Eustress and Distress: Neither Good Nor Bad, but Rather the Same?

Navigating the decision-making landscape of AI in risk finance: Techno-accountability unveiled

The integration of artificial intelligence (AI) systems has ushered in a profound transformation. This conversion is marked by revolutionary extrapolative capabilities, a shift toward data-centric decision-making processes, and the enhancement of tools for managing risks. However, the adoption of these AI innovations has sparked controversy due to their unpredictable and opaque disposition. This study employs the transactional stress model to empirically investigate how six technological stressors (techno-stressors) impact both techno-eustress (positive stress) and techno-distress (negative stress) experienced by finance professionals and experts. To collect data for this research, an e-survey was distributed to a diverse group of 251 participants from various sources. The findings, particularly the identification and development of techno-accountability as a significant factor, contribute to the risk analysis domain by improving the failure mode and effect analysis framework to better fit the rapidly evolving landscape of AI-driven innovations.

Adaptogens in Long-Lasting Brain Fatigue: An Insight from Systems Biology and Network Pharmacology

Long-lasting brain fatigue is a consequence of stroke or traumatic brain injury associated with emotional, psychological, and physical overload, distress in hypertension, atherosclerosis, viral infection, and aging-related chronic low-grade inflammatory disorders. The pathogenesis of brain fatigue is linked to disrupted neurotransmission, the glutamate-glutamine cycle imbalance, glucose metabolism, and ATP energy supply, which are associated with multiple molecular targets and signaling pathways in neuroendocrine-immune and blood circulation systems. Regeneration of damaged brain tissue is a long-lasting multistage process, including spontaneously regulating hypothalamus-pituitary (HPA) axis-controlled anabolic-catabolic homeostasis to recover harmonized sympathoadrenal system (SAS)-mediated function, brain energy supply, and deregulated gene expression in rehabilitation. The driving mechanism of spontaneous recovery and regeneration of brain tissue is a cross-talk of mediators of neuronal, microglia, immunocompetent, and endothelial cells collectively involved in neurogenesis and angiogenesis, which plant adaptogens can target. Adaptogens are small molecules of plant origin that increase the adaptability of cells and organisms to stress by interaction with the HPA axis and SAS of the stress system (neuroendocrine-immune and cardiovascular complex), targeting multiple mediators of adaptive GPCR signaling pathways. Two major groups of adaptogens comprise (i) phenolic phenethyl and phenylpropanoid derivatives and (ii) tetracyclic and pentacyclic glycosides, whose chemical structure can be distinguished as related correspondingly to (i) monoamine neurotransmitters of SAS (epinephrine, norepinephrine, and dopamine) and (ii) steroid hormones (cortisol, testosterone, and estradiol). In this narrative review, we discuss (i) the multitarget mechanism of integrated pharmacological activity of botanical adaptogens in stress overload, ischemic stroke, and long-lasting brain fatigue; (ii) the time-dependent dual response of physiological regulatory systems to adaptogens to support homeostasis in chronic stress and overload; and (iii) the dual dose-dependent reversal (hormetic) effect of botanical adaptogens. This narrative review shows that the adaptogenic concept cannot be reduced and rectified to the various effects of adaptogens on selected molecular targets or specific modes of action without estimating their interactions within the networks of mediators of the neuroendocrine-immune complex that, in turn, regulates other pharmacological systems (cardiovascular, gastrointestinal, reproductive systems) due to numerous intra- and extracellular communications and feedback regulations. These interactions result in polyvalent action and the pleiotropic pharmacological activity of adaptogens, which is essential for characterizing adaptogens as distinct types of botanicals. They trigger the defense adaptive stress response that leads to the extension of the limits of resilience to overload, inducing brain fatigue and mental disorders. For the first time, this review justifies the neurogenesis potential of adaptogens, particularly the botanical hybrid preparation (BHP) of Arctic Root and Ashwagandha, providing a rationale for potential use in individuals experiencing long-lasting brain fatigue. The review provided insight into future research on the network pharmacology of adaptogens in preventing and rehabilitating long-lasting brain fatigue following stroke, trauma, and viral infections.

Neurocardiology: Major mechanisms and effects

Neurocardiology is a broad interdisciplinary specialty investigating how the cardiovascular and nervous systems interact. In this brief introductory review, we describe several key aspects of this interaction with specific attention to cardiovascular effects. The review introduces basic anatomy and discusses physiological mechanisms and effects that play crucial roles in the interaction of the cardiovascular and nervous systems, namely: the cardiac neuraxis, the taxonomy of the nervous system, integration of sensory input in the brainstem, influences of the autonomic nervous system (ANS) on heart and vasculature, the neural pathways and functioning of the arterial baroreflex, receptors and ANS effects in the walls of blood vessels, receptors and ANS effects in excitable cells in the heart, ANS effects on heart rate and sympathovagal balance, endo-epicardial inhomogeneity, ANS effects with a balanced vagal and sympathetic stimulation, sympathovagal interaction, arterial baroreflex, baroreflex sensitivity and heart rate variability, arrhythmias and the arterial baroreflex, the cardiopulmonary baroreflex, the exercise pressor reflex, exercise-recovery hysteresis, mental stress, cardiac-cardiac reflexes, the cardiac sympathetic afferent reflex (CSAR), and neuromodulation. Also, the potential role of the discussed mechanisms in cardiovascular disorders will be touched upon.

Morphological and Photosynthetic Pigment Screening of Four Microgreens Species Exposed to Heavy Ions

Numerous challenges are posed by the extra-terrestrial environment for space farming and various technological growth systems are being developed to allow for microgreens' cultivation in space. Microgreens, with their unique nutrient profiles, may well integrate the diet of crew members, being a natural substitute for chemical food supplements. However, the space radiation environment may alter plant properties, and there is still a knowledge gap concerning the effects of various types of radiation on plants and specifically on the application of efficient and rapid methods for selecting new species for space farming, based on their radio-resistance. Thus, the hypotheses behind this study were to explore the following: (i) the pattern (if any) of radio-sensitivity/resistance; and (ii) if the morphological parameters in relation with pigment content may be a feasible way to perform a screening of radiation responses among species. To perform this, we irradiated dry seeds of basil, rocket, radish, and cress with iron (56Fe; 1550 MeV/(g/cm²)) and carbon (12C; 290 MeV/u, 13 keV/µm) heavy ions at the doses of 0.3, 1, 10, 20, and 25 Gy to investigate the growth responses of microgreens to acute radiation exposure in terms of morphological traits and photosynthetic pigment content. Results indicate that the microgreens' reaction to ionizing radiation is highly species-specific and that radiation is often sensed by microgreens as a mild stress, stimulating the same morphological and biochemical acclimation pathways usually activated by other mild environmental stresses, alongside the occurrence of eustress phenomena. Over extended periods, this stimulus could foster adaptive changes, enabling plants to thrive in space.

The repeated bout effect evokes the training-induced skeletal muscle cellular memory

Physical exercise is well-established as beneficial for health. With the 20th-century epidemiological transition, promoting healthy habits like exercise has become crucial for preventing chronic diseases. Stress can yield adaptive long-term benefits, potentially transmitted trans-generationally. Physical training exposes individuals to metabolic, thermal, mechanical, and oxidative stressors, activating cell signaling pathways that regulate gene expression and adaptive responses, thereby enhancing stress tolerance - a phenomenon known as hormesis. Muscle memory is the capacity of skeletal muscle to respond differently to environmental stimuli in an adaptive (positive) or maladaptive (negative) manner if the stimuli have been encountered previously. The Repeated Bout Effect encompasses our skeletal muscle capacity to activate an intrinsic protective mechanism that reacts to eccentric exercise-induced damage by activating an adaptive response that resists subsequent damage stimuli. Deciphering the molecular mechanism of this phenomenon would allow the incorporation of muscle memory in training programs for professional athletes, active individuals looking for the health benefits of exercise training, and patients with "exercise intolerance." Moreover, enhancing the adaptive response of muscle memory could promote healing in individuals who traditionally do not recover after immobilization. The improvement could be part of an exercise program but could also be targeted pharmacologically. This review explores Repeated Bout Effect mechanisms: neural adaptations, tendon and muscle fiber property changes, extracellular matrix remodeling, and improved inflammatory responses.

Antioxidant Therapy in Inflammatory Bowel Diseases: How Far Have We Come and How Close Are We?

Inflammatory bowel diseases (IBD) pose a growing public health challenge with unclear etiology and limited efficacy of traditional pharmacological treatments. Alternative therapies, particularly antioxidants, have gained scientific interest. This systematic review analyzed studies from MEDLINE, Cochrane, Web of Science, EMBASE, and Scopus using keywords like "Inflammatory Bowel Diseases" and "Antioxidants." Initially, 925 publications were identified, and after applying inclusion/exclusion criteria-covering studies from July 2015 to June 2024 using murine models or clinical trials in humans and evaluating natural or synthetic substances affecting oxidative stress markers-368 articles were included. This comprised 344 animal studies and 24 human studies. The most investigated antioxidants were polyphenols and active compounds from medicinal plants (n = 242; 70.3%). The review found a strong link between oxidative stress and inflammation in IBD, especially in studies on nuclear factor kappa B and nuclear factor erythroid 2-related factor 2 pathways. However, it remains unclear whether inflammation or oxidative stress occurs first in IBD. Lipid peroxidation was the most studied oxidative damage, followed by DNA damage. Protein damage was rarely investigated. The relationship between antioxidants and the gut microbiota was examined in 103 animal studies. Human studies evaluating oxidative stress markers were scarce, reflecting a major research gap in IBD treatment. PROSPERO registration: CDR42022335357 and CRD42022304540.

Balneotherapy and cortisol levels: an updated systematic review and meta-analysis

The main objective of this review is to examine the impact of balneotherapy on serum and salivary cortisol concentrations. A systematic search was conducted in PubMed, Scopus, Web of Science, PEDro, and Google Scholar. The databases were screened from inception up until April 2024. After screening the scientific literature, 845 articles were retrieved and 17 studies, involving a total of 765 participants, were eventually included in the review. Among them, four were randomized controlled trials, five were non-randomized studies, and eight were pre-post studies with no control group. The evidence gathered in this review indicates a significant short-term reduction in cortisol levels in healthy individuals undergoing balneotherapy, particularly those experiencing high levels of stress. Conversely, in patients with rheumatic conditions (especially if elderly), increases in cortisol levels induced by balneotherapy can act as beneficial hormetic stress, reducing inflammatory mediators and improving pain and functional quality of life. The meta-analysis shows an overall trend of reduction in stress hormone levels, more pronounced in the intervention group undergoing mud-balneotherapy compared to the control group, a finding that, however, does not reach statistical significance (g=-0.11 [95% CI: -0.30; 0.08]; p > 0.05). Current scientific evidence demonstrates that balneotherapy has a positive impact on the regulation of cortisol levels. The regulation of the hypothalamic-pituitary-adrenal axis and the beneficial effects observed on health parameters and quality of life allow mud-balneotherapy to be classified as eustressful stimuli useful in preventing stress-related pathologies in healthy individuals and in alleviating symptoms in patients with chronic conditions. Future research on the topic is advised.

Relationships between mental toughness, eustress-distress, and mindfulness in adolescents: A network analysis and mediator model testing

The main aim of this study was to investigate adolescents' eustress-distress and mindfulness by examining mental toughness (MT) using network and mediator analyses. The study included 414 adolescents. The results showed that MT was positively related to eustress and mindfulness, but distress was negatively related to MT. Based on the network analysis findings, we tested mindfulness' mediating role in the relationship between eustress-distress and MT. The findings showed that mindfulness played a significant mediating role. However, the mediating role of mindfulness was negative for the relationship between distress and toughness and positive for eustress. These findings advance eustress, distress, and mindfulness as mechanisms for understanding the effects of MT. Considering current knowledge of MT, eustress, distress, and mindfulness, the results are discussed.

Exploring the link between eustress and adolescent health in India: An empirical study

BACKGROUND

Modern psychological research challenges the conventional view of stress as solely detrimental by introducing the concept of eustress versus distress, emphasizing the potentially positive aspects of stress. In the context of India, limited studies have investigated the distinct effects of eustress and distress on adolescents, a group prone to stress-related health issues. This study aims to bridge this gap by examining the correlation between eustress and both mental and physical well-being among adolescents attending government schools in two districts of Haryana, India.

MATERIALS AND METHODS

A non-experimental quantitative research approach was adopted to achieve this objective. The study involved a sample of 400 adolescent students, equally split between genders, aged 15 to 18 years, enrolled in grades 10 to 12. Participants were selected through systematic random sampling from two districts in Haryana. The assessment tools employed in the study included the Post Graduate Institute Health Questionnaire and the Eustress Scale, which were utilized to evaluate the participants' mental, physical, and eustress levels.

RESULTS

In our study involving Indian adolescents, we discovered a substantial positive correlation (r = 0.563, P < 0.01) between eustress and mental health, underlining the valuable role of positive stress in enhancing psychological well-being. Notably, male participants exhibited significantly higher eustress scores (mean = 26.63) than their female counterparts (mean = 22.82, P < 0.01), indicating gender-specific variations in stress responses. Furthermore, our findings emphasized the influence of cultural nuances inherent to the Indian context on how adolescents perceived and experienced eustress. These outcomes emphasize the urgency of culturally sensitive interventions to promote adolescents' well-being.

CONCLUSION

This investigation contributes valuable insights into the nexus between eustress and adolescent health in the Indian context. The study accentuates the potential advantages of leveraging eustress to foster positive development by underlining the differential influence of eustress and distress on adolescent health. Future research endeavors and policy formulation could delve into the mechanisms underpinning eustress and distress, thus guiding strategies to enhance adolescents' health and overall well-being.

Stress management: how does the academic staff cope with it? a cross-sectional study at the university of Udine

BACKGROUND

Increasing work-related stress in academia can have an impact on physical and mental health. The aim of this study was to analyse the coping strategies of staff employed at the University of Udine and to verify whether sociodemographic data, professional position, and the presence of anxiety or depression symptoms are related to the use of different coping strategies.

METHODS

We conducted a cross-sectional study between June and December 2020 using the Brief COPE questionnaire. We correlated coping strategies with professional position, sociodemographic data, and the presence of anxiety or depressive symptoms measured with the Patient Health Questionnaire-9 and the General Anxiety Disorder-7.

RESULTS

A total of 366 people participated in the study, including 109 junior academics, 146 senior academics, and 111 administrative staff (response rate 23.6%). The three most frequently used coping strategies in terms of approach coping style were planning (6.77 ± 1.41), active coping (6.58 ± 1.45) and acceptance (6.23 ± 1.44). Women were more likely than men to report using approach and avoidant coping strategies (p < 0.001). Positive reframing and religion were most commonly used by administrative staff (p < 0.05), in contrast to junior academics, who were more likely to use substances and self-blame (p < 0.05). Anxiety was found to correlate with self-blame (OR 1.94) as a coping strategy, while depression was associated with venting (OR 2.83), self-blame (OR 3.27), and humor (OR 3.02).

CONCLUSION

Identifying profiles of coping strategies can help higher education institutions to implement support strategies for the academic community, ultimately promoting healthier lives and more effective teaching and research. Our study has shown that women and junior academics among staff at the Udine University would benefit from a tailored health promotion intervention that encourages the use of approach coping styles to reduce their risk of developing anxiety and depressive symptoms.

Review: Environmental enrichment builds functional capacity and improves resilience as an aspect of positive welfare in production animals

The success of the animal in coping with challenges, and in harnessing opportunities to thrive, is central to its welfare. Functional capacity describes the capacity of molecules, cells, organs, body systems, the whole animal, and its community to buffer against the impacts of environmental perturbations. This buffering capacity determines the ability of the animal to maintain or regain functions in the face of environmental perturbations, which is recognised as resilience. The accuracy of physiological regulation and the maintenance of homeostatic balance underwrite the dynamic stability of outcomes such as biorhythms, feed intake, growth, milk yield, and egg production justifying their assessment as indicators of resilience. This narrative review examines the influence of environmental enrichments, especially during developmental stages in young animals, in building functional capacity and in its subsequent expression as resilience. Experience of enriched environments can build skills and competencies across multiple functional domains including but not limited to behaviour, immunity, and metabolism thereby increasing functional capacity and facilitating resilience within the context of challenges such as husbandry practices, social change, and infection. A quantitative method for measuring the distributed property of functional capacity may improve its assessment. Methods for analysing embedded energy (emergy) in ecosystems may have utility for this goal. We suggest functional capacity provides the common thread that links environmental enrichments with an ability to express resilience and may provide a novel and useful framework for measuring and reporting resilience. We conclude that the development of functional capacity and its subsequent expression as resilience is an aspect of positive animal welfare. The emergence of resilience from system dynamics highlights a need to shift from the study of physical and mental states to the study of physical and mental dynamics to describe the positive dimension of animal welfare.

A Commentary on Fasting of Nonclinical Research Animals

This commentary discusses the implementation of fasting in nonclinical animal experimental subjects. The short-term removal of food from cages of experimental animals is in all respects innocuous. The term "stress" is ill-defined and the statutes and regulations governing animal research laboratories that exert their authority in the performance of their operations do so without substantive grounds to base compliance. The legislative and administrative history of the implementation of the Animal Welfare Act (AWA) has evolved into the development of laboratory management strategies that focus on the reduction of the biological cost of stress to the animals and the determination of when subclinical stress (eustress) becomes distress. Animal welfare is based on the tenet that in laboratories conducting animal research in compliance with Good Laboratory Practices (Title 21 USC, Chapter 13,§58), it is the study protocol and the study director that establish procedures and processes that are approved by each Institutional Animal Care and Use Committee to ensure the humane care and use of animals in research, teaching, and testing and to ensure compliance with guidelines and regulations. This approval process establishes the justification of eustress in the environment that do not rise to the threshold of distress under the AWA.

Regulation of P-Glycoprotein during Oxidative Stress

P-glycoprotein (Pgp, ABCB1, MDR1) is an efflux transporter protein that removes molecules from the cells (outflow) into the extracellular space. Pgp plays an important role in pharmacokinetics, ensuring the absorption, distribution, and excretion of drugs and its substrates, as well as in the transport of endogenous molecules (steroid and thyroid hormones). It also contributes to tumor cell resistance to chemotherapy. In this review, we summarize the mechanisms of Pgp regulation during oxidative stress. The currently available data suggest that Pgp has a complex variety of regulatory mechanisms under oxidative stress, involving many transcription factors, the main ones being Nrf2 and Nf-kB. These factors often overlap, and some can be activated under certain conditions, such as the deposition of oxidation products, depending on the severity of oxidative stress. In most cases, the expression of Pgp increases due to increased transcription and translation, but under severe oxidative stress, it can also decrease due to the oxidation of amino acids in its molecule. At the same time, Pgp acts as a protector against oxidative stress, eliminating the causative factors and removing its by-products, as well as participating in signaling pathways.

Sex features of the development of oxidative stress in high and low hypoxic resistancy rats, which experienced repeated stressful episodes of immobilization

OBJECTIVE

Aim: of the study was to find out the sexual characteristics of the development of oxidative stress in rats with high and low resistance to hypoxic hypoxia (HRH, LRH) during repeated stressful episodes of immobilization..

PATIENTS AND METHODS

Materials and Methods: The study was performed on 96 white HRH, LRH male and female Wistar rats. The animals were divided into eight groups: 1 - control (HRH, LRH) males and females, 2 - immobilization (HRH, LRH) males and females. Immobilization stress was induced by gently restraining the animals four Times by all paws and maxillary central incisors dorsally for 1 hour at an interval of 72 hours. The concentration of diene and triene conjugates (DC, TC), Schiff's bases (SB), TBA-active products (TBA-ap), activity of superoxide dismutase (SOD) and catalase (CAT), reduced glutathione (GSH), activity of glutathione peroxidase (GP) and glutathione reductase (GR) were determined in the homogenate of heart. A morphological study of heart preparations stained with hematoxilin and eosin was carried out. All studies were performed in control, after 24 hours after last immobilization.

RESULTS

Results: In control HRH, compared to LRH males, the values of TBA-ap were found to be lower. Under stress, an increase of LPO was noted in HRH and LRH males, only SB decreased. Higher level of LPO products noted in LRH rats compared to HRH. In control HRH females, compared to LRH, the content of DC, SB were higher and TBA-ap - lower. In HRH females, compared to HRH males, TC was higher and SB - lower. Under stress, in HRH females DC and TBA-ap were increased, TC and Sb - decreased. In LRH females all indicators increased. Lower TC and TBA-ap values were noted in HRH compared to LRH females rats. In control HRH males, compared to females, lower TC and higher values of SB were found. In LRH males, compared to females, the values of DC, TC, SB were higher. During stress, a more intensive course of LPO was noted in males. SOD in control HRH males, compared to LRH, was higher; CAT was not statistically different. Under stress, SOD decreased, CAT - increased. In HRH males, compared to LRH, in this group SOD was higher CAT - lower. In the control, HRH females, compared to LRH, had higher SOD, lower - CAT. Under stress, CAT increased in HRH females; in LRH females CAT decreased and SOD - increased. In HRH females, compared to LRH, CAT was higher. In control males, compared to females, SOD and CAT was higher. Under stress higher SOD was in females, and CAT - in males. GSH and GP were higher in control HRH compared to LRH males and females. Under stress, in males the GSH increased, GR decreased; GP in HRH decreased, in LRH it increased. HRH males, compared to LRH, GSH and GR were higher, GP - lower. Under stress, in females GSH, GP, GR in females decreased; HRH, compared to LRH, had higher GP and GH. In intact HRH males, compared to females, was higher GR and less GP; in LRH males, compared to females, GR was higher. Under stress, males had higher GSH, GP and GR values compared to females. The studied biochemical changes in the heart are accompanied by alterative changes in the structural components of the myocardium in the experimental groups.

CONCLUSION

Conclusions: Congenital resistance to hypoxia is associated with a greater power of the enzymatic and non-enzymatic links of the antioxidant system. Immobilization stress repeated four times with an interval of 72 hours is accompanied by the most significant increase in the content of lipid peroxidation products in the heart homogenate of lower resistant to hypoxia rats, especially males. A decrease in Schiff bases is observed in all males and highly hypoxia-resistant females. In males, a more intense accumulation of lipid peroxide oxidation products, higher catalase activity and a more active glutathione system were noted. Females have significantly higher superoxide dismutase activity. Morphological changes confirm more damage to the heart of low hypoxia-resistant rats, more males.

JAK-STAT signaling in inflammation and stress-related diseases: implications for therapeutic interventions

The Janus kinase-signal transducer and transcription activator pathway (JAK-STAT) serves as a cornerstone in cellular signaling, regulating physiological and pathological processes such as inflammation and stress. Dysregulation in this pathway can lead to severe immunodeficiencies and malignancies, and its role extends to neurotransduction and pro-inflammatory signaling mechanisms. Although JAK inhibitors (Jakinibs) have successfully treated immunological and inflammatory disorders, their application has generally been limited to diseases with similar pathogenic features. Despite the modest expression of JAK-STAT in the CNS, it is crucial for functions in the cortex, hippocampus, and cerebellum, making it relevant in conditions like Parkinson's disease and other neuroinflammatory disorders. Furthermore, the influence of the pathway on serotonin receptors and phospholipase C has implications for stress and mood disorders. This review expands the understanding of JAK-STAT, moving beyond traditional immunological contexts to explore its role in stress-related disorders and CNS function. Recent findings, such as the effectiveness of Jakinibs in chronic conditions such as rheumatoid arthritis, expand their therapeutic applicability. Advances in isoform-specific inhibitors, including filgotinib and upadacitinib, promise greater specificity with fewer off-target effects. Combination therapies, involving Jakinibs and monoclonal antibodies, aiming to enhance therapeutic specificity and efficacy also give great hope. Overall, this review bridges the gap between basic science and clinical application, elucidating the complex influence of the JAK-STAT pathway on human health and guiding future interventions.

Greater number of weekly stairs climbed is associated with lower low back pain prevalence among female but not male physical therapists

INTRODUCTION

Certain cardiovascular health benefits of stair climbing are now widely accepted, but no prior studies have as yet been found linking the quantity of stairs climbed to low back pain (LBP) morbidity. Low back pain is a common musculoskeletal impairment, and research has begun to show an association between LBP and gluteus maximus (GM) weakness. With stair climbing being the activity which most activates GM, the aim of the present research was to assess the relationship between stair ambulation and LBP prevalence. The hypothesis of this cross-sectional study was that individuals with LBP would report a significantly lower numbers of stair flights climbed compared with individuals without LBP.

METHODS

A survey tool was developed and distributed via email to a convenience sample of orthopedic physical therapists. Survey items included information regarding medical history, physical activity, workplace, and LBP factors, using a one-year prevalence period.

RESULTS

A total of 363 respondents took the survey and, after application of exclusion criteria, 248 records remained in our final sample. When analyzing all genders together, non LBP (NLBP) respondents reported a mean of 51.62 flights climbed per week; and LBP respondents reported 37.82 flights climbed per week, with P = 0.077. When males and females were analyzed separately, a statistically significant difference in mean number of flights of stairs climbed was found among female respondents (61.51 flights climbed for NLBP and 35.61 flights climbed for LBP females; P = 0.031). When analyzed based on chronicity of LBP, an even stronger association between stairs climbed and LBP prevalence was found for female respondents with acute LBP (P = 0.009).

CONCLUSIONS

More weekly stairs climbed was associated with a lower LBP prevalence among females, especially with respect to acute LBP. Randomized, longitudinal research is, however, required to confirm a relationship between stair climbing and LBP.

Effects of Interactions with Cats in Domestic Environment on the Psychological and Physiological State of Their Owners: Associations among Cortisol, Oxytocin, Heart Rate Variability, and Emotions

Interactions with animals, including cats, is believed to influence human health. However, studies that investigate the psychological and physiological effects of interacting with cats in their household environment are limited. In this remote study, 32 cat owners in Japan participated from June to October 2021. They completed two tasks, each on separate days in their homes: one simulating daily cat communication (Interaction condition) and another with no interactions (Rest condition). We quantified emotions (arousal level and pleasure level) before and after each condition using the Two-Dimensional Mood Scale Short-term as well as salivary cortisol and oxytocin levels of owners using enzyme-linked immune-sorbent assay. Autonomic nervous activity (sympathetic and parasympathetic) was also quantified by heart rate variability analysis. The free interaction with cats decreased emotional arousal and parasympathetic activity, and lead to increased heart rates in owners. There was a positive correlation between heart rate and cortisol concentration, and between cortisol and oxytocin concentration. Furthermore, the frequency of petting the cats was negatively correlated with the rate of change in the parasympathetic activity. In contrast, the parasympathetic nerves in the owners were activated under the Rest condition. Hence, the mechanism of health-enhancing effects of cat ownership includes an arousing effect, in contrast to the previously proposed stress-reduction effect. This result can aid in future developments in cat-human relationship studies. However, a detailed study with a larger sample size is needed to draw definite conclusions.

Laying the Foundation for the Challenge–Hindrance Stressor Framework 2.0

Although traditional views of workplace stress assume that all job demands have deleterious consequences, research indicates that some job demands may benefit employees. Notably, the Challenge–Hindrance Stressor Framework (CHSF) proposes that, although job demands that constrain, hinder, or thwart personal growth and achievement (hindrance stressors) have negative effects on work-related outcomes, job demands that provide the potential for personal growth and achievement (challenge stressors) have positive effects on these outcomes. Despite the attention generated by the CHSF, several criticisms and limitations hinder the potential of this framework. Thus, this article reviews our current understanding of the CHSF, addresses important criticisms about the nature and effects of challenge and hindrance stressors, and discusses how future research should approach conceptual and methodological challenges to lay the foundation for the next iteration of this framework—CHSF 2.0. Building on this new framework, we discuss some implications for cross-cultural research and for practitioners.

Glucocorticoids in relation to behavior, morphology, and physiology as proxy indicators for the assessment of animal welfare. A systematic mapping review

Translating theoretical concepts of animal welfare into quantitative assessment protocols is an ongoing challenge. Glucocorticoids (GCs) are frequently used as physiological measure in welfare assessment. The interpretation of levels of GCs and especially their relation to welfare, however, is not as straightforward, questioning the informative power of GCs. The aim of this systematic mapping review was therefore to provide an overview of the relevant literature to identify global patterns in studies using GCs as proxy for the assessment of welfare of vertebrate species. Following a systematic protocol and a-priory inclusion criteria, 509 studies with 517 experiments were selected for data extraction. The outcome of the experiments was categorized based on whether the intervention significantly affected levels of GCs, and whether these effects were accompanied by changes in behavior, morphology and physiology. Additional information, such as animal species, type of intervention, experimental set up and sample type used for GC determination was extracted, as well. Given the broad scope and large variation in included experiments, meta-analyses were not performed, but outcomes are presented to encourage further, in-depth analyses of the data set. The interventions did not consistently lead to changes in GCs with respect to the original authors hypothesis. Changes in GCs were not consistently paralleled by changes in additional assessment parameter on behavior, morphology and physiology. The minority of experiment quantified GCs in less invasive sample matrices compared to blood. Interventions showed a large variability, and species such as fish were underrepresented, especially in the assessment of behavior. The inconclusive effects on GCs and additional assessment parameter urges for further validation of techniques and welfare proxies. Several conceptual and technical challenges need to be met to create standardized and robust welfare assessment protocols and to determine the role of GCs herein.

Ozone in the adjunct medical treatment. The round personality of a molecule with hormetic properties

Ozone, an allotrope of oxygen, is enjoying an increasing interest in the setting and management of the medical adjunct treatment, which is called, maybe too simplistically, "ozone therapy". Ozone is not a medicine, so the word therapy does not properly fit this gaseous molecule. Like many natural compounds, for example plant flavonoids, even ozone interacts with aryl hydrocarbon receptors (AhRs) and, at low doses, it works according to the paradoxical mechanism of hormesis, involving mitochondria (mitohormesis). Ozone, in the hormetic range, exerts cell protective functions via the Nrf2-mediated activation of the anti-oxidant system, then leading to anti-inflammatory effects, also via the triggering of low doses of 4-HNE. Moreover, its interaction with plasma and lipids forms reactive oxygen species (ROS) and lipoperoxides (LPOs), generally called ozonides, which are enabled to rule the major molecular actions of ozone in the cell. Ozone behaves as a bioregulator, by activating a wide population of reactive intermediates, which usually target mitochondria and their turnover/biogenesis, often leading to a pleiotropic spectrum of actions and behaving as a tuner of the fundamental mechanisms of survival in the cell. In this sense, ozone can be considered a novelty in the medical sciences and in the clinical approach to pharmacology and medical therapy, due to its ability to target complex regulatory systems and not simple receptors.

Digital Pandemic Stress in Higher Education in Venezuela

The COVID-19 pandemic had a great impact on the process of integrating digital technologies in higher education and caused digital stress among professors, mainly in countries with a lower level of digitalization. In this work, quantitative research was carried out on the stress of professors in Venezuela due to the digitalization of their teaching activities caused by the pandemic, and gender gaps were identified in this regard. This digital stress was compared with that of professors in other countries with a low level of digitalization. For this purpose, a questionnaire designed by the authors was used. The questionnaire was distributed to a sample of 129 Venezuelan professors and 132 professors from countries with low digitalization levels. As a result, it was found that Venezuelan professors have lower digital competence and lower digital stress than their colleagues in weakly digitized countries, and that digital stress decreases as digital competence increases. Moreover, among Venezuelan professors, there was a strong gender gap in digital stress, which was higher among females in all subject areas, except for Health Sciences. This gender gap is specific to Venezuela since it differs from that in countries with low digital levels. According to the results, we urgently recommend investing resources in the digital training of faculty members, especially in regards to the integration of female professors.

Psychological distress and eustress in cancer and cancer treatment: Advances and perspectives

Facing cancer diagnosis, patients with cancer are prone to psychological stress and consequent psychological disorders. The association between psychological stress and cancer has long been a subject of high interest. To date, preclinical studies have gradually uncovered the promotive effects of psychological distress on tumor hallmarks. In contrast, eustress may exert suppressive effects on tumorigenesis and beneficial effects on tumor treatment, which brings a practicable means and psychosocial perspective to cancer treatment. However, the underlying mechanisms remain incompletely understood. Here, by focusing on the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system, as well as stress-related crucial neurotransmitters and hormones, we highlight the effects of distress and eustress on tumorigenesis, the tumor microenvironment, and tumor treatment. We also discuss the findings of clinical studies on stress management in patients with cancer. Last, we summarize questions that remain to be addressed and provide suggestions for future research directions.

Structural analysis and reliability of the Perceived Stress Scale in nursing professionals from Peru

OBJECTIVE

The objective was to provide psychometric evidence of the 14-item and 10-item version of the Perceived Stress Scale in nursing professionals from Peru.

METHOD

Data on 2848 professionals (92.275% women) between 23 and 69 years old (M = 21.876; SD = 10.763) was extracted from ENSUSALUD 2015. An exploratory structural equation modelling (ESEM) was applied with Mplus 7.0 software to analyse several measurement models in the PSS: unidimensional, bidimensional, models with method factor, and bifactor. Finally, the reliability was analysed.

RESULTS

The two-factor structure obtained adequate fit indices, and acceptable factorial loadings (>.50), while the unidimensional model has poor statistical support. The construct and score reliability was also adequate.

CONCLUSION

The two-factor model of the PSS-10 and PSS-14 presents adequate psychometric properties to expand its use to empirical research.

Stress in Medical Students: PRIMES, an Italian, Multicenter Cross-Sectional Study

Medical students (MSs) are healthcare workers and must also cope with education-related stressors. This study aims to assess factors associated with perceived stress in Italian MSs. A cross-sectional study was conducted in 12 Italian medical schools (MSCs) in November 2018. A questionnaire assessed socio-demographic characteristics, habits, opinions about MSC, and concerns about the future. Stress was assessed with the PSS-10. Descriptive and univariable tests were performed. A linear model was fitted to find associations of the PSS-10 score with characteristics. There were 2513 collected questionnaires. Median PSS-10 score was 18 (IQR 11). Median age was 22 (IQR 4) and 61% of the sample was female. Female gender, being part of a sexual minority, poor financial situation, competitive atmosphere, having hobbies, resting, and sleeping hindered by MSC were characteristics associated with higher PSS-10 scores. Current relationship, good family relationship, and no concerns about the future were protective factors. Being part of sexual minorities had greater effects in students not living away from home, while in the other group it was not having satisfying friendships. Medical students suffer higher levels of stress than the general population, and many MSC stressors are associated. Living away from home modifies risk and protective factors, offering the possibility to tailor group-specific interventions.

Machine Learning for Plant Stress Modeling: A Perspective towards Hormesis Management

Plant stress is one of the most significant factors affecting plant fitness and, consequently, food production. However, plant stress may also be profitable since it behaves hormetically; at low doses, it stimulates positive traits in crops, such as the synthesis of specialized metabolites and additional stress tolerance. The controlled exposure of crops to low doses of stressors is therefore called hormesis management, and it is a promising method to increase crop productivity and quality. Nevertheless, hormesis management has severe limitations derived from the complexity of plant physiological responses to stress. Many technological advances assist plant stress science in overcoming such limitations, which results in extensive datasets originating from the multiple layers of the plant defensive response. For that reason, artificial intelligence tools, particularly Machine Learning (ML) and Deep Learning (DL), have become crucial for processing and interpreting data to accurately model plant stress responses such as genomic variation, gene and protein expression, and metabolite biosynthesis. In this review, we discuss the most recent ML and DL applications in plant stress science, focusing on their potential for improving the development of hormesis management protocols.

Stress and Supportive Care Needs of Millennial Caregivers: A Qualitative Analysis

Millennial caregivers, born between 1981 and 1996, are an understudied caregiver group. They experience stress-related consequences of caregiving and are unique in their developmental stage and generational norms. The purpose of this study was to understand the context of caregiving and stressors for these caregivers. In total, 42 caregivers were recruited through Research Match and social media platforms. Caregivers completed online surveys with open-ended response questions and 15 caregivers completed semistructured interviews. Data were analyzed deductively and inductively using the Stress Process Model as a framework. Millennial caregivers described uncertainty and disruption as overarching experiences. Stressors related to balancing caregiving, work, and family responsibilities were most prominent. Caregivers reported needing support from friends/family, health care team members, community, and work/governmental policy. Mental health treatment was identified as most helpful for managing stress. Millennial caregivers have distinctive contexts that impact their caregiving needs. Caregiving interventions must take these needs into consideration.

Longitudinal Effects of Distress and Its Management During COVID-19 Lockdown in Spain

Introduction: The COVID-19 pandemic that hit Spain during March 2020 forced the strict confinement of the population for 2 months. The objectives of this study were (a) to assess the magnitude and duration of the influence of confinement on people's Distress, (b) to study the temporal sequence of stress, and (c) to show how different day-to-day activities and personal variables influence perceived Distress levels. Method: A daily registration was completed by 123 people, with ages ranging from 21 to 75 years old ( X ¯ = 43, SD = 10 years), of which there were 40 men (32%) and 83 females (68%). During 45 days of lockdown, from March 19th to May 3rd, participants were asked to respond to a socio-demographic survey and make daily records comprising the MASQ-D30 and some day-to-day behaviors. Pooled time series was applied to establish what effect time had on the dependent variable. Results: Distress has a 14-day autoregressive function and gender, physical activity, sexual activity, listening to music, and teleworking also influence Distress. It has been hypothesized that the intercept presents variability at level 2 (individual), but it has not been significant. Interactions between Gender-Telecommuting, and Gender-Physical Activity were observed. Approximately 66% of the variance of Distress was explained (R 2 = 0.663). Discussion: At the beginning of the lockdown, the average levels of Distress were well above the levels of the end (z = 3.301). The individuals in the sample have followed a very similar process in the development of Distress. During the lockdown, the "memory" of Distress was 2 weeks. Our results indicate that levels of Distress depend on activities during lockdown. Interactions exist between gender and some behavioral variables that barely influence Distress in men but decrease Distress in women. The importance of routine maintenance and gender differences must be considered to propose future interventions during confinement.

Impact of Acute and Chronic Psychosocial Stress on Vascular Inflammation

Significance: Atherosclerosis and its complications, such as acute coronary syndromes, are the leading causes of death worldwide. A wide range of inflammatory processes substantially contribute to the initiation and progression of cardiovascular disease (CVD). In addition, epidemiological studies strongly associate both chronic stress and acute psychosocial stress with the occurrence of CVDs. Recent Advances: Extensive research during recent decades has not only identified major pathways in cardiovascular inflammation but also revealed a link between psychosocial factors and the immune system in the context of atherosclerosis. Both chronic and acute psychosocial stress drive systemic inflammation via neuroimmune interactions and promote atherosclerosis progression. Critical Issues: The associations human epidemiological studies found between psychosocial stress and cardiovascular inflammation have been substantiated by additional experimental studies in mice and humans. However, we do not yet fully understand the mechanisms through which psychosocial stress drives cardiovascular inflammation; consequently, specific treatment, although urgently needed, is lacking. Future Directions: Psychosocial factors are increasingly acknowledged as risk factors for CVD and are currently treated via behavioral interventions. Additional mechanistic insights might provide novel pharmacological treatment options to reduce stress-related morbidity and mortality. Antioxid. Redox Signal. 35, 1531-1550.

Premature Senescence and Telomere Shortening Induced by Oxidative Stress From Oxalate, Calcium Oxalate Monohydrate, and Urine From Patients With Calcium Oxalate Nephrolithiasis

Oxidative stress, a well-known cause of stress-induced premature senescence (SIPS), is increased in patients with calcium oxalate (CaOx) kidney stones (KS). Oxalate and calcium oxalate monohydrate (COM) induce oxidative stress in renal tubular cells, but to our knowledge, their effect on SIPS has not yet been examined. Here, we examined whether oxalate, COM, or urine from patients with CaOx KS could induce SIPS and telomere shortening in human kidney (HK)-2 cells, a proximal tubular renal cell line. Urine from age- and sex-matched individuals without stones was used as a control. In sublethal amounts, H₂O₂, oxalate, COM, and urine from those with KS evoked oxidative stress in HK-2 cells, indicated by increased protein carbonyl content and decreased total antioxidant capacity, but urine from those without stones did not. The proportion of senescent HK-2 cells, as indicated by SA-βgal staining, increased after treatment with H₂O₂, oxalate, COM, and urine from those with KS. Expression of p16 was higher in HK-2 cells treated with H₂O₂, oxalate, COM, and urine from those with KS than it was in cells treated with urine from those without stones and untreated controls. p16 was upregulated in the SA-βgal positive cells. Relative telomere length was shorter in HK-2 cells treated with H₂O₂, oxalate, COM, and urine from those with KS than that in cells treated with urine from those without stones and untreated controls. Transcript expression of shelterin components (TRF1, TRF2 and POT1) was decreased in HK-2 cells treated with H₂O₂, oxalate, COM, and urine from those with KS, in which case the expression was highest. Urine from those without KS did not significantly alter TRF1, TRF2, and POT1 mRNA expression in HK-2 cells relative to untreated controls. In conclusion, oxalate, COM, and urine from patients with CaOx KS induced SIPS and telomere shortening in renal tubular cells. SIPS induced by a lithogenic milieu may result from upregulation of p16 and downregulation of shelterin components, specifically POT1, and might contribute, at least in part, to the development of CaOx KS.

The semantics of microglia activation: neuroinflammation, homeostasis, and stress

Microglia are emerging as critical regulators of neuronal function and behavior in nearly every area of neuroscience. Initial reports focused on classical immune functions of microglia in pathological contexts, however, immunological concepts from these studies have been applied to describe neuro-immune interactions in the absence of disease, injury, or infection. Indeed, terms such as 'microglia activation' or 'neuroinflammation' are used ubiquitously to describe changes in neuro-immune function in disparate contexts; particularly in stress research, where these terms prompt undue comparisons to pathological conditions. This creates a barrier for investigators new to neuro-immunology and ultimately hinders our understanding of stress effects on microglia. As more studies seek to understand the role of microglia in neurobiology and behavior, it is increasingly important to develop standard methods to study and define microglial phenotype and function. In this review, we summarize primary research on the role of microglia in pathological and physiological contexts. Further, we propose a framework to better describe changes in microglia1 phenotype and function in chronic stress. This approach will enable more precise characterization of microglia in different contexts, which should facilitate development of microglia-directed therapeutics in psychiatric and neurological disease.

Suicide in primary care: How to screen and intervene

Suicide is significant public health concern within the United States. Research results are mixed about the effectiveness of universal screening and interventions with patients who are at-risk for suicide. Primary care is a logical intervention point to mitigate risk among patients in each of these areas. The Department of Veterans Affairs and Department of Defense have developed comprehensive guidelines for the assessment and management of suicidal patients. This approach involves specific screening tools, risk stratification by categories and interventions used by clinicians to help reduce risk levels in their patients. This article aims to provide a model, built on the principles of these guidelines, which primary care physicians can use to identify, assess and intervene with patients who are at-risk for suicide.

Redox Imbalance and Mitochondrial Release of Apoptogenic Factors at the Forefront of the Antitumor Action of Mango Peel Extract

Today, an improved understanding of cancer cell response to cellular stress has become more necessary. Indeed, targeting the intracellular pro-oxidant/antioxidant balance triggering the tumor commitment to cell demise could represent an advantageous strategy to develop cancer-tailored therapies. In this scenario, the present study shows how the peel extract of mango-a tropical fruit rich in phytochemicals with nutraceutical properties-can affect the cell viability of three colon cancer cell lines (HT29, Caco-2 and HCT116), inducing an imbalance of cellular redox responses. By using hydro-alcoholic mango peel extract (MPE), we observed a consistent decline in thiol group content, which was accompanied by upregulation of MnSOD-a mitochondrial scavenger enzyme that modulates the cellular response against oxidative damage. Such an effect was the consequence of an early production of mitochondrial superoxide anions that appeared after just 30 min of exposure of colon cancer cells to MPE. The effect was accompanied by mitochondrial injury, consisting of the dissipation of mitochondrial membrane potential and a decrease in the level of proteins localized in the mitochondrial membrane-such as voltage-dependent anion-selective channel (VDAC1), mitofilin, and some members of Bcl-2 family proteins (Mcl-1, Bcl-2 and Bcl-X_L)-with the mitochondrial release of apoptogenic factors (cytochrome C and AIF). The analysis of the cytotoxic effects exerted by the different constituents of MPE (gallic acid, mangiferin, citric acid, quinic acid, pentagalloyl glucose, and methyl gallate) allowed us to identify those phytochemicals responsible for the observed anticancer effects, sustaining their future employment as chemopreventive or therapeutic agents.

Psychological Impacts of the COVID-19 Pandemic Among Portuguese and Swiss Higher-Education Students: Protocol for a Mixed Methods Study

BACKGROUND

Higher-education students are particularly vulnerable to both everyday stressors and mental health problems. Public health emergencies may generate a range of unforeseen potential stressors for vulnerable individuals and communities. The current pandemic has apparently led to an increase in psychiatric symptoms among these students.

OBJECTIVE

The goal of this study is to characterize the psychological impact of the COVID-19 pandemic among Portuguese and Swiss higher-education students.

METHODS

This project will use a mixed methods sequential explanatory design in Portugal and Switzerland, with two consecutive phases. During Phase I, a quantitative study will assess the psychological responses of higher-education students during the COVID-19 pandemic. A convenience sampling method will be used for collecting information from students. The association between variables will be determined with univariable and multivariable analyses. During Phase II, qualitative data will be collected in order to understand the determinants of psychological stress and the strategies adopted by students as a result of the COVID-19 pandemic, as well as to identify their opinions and feelings about the teaching-learning process during quarantine. In this phase, participants will be selected using a maximum-variation sampling method. Data from focus group discussions will be coded and inductively analyzed using a thematic analysis approach. Finally, quantitative and qualitative results will be merged during interpretation to provide complementary perspectives.

RESULTS

This paper describes and discusses the protocol for this mixed methods study, which will be completed in December 2021. This study was formally approved by the local ethics committee (CE/IPLEIRIA/22/2020) in Portugal and authorized by the Swiss Association of Research Ethics Committees, swissethics (CER-VD-2020-02889).

CONCLUSIONS

This research can contribute to the development of teaching tools and methods that reinforce positive mental health strategies, hope, and adaptive coping among students, and to the development of a class on mental health interventions in the context of catastrophic and traumatic events. This project will also help government stakeholders as well as health and education professionals safeguard the psychological well-being of students facing an expanding COVID-19 pandemic.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/28757.

Association between Stress at Work and Temporomandibular Disorders: A Systematic Review

Temporomandibular disorders (TMD) have been traditionally associated with psychosocial factors; however, occupational stress as a factor related to TMD has not been adequately assessed in the literature. The aim was to investigate the association between stress at work and TMD on adult paid workers. An electronic search included PubMed, Scopus, Web of Science, Embase, and LILACS databases. Manual searches in the included articles' reference and gray literature were performed. There were no restrictions regarding language or publication period. The inclusion criteria comprised observational studies with paid workers of any category, of both sexes, above 18 years old, assessing occupational stress/stress or distress and TMD as diagnosis or isolated signs and symptoms. Methodological quality was evaluated using Joanna Briggs tools. We narratively assessed the evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. We collected 12 studies. 50% reported a positive association between stress and TMD diagnostic across various job categories. On the other hand, TMJ sounds (a TMD sign) and work stress were associated only in a musicians' population. However, the shortage of eligible articles and the methodological limitations provided a very low certainty of the evidence; only 4 of the studies used validated tools for both stress and TMD (2 reporting positive association). The association between stress and TMD is inconclusive by the available data. In the future, we expect more robust epidemiologic studies addressing these relevant aspects.

Can aging research generate a theory of health?

While aging research and policy aim to promote 'health' at all ages, there remains no convincing explanation of what this 'health' is. In this paper, I investigate whether we can find, implicit within the sciences of aging, a way to know what health is and how to measure it, i.e. a theory of health. To answer this, I start from scientific descriptions of aging and its modulators and then try to develop some generalizations about 'health' implicit within this research. After discussing some of the core aspects of aging and the ways in which certain models describe spatial and temporal features specific to both aging and healthy phenotypes, I then extract, explicate, and evaluate one potential construct of health in these models. This suggests a theory of health based on the landscape of optimized phenotypic trajectories. I conclude by considering why it matters for more candidate theories to be proposed and evaluated by philosophers and scientists alike.

Spanish radiographers' concerns about the COVID-19 pandemic

Introduction

The current outbreak of COVID-19 has caused worldwide healthcare and social emergency in which healthcare professionals were under extreme work conditions while being fearful of becoming infected or spreading the disease to their relatives. The perceived threat of COVID-19 has the potential to cause severe psychological maladjustment. The aim of the study is to explore Spanish radiographers’ concerns about the COVID-19 pandemic.

Methods

This study was quantitative, observational and cross-sectional. The sample was made up of 546 radiographers working in Spain during the outbreak. The instrument used for analysis was an ad hoc questionnaire with socio-demographic questions and the questionnaire on perception of threat from COVID-19 validate to spanish healthcare professionals.

Results

The sample consisted of 70.1% of female, 29.7% of male and 0.2% undeclare sex participants. The results showed a high level of a perceived threat from COVID-19 (7.57 ± 0.088), furthermore we observed a high level of threat about the possibility of infecting family members (8.49 ± 0.25), patients (8.33 ± 0.086), and coworkers (8.35 ± 0.084). Furthermore, females have a higher level of a perception of threat to spread infection between patients (r = −0.136; p = 0.001) and coworkers (r = −0.118; p = 0.006), than males.

Conclusion

COVID-19 pandemic is perceived as a serious threat, being especially concerned about the threat of spreading the infection to family, coworkers, and patients. The perception of risk depends partly on professionals’ gender and family responsibilities.

Implications for practice

Our findings suggest that it is recommended that healthcare professionals receive formation to reinforce and improve their emotional competencies for coping successfully with potentially stressful situations like COVI19 pandemic.

The Cutaneous Physiological Redox: Essential to Maintain but Difficult to Define

Skin is a unique tissue, possessing extremely efficient protective and regulative mechanisms, similar only to the gut and lungs. These tissues serve as an interface with the environment and are exposed to stressors from both endogenous and exogenous sources. Interestingly, all these stressors lead downstream to a cellular production of reactive oxygen species (ROS) and other electrophiles, which, in turn could have deleterious outcomes for the living organism. Hence, such tissues should always maintain a “high-alert” condition in order to cope with these various insults. Nevertheless, a moderate production of ROS induced by stressors could actually be beneficial, although it is impossible to predict if and which exposure would lead to which outcome. Consequently, a parameter which would indicate the skin’s readiness to cope with continuously fluctuating conditions is required. It has been proposed that the redox status may serve as a suitable indicator. In this opinion manuscript, we argue that the redox status is a vague parameter that is difficult to characterized and quantify due to its extremely dynamic nature. The common convention that the redox status is composed solely of the balance between oxidants and reductants (ROS and antioxidants) is also thought-provoking. Since this parameter in vivo behaves in a dynamic and complex manner, it better fits the description of a process, rather than an individual parameter. We suggest that the homeostatic modulation of the physiological redox (PR) should be in focus, rather than the redox status parameter itself. It is further suggested that low molecular weight antioxidants (LMWA) are, in fact, rather insignificant concerning the PR maintenance, and that the major contributors to this delicate modulation are regulative, protein-based systems such as the protective phase II antioxidant enzymes. Moreover, we show that skin microbiome and cutaneous advanced lipid peroxidation end-products (ALEs) take part in sustaining the cutaneous PR homoeostasis via activation of the Nrf2–Keap1 protective pathway.