Sleep Deprivation and Fatigue among Nurses Working Consecutive Night Shifts: A Prospective Observational Study.

PURPOSE: This study aimed to identify changes in sleep patterns and fatigue levels during consecutive night shifts among shift nurses and to determine the association between sleep parameters and increased fatigue levels during work. METHODS: This prospective observational study employing ecological momentary assessments was conducted using data collected from 98 shift nurses working in Korean hospitals between June 2019 and February 2021. The sleep patterns were recorded using actigraphy. The participants reported their fatigue levels at the beginning and end of each night shift in real time via a mobile link. Linear mixed models were used for the analysis. RESULTS: Nurses spent significantly less time in bed and had shorter sleep durations during consecutive night shifts than on off-duty days, whereas their wake times after sleep onset were much longer on off-duty days than on on-duty days. Fatigue levels were higher on the second and third night-shift days than on the first night-shift days. A shorter time spent in bed and asleep was associated with a greater increase in fatigue levels at the end of the shift than at the beginning. CONCLUSION: Nurses experience significant sleep deprivation during consecutive night shifts compared with off-duty days, and this sleep shortage is associated with a considerable increase in fatigue levels at the end of shifts. Nurse managers and administrators must ensure sufficient intershift recovery time during consecutive night shifts to increase the time spent in bed and sleeping.

Utility of customized 3D compression mask with pressure sensors on facial burn scars: A single-blinded, randomized controlled trial.

PURPOSE: A pressure of approximately 15-25 mmHg is used for effective compression therapy to prevent and treat hypertrophic scar formation in patients with burns. However, conventional facial compression garments present challenges owing to inadequate pressure distribution in curved areas such as the cheeks, around the mouth, and the slope of the nose. This study aimed to evaluate the utility of a custom-made 3D compression mask equipped with pressure sensors to treat facial burn scars. METHODS: This single-blinded, prospective randomized controlled trial was conducted between May and October 2023, involving 48 burn scars in 12 inpatients with facial burns. We created the custom-made 3D compression mask equipped with pressure sensors, inner lined with biocompatible silicon, and a harness system using 3D printing technology, which can continuously monitor whether an appropriate pressure of 15-25 mmHg maintains. The biological scar properties, Vancouver Scar Scale (VSS), and Patient and Observer Scar Assessment Scale (POSAS) scores in patients with facial burns were assessed before applying the compression mask and garment and at 4 and 12 weeks after application. RESULTS: Pre-application assessment of biological scar properties, VSS, and POSAS revealed no statistically significant differences between the 3D mask and control groups (p > 0.05 for all). Throughout the 12-week application, skin hydration and scar thickness significantly increased (p < 0.001) and reduced (p = 0.010), respectively, in the 3D mask group compared to the control group. Additionally, significant improvements in scar pliability (p = 0.004) and height (p = 0.009) of VSS, itching (p = 0.047), scar stiffness (p = 0.001), thickness (p = 0.011), and irregularity (p < 0.001) of POSAS-patient component, and scar thickness (p = 0.001), pliability (p = 0.012), and surface area (p = 0.027) of the POSAS-observer component were observed in 3D mask group throughout the 12-week application compared to the control group. CONCLUSION: The customized 3D compression mask equipped with pressure sensors significantly improved scar thickness, skin hydration, and various assessment scale parameters throughout the 12-week application.

The effect of Tai Chi exercise intervention on sleep quality in community residing older adults: a systematic review and meta-analysis.

PURPOSE: While clinical research has shown that Tai Chi exercise may improve the sleep quality of older adults, there is a lack of robust evidence-based verification. Therefore, this study conducted a systematic review of published research on the effect of Tai Chi exercise on the sleep quality of community-dwelling older adults, aiming to provide solid evidence-based medicine to enhance their sleep quality. METHODS: A systematic search was conducted on PubMed, Embase, Cochrane Library, Web of Science, CNKI, WanFang, VIP, and SinoMed databases from their inception to December 9, 2022. The Cochrane risk of bias assessment tool 2.0 was used to assess the risk of bias in the included studies. RESULTS: This systematic review included 12 original articles, involving a total of 1,058 community-dwelling older adults, with 553 in the Tai Chi group and 505 in the control group. The meta-analysis results revealed a significant improvement in the sleep quality of community-dwelling older adults who practiced Tai Chi compared to the control group [WMD = - 1.96 (95% CI: - 3.02 to - 0.90, z = 3.62, P < 0.001)]. Subgroup analysis showed that Tai Chi had significantly beneficial effects regardless of age, country/region, intervention time, and Tai Chi type. CONCLUSIONS: Tai Chi exercise can serve as an effective non-medication approach for addressing sleep problems in this demographic. Among the various types of Tai Chi exercises, the 24-form Tai Chi exercise emerges as a preferred option. Moreover, Tai Chi exercise proves to be an excellent choice for older people in their later years, promoting their overall well-being and health.

Psychometric properties of the Korean version of the Stanford Presenteeism Scale in a nurse population.

Presenteeism, which refers to going to work despite being ill, has been associated with loss of work productivity, decreased quality of care, and an increased risk of health problems. The prevalence of presenteeism is particularly high among nurses; therefore, a reliable and valid tool is needed to assess presenteeism. This study aimed to translate the Stanford Presenteeism Scale (SPS) and to examine its psychometric properties in a Korean nurse population. A methodological study was performed in January 2023. The original SPS-6 (English-language) was translated and adapted to the Korean language using a committee approach translation, cognitive interviews, and content validation with a review panel of experts. An online survey was completed by 608 Korean nurses. The internal consistency, item-to-total correlation, construct validity, concurrent validity, and discriminant validity were examined as psychometric properties of the Korean version of the SPS. The final version of the K-SPS consists of four items shortened from the original six items. Cronbach's alpha of the K-SPS-4 was 0.74, indicating adequate reliability. Confirmatory factor analysis showed a one-factor solution with a good fit. There was a positive correlation between the K-SPS-4 and the Work Limitations Questionnaire. Discriminant validity was evidenced by the positive correlation of the K-SPS-4 with job satisfaction and the negative correlation with job stress. The K-SPS-4 has acceptable psychometric properties, supporting the feasibility of its use in assessing the level of presenteeism among Korean nurses. The validated K-SPS-4 can provide a basis for developing intervention programs to enhance productivity and promote health among nurses in clinical settings.

Effects of Tai Chi and Qigong on cognitive and physical functions in older adults: systematic review, meta-analysis, and meta-regression of randomized clinical trials.

BACKGROUND: Older adults experience age-related declines in physical and cognitive functions due to interactions between aging and chronic diseases. Tai Chi and Qigong (TCQ) might be beneficial in improving the physical function and delaying the cognitive decline of this population. The potential underlying mechanism was explored to determine the effects of TCQ on cognitive function via direct or indirect pathways. PURPOSE: The objective of this systematic review was to determine the effects of TCQ on cognitive and physical functions in older adults using meta-analysis, and to determine the impact of TCQ on cognitive function while controlling for physical function using a meta-regression approach. METHODS: A systematic search of 13 electronic databases (in English, Korean, and Chinese languages) identified 10,292 potentially eligible studies published between inception and May 2022. The bias in individual studies was assessed using the Cochrane Risk of Bias (version 2.0) tool. The heterogeneity of the studies was evaluated using a 95% prediction interval, and the meta-analysis and meta-regression were implemented using the Comprehensive Meta-Analysis (version 3) software. RESULTS: Our search identified 17 randomized studies (n = 2,365, mean age = 70.3 years). The results of the meta-analysis that used a random-effects model indicated that TCQ had significant effects on both cognitive (Hedges' g = 0.29, 95% confidence interval [CI] = 0.17 to 0.42) and physical (Hedges' g = 0.32, 95% CI = 0.19 to 0.44) functions. We used meta-regression to explore the effect size of TCQ in association with physical function level. The regression model was significant (Q = 25.01, p = .070), and 55% of the heterogeneity was explained by physical function as a moderator variable. The effects of TCQ on cognitive function remained significant in this model when controlling for the effect of physical function (ß = 0.46, p = .011). CONCLUSION: This meta-regression of 17 randomized studies strongly suggests that TCQ has beneficial effects on physical and cognitive functions in older adults. The effect of TCQ on cognitive function remained significant after taking into account the significant effects of physical function as a moderator. The findings imply the potential health benefits of TCQ by promoting cognitive function in older adults directly and indirectly through enhancing physical function. PROSPERO REGISTRATION NUMBER: *PROSPERO international prospective register of systematic reviews, registration ID CRD42023394358.

Physical and cognitive function to explain the quality of life among older adults with cognitive impairment: exploring cognitive function as a mediator.

BACKGROUND: Physical and cognitive function are both indicators of aging, characterized by a loss of adaptive response to life challenges and functional limitations, subsequently affecting their quality of life. This study aimed to identify the direct effect of physical function and the indirect effect of cognitive function on the quality of life in older adults with mild cognitive impairment. METHODS: The study participants were 79 older adults recruited from community centers in four urban districts of Korea. All participants completed a self-reported questionnaire for demographic characteristics and outcome variables. Outcome measures included physical function (grip strength, balance, and mobility), cognitive function, and mental and physical components of quality of life (QOL). Statistical analyses were conducted using hierarchical multiple linear regression and the PROCESS macro for mediation analysis. RESULTS: The mean age of participants was 77.46 years old with an elementary or lower education level (53.2%). The mean score of cognitive function was 16.39 (SD = 6.5). Physical function (grip strength, balance, mobility) and cognitive function explained 25% of the variance in physical (p = 0.004) and 29% in mental (p < 0.001) components of QOL after controlling for age, sex, and education level. Mobility was associated with both physical (ß=-0.27, p = 0.024) and mental (ß=-0.36, p = 0.002) components of QOL. The cognitive function partially mediated the relationship between balance and the physical component of QOL; the proportion of mediation was 55%. CONCLUSION: In conclusion, physical and cognitive function were significant predictors of QOL in older adults with cognitive impairment. Specifically, balance has significant indirect effects on the physical component of QOL through cognitive function as a mediator. Health-promoting strategies could be more effective when focusing on the direct effect of physical function as well as the mediating effect of cognitive function to promote the quality of life in this population.

Translation and Linguistic Validation of the Assessment of Physical Activity in Frail Older People into Simplified Chinese Using Cognitive Interviewing Methodology.

The Assessment of Physical Activity in Frail Older People (APAFOP) is a patient-reported outcome measure assessing physical activity among community-dwelling older adults. However, this instrument has not been verified in the Chinese context. Thus, we translated the APAFOP into Chinese and then linguistically validated the Chinese version of APAFOP (APAFOP-C) by following the guidelines developed by Beaton and Willis. The translation process took 6 months. We identified nine translation issues in the translation process, of which experiential equivalence issues were the most frequent. It took three rounds of cognitive interviews to achieve linguistic validity, and the most significant issues were related to the layout of the questionnaire identified during the cognitive interview. In conclusion, the items of the APAFOP-C were considered comprehensive and relevant to assessing the physical activities of frail older adults in China. This study has laid the foundation for future evaluation of its measurement properties.

Effects of Tai Chi and Qigong on the mobility of stroke survivors: A systematic review and meta-analysis of randomized trials.

BACKGROUND: Stroke survivors often experience impaired mobility and physical functions. Tai Chi and Qigong have been shown to have physical and psychological benefits for stroke patients. PURPOSE: To summarize the evidence on Tai Chi and Qigong for improving mobility in stroke survivors, specifically the ability to walk, dynamic balance, and activities of daily living (ADL). METHODS: Independent searches of 16 electronic databases in English, Korean, and Chinese from their inception until December 2021 were conducted by two research teams. Methodological quality was assessed using Cochrane's risk of bias tool 2.0. Comprehensive Meta-Analysis 3.0 software was used to calculate effect sizes with subgroup analysis and to assess heterogeneity and publication bias. RESULTS: The meta-analysis included 27 randomized trials (18 with Tai Chi and 9 with Qigong) on stroke survivors (N = 1,919). None of the studies were considered at high risk of bias, about 70% had some concerns, and 30% were considered low risk. Meta-analysis of 27 randomized controlled trials with random-effects models indicated that Tai Chi and Qigong effectively improved mobility, specifically on the ability to walk (Hedges'g = 0.81), dynamic balance (Hedges'g = 1.04), and ADL (Hedges'g = 0.43). The effects of Tai Chi and Qigong were significant for short-term and long-term programs (Hedges'g 0.91 vs. 0.75), and when compared with active controls and no treatment group (Hedges'g 0.81 vs. 0.73). CONCLUSION: Tai Chi and Qigong performed for 12 weeks or less were effective in improving the mobility of stroke survivors. Further studies are warranted to assess whether Tai Chi and Qigong work best as an adjunct to rehabilitation, an effective alternative to rehabilitation or as a maintenance strategy, and whether the results could be further optimized by assessing different schools of Tai Chi and Qigong, different types of stroke patients, and different points in the post-stroke recovery process. PROSPERO REGISTRATION NUMBER: This study has been registered on the UK National Institute for Health Research (http://www.crd.york.ac.uk/PROSPERO) PROSPERO registration number: CRD42020220277.

Effects of Acute Moderate Hypoxia versus Normoxia on Metabolic and Cardiac Function and Skeletal Muscle Oxygenation during Endurance Exercise at the Same Heart Rate Level.

This study aimed to investigate the effects of acute moderate hypoxia (HYP), compared with those of normoxia (NORM), during endurance exercise with the same HR level on metabolic function, skeletal muscle oxygenation, and cardiac function. Twelve healthy men (aged 25.1 ± 2.3 years) completed 30 min of endurance exercise using a cycle ergometer with the same HR level (136.5 ± 1.5 bpm) corresponding to 70% maximal heart rate (HRmax) under NORM (760 mmHg) and HYP (526 mmHg, simulated 3000 m altitude) after a 30 min exposure in the respective environments on different days, in random order. Exercise load, rating of perceived exertion (RPE), metabolic function (saturation of percutaneous oxygen; SpO2, minute ventilation; oxygen uptake; VO2, carbon dioxide excretion; respiratory exchange ratio; RER, and oxygen pulse), skeletal muscle oxygen profiles (oxyhemoglobin, oxhb, deoxyhemoglobin, dxhb, total hemoglobin, and tissue oxygenation index; StO2), and cardiac function (heart rate, stroke volume, cardiac output, end-diastolic volume, end-systolic volume, and ejection fraction) were measured during endurance exercise. HYP showed a lower exercise load with the same RPE during exercise than did NORM. In addition, HYP showed a lower SpO2, VO2, oxygen pulse, oxhb, and StO2, and a higher RER and dxhb during exercise than NORM. We found that HYP showed lower exercise load and VO2 at the same RPE than NORM and also confirmed a higher anaerobic metabolism and oxygen inflow into skeletal muscle tissue due to the limitation of oxygen delivery capacity.

Expression Profile of Sorghum Genes and Cis-Regulatory Elements under Salt-Stress Conditions.

Salinity stress is one of the most important abiotic stresses that causes great losses in crop production worldwide. Identifying the molecular mechanisms of salt resistance in sorghum will help develop salt-tolerant crops with high yields. Sorghum (Sorghum bicolor (L.) Moench) is one of the world's four major grains and is known as a plant with excellent adaptability to salt stress. Among the various genotypes of sorghum, a Korean cultivar Nampungchal is also highly tolerant to salt. However, little is known about how Nampungchal responds to salt stress. In this study, we measured various physiological parameters, including Na+ and K+ contents, in leaves grown under saline conditions and investigated the expression patterns of differentially expressed genes (DEGs) using QuantSeq analysis. These DEG analyses revealed that genes up-regulated in a 150 mM NaCl treatment have various functions related to abiotic stresses, such as ERF and DREB. In addition, transcription factors such as ABA, WRKY, MYB, and bZip bind to the CREs region of sorghum and are involved in the regulation of various abiotic stress-responsive transcriptions, including salt stress. These findings may deepen our understanding of the mechanisms of salt tolerance in sorghum and other crops.

[Effect of 2% Chlorhexidine Bathing on the Incidence of Hospital-Acquired Infection and Multidrug-Resistant Organisms in Adult Intensive Care Unit Patients: Systematic Review and Meta-Analysis].

PURPOSE: This systematic review and meta-analysis analyzed the effects of 2% chlorhexidine bathing on the incidence of hospital-acquired infection (HAI) and multidrug-resistant organisms (MDRO) in adult intensive care units. METHODS: PubMed, CINAHL, Cochrane library, and RISS database were systematically searched, and 12 randomized studies were included in the analysis. Comprehensive Meta-Analysis version 3.0 was used to calculate the effect size using the odds ratio (OR) and a 95% confidence interval (CI). Subgroup analysis was performed according to the specific infection and intervention types. RESULTS: In general, 2% chlorhexidine bathing has a significant effect on the incidence of HAI (OR, 0.59; 95% CI, 0.40~0.86) and MDRO (OR, 0.52; 95% CI, 0.34~0.79). Subgroup analyses show 2% chlorhexidine bathing is effective in bloodstream infections (OR, 0.51; 95% CI, 0.39~0.66) but not for urinary tract infections, ventilator-associated pneumonia infections, and Clostridium difficile infections. Moreover, 2% chlorhexidine bathing alone or its combination with other interventions has a significant effect on the incidence of HAI and MDRO (OR, 0.59; 95% CI, 0.38~0.92). CONCLUSION: This meta-analysis reveals that 2% chlorhexidine bathing significantly reduces the incidence of HAI and MDRO in intensive care units. The effect of 2% chlorhexidine bathing on pediatric patients or patients at general wards should be further assessed as a cost-effective intervention for infection control.

The photophysical behavior of the photochromic naphthopyran derivative having photo-switching ability.

The photophysical behavior of the photochromic naphthopyran derivative 9 with photo-switching ability has been investigated in solution phase as well as in crystalline form. The proposed switching motifs might be a versatile framework in the development of photonic devices whose properties can be toggled between two states on exposure to electromagnetic radiations. The closed form of 9 undergoes reversible transformation upon irradiation with light by changing the molecular structure from ring closed conformation 9 to the ring opened form 10. The compound 9 exhibited first absorption signal at 238nm with shoulder peak at 261nm and second absorption signal at 353nm while on photo-irradiation, the colorless solution of 9 turn to colored and there was ratiometric downfall in the signal intensity for shoulder signal at 261nm as well as second absorption signal at 353nm and ultimately results in the disappearance of these both signal after 20min of irradiations. Meanwhile, the colorimetric change in the reaction solution and considerable shift in the absorption and emission signal intensity as well as position suggest the conformational changes in the molecules from less conjugate conformation 9 to the extended conjugated conformation 10.

(7-Dimethylamino-1-hydroxy-3-naphthyl)(morpholino)methanone.

In the title compound, C(17)H(20)N(2)O(3), the morpholine ring is in a slightly distorted chair form. The crystal structure is stabilized by an inter-molecular O-H⋯O hydrogen bond between the H atom of the hydroxyl group and the O atom of a neighbouring carbonyl group. A weak inter-molecular C-H⋯π inter-action is also present.