Validity evidence for the Family Role Overload Scale

Role overload in the family can be understood as a feeling of inability to complete duties that are the individual's responsibility, and this hardship occurs due to the accumulation of tasks in the family, which can cause discomfort. The aim of this study was to obtain valid evidence of Family Role Overload in Brazilian samples. Six hundred and forty Brazilian workers of both genders took part in the study. Confirmatory factor analyses showed that the Brazilian version remained single-factor and had six items. The multi-group analyses showed configural, metric, and scalar invariance between the groups divided in terms of gender and the existence or absence of children. The scale showed positive correlations with perceived family demands and family-work conflict and a negative correlation with perceived social support in the family. It was therefore concluded that the instrument had psychometric properties that recommend its use in future research.

A sobrecarga de papeis na família pode ser compreendida como sentimento de incapacidade em concluir obrigações que são de responsabilidade do indivíduo, e essa dificuldade acontece devido ao acúmulo de tarefas na família, que podem trazer desconforto. O presente trabalho teve por objetivo obter evidências de validade da Sobrecarga de Papéis na Família em amostras brasileiras. Participaram do estudo 640 trabalhadores brasileiros, de ambos os gêneros. As análises fatoriais confirmatórias evidenciaram que a versão brasileira se manteve unifatorial e com seis itens. As análises multigrupo atestaram a invariância configural, métrica e escalar entre os grupos divididos em termos de gênero e sobre a presença ou ausência de filhos. A escala apresentou correlações positivas com demandas percebidas da família e conflito família-trabalho e correlação negativa com suporte social percebido na família. Concluiu-se, assim, que o instrumento apresentou propriedades psicométricas que recomendam seu uso em investigações futuras.

La sobrecarga de rol en la familia puede ser entendida como un sentimiento de incapacidad para completar las obligaciones que son responsabilidad del individuo, y esta dificultad ocurre debido a la acumulación de tareas en la familia, lo que puede causar malestar. El objetivo de este estudio fue obtener evidencias de la validez de la Escala de Sobrecarga del Rol Familiar en muestras brasileñas. Participaron en el estudio 640 trabajadores brasileños de ambos sexos. Los análisis factoriales confirmatorios mostraron que la versión brasileña se mantuvo monofactorial y con seis ítems. Los análisis multigrupo mostraron invariancia configuracional, métrica y escalar entre los grupos divididos en función del género y de la presencia o ausencia de hijos. La escala mostró correlaciones positivas con las demandas familiares percibidas y el conflicto familia-trabajo y una correlación negativa con el apoyo social percibido en la familia. Por lo tanto, se concluyó que el instrumento posee propiedades psicométricas que recomiendan su uso en futuras investigaciones.

O-GlcNAcylation of circadian clock protein Bmal1 impairs cognitive function in diabetic mice.

Neuronal damage in the hippocampus induced by high glucose has been shown to promote the onset and development of cognitive impairment in diabetes, but the underlying molecular mechanism remains unclear. Guided by single-cell RNA sequencing, we here report that high glucose increases O-GlcNAcylation of Bmal1 in hippocampal neurons. This glycosylation promotes the binding of Clock to Bmal1, resulting in the expression of transcription factor Bhlhe41 and its target Dnajb4. Upregulated Dnajb4 in turn leads to ubiquitination and degradation of the mitochondrial Na + /Ca2+ exchanger NCLX, thereby inducing mitochondrial calcium overload that causes neuronal damage and cognitive impairment in mice. Notably, Bhlhe41 downregulation or treatment with a short peptide that specifically blocks O-GlcNAcylation of Bmal1 on Ser424 mitigated these adverse effects in diabetic mouse models. These data highlight the crucial role of O-GlcNAcylation in circadian clock gene expression and may facilitate the design of targeted therapies for diabetes-associated cognitive impairment.

Targeting CXCR2 ameliorated tacrolimus-induced nephrotoxicity by alleviating overactivation of PI3K/AKT/mTOR pathway and calcium overload.

OBJECTIVES: The purposes of this study were to (i) verify the role of CXCR2 in tacrolimus-induced nephrotoxicity, (ii) explore the specific mechanism of CXCR2-mediated tacrolimus nephrotoxicity, and (iii) target the antagonism of CXCR2 and provide a potential target for the treatment of tacrolimus-induced nephrotoxicity in children. METHODS: CXCR2 knockout (CXCR2-KO) mice were used to evaluate the role of CXCR2 in tacrolimus-induced nephrotoxicity. Wistar rats were used to explore the underlying mechanism. RESULTS: In the knockout mice, compared with N-WT group, the renal function index was deteriorative (P < 0.01), the degree of renal fibrosis was aggravated (P < 0.01), the pathological expression of E-cadherin (P < 0.01) and α-SMA (P < 0.01) were occurred in T-WT group. Inversely, compared with T-WT group, the above indicators were improved in T-KO group (P < 0.01). In wistar rats, compared with N group, the renal function index was deteriorative (P < 0.05 or P < 0.01), fibrosis and calcium overload occurred (P < 0.01), CXCL2-CXCR2 was activated (P < 0.05), and meanwhile PI3K/AKT/mTOR pathway was activated (P < 0.05 or P < 0.01) in T group. Inversely, compared with T group, the above indicators were reversed in C group (P < 0.05 or P < 0.01). CONCLUSION: The present study was firstly to report that CXCL2-CXCR2 activated PI3K/AKT/mTOR pathway and calcium overload in tacrolimus-induced nephrotoxicity, and targeting CXCR2 could inhibit the progression of tacrolimus-induced nephrotoxicity.

Intraoperative Fluid Balance and Perioperative Complications in Ovarian Cancer Surgery.

BACKGROUND: Fluid overload and hypovolemia promote postoperative complications in patients undergoing cytoreductive surgery for ovarian cancer. In the present study, postoperative complications and anastomotic leakage were investigated before and after implementation of pulse pressure variation-guided fluid management (PPVGFM) during ovarian cancer surgery. PATIENTS AND METHODS: A total of n = 243 patients with ovarian cancer undergoing cytoreductive surgery at the University Hospital Bonn were retrospectively evaluated. Cohort A (CA; n = 185 patients) was treated before and cohort B (CB; n = 58 patients) after implementation of PPVGFM. Both cohorts were compared regarding postoperative complications. RESULTS: Ultrasevere complications (G4/G5) were exclusively present in CA (p = 0.0025). No difference between cohorts was observed regarding severe complications (G3-G5) (p = 0.062). Median positive fluid excess was lower in CB (p = 0.001). This was independent of tumor load [peritoneal cancer index] (p = 0.001) and FIGO stage (p = 0.001). Time to first postoperative defecation was shorter in CB (CB: d2 median versus CA: d3 median; p = 0.001). CB had a shorter length of hospital stay (p = 0.003), less requirement of intensive medical care (p = 0.001) and postoperative ventilation (p = 0.001). CB received higher doses of noradrenalin (p = 0.001). In the combined study cohort, there were more severe complications (G3-G5) in the case of a PFE ≥ 3000 ml (p = 0.034) and significantly more anastomotic leakage in the case of a PFE ≥ 4000 ml (p = 0.006). CONCLUSIONS: Intraoperative fluid reduction in ovarian cancer surgery according to a PPVGFM is safe and significantly reduces ultrasevere postoperative complications. PFEs of ≥ 3000 ml and ≥ 4000 ml were identified as cutoffs for significantly more severe complications and anastomotic leakage, respectively.

Emerging psychosocial factors and work overload perceptions of Mexican university teachers and students working and studying from home during the COVID-19 pandemic.

Introduction: In Mexico, academic activities during the COVID-19 pandemic were conducted from home for over 2 years. Especially during the initial months of the pandemic, the lockdown conditions necessitated a reorganization and a new understanding of social dynamics. Therefore, this study aimed to explore the perceptions of university students and teachers regarding emerging psychosocial factors that either encouraged or hindered work and/or study from home during confinement, as well as their perceptions of work overload. Furthermore, the differences between students and teachers in the studied variables were analyzed. Method: A predominantly quantitative, cross-sectional, and correlational study was conducted with 108 participants (42.6% university teachers; 57.4% graduate or postgraduate students) who filled out an online questionnaire encompassing two open-ended inductors to identify the positive and negative aspects of working or studying from home and their frequency of perceptions, the COVID-19 Work Overload from Home Scale (ESTC-COVID-19), and questions about the hours per day devoted to different activities. The open responses were categorized by two independent groups of the research team; the emerging categories were then consensually agreed upon and further transformed into dummy and continuous variables. These variables and the results of the ESTC-COVID-19 were analyzed with SPSS 19 using Pearson's correlation coefficient, the Chi-squared test, and Student's t-test. The results identified 9 positive and 10 negative emerging psychosocial factors attributed to at least 10% of the sample's open answers. In addition, work overload correlated negatively with the emerging factor of "Making better use of time" and positively with "Work, school, and/or domestic activities overload;" moreover, students perceived more work overload than teachers. Discussion: Differences between students and teachers were observed in the following psychosocial factors: "Self-management," "Comfort," and "Enjoying home" (as positive factors) and "Domestic work" and "Interruptions, distractors, noise" (as negative factors), with students generally reporting more discomfort than teachers. The study analyzes these differences in relation to the demands and nature of the study and work activities undertaken by both groups, as well as the previous training of the skills and the resources required to carry them out.

[The ROSE concept: modern fluid management in intensive care medicine]. / Das ROSE-Konzept ­ modernes Flüssigkeitsmanagement in der Intensivmedizin.

The ROSE concept, which is the acronym of resuscitation, optimization, stabilization and evacuation, describes the phases of fluid therapy, based on the pathophysiology of septic shock. During the first two phases, aggressive fluid therapy that is guided by clinical and hemodynamic parameters is mandatory. During the stabilization phase, recovery from shock and microcirculatory injury occurs, which enables the depletion of fluid overload in the fourth and final phase. Ultimately, euvolemia needs to be regained, which reverts interstitial edema and organ dysfunction.

Polydatin Prevents Electron Transport Chain Dysfunction and ROS Overproduction Paralleled by an Improvement in Lipid Peroxidation and Cardiolipin Levels in Iron-Overloaded Rat Liver Mitochondria.

Increased intramitochondrial free iron is a key feature of various liver diseases, leading to oxidative stress, mitochondrial dysfunction, and liver damage. Polydatin is a polyphenol with a hepatoprotective effect, which has been attributed to its ability to enhance mitochondrial oxidative metabolism and antioxidant defenses, thereby inhibiting reactive oxygen species (ROS) dependent cellular damage processes and liver diseases. However, it has not been explored whether polydatin is able to exert its effects by protecting the phospholipid cardiolipin against damage from excess iron. Cardiolipin maintains the integrity and function of electron transport chain (ETC) complexes and keeps cytochrome c bound to mitochondria, avoiding uncontrolled apoptosis. Therefore, the effect of polydatin on oxidative lipid damage, ETC activity, cytochrome levels, and ROS production was explored in iron-exposed rat liver mitochondria. Fe2+ increased lipid peroxidation, decreased cardiolipin and cytochromes c + c1 and aa3 levels, inhibited ETC complex activities, and dramatically increased ROS production. Preincubation with polydatin prevented all these effects to a variable degree. These results suggest that the hepatoprotective mechanism of polydatin involves the attenuation of free radical production by iron, which enhances cardiolipin levels by counteracting membrane lipid peroxidation. This prevents the loss of cytochromes, improves ETC function, and decreases mitochondrial ROS production.

Differential gut microbiota composition in ß-Thalassemia patients and its correlation with iron overload.

Recent research highlights the significant impact of the gut microbiota on health and disease. Thalassemia, a hereditary blood disorder, requires regular blood transfusions, leading to an accumulation of iron in the body. Such changes could potentially alter the intestinal microbiota, thereby increasing the susceptibility of thalassemic patients to infection. In this study, we analyzed the fecal microbiota of 70 non-transfusion-dependent (NTDT) ß-thalassemia/HbE patients and 30 healthy controls. Our findings indicate that iron chelation intervention had no detectable effect on the microbiome profile of thalassemic patients. However, the cross-sectional analysis revealed that the bacterial diversity and community structure in patients were significantly less diverse and distinct compared to those of healthy subjects. Using reference frames, we were also able to demonstrate that bacterial taxa that are known to produce short chain fatty acids, from the genera Alistipes, Coprococcus, and Oscillospira, and those from the family Ruminococcaceae, were less prevalent in the patients. In contrast, bacterial taxa associated with an unhealthy gut, including the genus Clostridium and those from the families Fusobacteriaceae, Enterobacteriaceae, and Peptostrptococcaceae, were more prevalent in patients and found to be correlated with higher levels of ferritin. Collectively, these changes in the microbiota could be regarded as markers of raised ferritin levels, and therefore, awareness should be exercised as they could interfere, albeit indirectly, with the treatment of the co-morbidities of thalassemia.

Organ-Specific Iron Overload in Non-Transfusion-Dependent Thalassemia Patients: Insights from Quantitative MRI Evaluation.

OBJECTIVE: To elucidate the iron load in different organs of non-transfusion-dependent thalassemia (NTDT) patients using magnetic resonance imaging (MRI) T2* scan. METHODS: Thirty-four NTDT patients, including 28 NTDT iron chelation without and 6 NTDT with iron chelation, together with 15 normal controls, underwent MRI examination between December 2022 and July 2024 were enrolled in the study. Measured T2* of the pituitary gland, kidney cortex, heart, liver, pancreas, spleen. Liver and spleen volumes were evaluated. RESULTS: Of the 28 patients in NTDT without iron chelation group, 19 patients with iron overload in the liver, 9 patients with iron overload in the kidneys, and 4 patients with iron overload in the spleen. Most patients with abnormal kidney and spleen iron (76.9 %) had liver iron overload. Compared with the control group, NTDT without iron chelation patients had lower T2* in the liver, kidney, and spleen (p < 0.05). And heart T2* was correlated with kidney T2* (r = 0.480, p = 0.010) and pancreas (r = 0.411, p = 0.037). Liver T2* was correlated with spleen T2* (r = 0.479, p = 0.011). Pancreas T2* was correlated with pituitary T2* (r = -0.433, p = 0.031). CONCLUSIONS: NTDT patients exhibit significant organ-specific iron overload, particularly in the liver, kidneys, and spleen. The correlations between iron levels in different organs suggest interconnected mechanisms of iron accumulation. These findings highlight the importance of regular MRI screening to monitor and manage iron overload in NTDT patients.

Hippocampal iron overload and spatial reference memory impairment: Insights from a rat model.

BACKGROUND: Brain iron overload may induce neuronal death and lead to cognitive impairment. The hippocampus is a critical limbic structure involved in memory. This study aimed to investigate iron overload and its role in hippocampal damage and memory impairment using a rat model. METHODS: Young rats (2 weeks old) received intraperitoneal injections of high-dose iron solution (Group H, n = 10), low-dose iron solution (Group L, n = 10) and normal saline as control (Group D, n = 5). The Morris water maze (MWM) test was performed on all rats to evaluate their spatial reference memory by assessing their escape latency time and number of platform crossing. The iron content and neuronal damage in hippocampal tissue sections of the rats were assessed semi-quantitatively using diaminobenzidine (DAB)-enhanced Perl's Prussian blue (PPB) staining, and their correlation with spatial reference memory performance was evaluated. RESULTS: The escape latency in Group H was significantly longer compared to Groups L and D (P < 0.05). The number of platform crossings was significantly lower in Group H than in Group L or D (P < 0.001). The neuronal cells in Group H had more brown iron deposits than those of Groups L and D. There were significant correlations between the severity of structural damage in the hippocampal tissue and the number of platform crossings (P1 = 0.001 for Group H; P2 = 0.043 for Group L). CONCLUSION: This study showed an association between hippocampal iron-induced structural damage and spatial reference memory impairment in a rat model. This work should advance our understanding of hippocampal iron overload on cognitive functioning.

Exploring alterations of gut/blood microbes in addressing iron overload-induced gut dysbiosis and cognitive impairment in thalassemia patients.

Iron overload causes cognitive impairment in thalassemia patients. The gut-brain axis plays an important role in cognitive function. However, the association between gut/blood microbiome, cognition, and iron burden in thalassemia patients has not been thoroughly investigated. We aimed to determine those associations in thalassemia patients with different blood-transfusion regimens. Sixty participants: healthy controls, transfusion-dependent thalassemia (TDT) patients, and non-transfusion-dependent (NTDT) patients, were recruited to evaluate iron overload, cognition, and gut/blood microbiome. TDT patients exhibited greater iron overload than NTDT patients. Most thalassemia patients developed gut dysbiosis, and approximately 25% of the patients developed minor cognitive impairment. Increased Fusobacteriota and Verrucomicrobiota with decreased Fibrobacterota were observed in both TDT and NTDT groups. TDT patients showed more abundant beneficial bacteria: Verrucomicrobia. Iron overload was correlated with cognitive impairment. Increased Butyricimonas and decreased Paraclostridium were associated with higher cognitive function. No trace of blood microbiota was observed. Differences in blood bacterial profiles of thalassemia patients and controls were insignificant. These findings suggest iron overload plays a role in the imbalance of gut microbiota and impaired cognitive function in thalassemia patients. Harnessing probiotic potential from those microbes could prevent the gut-brain disturbance in thalassemia patients.

Unusual Confluence: Exploring the Association of Biliary Atresia, Wilson Disease, and Iron Overload.

The case involves a 33-year-old man with biliary atresia, Wilson disease (WD), and iron overload. Biliary atresia, a cholangiodestructive disease, leads to cirrhosis if untreated. WD, caused by ATP7B gene mutations, results in copper accumulation affecting the liver and brain. Iron overload can be seen in cases of WD and with hereditary hemochromatosis gene mutations. The patient's concurrent presentation of these conditions poses a unique clinical challenge. Elevated iron levels may worsen WD outcomes. A detailed history and physical examination, genetic testing, and close follow-up are crucial. The case highlights the need for increased awareness and vigilant monitoring of patients with overlapping liver diseases.

[Ferritin as a biomarker of aging: geroprotective peptides of standardized human placental hydrolysate. A review].

Ferritin, an iron transport protein, is an acute phase protein of inflammation and oxidative stress (OS), a biomarker of cytolysis and ferroptosis. Inflammation, OS and iron overload are characteristic processes of the pathophysiology of aging. Human placental hydrolysates (HPHs) are promising hepatoprotective agents for anti-aging therapy. The goal of the team of authors was to systematize data on ferritin as a marker of aging and to identify peptides that counteract the aging pathophysiology, including through the regulation of iron and ferritin metabolism, in the HPH Laennec (manufactured by Japan Bioproducts). The results of basic and clinical studies confirm the above relationships and indicate that blood ferritin levels characterize the chronological and biological aging of the human body.

MPV17 Prevents Myocardial Ferroptosis and Ischemic Cardiac Injury through Maintaining SLC25A10-Mediated Mitochondrial Glutathione Import.

Ferroptosis is a recently identified iron-dependent programmed cell death with lipid peroxide accumulation and condensation and compaction of mitochondria. A recent study indicated that ferroptosis plays a pivotal role in ischemic cardiac injury with the mechanisms remain largely unknown. This study demonstrates that when an iron overload occurs in the ischemia/reperfusion cardiac tissues, which initiates myocardial ferroptosis, the expression levels of mitochondrial inner membrane protein MPV17 are reduced. Overexpression of MPV17 delivered via adenovirus significantly reduced ferroptosis in both cardiomyocytes with high levels of iron and cardiac I/R tissues. Mitochondrial glutathione (mtGSH), crucial for reactive oxygen species scavenging and mitochondrial homeostasis maintenance, is depleted in myocardial ferroptosis caused by iron overload. This mechanistic study shows that MPV17 can increase mitochondrial glutathione levels through maintaining the protein homeostasis of SLC25A10, which is a mitochondrial inner-membrane glutathione transporter. The absence of MPV17 in iron overload resulted in the ubiquitination-dependent degradation of SLC25A10, leading to impaired mitochondrial glutathione import. Moreover, we found that MPV17 was the targeted gene of Nrf2, which plays a pivotal role in preventing lipid peroxide accumulation and ferroptosis. The decreased expression levels of Nrf2 led to the inactivation of MPV17 in iron overload-induced myocardial ferroptosis. In summary, this study demonstrates the critical role of MPV17 in protecting cardiomyocytes from ferroptosis and elucidates the Nrf2-MPV17-SLC25A10/mitochondrial glutathione signaling pathway in the regulation of myocardial ferroptosis.

Elevated Plasma Atherogenic and Triglyceride-Glucose Indices: Markers of Cardiovascular Risk in Transfusion-Dependent Thalassemia.

BACKGROUND: Transfusion-dependent thalassemia (TDT) is an autosomal recessive disorder characterized by defective hemoglobin synthesis, leading to severe complications such as iron overload and multi-organ dysfunction. This study aims to elucidate the distinctive clinical and biochemical profiles of TDT patients compared to healthy controls, with an emphasis on cardiovascular risk assessment using novel markers such as the Plasma Atherogenic Index (PAI) and Triglyceride-Glucose (TyG) index. METHODS: This cross-sectional study included 32 TDT patients and 36 healthy controls, matched for age and gender. Comprehensive demographic, laboratory, and imaging data were collected and analyzed. TDT patients were further stratified based on cardiac involvement and ferritin levels. Key assessments included hemoglobin levels, liver enzymes, lipid profiles, and cardiac imaging. The PAI and TyG index were calculated to evaluate cardiovascular risks. Statistical analyses were performed using SPSS 27.0, employing Student's t-test, Mann-Whitney U test, and Pearson chi-square test as appropriate. RESULTS: No significant differences in basic demographic parameters were observed between groups; however, TDT patients exhibited significant clinical and laboratory differences. Notably, these patients had lower hemoglobin levels, higher platelet counts, elevated liver enzymes (ALT and AST), and markedly increased ferritin levels. Lipid profiles were significantly altered, with lower levels of total cholesterol, HDL, and LDL but elevated triglycerides. Importantly, the PAI was significantly higher in TDT patients, suggesting an increased atherosclerotic risk. Subgroup analysis revealed that patients with cardiac involvement had worse metabolic profiles, higher TyG indices, and prolonged QT intervals, indicating heightened cardiovascular risk. As the iron burden increases, the TyG index and PAI may lose their sensitivity in distinguishing between varying levels of iron overload, suggesting that their effectiveness plateaus beyond a certain threshold of iron accumulation. CONCLUSION: TDT patients show significant hematological and metabolic deviations, including elevated cardiovascular risk markers like PAI and TyG index. As iron burden increases, these markers lose discriminative power, and cardiac involvement escalates rapidly once a critical iron threshold is surpassed, as supported by studies showing a non-linear relationship between iron load and cardiac complications. Comprehensive cardiovascular risk assessment and tailored management are essential for these patients. Future studies should focus on tracking cardiovascular risk progression and the effects of targeted interventions.

ß-Thalassemia Major Complicated by Acute Myeloid Leukemia.

This report describes the rare co-occurrence of acute myeloid leukemia (AML) French-American-British type M2 in a 4.5-year-old boy with previously diagnosed thalassemia major, an inherited hemoglobinopathy, typically presenting with severe, transfusion-dependent anemia. Chronic transfusions, though lifesaving, can lead to iron overload, which may generate free radicals and potentially contribute to malignancy. Our case highlights the importance of close monitoring for secondary malignancies in thalassemia patients. Our patient born to consanguineous parents, presented with persistent fever, abdominal pain, and splenomegaly. Hematological investigations revealed severe cytopenias (low blood cell counts) and many immature blood cells (blasts). Bone marrow examination confirmed AML M2, characterized by an overabundance of myeloid blasts. Despite the initiation of myeloid leukemia-directed aggressive chemotherapy, the patient, unfortunately, succumbed to the disease within a month of diagnosis.

Role of Overload and Psychoemotional Variables on Health-Related Quality of Life in Informal Caregivers of People with Alzheimer's Disease.

Background: Carers of people with Alzheimer's disease often have a high degree of commitment and dedication which may also compromise physical and emotional, leisure, and occupational self-care. This study aimed to explore health-related quality of life (HRQoL) and psychoemotional variables in caregivers with and without caregiver overload and its relationship. Methods: A single-measure cross-sectional correlational study was carried out involving 59 informal caregivers of people with Alzheimer's disease with a mean age of 59.30 (±10.58). The participants completed the adult HRQoL questionnaires (EQ-5D-3L), Zarit Burden Inventory test, General Happiness Questionnaire, Satisfaction with Life Scale, Rosenberg self-esteem scale, Occupational Balance Questionnaire (OBQ-E), International Fitness Scale (IFIS), Family Apgar scale, and Duke-UNC-11 Functional Social Support Questionnaire. Results: A significantly higher level of HRQoL (p = 0.029) in subjective happiness (p = 0.018), perceived social support (p = 0.046), avoidance (p = 0.034), occupational balance (p = 0.002), life satisfaction (p = 0.037), and self-perceived physical fitness (p = 0.021) was found in caregivers without perceived overload. Also, HRQoL was directly associated with self-perceived physical fitness (ß = 0.534; p < 0.001) and occupational balance (ß = 0.375; p < 0.001) and self-esteem (ß = 0.249; p < 0.016). Conclusions: Caregivers who do not perceive overload have better levels of HRQoL and psychoemotional variables, establishing a relationship between HRQoL with self-perceived physical fitness, occupational balance, and self-esteem.

Tolvaptan and the role of kidney aquaporin-2 abundance in managing volume overload in patients with CKD.

Objective: This retrospective study evaluated tolvaptan's efficacy, safety, and predictive indicators in managing volume overload in chronic kidney disease (CKD) patients. Methods: CKD patients with volume overload, treated with loop diuretics alone or with tolvaptan at Zhongda Hospital, Southeast University, from 1 March 2022 to 31 December 2023, were included. Patients were divided into loop diuretic (Group C) and loop diuretic combined with tolvaptan (Group T) cohorts. Primary outcomes included volume control, changes in weight, urine output, and laboratory parameters within 1 week post-medication. Adverse events such as hypernatremia and hyperkalemia, etc., were recorded. We further conducted immunohistochemical staining of renal biopsy tissues to investigate the roles of aquaporin-2 (AQP2) in the collecting duct and plasma albumin in predicting the efficacy of tolvaptan. Results: Of 174 CKD patients with volume overload, 108 (67.07%) were male. Group C and Group T each comprised 87 patients. At baseline, no significant differences in urine output and weight were noted. By day 3, Group T exhibited a greater increase in urine output (P < .001) and weight reduction (P < .001). At day 7, Group T maintained more significant diuretic effects (P < .001). More Group C patients required ultrafiltration therapy (P = .040). Adverse event rates did not significantly differ. Notably, AQP2 expression in the collecting duct may predict tolvaptan responsiveness, while plasma albumin did not affect efficacy. Conclusion: Tolvaptan showed efficacy and safety in managing volume overload in CKD patients. The expression of AQP2 in the collecting duct could predict tolvaptan's efficacy.This study protocol was approved by the Ethics Committee of Zhongda Hospital Affiliated to Southeast University (Approval No. 2023ZDSYLL180-P01, Clinical Trial Registration No. ChiCTR2300075274, Trial Registration Link: https://www.chictr.org.cn/guide.html).

Exploring the Moderating Effect of Musculoskeletal Pain on Technostress-Induced Burnout: A Cross-Sectional Study of Bank Employees.

BACKGROUND/OBJECTIVES: Information and Communications Technology (ICT) advancements and high customer expectations are boosting the use of digital transformation and tech tools in business processes in a competitive environment. This trend enhances business effectiveness and efficiency but also introduces technostress as a new workplace stress factor. Technostress, defined as stress induced by using ICT in the workplace, has become increasingly prevalent in modern work environments, especially in sectors such as banking, due to digital transformation. As technology use intensifies, it raises concerns about potential adverse psychological and physiological effects on employees, particularly in relation to burnout. From a physiological perspective, musculoskeletal disorders (MSDs) are quite common among employees who use ICT for extended periods. MSDs can play a significant moderating role in the relationship between technostress and burnout. In this context, this study aimed to examine the moderating role of MSDs in the effect of technostress on burnout. METHODS: This quantitative study surveyed a convenience sample of 220 bank employees, drawing on COR theory, the JD-R model, the P-E fit approach, and transactional stress theory. Data were analyzed using Structural Equation Modeling with SmartPLS 4.0 software, enabling examination of relationships between variables derived from these frameworks. RESULTS: The results reveal that technostress increases bank employees' burnout experience. Additionally, bank employees with MSDs experience higher burnout levels than those without MSDs. CONCLUSIONS: The study's findings provide valuable insights into managing workplace stress, addressing mental health problems, and promoting employee well-being in the digital age. These results have potential implications for academic understanding and practical applications in sustainable management.

Magnetic Resonance Imaging Findings and Potential Anatomic Risk Factors for Anterolateral Ankle Impingement in Children and Adolescents Suffering from Non-Overload Atraumatic Ankle Pain.

BACKGROUND/OBJECTIVES: To assess magnetic resonance image (MRI) findings in children and adolescents with atraumatic non-overload ankle pain and to identify potential anatomic risk factors. METHODS: In total, 310 MRIs of 6- to 20-year-old patients were evaluated regarding detectable ankle pathologies. A total of 147 patients (68 males; 79 females) suffered from atraumatic non-overload ankle pain. The findings were compared to a control group (163 patients: 89 males; 74 females), including patients with ankle trauma in the 4 weeks prior to MRI examination. A t-test for unpaired samples and a binary logistic regression model were used to identify significant differences between both groups and determine potential anatomic risk factors. RESULTS: In the group with atraumatic ankle pain, 95 patients (64.6%) showed at least one pathology. Anterolateral impingement of the upper ankle joint was found in 29 patients (19.7%). Its occurrence was significantly higher in atraumatic non-overload patients than in the control group (p = 0.043). Moreover, a significant correlation between anterolateral impingement of the upper ankle and the presence of hindfoot valgus malposition (n = 25; 17.0%) could be proven in atraumatic non-overload patients (p = 0.035). CONCLUSIONS: Anterolateral impingement of the upper ankle joint is frequently observed in children and adolescents suffering from atraumatic non-overload ankle pain, whereby a hindfoot valgus malposition seems to present an anatomic risk factor.