were neurological outcomes measured by modified Rankin Scale (mRS), anticoagulant treatment, recurrence, and mortality. Results One hundred and seven CVST patients were included with a mean age (± SD) of 42.7 ± 20.4 years. Following the treatment, neurological outcomes significantly improved, with the proportion of patients with mRS 0–1 increasing from 18.7% at diagnosis to 83.2% and 85.1% at three and six months, respectively (P < 0.001). Clinical variables were associated with residual neurological symptoms (mRS≥1) included age ≥ 50 years (OR 4.1, 95% CI; 1.7–9.4, P 0.001), male sex (OR 3.0, 95%CI; 1.4–6.6, P 0.006), the thrombus involvement in deep sinus system (OR 6.1, 95%CI; 1.1–76.9, P 0.04) and cerebral vein and dural sinus thrombosis (CVT) risk score ≥ 1 (OR 3.1, 95%CI; 1.3–7.5, P 0.014). Patients whose CVST was associated with hormonal therapy were found to have a lower risk of residual neurological symptoms (OR 0.2, 95%CI 0.1–0.6, P 0.004). Hormonal therapy was associated with anticoagulant discontinuation (OR 2.7, 95% CI 1.1–7.0; P = 0.04). The presence of malignancy increased the risk of bleeding (OR 5.8, 95% CI 1.4–24.1; P 0.016). Overall mortality was 2.8%. Of which 50% were related to major bleeding. Conclusions A significant improvement in neurological outcomes was observed at 3 and 6 months after diagnosis. Older age, male sex, thrombus involvement in deep sinus system were associated with residual neurological symptoms.

Prevalence of neonatal sepsis and associated factors among neonates admitted in the neonatal intensive care unit at Lira Regional Referral Hospital, Northern Uganda

Background Sepsis is one of the leading causes of mortality and morbidity among neonates. An estimated 5.29–8.73 million Disability-adjusted life years (DALYs) are lost annually in SSA due to neonatal sepsis (NS). Uganda registered stagnated neonatal mortality of 27 deaths per 1000 live births in 2020 of which 12% was attributed to NS. Early risk factor identification and improved obstetric care are proven to reduce deaths due to NS, yet there is scanty literature on the LRRH. We, therefore, determined the prevalence of NS and identified its associated factors within the LRRH of northern Uganda. Methods A hospital-based, cross-sectional study with a retrospective chart review was conducted in the neonatal intensive care unit (NICU) at Lira Regional Referral Hospital (LRRH), in northern Uganda. 194 records of neonates admitted to the NICU from September 2022 to February 2023 were reviewed. The participant records were selected by systematic sampling technique and a structured data extraction tool was used to collect data. Using SPSS version 25 data entry and analysis were done. The univariable analysis gave a general description of the data. Logistic regression analysis was used to show associations and the statistical significance was declared at a P value of 0.05 after multivariable analysis. Results Among a total of 194 neonates whose charts were reviewed, 80 neonates had neonatal sepsis, giving a proportion of 0.412 and then prevalence of 41.2%. Age in days of the neonate (AOR = 4.212, 95% CI: [1.627-10.903]) for neonates of 1-3days of age, sex where males (AOR = 2.09, 95% CI: [1.123-3.887]), an APGAR score of 1-4 at birth (AOR = 0.309, 95% CI: [0.115-0.831]) and weight at birth <2500g (AOR = 2.543, 95% CI: [1.381-4.683]) were significantly related to it. Conclusions and recommendations The results found the prevalence of NS among neonates admitted to the NICU of LRRH high at 41.2%. Factors 1-3 days of age, male sex, a birth weight of <2500g, and an Apgar score of 1-4 at birth among all neonates were significant. Therefore, it was suggested that caregivers ensure safe newborn care, detect infections early, and use prophylactic antibiotics for high-risk babies after birth, to reduce NS. Further research will be conducted on the major causative agents and outcomes of NS in the NICU of LRRH.

Unexpected effects of pandemic-related changes on mental health: Evidence from a nationwide survey in South Korea

Background Substantial evidence indicates that the COVID-19 pandemic has adversely affected population mental health globally. However, most studies assumed a linear relationship where only negative pandemic-induced changes led to worse mental health outcomes, overlooking the complex relationship between COVID-19-related changes and mental health. This study examined how various types and magnitudes of pandemic-related changes relate to depression and suicidal thoughts in a large, nationwide adult population sample. Methods We analyzed data from the 2021 Korean Community Health Survey, a cross-sectional survey of 229,213 adults. The study examined the association between mental health outcomes and three types of pandemic-related changes: daily life impact (scored 0–100), economic activities (employment and income changes), and health behaviors (physical activity, instant food consumption, alcohol consumption, and smoking). Complex sample multiple logistic regression analysis was used to assess these associations, adjusting for sociodemographic factors. Results The relationship between pandemic-related changes and mental health showed non-linear patterns. Compared to those reporting moderate changes, individuals reporting either no change (depression: aOR 1.253, 95% CI 1.135–1.384; suicidal thoughts: aOR 1.355, 95% CI 1.236–1.486) or complete disruption (depression: aOR 1.895, 95% CI 1.667–2.155; suicidal thoughts: aOR 1.788, 95% CI 1.558–2.052) in daily life showed higher risks of poor mental health. Unexpectedly, positive changes such as improved working conditions (suicidal thoughts: aOR 1.419, 95% CI 1.200–1.677) and increased income (depression: aOR 1.304, 95% CI 1.139–1.493; suicidal thoughts: aOR 1.244, 95% CI 1.079–1.435) were also associated with adverse mental health outcomes. Conclusions This study reveals that both minimal and substantial changes in daily life, as well as both positive and negative changes in economic conditions and health behaviors, were associated with poor mental health outcomes during the pandemic. These findings suggest the need for comprehensive mental health interventions that consider various types and magnitudes of life changes during crisis situations.