The Principle of Limb Reconstruction-"One Walking, Two Lines, and Three Balances": A Retrospective Analysis of Post-Traumatic Lower Limb Deformity Correction.

OBJECTIVE: The principles of limb reconstruction are crucial for treatment success, but there is no unified standard for complex limb deformities. The aim of this study was to analyze the characteristics of the cases of post-traumatic lower limb deformity and explore the new principle of limb reconstruction. METHOD: A retrospective analysis was conducted of 148 patients with post-traumatic lower limb deformity who underwent surgery from May 1978 to December 2023; 85 were males (57.4%) and 63 were females (42.6%); 65 cases of left side (43.9%), 79 cases of right side(53.4%), and 4 cases were on both sides (2.7%), the average age was 24.64 years (5-69). There were 4 cases suffering hip deformities, 40 cases of femoral deformities, 18 cases from knee, 40 cases from tibiofibular, 93 cases of foot and ankle deformities, and some patients also had two or more types. All patients underwent surgical intervention in an average of 40.5 months (12-96) after injury. According to the evaluation of limb deformities, deformity correction and functional reconstruction with external fixation were implemented, following the principle of "one walking, two lines, and three balances." The clinical evaluation adopts the criteria of Qinsihe lower limb deformity correction and functional reconstruction. RESULT: 148 patients with post-traumatic lower limb deformities were followed up for 40.9 (12-356) months. The main surgical procedures implemented were tendon lengthening and soft tissue release (84 cases), osteotomy (93 cases), joint fusion (30 cases), and tendon transposition (16 cases); there were multiple surgical procedures in some patients. Among them, 124 cases used external fixators for stress control and 27 cases used internal fixation, while 3 cases used plaster or brace. There were 5 wire reactions postoperatively, which improved after dressing change and oral antibiotics. There were 2 pin infections, which improved by pin removing. No surgical related deep infections occurred, and no surgical related neurovascular damage occurred. At the last follow-up, all limb deformities were corrected, limb function improved, and the results of treatment was very satisfactory. According to Qinsihe evaluation criteria for lower limb deformities, 74 cases were excellent, 56 cases good, and 18 cases fair, with an excellent and good rate of 87.84%. CONCLUSION: Stress control with external fixation is effective, safe, and controllable in correcting and reconstructing post-traumatic lower limb deformities. The principle of "one walking, two lines, and three balances" plays an important role in the entire process of stress control limb reconstruction.

Deciphering the alleviation potential of nitric oxide, for low temperature and chromium stress via maintaining photosynthetic capacity, antioxidant defence, and redox homeostasis in rice (Oryza sativa).

Sodium nitroprusside (SNP) is a potent nitric oxide (NO) donor that enhances plant tolerance to various abiotic stresses. This research aims to assess the effect of SNP application on rice seedlings subjected to individual and combined exposure to two abiotic stresses viz., low-temperature (LT) and chromium (Cr). Exposure to LT, Cr, and LT+Cr caused severe oxidative damage by stimulating greater production and accumulation of reactive oxygen species (ROS) leading to lipid peroxidation and cell membrane instability. The combined LT+CR stress more intensly increased the cellular oxidative stress and excessive Cr uptake that in turn deteriorated the chlorophyll pigments and photosynthesis, as well as effected the level of tetrapyrrole biosynthesis in rice plants. The reduction in rice seedling growth was more obvious under LT+Cr treatment than their individual effects. The exogenous application of SNP diminished the toxic impact of LT and Cr stress. This was attributed to the positive role of SNP in regulating the endogenous NO levels, free amino acids (FAAs) contents, tetrapyrrole biosynthesis and antioxidants. Consequently, SNP-induced NO decreased photorespiration, ROS generation, lipid peroxidation, and electrolyte leakage. Moreover, exogenous SNP diminished the Cr uptake and accumulation by modulating the ionic homeostasis and strengthening the heavy metals detoxification mechanism, thus improving plant height, biomass and photosynthetic indexes. Essentially, SNP boosts plant tolerance to LT and Cr stress by regulating antioxidants, detoxification mechanism, and the plant's physio-biochemical. Hence, applying SNP is an effective method for boosting rice plant resilience and productivity in the face of escalating environmental stresses and pollutants.

Surface modified ZnO NPs by betaine and proline build up tomato plants against drought stress and increase fruit nutritional quality.

Drought stress is a serious challenge for global food production. Nanofertilizers and nanocomposites cope with such environmental stresses and also increase nutritional contents of fruits. An in vitro experiment was designed to use Zinc Oxide Nanoparticles (ZnO NPs) primed with Proline and Betaine (ZnOP and ZnOBt NPs) at 50 and 100 mg/kg soil against drought stress in Tomato (Solanum lycopersicum) plants. Plant morphological, biochemical, and fruit nutritional quality were accessed. Maximum plant height was observed under the treatment of ZnOP50 (1.09 m) and ZnO 100 (1.06 m). ZnOP and ZnOBt also improved the chlorophyll content up to 86% and 87.16%, respectively. Application of ZnOP NPs also demonstrated maximum tomato yield (204 g tomato/plant) followed by ZnO NPs and ZnOBt NPs. Nanocomposites decreased phenolics and flavonoids contents in drought stressed plants demonstrating the mitigation of oxidative stress. Nanofertilizer also increased the concentration of phenolics and flavonoids in fruits that increased the nutritional contents. Furthermore a significant accumulation of betaine, proline, and lycopene in fruits on nanocomposite treatment made it nutritional and healthy. Lycopene content increased up to 2.01% and 1.23% in presence of ZnOP50 and ZnOP100, respectively. These outcomes validate that drought stress in plant can be reduced by accumulation of different phytochemicals and quenching oxidative stress. The study deems that nano zinc carrying osmoregulators can greatly reduce the negative effects of drought stress and increase nutritional quality of tomato fruits.

Factors associated with stress-related symptoms among people with epilepsy in Ethiopia, a cross-sectional study.

Introduction: Stress is a common psychological problem present in people with epilepsy and has a serious impact on the health-related satisfaction of people with epilepsy and their cohabiters. This study aimed to assess the magnitude and related factors of stress. Methods: A hospital-based cross-sectional study was carried out among 301 systematically chosen people with epilepsy. The seven stress-related items of the Depression, Anxiety, and Stress -21 questionnaire was used to measure stress. Data were entered using Epi Info and analyzed by SPSS version 25. Predictors with a p-value < 0.20 in the bivariate logistic regression were transferred into the multivariate model. A p-value of less than 0.05 was viewed as statistically significant. Result: The prevalence of stress symptoms in this study was 23.9%. Daily labor occupational status with Adjusted Odds ratio [(AOR) = 0.042, 95% CI: 0.004, 0.469], onset of illness at the age of 18 years and above (AOR = 0.188, 95% CI: 0.046, 0.771), perceived stigma (AOR = 3.320, 95% CI: 1.345, 8.200), the presence of anxiety symptoms (AOR = 8.275, 95% CI: 3.345, 20.471), and belief that the condition is untreatable (AOR = 6.360, 95% CI: 1.647, 24.562) were significantly associated factors. Conclusion: The occurrence of stress was high, and it reinforced that there is a requisite for the identification and handling of stress-related symptoms among people with epilepsy.

Stress control as a method to reduce perceived pain in oral lichen planus.

Introduction: Oral lichen planus (OLP) is a common chronic, T-cell-mediated, inflammatory and non-infectious mucodermatosis. Patients diagnosed with oral lichen planus are more prone to depression, anxiety and higher perceived mental stress than the rest of the population. Aim: This study investigated stress control methods as a means of reducing pain levels in patients with oral lichen planus. Material and methods: The study involved 62 adult oral lichen planus patients who have never received any OLP treatment before. Patients with a high level of perceived mental stress received, in addition to standard pharmacological treatment, herbal sedative medication or Jacobson's Progressive Muscle Relaxation guidance (JPMR), and the patients without a high level of perceived mental stress level did not receive any additional stress control methods. The research tool was the PSS questionnaire and NRS pain level scale. Results: Before the treatment, the level of perceived pain did not differ in any of analysed groups. After the treatment, in the group not using any stress control methods, the mean NRS level was significantly higher than in the group performing Jacobson's Progressive Muscle Relaxation (2.79 ±1.76 vs. 1.08 ±1.29), and also significantly higher than in the group receiving the herbal sedative (2.79 ±1.76 vs. 1.41 ±2.06). Conclusions: The use of mental stress control methods as an additional element of therapy has a positive effect on the success of oral lichen planus treatment since it helps to reduce the perceived pain level in the oral mucosa better than a standard pharmacological therapy alone.

On the Single-Point Calculation of Stress-Strain Data under Large Deformations with Stress and Mixed Control.

Stress-strain data with a given constitutive model of material can be calculated directly at a single material point. In this work, we propose a framework to perform single-point calculations under large deformations with stress and mixed control, to test and validate sophisticated constitutive models for materials. Inspired by Galerkin-FFT methods, a well-defined mask projector is used for stress and mixed control, and the derived nonlinear equations are solved in Newton iterations with Krylov solvers, simplifying implementation. One application example of the single-point calculator in developing sophisticated models for anisotropic single crystal rate-independent elastoplasticity is given, illustrating that the proposed algorithm can simulate asymmetrical deformation responses under uni-axial loading. Another example for artificial neural network models of the particle reinforced composite is also given, demonstrating that the commonly used machine learning or deep learning modeling frameworks can be directly incorporated into the proposed calculator. The central difference approximation of the tangent is validated so that derivative-free calculations for black-box constitutive models are possible. The proposed Python-coded single-point calculator is shown to be capable of quickly building, testing, and validating constitutive models with sophisticated or implicit structures, thus boosting the development of novel constitutive models for advanced solid materials.

How sports lead to the physical fitness in China? / Cómo conducen los deportes a la aptitud física en China?

The objective of this study is to address the role of sports in physical fitness. To achieve this objective, the relationship between sports, stress control, physiological motivation and physical fitness was examined. To check these relationships, seven hypotheses were proposed. Data were collected from players related to the various games in China such as football, hockey, basketball etc. The primary data were collected with the help of questionnaire. Partial Least Square (PLS) was used for data analysis. It is found that; sports have positive effect on physical fitness. Sports also has positive effect on stress control. Furthermore, sports have positive effect on physiological motivation. The stress control has positive effect on physical motivation. Finally, physiological motivation also has positive effect on physical fitness. Therefore, this study shows that sports has important contribution towards physical fitness. Sports increases the physiological motivation with the help of stress control and physiological motivation. Both the stress control and physiological motivation has positive role to transfer the effect of sports on physical motivation.(AU)

A Griggs apparatus upgrade for stress-controlled testing of geological material at high temperature and pressure.

The Griggs apparatus is a triaxial piston-cylinder instrument used in deformation experiments of geological material at temperatures up to 1200 °C and confining pressures up to 3 GPa. Currently, most Griggs apparatuses can carry out deformation experiments only at constant displacement rate. As a result, few experimental studies have explored other geologically-relevant deformation scenarios. We present supplemental instrumentation and software that enables Griggs apparatus users to carry out deformation experiments at controlled differential stress conditions. The add-on instrument includes a feedback loop mechanism that regulates the imposed differential stress on the sample and a data acquisition system that allows for real-time display of mechanical data in units of stress and displacement. We demonstrate the application of this instrument through two deformation experiments at constant differential stress on (1) an aluminum cylinder at room temperature and (2) a quartz aggregate at 850 °C, both at ~1 GPa confining pressure. These experiments show that the instrument can reliably control the imposed differential stress on the sample throughout the deformation. Applications of the instrument can be extended beyond constant differential stress to more sophisticated stress paths (e.g., stress pulse, stress ramp) or to maintain true strain rates by accounting for anticipated geometrical changes in the sample during deformation.

Evaluation of stress-control layout at the Subtropolis Mine, Petersburg, Ohio.

The Subtropolis room-and-pillar mine extracts the Vanport Limestone (Allegheny Formation, Pennsylvanian System) near Petersburg, Ohio. Strata instability problems associated with excessive concentrations of lateral stress caused the mine operator to implement a change in layout design. This mining method has been identified as a stress control layout and has been used by other underground stone mines in the past with varying degrees of success. Practical experience has shown that entry headings advance in the direction of the principal lateral stress, producing lower stress concentrations with better mining conditions. It is important to minimize stress concentrations along the mining front, so an arrow-shaped advance is recommended. This technique advances more developments (headings) in a "good" direction and reduces developments (crosscuts) in the "bad direction." As is expected, the stress control layout enhances the potential for shear failures in crosscuts. It is, therefore, important to focus crosscut engineering interventions that either: (a) lower stress concentrations (for example, an arched roof) or (b) enhance strength of the strata containing the shears (for example, rock reinforcement). This study focuses on observing strata conditions on a regular basis and monitoring the response of these strata to changing geologic and mining conditions through 3D Dynamic LiDAR scans.

In-Fiber Production of Laser-Structured Stress-Mediated Semiconductor Particles.

The ability to generate stressed semiconductor particles is of great importance in the development of tunable semiconductor and photonic devices. However, existing methods including both bottom-up synthesis and top-down fabrication for producing semiconductor particles are inherently free of stress effects. Here, we report a simple approach to generate controllable stress effects on both encapsulated and free-standing semiconductor particles using laser-structured in-fiber materials engineering. The physical mechanism of thermally induced in-fiber built-in stress is investigated, and the feasibility of precisely tuning the stress state during the particle formation is experimentally demonstrated by controlling the laser treatment. Gigapascal-level built-in stress, which is a sufficiently strong stimulus to enable inelastic deformations on the fabricated semiconductor particles, has been achieved via this approach. Both encapsulated and free-standing stressed semiconductor particles are generated for a wide range of in-fiber and out-fiber optoelectronic and biomedical applications.

Control of stress and damage in structures by piezoelectric actuation: 1D theory and monofrequent experimental validation.

This contribution presents novel results on feed-forward control of stress in piezoelectric structures by means of piezoelectric actuation. For that sake, we focus on a one-dimensional benchmark problem, a piezoelectric transducer that is excited by a piezoelectric stack actuator. We investigate the following problem: Is it possible to actuate the piezoelectric transducer in such a manner that the dominant axial stress component is nullified. In order to find a theoretical solution for this question, we discretize our system as a two-degree-of-freedom (2DOF) model. The equations of motion are transformed into the differential equations for the inner forces by taking advantage of the constitutive relations, which relate displacement, stress, and electric field. Finally, we find a mathematical relation for the piezoelectric transducer excitation in order to annihilate the transducer force. A static and a frequency-dependent approximate solution for the transducer actuation signal are derived. The latter solution reduces the inner force drastically in a certain frequency range. After numerical results for the force-control algorithm are presented, we finally experimentally verify our theory: First, the force-controlled configuration is exposed to a monofrequent harmonic excitation test run for 30 min, showing no sign of fatigue or material failure, because the transducer force is below the ultimate tensile strength. Then, the system is excited by the same harmonic excitation again, but the control signal for the piezoelectric transducer is turned off. The result is a visible damage of the piezoelectric transducer, leading to a significant change of the first eigenfrequency.

Factors associated with excessive daytime sleepiness among Brazilian adolescents.

This study aimed to verify the prevalence and factors associated with excessive daytime sleepiness (EDS) among adolescents. In all, 1.132 people participated. They were aged between 14 and 19 years, of both sexes and they came from a city in southern Brazil. Many socio-demographic variables were collected (sex, age group, socioeconomic status, period of study, year of school and work), also variables related to their health (level of physical activity, alcohol intake, smoking, misuse of medicines, stress control, duration of sleep, sedentary behavior and self-rated health) and EDS, through the Pediatric Daytime Sleepiness Scale (PDSS). The prevalence of EDS in general sample was 54.2% and average score in PDSS was 16.0 (5.7). Comparing results between both sexes, female sex presents the higher prevalence of EDS (64.3%) and greatest average PDSS score 17.5 (5.4) compared to male sex (35.7%) with 14.5 (5.6%) score (p < .001). In analysis of the prevalence ratio, using 15 as an EDS cut-off point, prevalence was 35% higher in the female sex (PR = 1.35 CI 95% 1.08-1.69, p = .010). In addition, adolescents which had lower self-rated health (PR = 1.24 CI 95% 1.01-1.52, p = .038), low stress control (PR = 1.28 CI 95% 1.05-1.57, p = .014) and short sleep duration (PR = 1.30 CI 95% 1.02-1.65, p = .029), presented higher prevalence of EDS. High prevalence of EDS was identified, being more common in young women. Adequate sleep, greater stress control and better health perception should be promoted among Brazilian adolescents.

Antagonistic effects of growing season and autumn temperatures on the timing of leaf coloration in winter deciduous trees.

Autumn phenology remains a relatively neglected aspect in climate change research, which hinders an accurate assessment of the global carbon cycle and its sensitivity to climate change. Leaf coloration, a key indicator of the growing season end, is thought to be triggered mainly by high or low temperature and drought. However, how the control of leaf coloration is split between temperature and drought is not known for many species. Moreover, whether growing season and autumn temperatures interact in influencing the timing of leaf coloration is not clear. Here, we revealed major climate drivers of leaf coloration dates and their interactions using 154 phenological datasets for four winter deciduous tree species at 89 stations, and the corresponding daily mean/minimum air temperature and precipitation data across China's temperate zone from 1981 to 2012. Results show that temperature is more decisive than drought in causing leaf coloration, and the growing season mean temperature plays a more important role than the autumn mean minimum temperature. Higher growing season temperature and lower autumn minimum temperature would induce earlier leaf coloration date. Moreover, the mean temperature over the growing season correlates positively with the autumn minimum temperature. This implies that growing season mean temperature may offset the requirement of autumn minimum temperature in triggering leaf coloration. Our findings deepen the understanding of leaf coloration mechanisms in winter deciduous trees and suggest that leaf life-span control depended on growing season mean temperature and autumn low temperature control and their interaction are major environmental cues. In the context of climate change, whether leaf coloration date advances or is delayed may depend on intensity of the offset effect of growing season temperature on autumn low temperature.

Plant growth-promoting actinobacteria: a new strategy for enhancing sustainable production and protection of grain legumes.

Grain legumes are a cost-effective alternative for the animal protein in improving the diets of the poor in South-East Asia and Africa. Legumes, through symbiotic nitrogen fixation, meet a major part of their own N demand and partially benefit the following crops of the system by enriching soil. In realization of this sustainability advantage and to promote pulse production, United Nations had declared 2016 as the "International Year of pulses". Grain legumes are frequently subjected to both abiotic and biotic stresses resulting in severe yield losses. Global yields of legumes have been stagnant for the past five decades in spite of adopting various conventional and molecular breeding approaches. Furthermore, the increasing costs and negative effects of pesticides and fertilizers for crop production necessitate the use of biological options of crop production and protection. The use of plant growth-promoting (PGP) bacteria for improving soil and plant health has become one of the attractive strategies for developing sustainable agricultural systems due to their eco-friendliness, low production cost and minimizing consumption of non-renewable resources. This review emphasizes on how the PGP actinobacteria and their metabolites can be used effectively in enhancing the yield and controlling the pests and pathogens of grain legumes.

Current application and development of general anesthesia monitoring / 医疗卫生装备

The monitoring methods,technologies development and their application were discussed in sedation,analgesia,muscle relaxation and stress control during general anesthesia.The principles,advantages and problems of the existing technologies were analyzed.The existing technologies had deficiencies in specificity and anti-interference ability due to differences in patients,types of anesthetics and action mechanism,so that precision dose control of anesthetics could not be fulfilled during clinical application.Therefore,further studies on novel general anesthesia monitoring techniques are desperately needed.

Current application and development of general anesthesia monitoring / 医疗卫生装备

The monitoring methods,technologies development and their application were discussed in sedation,analgesia,muscle relaxation and stress control during general anesthesia.The principles,advantages and problems of the existing technologies were analyzed.The existing technologies had deficiencies in specificity and anti-interference ability due to differences in patients,types of anesthetics and action mechanism,so that precision dose control of anesthetics could not be fulfilled during clinical application.Therefore,further studies on novel general anesthesia monitoring techniques are desperately needed.

Restrain of birds with bottles of polyethylene terephthalate, tested in red-browed from the Atlantic Forest / Contenção de aves com garrafas de politereftalato de etileno, testado em papagaios-chauá (Amazona rhodocorytha,Salvadori, 1890) da Mata Atlântica

In wild animals, containment is the moment of greatest stress caused by the investigator to the animal due to its natural resistance to the moment of capture, handling, containment and transport, attitudes frankly contrary to his nature. In birds, the restraint must meet certain criteria in order to control the animal's movements, avoiding trauma at the same time that you need to keep your breathing amplitude. The high risk of death during the restraint of these animals raised the need to design a device, from bottles of poly ethylene terephthalate (PET), for containing parrots-browed Amazon (Amazona rhodocorytha), a parrot endemic to the Atlantic Forest in southeastern Brazil, and endangered with extinction, which allowed the observation of respiration, the reduction of handling time of birds for collection of biological material, and consequent reduction of stress and risk of death during the evaluation of several biological data and health of the bird. The PET bottle container can be used as a model for any bird, provided it suits the size of the animal.

Em animais silvestres, a contenção é o momento de maior estresse promovido pelo pesquisador ao animal, devido à resistência natural ao momento da captura, ao manuseio, à contenção e ao transporte, atitudes francamente contrárias à sua índole. Em aves, a contenção deve obedecer a alguns critérios, com o objetivo de controlar os movimentos do animal, evitando traumas, ao mesmo tempo em que é preciso manter sua amplitude respiratória. O alto risco de morte, durante a contenção desses animais, suscitou a concepção de um dispositivo, proveniente de garrafas de politereftalato de etileno (PET), para a contenção de papagaios-chauá (Amazona rhodocorytha), psitacídeo endêmico da Mata Atlântica, na região Sudeste do Brasil, e ameaçado de extinção. Esse dispositivo permitiu a observação dos movimentos respiratórios, a diminuição do tempo de manuseio das aves, para coleta de materiais biológicos, e a consequente redução do estresse e dos riscos de morte, durante a avaliação de diversos dados biológicos e sanitários dessa ave. Tal contenção pode ser utilizada como modelo para qualquer outra ave, desde que se adapte o tamanho do animal, ao recipiente de garrafa PET.

Inhibition of Mammary Cancer Progression in Fetal Alcohol Exposed Rats by ß-Endorphin Neurons.

BACKGROUND: Fetal alcohol exposure (FAE) increases the susceptibility to carcinogen-induced mammary cancer progression in rodent models. FAE also decreases ß-endorphin (ß-EP) level and causes hyperstress response, which leads to inhibition of immune function against cancer. Previous studies have shown that injection of nanosphere-attached dibutyryl cyclic adenosine monophosphate (dbcAMP) into the third ventricle increases the number of ß-EP neurons in the hypothalamus. In this study, we assessed the therapeutic potential of stress regulation using methods to increase hypothalamic levels of ß-EP, a neuropeptide that inhibits stress axis activity, in treatment of carcinogen-induced mammary cancer in fetal alcohol exposed rats. METHODS: Fetal alcohol exposed and control Sprague Dawley rats were given a dose of N-Nitroso-N-methylurea (MNU) at postnatal day 50 to induce mammary cancer growth. Upon detection of mammary tumors, the animals were either transplanted with ß-EP neurons or injected with dbcAMP-delivering nanospheres into the hypothalamus to increase ß-EP peptide production. Spleen cytokines were detected using reverse transcription polymerase chain reaction assays. Metastasis study was done by injecting mammary cancer cells MADB106 into jugular vein of ß-EP-activated or control fetal alcohol exposed animals. RESULTS: Both transplantation of ß-EP neurons and injection of dbcAMP-delivering nanospheres inhibited MNU-induced mammary cancer growth in control rats, and reversed the effect of FAE on the susceptibility to mammary cancer. Similar to the previously reported immune-enhancing and stress-suppressive effects of ß-EP transplantation, injection of dbcAMP-delivering nanospheres increased the levels of interferon-γ and granzyme B and decreased the levels of epinephrine and norepinephrine in fetal alcohol exposed rats. Mammary cancer cell metastasis study also showed that FAE increased incidence of lung tumor retention, while ß-EP transplantation inhibited lung tumor growth in both normal and fetal alcohol exposed rats. CONCLUSIONS: Our results suggest that increase of ß-EP production in the hypothalamus may serve as a potential therapeutic strategy for treating the cancer growth in patients with chronic stress and compromised immune function, such as the patients with FAE.

"Stress Control" as a Large Group Psychoeducational Intervention at Step 2 of IAPT Services: Acceptability of the Approach and Moderators of Effectiveness.

BACKGROUND: "Stress Control" (SC) has been adopted as a core intervention in step 2 of Improving Access to Psychological Therapies (IAPT) services, but contemporary evidence of effectiveness has lagged behind service uptake. AIMS: To investigate the acceptability and effectiveness of SC and to explore moderators of outcome. METHOD: Analysis of acceptability (via attendance rates) and effectiveness (via IAPT minimum dataset). RESULTS: SC was well tolerated with 73.3% of all patients and 75.4% of "clinical cases" attending three or more sessions. Of the 546 "clinical cases" attending SC and not in receipt of other interventions, 37% moved to recovery. Attendance improved outcome; for those patients attending all SC sessions the recovery rate rose to 59.2%. CONCLUSION: SC appears a well-tolerated and effective intervention that enables large numbers to gain access to treatment in an organizationally efficient manner. Attendance is important in facilitating SC outcomes and research evaluating attendance interventions are needed.

[Let's save our nurses and doctors!]. / Mentsük meg novéreinket, orvosainkat!

INTRODUCTION: Several studies have shown that healthcare service is a dangerous workplace, but the reasons have been remained unexplained. AIM: The aim of the authors was to obtain data on the health condition of health care professionals and identify the underlying risk factors for the increased morbidity. METHOD: Health care data obtained from 276 bedside nurses in 2004 and 1250 hospital employees in 2009 were analysed. In addition, the fate of department directors of Szent György University Hospital in Székesfehérvár between 1979 and 2010 was recorded and the data were compared to those obtained from a smaller hospital in Budapest during the same time period. RESULTS: The body mass index of bedside nurses between the age of 30-35 years reached the upper limit of normal (which occurred 5-10 years earlier as compared to the average population) and then it increased continuously above the average value. In hospital employees the increase of body mass index was accompanied by an increase in the frequency of chronic diseases such as hypertension, allergy, thyroid dysfunction, rheumatologic diseases, diabetes, peptic ulcer, cancer and depression. When the cause of death of the department directors who died between 1979 and 2010 was analyzed the authors found that cancer death occurred in 77% and 82% of department directors in Székesfehérvár and Budapest hospitals, respectively, while cancer death rate in 2011 was 25.4% in Hungary. CONCLUSIONS: The authors propose that continuous psychological stress, night shifts, nonstop standby and surcharge may all suppress the activity of the immune system. This proposal seems to be supported by novel psycho-neuro-immunological research data. The solution could be early prevention using stress control.