The meaning of respect and dignity for intensive care unit patients: A meta-synthesis of qualitative research.

AIM: To synthesize qualitative research on perspectives and understandings of Intensive Care Unit (ICU) patients, family members, and staff regarding respect and dignity in ICU, in order to explore the connotations and meanings of respect and dignity in ICU. DESIGN: A qualitative meta-synthesis. METHODS: The Chinese and English databases were systematically searched, including PubMed, Web of Science, CINAHL, Embase, Cochrane Library, CNKI, Wangfang Data, VIP, and CBM from each database's inception to July 22, 2023. Studies were critically appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. Qualitative data were extracted, summarized, and meta-synthesized. (PROSPERO: CRD42023447218). RESULTS: A total of 9 studies from 6 countries were included in the meta-synthesis. Thirty-six main themes and 67 sub-themes were extracted, which were eventually integrated into 9 categories and 4 themes: (1) integrity of humanity; (2) autonomy; (3) equality; (4) environmental support. CONCLUSION: To maintain patient dignity, it is necessary to create an environment of respect within the ICU where healthcare professionals uphold the concept of preserving human integrity and respect patients' autonomy and equality. Healthcare professionals need to value the dignity of ICU patients and treat them as unique individuals during treatment and care. Hospital managers should also strive to create a respectful environment to provide environmental support for dignity care implementation.

Comparison of the effects of platelet-rich plasma and corticosteroid injection in rotator cuff disease treatment: a systematic review and meta-analysis.

HYPOTHESIS: Platelet-rich plasma (PRP) and corticosteroids are used to treat rotator cuff diseases. However, few reviews have compared the effects of these 2 treatments. In this study, we compared the effects of PRP and corticosteroid injection on the prognosis of rotator cuff diseases. MATERIALS AND METHODS: According to the Cochrane Manual of Systematic Review of Interventions, the PubMed, Embase, and Cochrane databases were searched comprehensively. Two independent authors screened suitable studies and performed data extraction and risk of bias assessment. Only randomized controlled trials comparing the effects of PRP and corticosteroid in the treatment of rotator cuff injuries were included, as measured by clinical function and pain during different follow-up periods. RESULTS: Nine studies with 469 patients were included in this review. In short-term treatment, corticosteroids were superior to PRP in the improvement of Constant, Simple Shoulder Test, and American Shoulder and Elbow Surgeons scores (mean difference [MD] -5.08, 95% confidence interval [CI] -10.26, 0.06; P = .05 and MD -0.97, 95% CI -1.68, -0.07; P = .03 and MD -6.67, 95% CI -12.85, -0.49; P = .03, respectively). No statistically significant difference was observed between the 2 groups at midterm (P > .05), and the recovery of the Simple Shoulder Test and American Shoulder and Elbow Surgeons scores in PRP treatment was significantly better than that in corticosteroid treatment in the long term (MD: 1.21, 95% CI: 0.68, 1.74; P < .00001 and MD: 6.96, 95% CI: 3.90, 9.61; P < .00001, respectively). In pain reduction based on visual analog scale score, corticosteroids led to better pain reduction (MD: 0.84, 95% CI: 0.03, 1.64; P = .04), but no significant difference was observed in pain reduction between the 2 groups in the any term (P > .05). However, these differences did not reach the minimum clinically important difference. CONCLUSIONS: Current analysis showed that corticosteroids have better efficacy in short term, whereas PRP is more beneficial for long-term recovery. However, no difference was observed in the mid-term efficacy between the 2 groups. Randomized controlled trials with longer follow-up periods and larger sample sizes are also needed to determine the optimal treatment.

Males with low risk-taking propensity overestimate risk under acute psychological stress.

Arousing research has investigated stressed individuals' decision biases, but whether and how stress and individual traits interact to impact the underlying decision-making process is unknown. Here, we aim to explore the effect of acute stress on the interaction between the objective level of risk and subjective risk preference (i.e. risk-taking propensity). Eighty-three healthy males participated in the study. We adopted the Trier Social Stress Test (TSST) to induce acute psychological stress and categorized participants into the high or low risk-taking propensity (HRP/LRP) group according to their traits in daily life. The Balloon Analogue Risk Task (BART) was applied to measure their feedback processing in a risky decision task, while behavioral indexes and EEG signals were recorded. The results showed that stressful participants pumped fewer times than the controls, especially for the LRP under stress, indicating that they were more willing to avoid taking risks. Compared with the stressed HRP group, the stressed LRP showed higher salivary cortisol responses and a more positive FRN following positive feedback in higher risk levels. It implies that acute psychological stress leads the LRP to overestimate the risk probability and become more cautious in the sequential processing of risk. These findings highlight the role of the feedback process and individual traits in risky decision-making under stress.

The psychological experiences of nurses after inpatient suicide: A meta-synthesis of qualitative research studies.

AIMS: To explore nurses' psychological experiences after inpatient suicide. DESIGN: Qualitative studies were meta-synthesized. DATA SOURCES: Eight databases (PubMed, Web of Science, CINAHL, Embase, Wanfang Data, VIP database, CBM and CNKI) were searched for qualitative studies from each database's inception to 31 August 2020. REVIEW METHODS: Studies were critically appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. Qualitative data were extracted, summarized, and meta-synthesized. RESULTS: Eleven studies were included, and five themes were identified: (a) emotional experience, (b) cognitive experience, (c) coping strategies, (d) self-reflection and (e) impact on self and practise. CONCLUSION: Nurses reported various negative emotions after inpatient suicide. Hospital administrators should recognize nurses' second victim psychological trauma. Moreover, they must develop theory-based education, training and psychological support programmes to promote nurses' mental health. Hospital patient safety management is also important to ensure patient safety whilst preventing nurses from becoming second victims. IMPACT: Understanding the psychological experiences of nurses who have undergone inpatient suicide will inform future research and practise. Nurses require psychological support after experiencing adverse events. Education and training are necessary to help nurses acquire suicide knowledge, understand the role of the second victim, better cope with adverse events and promote self-growth. Hospitals should strengthen the construction of a safety culture to ensure patient safety.

Serum-derived three-circRNA signature as a diagnostic biomarker for hepatocellular carcinoma.

BACKGROUND: Hepatocellular carcinoma (HCC) is a common tumor characterized by high morbidity and mortality rates. The importance of circRNA in cancer diagnosis has been established. The study aimed to identify differentially-expressed circRNAs (DECs) in human blood exosomes from patients with HCC and to investigate their diagnostic value. METHODS: The circRNA expression profiles of HCC and normal human blood samples were downloaded and processed from the exoRBase database. At the cutoff criteria of a fold change (FC) > 2.0 and P < 0.05, DECs were screened utilizing the limma package in the R software. A receiver operator characteristic curve (ROC) was used to study its diagnostic value. Quantitative reverse transcription-polymerase chain reaction (qRT-PCR) analysis was performed to confirm the three-circRNAs expression in the blood samples with HCC. Various bioinformatics tools were used to characterize the potential biological pathways induced by circRNAs. RESULTS: Compared with the normal samples, seven up-regulated and five down-regulated circRNAs were determined in the HCC samples. ROC analyses demonstrated that hsa_circ_0004001, hsa_circ_0004123, hsa_circ_0075792, and a combination of the three biomarkers exhibited higher sensitivity and specificity. The qRT-PCR confirmed that the three circRNAs were upregulated in the blood samples with HCC. Chi squared tests implied that the expression of three circRNAs was positively correlated with the TNM stage and tumor size. The circRNAs participated in VEGF/VEGFR, PI3K/Akt, mTOR, and Wnt signaling pathways by targeting miRNAs. CONCLUSIONS: The study established the existence of seven up-regulated and five down-regulated circRNAs in HCC. Additionally, hsa_circ_0004001, hsa_circ_0004123, hsa_circ_0075792, and a combination of the three were utilized as valuable diagnostic biomarkers in HCC.

Perceived control moderates the impact of academic stress on the attention process of working memory in male college students.

Academic stress is a common long-term stress among the student population and is known to impact working memory within the frontoparietal attention network. Perceived control is an individual variation that may play a buffering role between stress and overall adjustment. In this study, we addressed the moderating effects of perceived control between academic stress and working memory. Fifty-nine male college students participated in the study. Academic stress and perceived control were assessed before participants completed a working memory (n-back) task. Event-related potentials (ERPs) including P2 and P3 were analyzed to examine the attention and maintenance processes of working memory. A moderating effect of perceived control on the relationship between academic stress and working memory was found. For students with low levels of perceived control, academic stress was negatively associated with P2 amplitudes at the high workload (3-back) task, suggesting a negative impact on attention process of working memory. In contrast, academic stress did not affect students with high and moderate levels of perceived control. The results indicate that perceived control may serve as a buffer to protect the cognitive function from the disruption of academic stress.

Nanoparticles: Oral Delivery for Protein and Peptide Drugs.

Protein and peptide drugs have many advantages, such as high bioactivity and specificity, strong solubility, and low toxicity. Therefore, the strategies for improving the bioavailability of protein peptides are reviewed, including chemical modification of nanocarriers, absorption enhancers, and mucous adhesion systems. The status, advantages, and disadvantages of various strategies are systematically analyzed. The systematic and personalized design of various factors affecting the release and absorption of drugs based on nanoparticles is pointed out. It is expected to design a protein peptide oral delivery system that can be applied in the clinic.

The Catsper channel and its roles in male fertility: a systematic review.

The Catsper channel is a sperm-specific, Ca2+-permeable, pH-dependent, and low voltage-dependent channel that is essential for the hyperactivity of sperm flagellum, chemotaxis towards the egg, capacitation and acrosome reaction. All of these physiological events require calcium entry into sperm cells. Remarkably, Catsper genes are exclusively expressed in the testis during spermatogenesis, and are sensitive to ion channel-induced pH change, such as NHEs, Ca2+ATPase, K+ channel, Hv1 channel and HCO3- transporters. Furthermore, the Catsper channel is regulated by some physiological stimulants, such as progesterone, cyclic nucleotides (e.g., cAMP, cGMP), zona pellucida (ZP) glycoproteins and bovine serum albumin (BSA). All of these factors normally stimulate Ca2+ entry into sperm through the Catsper channel. In addition, the Catsper channel may be a potential target for male infertility treatment or contraception. This review will focus on the structure, functions, regulation mechanisms and medicinal targets of the Catsper channel.

The moderating role of catastrophizing in day-to-day dynamic stress and depressive symptoms.

The way individuals handle daily stressors can significantly influence their mental health. Those who struggle with emotion regulation are especially vulnerable to the negative effects of stress. This study explored the role of catastrophizing, a maladaptive emotion regulation strategy, in shaping the relationships between daily stress responses and depressive symptoms. A total of 75 healthy college students participated in the study. We adopted an Ecological Momentary Assessment protocol over 14 consecutive days to capture the day-to-day dynamics of stress reactivity and recovery. Our findings indicate that individuals with higher levels of catastrophizing exhibited increased daily stress reactivity and delayed daily stress recovery, consequently raising their likelihood of experiencing amplified depressive symptoms. In contrast, those with lower levels of catastrophizing did not experience the same negative effects of increased daily stress reactivity on their mental health. These results enhance understanding of how real-life stressors contribute to the development of mental health issues and underscore the importance of adaptive emotion regulation for improved overall health and well-being.

The impact of subliminal stimuli on interpersonal trust and team trust.

Although numerous studies related to trust have emerged in recent decades, few studies have explored the impact of subliminal stimuli on trust from an unconscious perspective. This study investigated (a) whether subliminal stimuli could influence interpersonal trust and team trust and (b) whether subjective trust played a mediating role between subliminal stimuli and behavioral trust. It contained two experiments. In Experiment 1, a total of 72 participants took part in a single factor design and completed five tasks. In Experiment 2, a total of 98 participants participated in a single factor design and completed five tasks. Results indicated that subliminal stimuli had a significant impact on interpersonal trust and team trust. Subjective trust played a mediating role between subliminal stimuli and behavioral trust. The results suggest that subliminal priming techniques can influence interpersonal trust and team trust. These techniques first influence subjective trust and then further influence behavioral trust.

The effect of subliminal priming on team trust: The mediating role of perceived trustworthiness.

The present study aimed to explore the effect of subliminal priming on team trust and the mechanism through the mediating role of perceived trustworthiness. A total of 144 participants were asked to complete a lexical decision task that was embedded with the "trust" or "suspicion" Chinese words as the subliminal stimuli. Then, they played a public good game and evaluated the perceived trustworthiness of the team. The results of the study showed that subliminal stimuli had a significant effect on team trust [ß = -0.99, 95% CI = (-1.64, -0.33)]. Perceived trustworthiness was found to have a significant mediating effect between the priming condition and team trust [ß = -0.35, 95% CI = (-0.72, -0.02)]. The current study revealed the underlying mechanism through which subliminal priming techniques influence team trust and informed efforts by altering perceived trustworthiness.

Open people are more likely to trust their new team members under subliminal influence.

The activation of subliminal stimuli plays an indispensable role in trust research. This study aimed to investigate the effect of subliminal stimuli on team trust and the moderating role of openness on the relationship between subliminal stimuli and team trust. A total of 155 participants were recruited to complete five tasks. The results suggested a significant influence of subliminal stimuli on team trust and the significant moderating role of openness. This study revealed the mechanism of the effect of subliminal stimuli on team trust, which lays an empirical foundation for individualized team trust improvement intervention. The current study provided novel insights that subliminal priming technology offers a new way to improve team trust.

The effectiveness of Interpersonal Psychotherapy-Adolescent Skills Training for adolescents with depression: a systematic review and meta-analysis.

Background: Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) is a standardized depression prevention program for adolescents conducted in campus settings. The purpose of this review is to examine the randomized controlled trials of IPT-AST for the prevention of adolescent depression in the past 20 years. Methods: A systematic search of relevant electronic databases (PubMed, WOS, Embase, PsycINFO, the Cochrane Library, CNKI and WANFANG DATA) and study reference lists was conducted. Any study investigating the effectiveness of IPT-AST in 12- to 20-year-olds with depressive symptoms was eligible. Synthesis was via narrative summary and meta-analysis. Results: A total of 6 studies met the inclusion criteria. Meta-analysis results showed a remarkable improvement in patients' depressive symptoms after IPT-AST intervention (WMD = -5.05, 95% CI = -8.11 to -1.98, p < 0.05, I2 = 77%). Six month follow-up data showed that the intervention outcomes of IPT-AST remained significant (WMD = -3.09, 95% CI: -5.23 to -0.94, p < 0.05, I2 = 57%). Conclusion: This meta-analysis showed that IPT-AST was effective in adolescents with depressive symptoms at post-prevention and at 6-month follow-up. However, these conclusions are cautious, as they are based on a small number of studies and the presence of author duplication. Future studies should use multi-center, large-sample randomized controlled trials to evaluate the efficacy of IPT-AST for preventing depression in adolescents. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023393047.

Stress mindset and mental health status among Chinese high school students: The mediating role of exam stress appraisals.

Exam stress is one of the main stressors for adolescents, which can trigger severe mental health problems and performance decline. As an alterable individual variable that influences stress consequences, stress mindset has attracted academic attention recently. However, the relationship between stress mindset and adolescents' responses toward exams has not been fully understood. This study aimed to investigate whether stress mindset affected pre-exam mental health status and exam performance, and whether appraisals of exam mediated such influence. We collected stress mindset, threat and challenge appraisals, pre-exam mental health status, and exam scores from 185 Chinese 11th-grade students. All of them would take an important and unified exam organized on the school level. Results showed that the stress-is-enhancing mindset negatively predicted students' symptoms of depression, anxiety, and stress, but had no direct effect on performance. Further mediation analysis showed that stress-is-enhancing mindset was positively associated with the challenging appraisal and was negatively associated with the threat appraisal, thus having better health status (including fewer symptoms of depression, anxiety, and stress) and performance. These results suggest that the stress mindset had an association with students' response toward exams, and how they appraised the upcoming exam would be an important indirect pathway. Future studies may benefit from changing students' mindsets to protect them from negative consequences of exam stress.

Opioids for treating refractory dyspnea in patients with heart failure: A protocol for systematic review and meta-analysis.

BACKGROUND: Dyspnea is a hallmark symptom of heart failure. The existing clinical studies have indicated that opioid can effectively improve the clinical symptoms of heart failure patients with dyspnea. However, there has not been any relevant systematic review and meta-analysis. We performed a protocol for systematic review and meta-analysis to evaluate the safety and efficacy of opioid therapy for heart failure patients with refractory dyspnea. METHODS: We searched 3 foreign electronic databases (Cochrane Library, Embase, Pubmed) and 4 Chinese electronic databases (China National Knowledge Infrastructure, Wang Fang Database, Chinese Biomedical Literature Database and Chinese Scientific Journal Database) to collect potential studies from their inceptions to October 2022. The risk of bias in the included articles was assessed according to the Risk of Bias Assessment Tool in Cochrane Handbook of Systematic Reviews (5th edition). The quality of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation approach. Data were analyzed using the RevMan Version 5.4.1. RESULTS: This study will evaluate whether opioid is effective and safe for treating refractory dyspnea in patients with heart failure. CONCLUSION: This meta-analysis will provide comprehensive evidence of opioid therapy for heart failure patients with dyspnea.

The experiences of caregivers of children with epilepsy: A meta-synthesis of qualitative research studies.

Objective: Epilepsy is one of the most common chronic neurological disorders in children. The caregivers of these children bear heavy burden of care in the process of taking care of them. The objective of this metasynthesis was to explore the experiences and needs of caregivers of children with epilepsy. Methods and data sources: Eight databases (PubMed, CINAHL, EMBASE, Web of Science, CNKI, Wanfang Data, VIP database, and CBM) were searched for qualitative studies from each database's inception to 31 June 2021. Studies were critically appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. Qualitative data were extracted, summarized, and meta-synthesized. Results: 13 studies were included, covering the data of 316 participants. 36 research results were extracted from these studies, which were combined into 11 categories, and finally formed 4 themes: (a) heavy burden of care; (b) emotional experience; (c) coping strategies; (d) care needs. Conclusion: Caregivers beared a heavy burden of care and psychological burden. Despite the adoption of different coping strategies, their emotional distress was still very serious. Caregivers had unmet care needs. In order to improve caregivers' care capacity, the society and healthcare workers need to provide them with information support, psychological support, and take measures to create a friendly medical and living environment for them. Impact: Understanding the experiences of caregivers of children with epilepsy will inform future research and practice. Healthcare workers could develop interventions to reduce caregiver burden and improve the level of caregivers' mental health. On the other hand, effective programs should be designed to improve caregivers' knowledge of the disease and enhance their ability to care. Society needs to take steps to improve the medical environment and the social stigma that is not friendly to epilepsy.

Association Between Passive Smoking and Menstrual Discomfort: A Cross-Sectional Study of 2,571 Non-smoking Chinese Nurses.

Introduction: Menstrual discomfort affects women's quality of life, which is an important public health issue. Evidence confirming the link between passive smoking and menstrual discomfort is limited. Therefore, the aim of this study is to investigate the aforementioned topic on the basis of a cross-sectional study of 2,571 non-smoking Chinese nurses. Methods: Demographic information and passive smoking were assessed using a self-administered questionnaire. Menstrual discomfort was characterized as dysmenorrhea, illness or weakness, bed rest, and restlessness during menstruation, which was assessed using a modified version of the Cornell Medical Index-Health Questionnaire. Multivariate-adjusted odds ratio (OR) and 95% confidence intervals (CIs) were estimated using the logistic regression model. Results: A total of 1:195 nurses (46.48%) were exposed to passive smoking. Compared with non-passive smoking nurses, passive smoking nurses were more likely to have menstrual discomfort symptoms (72.38 vs. 64.39%), especially symptoms of dysmenorrhea (49.54 vs. 42.08%), illnesses or weakness (48.28 vs. 42.08%), and restlessness during menstruation (53.05 vs. 46.22%). Exposure to passive smoking was significantly associated with menstrual discomfort (OR = 1.41, 95%CI: 1.19-1.67), especially symptoms of dysmenorrhea (OR = 1.32, 95%CI: 1.13-1.56), illness or weakness (OR = 1.24, 95%CI: 1.06-1.46), and restlessness (OR = 1.26, 95%CI: 1.08-1.48) during menstruation. The subgroup analyses, stratified by age, children, and marital status, agreed with the main findings. Conclusions: Exposure to passive smoking was related to symptoms of dysmenorrhea and menstrual discomfort.

Effects of mindful breathing combined with sleep-inducing exercises in patients with insomnia.

BACKGROUND: Insomnia is the most common sleep disorder. It disrupts the patient's life and work, increases the risk of various health issues, and often requires long-term intervention. The financial burden and inconvenience of treatments discourage patients from complying with them, leading to chronic insomnia. AIM: To investigate the long-term home-practice effects of mindful breathing combined with a sleep-inducing exercise as adjunctive insomnia therapy. METHODS: A quasi-experimental design was used in the present work, in which the patients with insomnia were included and grouped based on hospital admission: 40 patients admitted between January and April 2020 were assigned to the control group, and 40 patients admitted between May and August 2020 were assigned to the treatment group. The control group received routine pharmacological and physical therapies, while the treatment group received instruction in mindful breathing and a sleep-inducing exercise in addition to the routine therapies. The Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder 7-item (GAD-7) scale, and Insomnia Severity Index (ISI) were utilized to assess sleep-quality improvement in the patient groups before the intervention and at 1 wk, 1 mo, and 3 mo postintervention. RESULTS: The PSQI, GAD-7, and ISI scores before the intervention and at 1 wk postintervention were not significantly different between the groups. However, compared with the control group, the treatment group exhibited significant improvements in sleep quality, daytime functioning, negative emotions, sleep latency, sleep duration, sleep efficiency, anxiety level, and insomnia severity at 1 and 3 mo postintervention (P < 0.05). The results showed that mindful breathing combined with the sleep-inducing exercise significantly improved the long-term effectiveness of insomnia treatment. At 3 mo, the PSQI scores for the treatment vs the control group were as follows: Sleep quality 0.98 ± 0.48 vs 1.60 ± 0.63, sleep latency 1.98 ± 0.53 vs 2.80 ± 0.41, sleep duration 1.53 ± 0.60 vs 2.70 ± 0.56, sleep efficiency 2.35 ± 0.58 vs 1.63 ± 0.49, sleep disturbance 1.68 ± 0.53 vs 2.35 ± 0.53, hypnotic medication 0.53 ± 0.64 vs 0.93 ± 0.80, and daytime dysfunction 1.43 ± 0.50 vs 2.48 ± 0.51 (all P < 0.05). The GAD-7 scores were 2.75 ± 1.50 vs 7.15 ± 2.28, and the ISI scores were 8.68 ± 2.26 vs 3.38 ± 1.76 for the treatment vs the control group, respectively (all P < 0.05). CONCLUSION: These simple, cost-effective, and easy-to-implement practices used in clinical or home settings could have profound significance for long-term insomnia treatment and merit wide adoption in clinical practice.

Neural signature of affective but not cognitive self-regulation predicts cortisol response to psychosocial stress.

Self-regulation is theoretically closely related to coping with stressful events, yet whether self-regulation capacities can predict individual stress responses is largely unknown. Cognitive control and emotion regulation are two major aspects involved in self-regulation, both of which are mechanisms to support goal-directed behaviors. Here, we aimed to elucidate whether the neural processes involved in emotion regulation and cognitive control could predict the cortisol response to stress. Therefore, we recorded first electroencephalography (EEG) during a cognitive conflict task (Simon task) and an emotion regulation task (cognitive reappraisal and expressive suppression) before healthy participants (n = 72) underwent a psychosocial stressor. Our results showed that late positive potentials (LPPs) during the emotion regulation task predicted both cortisol reactivity to and recovery from stress. Cognitive control and its neural underpinning, however, did not predict the individual stress response. These findings indicate that neural emotion regulation processes can predict HPA axis response to stress, and suggest a differential involvement of cognitive and affective components of self-regulation in the adaptation to stressful events.