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Background: Exploration of the relationship between individual work immersion and perceived stress is critical for clinical nurses' effective psychological interventions and human resource management, as well as to alleviate nursing staff shortages. In order to further dissect the influencing factors of perceived stress among nursing staff, our study introduces the concepts of perfectionism and social connectedness to analyze the specific pathways that influence perceived stress in terms of an individual's intrinsic and external personality traits. This study provides relevant recommendations for the development of stress management measures for nursing staff. Methods: This was a cross-sectional survey. 993 registered clinical nurses were included from four hospitals in Guangzhou through a convenience sampling method. Clinical nurses' work immersion, perceived stress, perfectionism, and social connectedness were investigated using questionnaires based on latent profile analysis. The relationships between variables were analyzed using t-tests, analysis of variance, Pearson's correlation analysis, latent profile analysis, and moderated mediation analysis. Results: The results showed that (1) general influences on nurses' perceived stress included only child, labor relationship, labor allowance, and family support; (2) nurses' work immersion contained four subgroups: lowest (12.6%), medium-low (39.8%), medium-high (39.9%), and highest (7.7%); (3) positive and negative perfectionism played a mediating role between the association of work immersion and perceived stress; (4) social connectedness played a moderating role in the mediation model of perceived stress. Conclusions: Work immersion, perfectionism, and social connectedness have an important impact on clinical nurses' perceived stress. Nursing managers or leaders should pay attention to the differences of individual work immersion status, adopt reasonable stress management strategies, accurately identify positive perfectionist groups and strengthen the relationship between groups, so as to ensure the quality of nursing care, and reduce nursing turnover and alleviate the problem of staff shortage. [ABSTRACT FROM AUTHOR]

Background: Clinically, although chemotherapy is one of the most commonly used methods of treating tumors, chemotherapeutic drugs can induce autophagic flux and increase tumor cell resistance, leading to drug tolerance. Therefore, theoretically, inhibiting autophagy may improve the efficacy of chemotherapy. The discovery of autophagy regulators and their potential application as adjuvant anti-cancer drugs is of substantial importance. In this study, we clarified that Fangjihuangqi Decoction (FJHQ, traditional Chinese medicine) is an autophagy inhibitor, which can synergistically enhance the effect of cisplatin and paclitaxel on non-small cell lung cancer (NSCLC) cells. Methods: We observed the changes of autophagy level in NSCLC cells under the effect of FJHQ, and verified the level of the autophagy marker protein and cathepsin. Apoptosis was detected after the combination of FJHQ with cisplatin or paclitaxel, and NAC (ROS scavenger) was further used to verify the activation of ROS-MAPK pathway by FJHQ. Results: We observed that FJHQ induced autophagosomes in NSCLC cells and increased the levels of P62 and LC3-II protein expression in a concentration- and time-gradient-dependent manner, indicating that autophagic flux was inhibited. Co-localization experiments further showed that while FJHQ did not inhibit autophagosome and lysosome fusion, it affected the maturation of cathepsin and thus inhibited the autophagic pathway. Finally, we found that the combination of FJHQ with cisplatin or paclitaxel increased the apoptosis rate of NSCLC cells, due to increased ROS accumulation and further activation of the ROS-MAPK pathway. This synergistic effect could be reversed by NAC. Conclusion: Collectively, these results demonstrate that FJHQ is a novel late-stage autophagy inhibitor that can amplify the anti-tumor effect of cisplatin and paclitaxel against NSCLC cells. [ABSTRACT FROM AUTHOR]

Aim: To examine the mediating effect of sleep quality on the relationship between lower urinary tract symptoms and health‐related quality of life in women with type‐II diabetes. Design: A cross‐sectional study. Methods: A study questionnaire comprising three valid instruments was used to obtain data about lower urinary tract symptoms, sleep quality and physical and mental component summary health‐related quality of life between July 2017 and December 2018 (n = 343). Pearson's correlation coefficients were estimated initially to examine the relationships between the three variables. Multiple regression models were tested using a regression‐based approach Hayes PROCESS macro for SPSS to examine the significance of proposed mediation effects. Results: Most participants experienced at least one urinary symptom (n = 268, 78.1%). The total number of types of lower urinary tract symptoms experienced by participants was significantly inversely correlated with physical and mental component summary health‐related quality of life, and sleep quality. Participants' sleep quality was significantly correlated with physical and mental component summary health‐related quality of life. The relationships of lower urinary tract symptoms with physical and mental component summary health‐related quality of life were, respectively, fully and partially mediated by sleep quality. Conclusion: Sleep quality played a mediating role on the relationship between lower urinary tract symptoms and health‐related quality of life. Our findings could lead to improvements of diabetes care in nursing and healthcare practices. Impact Understanding the role of sleep quality in the adverse effects of lower urinary tract symptoms on health‐related quality of life contributes to the development and delivery of appropriate strategies to promote optimal health‐related quality of life. We recommended including assessments of lower urinary tract symptoms, sleep and health‐related quality of life in routine diabetes management. Nurses and healthcare professionals should concurrently reduce lower urinary tract symptoms and improve sleep to achieve this population's optimal health‐related quality of life. Patients or public contribution: We recruited a sample of older women with type‐II diabetes at the endocrinology and metabolism outpatient departments of two hospitals. Study participants provided responses on the study questionnaires. The two hospitals provided needed supports (e.g., height/weight scales, suitable places for interview) during the data collection process. [ABSTRACT FROM AUTHOR]

Objective. This study aims to explore the mediation role of perceived stress between nonrestorative sleep (NRS) and emotional distress, as well as the moderation role of resilience among NRS, perceived stress, and emotional distress in university students. Method. We recruited 851 students from the Be Resilient to Nursing Career program (BRNC, registration number: NFYKDX002) in June 2022. Nonrestorative sleep scale (NRSS), 10-item perceived stress scale (PSS-10), 10-item Kessler psychological distress scale (K10), and 10-item Connor–Davidson resilience scale (CD-RISC-10) were administered through a paper questionnaire. Latent profile analysis and moderated mediation analysis were performed. Results. Three profiles of perceived stress were identified: high ability-low stress (24.5%), middle ability-high stress (65.0%), and low ability-middle stress (10.5%). The mediation role of perceived stress between NRS and emotional distress was significant (SE = 0.025; 95% confidence interval = −0.369, −0.269). The moderation role of resilience among NRS, perceived stress, and emotional distress was not significant. Conclusion. Heterogeneity exists in freshmen students' perceived stress. Perceived stress plays a significant mediating role between NRS and emotional distress, while resilience cannot significantly moderate the associations among NRS, perceived stress, and emotional distress. The trial is registered with ChiCTR2000038693. [ABSTRACT FROM AUTHOR]

Objective: Chinese herbal medicine (CHM) is quite popular in Asia. The purpose of this study is to investigate the benefits of decreasing the risk of cirrhosis in patients with non-alcoholic fatty liver disease (NAFLD) by using CHM. Design: We performed a 1:3 propensity score-matched cohort study to analyze patients with NAFLD diagnosed between January 1, 1997 and December 31, 2011 through the Taiwanese National Health Insurance Research Database. Patients who received CHM therapy from the initial date of diagnosis of NAFLD to December 31, 2011 were included in the CHM group. Patients who were not treated with CHM during the same interval were categorized in the non-CHM group. Cox regression model was used to adjust for sex, age, comorbidities, and drug use. Hazard ratios were also compared between the two groups. Results: A total of 13,072 patients were identified after 1:3 propensity score matching. The patients had similar basic characteristics. A lower cumulative incidence of cirrhosis was found in the CHM cohort (log-rank test, p < 0.0001). Finally, 176 patients in the CHM cohort (4.66 per 1000 person-years) and 582 patients in the non-CHM cohort (7.92 per 1000 person-years) developed cirrhosis (adjusted hazard ratios 0.63, 95% confidence interval 0.53–0.75). The effect of CHM to lower cirrhosis incidence was independent of sex, drug use, and comorbidities, including diabetes mellitus, hypertension, and cardiovascular diseases. Patients older than 40 years of age and without comorbidities such as chronic obstructive pulmonary disease, hyperlipidemia, alcoholism, tobacco use, or obesity also benefited from CHM. Conclusions: Our study is the first large-scale investigation in Taiwan that shows the association between patients with NAFLD and cirrhosis prevention after CHM intervention. The results may be useful for treatment and for decision making for patients and clinical doctors. Further restricted trials are needed to support our findings. [ABSTRACT FROM AUTHOR]