Perceived Stress, Salivary Cortisol, and Temperament Traits among Students of Dental Medicine: A Prospective and Interventional Study

Academic stress affects students' psychological and physiological well-being. Dental undergraduate programs are known for their demanding curriculum, leading to significant stress symptoms. The objective was to determine if salivary cortisol levels were higher in students exposed to academic stress, assess the relationship between stress severity/temperament and cortisol values, and explore relaxation technique effects. Salivary cortisol was measured at two time points for all participants: Before exams and during a relaxation period after summer break. A third measurement was conducted for students with high pre-test cortisol levels who received instructions on progressive muscle relaxation (PMR) before subsequent exams. Additionally, participants completed two questionnaires: Perceived Stress Scale (PSS) and Fisher's Temperament Questionnaire. The group analysis based on the PSS indicated that 39 participants reported high stress. Women demonstrated significantly higher stress than men (p = 0.042054). A significant difference in stress levels was observed between director and builder temperament types (p = 0.029276). Cortisol levels showed a significant decrease from the first measurement to the second measurement, and the third measurement after implementing PMR. The grade in the "Dermatovenereology" course correlated with stress level according to the PSS (k = 0.578467). Pre-test cortisol levels correlated with the frequency of using PMR guidelines during winter test periods (k = 0.416138). Stress negatively affects the immune system and poses health risks. Implementing stress reduction techniques in dental/medical education could benefit students and the healthcare system.

Significance of N6-methyladenosine RNA methylation regulators in diagnosis and subtype classification of primary Sjögren's syndrome

The importance of N6-methyladenine (m6A) in mRNA metabolism, physiology, pathology and other life processes is well recognized. However, the exact role of m6A regulators in primary Sjögren's syndrome (PSS) remains unclear. In this study, we used bioinformatics and machine learning random forest approach to screen eight key m6A regulators from the Gene Expression Omnibus GSE7451, GSE40611 and GSE84844 datasets. An accurate nomogram model for predicting PSS risk was established based on these regulators. And using consensus clustering, patients diagnosed with PSS were classified into two different m6A patterns. We found that patients in group B had higher m6A scores compared to those in group A: furthermore, both groups were closely related to immunity and possibly to other diseases. These results emphasise the important role of m6A regulators in the pathogenesis of PSS. Our study of m6A patterns may inform future immunotherapy strategies for PSS.

Negative Association of Lignan and Phytosterol Intake with Stress Perception during the COVID-19 Pandemic-A Polish Study on Young Adults

BACKGROUND

There has been an increasing global prevalence of depression and other psychiatric diseases in recent years. Perceived stress has been proven to be associated with psychiatric and somatic symptoms. Some animal and human studies have suggested that consuming foods abundant in lignans and phytosterols may be associated with lower levels of stress, depression, and anxiety. Still, the evidence is not yet strong enough to draw firm conclusions. Thus, we investigated the association between dietary intake of these phytochemicals and the level of stress experienced by adult individuals.

METHODS

Diet was assessed using self-reported 7-day dietary records. The intakes of lignans and phytosterols were estimated using databases with their content in various food products. The Perceived Stress Scale (PSS) was implemented to measure the level of perceived stress. A logistic regression analysis was used to test for associations.

RESULTS

The odds of elevated PSS were negatively associated with dietary intake of total phytosterols, stigmasterol, and β-sitosterol, with evidence of a decreasing trend across tertiles of phytochemicals. The analysis for doubling the intake reinforced the aforementioned relationships and found protective effects against PSS for total lignans, pinoresinol, and campesterol.

CONCLUSIONS

Habitual inclusion of lignans and phytosterols in the diet may play a role in psychological health. To address the global outbreak of depression and other mental health issues triggered by stress, it is important to take a holistic approach. There is a need to develop effective strategies for prevention and treatment, among which certain dietary interventions such as consumption of products abundant in lignans and phytosterols may play a substantial role.

Assessing the stress-relief impact of an art-based intervention inspired by the broaden-and-build theory in college students

Background and objectives

This study's primary objective is to investigate the impact of art-making on the mental well-being of college students, who often experience heightened stress during their initial university years.

Methods

Employing a comprehensive methodology, combining interviews and the Perceived Stress Scale (PSS), the research aimed to assess whether a four-week art-making intervention can effectively alleviate stress levels among college students. In the experimental group, participants engaged in a variety of art-making activities, including freehand drawing, clay modeling, and crafting.

Results

The results revealed that, in the pre-test, there were no significant differences between the experimental and control groups for each assessed indicator. However, in the post-test, significant differences emerged across all indicators. Further analysis demonstrated a significant reduction in stress perception among the experimental group participants between the pre-test and post-test phases.

Conclusion

In conclusion, this study provides compelling evidence that art-making has the potential to foster positive personal development and significantly reduce stress levels among college students.

Associations of Perceived Stress and Psychological Resilience With Cognition and a Modifiable Dementia Risk Score in Middle-Aged Adults

OBJECTIVES

Psychological stress has been proposed as a risk factor for cognitive impairment and dementia. However, it remains unclear how an individual's stress-coping ability (i.e., psychological resilience) is related to cognition. This cross-sectional study investigated whether perceived stress and psychological resilience were associated with cognition and a modifiable dementia risk score in a large community-based sample of cognitively normal adults. The moderating effect of psychological resilience was also examined.

METHODS

Participants (mean age = 57 ± 7 years) enrolled in the web-based Healthy Brain Project completed the Perceived Stress Scale and the Connor-Davidson Resilience Scale. Domains of attention and working memory were assessed using the Cogstate Brief Battery (n = 1,709), and associative memory was assessed using the Cambridge Neuropsychological Test Automated Battery (n = 1,522). Dementia risk was estimated for 1,913 participants using a modified version of the Cardiovascular Risk Factors, Aging, and Incidence of Dementia dementia risk score, calculated using only readily modifiable dementia risk factors.

RESULTS

In separate linear regression analyses adjusted for age, sex, education, and race, greater levels of perceived stress and lower levels of psychological resilience were associated with poorer performance across all cognitive domains, as well as a higher modifiable dementia risk score. Psychological resilience did not moderate the effect of perceived stress on cognition or the dementia risk score.

DISCUSSION

Higher perceived stress and lower resilience were associated with poorer cognition and a greater burden of modifiable dementia risk factors. Intervention studies are required to determine if lowering stress and building resilience can mitigate cognitive deficits and reduce dementia risk.

A signal amplification for Trp isomers electrochemical recognition based on PEDOT:PSS and CS/PAA multilayers

In this work, enhanced tryptophan (Trp) isomers recognition was successfully demonstrated on (CS/PAA)3.5@PEDOT:PSS/GCE, a multilayer chiral sensor with good stability and reproducibility. The (CS/PAA)n multilayers chiral interface was first fabricated via alternating self-assembly of chiral chitosan (CS) and achiral polyacrylic acid (PAA). Conductive PEDOT:PSS was then compounded with (CS/PAA)n multilayers to obtain the chiral sensor for the electrochemical recognition of Trp isomers. The structure of the sensor and its chirality properties for Trp isomers were characterized by fourier transform infrared spectroscopy (FT-IR)，scanning electron microscopy (SEM) and electrochemical methods. The SEM images showed uniform distribution of PEDOT:PSS in the multilayer films, which changed the internal structure of the (CS/PAA)3.5. Consequently, (CS/PAA)3.5@PEDOT:PSS multilayers rendered more chiral centers in addition to improved good conductivity, which significantly amplified the oxidation peak current ratio of D-Trp to L-Trp (ID/IL) up to 6.71 at 25 °C. In addition, a linear relationship was observed between the peak current and Trp enantiomer concentration in the range of 0.002-0.15 mM, and the detection limits of D-Trp and L-Trp were 0.33 and 0.67 μM, respectively. More importantly, the percentage of D-Trp in non-racemic Trp enantiomers mixture solutions were successfully determined on the chiral interface, showing its effectiveness and promising potential in practical applications.

Chronic conditions and depressive symptoms in middle-aged and older Chinese adults: Roles of perceived social support and area of residence

BACKGROUND

Many studies have shown that having noncommunicable chronic diseases (NCDs) is strongly associated with depressive symptoms in elderly people; however, the mechanisms of this association are not fully understood. This study aims to investigate whether perceived social support (PSS) mediates the effect of NCDs on depressive symptoms and whether these relationships differ depending on where middle-aged and elderly people live.

METHODS

The study population was from the psychology and behavior investigation of Chinese residents (PBICR). A total of 8732 people aged 45 and older were included in the hypothetical modulated model. Perceived Social Support Scale (PSSS) and Patient Health Questionnaire-9 (PHQ-9) were used to evaluate PSS and depressive symptoms.

RESULTS

NCDs were positively related to depressive symptoms (β = 0.81, p < 0.01) and indirectly mediated through PSS (β = 0.08). Residency moderated the relationship between NCDs and PSS (β = -0.16, p < 0.01) and between NCDs and depressive symptoms (β = 0.29, p < 0.01). Specifically, the effect of NCDs on PSS and depressive symptoms was greater in rural middle-aged and older adults.

CONCLUSIONS

NCDs raise the risk of depressive symptoms in middle-aged and older Chinese, with PSS playing a partially protective role. In addition, the area of residence moderated the connection between the number of NCDs and PSS, NCDs, and depressive symptoms in middle-aged and older adults.

Neurological injury in primary Sjogren's syndrome

The incidence of neurological injury in primary Sjogren's syndrome varies between 2.5 and 60%. The authors aimed to evaluate its prevalence and characteristics in patients with primary Sjogren's syndrome in a sample of the Syrian population.

Patients and methods

Forty-eight patients with primary Sjogren's syndrome, attending outpatient clinics at Damascus Hospital between January 2020 and January 2022 in this cross-sectional study at the outpatient clinics, were interviewed and examined, and the necessary laboratory and radiological examinations were demanded. Information was collected on disease duration, onset time, and patterns of neurological symptoms.

Results

Forty-eight patients, including 42 females, aged 56.1±10.3 years were enroled.Central nervous system involvement was found in 34 patients. 85% of patients had generalized nerve manifestations, while local nerve manifestations were found in 77,5% of patients. The common neurological manifestation was headaches, then cognitive disorders, and the most common pattern of headache was migraine. Beck Depression Index showed a significant increase in the apathy evaluation scale.The study of cognitive changes showed a significant increase in the Mini-Mental State Examination (MMSE) index.Carotid Doppler showed the presence of injury in 42.4% of patients. The magnetic resonance imaging showed positive findings in 21 patients and positive evoked potentials in 52% of patients.

Discussion

Studies showing the prevalence of Sjogren's neurological injury patterns are insufficient, but this was changed when the criteria for diagnosing Sjogren's syndrome was modified, and the definition of neurological traits in the context of the syndrome was expanded.The presence of a high rate of headaches, cognitive changes, and fatigue confirms that generalized nervous system injuries are more common than local injuries. Migraine was the most common pattern of headache found in patients with the syndrome compared with other patterns such as tension headaches and headaches due to medications, especially analgesics.This was associated with the presence of anti-SSA antibodies and Raynaud's phenomenon, which suggest that the headache mechanism may be due to vascular endothelial dysfunction or an immune-mediated inflammation injury of the neurovascular system.The changes that appeared on the MRI images suggested premotor cortex involvement rather than mesolimbic cortical impairment, and its presence was also associated with SSA antibody positivity, and it is caused by inflammation.

Conclusion

Primary Sjogren's syndrome should be considered as having any unspecified or specific neurological disorder.

Fabrication of Silver Nanobowl Arrays on Patterned Sapphire Substrate for Surface-Enhanced Raman Scattering

The current article discusses surface-enhanced Raman spectroscopy (SERS) as a powerful technique for detecting molecules or ions by analyzing their molecular vibration signals for fingerprint peak recognition. We utilized a patterned sapphire substrate (PSS) featuring periodic micron cone arrays. Subsequently, we prepared a three-dimensional (3D) PSS-loaded regular Ag nanobowls (AgNBs) array using self-assembly and surface galvanic displacement reactions based on polystyrene (PS) nanospheres. The SERS performance and structure of the nanobowl arrays were optimized by manipulating the reaction time. We discovered that the PSS substrates featuring periodic patterns exhibited superior light-trapping effects compared to the planar substrates. The SERS performance of the prepared AgNBs-PSS substrates was tested under the optimized experimental parameters with 4-mercaptobenzoic acid (4-MBA) as the probe molecule, and the enhancement factor (EF) was calculated to be 8.96 × 10⁴. Finite-difference time-domain (FDTD) simulations were conducted to explain that the AgNBs arrays' hot spots were distributed at the bowl wall locations. Overall, the current research offers a potential route for developing high-performance, low-cost 3D SERS substrates.

Comparison between carbohydrate and salt-based macromolecular crowders for cell preservation at higher temperatures

In this investigation, the macromolecular crowding effect of a carbohydrate-based polymer, pullulan, and a salt-based polymer, poly-(4-styrenesulfonic-acid) sodium salt (PSS) was compared for the storage of A549 lung carcinoma cells, at temperatures greater than that of liquid nitrogen storage tanks. A DoE-CCD response surface model was used to optimise medium compositions comprising DMSO and a macromolecular crowder (MMC; pullulan, PSS and their combinations). The effect of adding MMCs was evaluated in terms of post-preservation viability, apoptotic population and growth curve analysis. The optimised medium consisting of 10% DMSO and 3% pullulan in the basal medium (BM) could facilitate long-term cell preservation for 90 days at - 80 °C, resulting in cell viability of ∼83%. The results also showed a significant decrease in the apoptotic population at all time points for the optimised composition of the freezing medium. These results indicated that adding 3% pullulan to the freezing medium improved the post-thaw viability and reduced the apoptotic cell population.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13205-023-03571-6.

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

Introduction

Oral lichen planus (OLP) is a common chronic, T-cell-mediated, inflammatory and non-infectious mucodermatosis. Patients diagnosed with oral lichen planus are more prone to depression, anxiety and higher perceived mental stress than the rest of the population.

Aim

This study investigated stress control methods as a means of reducing pain levels in patients with oral lichen planus.

Material and methods

The study involved 62 adult oral lichen planus patients who have never received any OLP treatment before. Patients with a high level of perceived mental stress received, in addition to standard pharmacological treatment, herbal sedative medication or Jacobson's Progressive Muscle Relaxation guidance (JPMR), and the patients without a high level of perceived mental stress level did not receive any additional stress control methods. The research tool was the PSS questionnaire and NRS pain level scale.

Results

Before the treatment, the level of perceived pain did not differ in any of analysed groups. After the treatment, in the group not using any stress control methods, the mean NRS level was significantly higher than in the group performing Jacobson's Progressive Muscle Relaxation (2.79 ±1.76 vs. 1.08 ±1.29), and also significantly higher than in the group receiving the herbal sedative (2.79 ±1.76 vs. 1.41 ±2.06).

Conclusions

The use of mental stress control methods as an additional element of therapy has a positive effect on the success of oral lichen planus treatment since it helps to reduce the perceived pain level in the oral mucosa better than a standard pharmacological therapy alone.

A new method in the synthesis of conductive polymers; synthesis, characterization, and investigation of photocatalytic properties of polyaniline

As known, in the synthesis of conductive polyaniline polymer from aniline monomer, the polymerization medium must be acidic. In order to make the polymerization medium acidic, protonic acids such as HCl and H2SO4 are generally used. In this study, two acids have been used to make the polymerization medium acidic. One of them, as we know, is H2SO4 as a protonic acid. The other acid is the zinc ion, which is a Lewis acid. The metal ion has never been used for this purpose up to now. Two polyaniline polymers have been synthesized to prove that conductive polymers can also be synthesized in the presence of metal ions instead of protonic acid. One of them is the polyaniline polymer, synthesized in the presence of H2SO4(PANI). The other polymer is polyaniline polymer, synthesized in the presence of zinc ions as acid (PANI-Zn-PSS). The synthesized polymers have been characterized by using scanning electron microscopy (SEM), energy dispersive X-ray spectrometry (EDX), X-ray diffraction diffractometry (XRD), Fourier transform infrared spectroscopy (FTIR), Ultraviolet-visible spectrophotometer (UV-vis.), thermal analysis techniques (thermo-gravimetric analysis, TGA)/differential thermal analysis, DTA) and electrical conductivity measurements kit. The photocatalytic activities of polymers synthesized have been investigated by the degradation of methylene blue (MB) dye in aqueous medium under UV light.

Long-Term Spasticity Management in Post-Stroke Patients: Issues and Possible Actions-A Systematic Review with an Italian Expert Opinion

Spasticity is a well-known motor dysfunction occurring after a stroke. A group of Italian physicians' experts in treating post-stroke spasticity (PSS) reviewed the current scientific evidence concerning the state-of-the-art clinical management of PSS management and the appropriate use of botulinum toxin, aiming to identify issues, possible actions, and effective management of the patient affected by spasticity. The participants were clinicians specifically selected to cover the range of multidisciplinary clinical and research expertise needed to diagnose and manage PSS. When evidence was not available, the panel discussed and agreed on the best way to manage and treat PSS. To address the barriers identified, the panel provides a series of consensus recommendations. This systematic review provides a focused guide in the evaluation and management of patients with PSS and its complications. The recommendations reached by this panel of experts should be used by less-experienced doctors in real life and should be used as a guide on how to best use botulinum toxin injection in treating spasticity after a stroke.

[Clinical care pathway appropriateness of the intoxicated paediatric patient: a retrospective evaluation with Poisoning Severity Score]

OBJECTIVES

to assess the clinical care impact resulting from the lack of a regional reference Centre for Paediatric Poisoning in Liguria Region (Northern Italy) and to describe the demographic and clinical characteristics of paediatric patients who accessed the Emergency Department of the 'Gaslini' Paediatric Hospital (Genoa, Liguria Region) for intoxication.

DESIGN

retrospective cohort study.

SETTING AND PARTICIPANTS

patients' cases of both sexes, <18 years old, who accessed the Emergency Department of the 'Gaslini' Paediatric Hospital between January 2017 and December 2019 for intoxication.

MAIN OUTCOME MEASURES

the Poisoning Severity Score (PSS), a simple and reliable scoring system to describe poisonings and define their severity, was used. The primary objective was pursued by investigating the percentage of cases of intoxication which followed, in the study period, a clinical care pathway inconsistent with the degree of severity ascertained through the retrospective application of the PSS. Clinical-demographic data, triage tag color-coding, and causes of intoxication of cases were also collected. Descriptive statistics were used to summarize results.

RESULTS

a total of 172 cases were identified over the study period; 28 did not meet the inclusion criteria. The final analysis involved 144 cases of intoxication, 70 were from females and 74 from males, with a median age of 3 years-old; 60% of study cases followed a clinical care pathway consistent with the intoxication severity ascertained trough the PSS, in 40% of study cases the clinical care pathway was inconsistent with PSS. The triage tag colour-code assigned was green in 16% of accesses, yellow in 82%, and red in only 2%. Out of the total of accesses, 40% of cases were attributed to drug intoxication in which the agents most involved were analgesics and sedative-hypnotic drugs, 30% to carbon monoxide and fumes poisoning, 23% to food/other substance intoxication, and 7% to alcohol intoxication.

CONCLUSIONS

implementing a referral Centre for Paediatric Poisoning could potentially affect 40% of access to the Emergency Department. Further analysis should be carried out to clarify whether an integrated Telemedicine Service could guide the correct management of intoxicated paediatric patients by referring them, through the Poisoning Severity Score system, for home monitoring or immediate hospitalization, if necessary.

High-Resolution Small RNAs Landscape Provides Insights into Alkane Adaptation in the Marine Alkane-Degrader Alcanivorax dieselolei B-5

Alkanes are widespread in the ocean, and Alcanivorax is one of the most ubiquitous alkane-degrading bacteria in the marine ecosystem. Small RNAs (sRNAs) are usually at the heart of regulatory pathways, but sRNA-mediated alkane metabolic adaptability still remains largely unknown due to the difficulties of identification. Here, differential RNA sequencing (dRNA-seq) modified with a size selection (~50-nt to 500-nt) strategy was used to generate high-resolution sRNAs profiling in the model species Alcanivorax dieselolei B-5 under alkane (n-hexadecane) and non-alkane (acetate) conditions. As a result, we identified 549 sRNA candidates at single-nucleotide resolution of 5'-ends, 63.4% of which are with transcription start sites (TSSs), and 36.6% of which are with processing sites (PSSs) at the 5'-ends. These sRNAs originate from almost any location in the genome, regardless of intragenic (65.8%), antisense (20.6%) and intergenic (6.2%) regions, and RNase E may function in the maturation of sRNAs. Most sRNAs locally distribute across the 15 reference genomes of Alcanivorax, and only 7.5% of sRNAs are broadly conserved in this genus. Expression responses to the alkane of several core conserved sRNAs, including 6S RNA, M1 RNA and tmRNA, indicate that they may participate in alkane metabolisms and result in more actively global transcription, RNA processing and stresses mitigation. Two novel CsrA-related sRNAs are identified, which may be involved in the translational activation of alkane metabolism-related genes by sequestering the global repressor CsrA. The relationships of sRNAs with the characterized genes of alkane sensing (ompS), chemotaxis (mcp, cheR, cheW2), transporting (ompT1, ompT2, ompT3) and hydroxylation (alkB1, alkB2, almA) were created based on the genome-wide predicted sRNA-mRNA interactions. Overall, the sRNA landscape lays the ground for uncovering cryptic regulations in critical marine bacterium, among which both the core and species-specific sRNAs are implicated in the alkane adaptive metabolisms.

Evaluation of Macular and Peripapillary Blood Flow in Response to Intraocular Pressure Reduction in Patients With Posner-Schlossman Syndrome

Purpose: The study aimed to evaluate the effect of intraocular pressure (IOP) reduction on macular and peripapillary microcirculation in patients with Posner-Schlossman syndrome (PSS) by optical coherence tomography angiography (OCTA). Methods: A prospective comparative study was conducted. Patients diagnosed with PSS at the Eye Center of Xiangya Hospital, Central South University, from February 2020 to November 2021 were consecutively included. OCTA was used for the macular and peripapillary microcirculation measurements, and optical coherence tomography (OCT) was employed for the retinal nerve fiber layer (RNFL) and lamina cribrosa depth (LCD) measurements. The patients received OCT and OCTA examinations at baseline and 1 week post-treatment when the IOP was under control. Changes in macular and peripapillary microcirculation, RNFL, and LCD were calculated for all the analyzed areas. Results: Twenty-one eyes from 21 patients were included in the study. Pre-treatment and post-treatment IOP were 43.17 ± 10.36 mm Hg (range, 30-60 mm Hg) and 17.17 ± 2.85 mm Hg (range, 13-23 mm Hg), respectively. No statistically significant changes were detected in RNFL, LCD, or macular and peripapillary microcirculation after significant IOP reduction. Conclusion: The results suggested that a large IOP reduction may not result in a significant increase in peripapillary and macular capillary perfusion in patients with PSS.

Effect of Mindfulness-Based Stress Reduction on the Well-Being, Burnout and Stress of Italian Healthcare Professionals during the COVID-19 Pandemic

COVID-19 has overwhelmed healthcare systems and increased workload and distress in healthcare professionals (HCPs). The objective of this study was to evaluate baseline distress before and after the pandemic, and the effect of Mindfulness-Based Stress Reduction (MBSR) training on well-being (PGWBI), stress (PSS) and burnout (MBI) in Italian HCPs. Moreover, the “fear of COVID-19” (FCV-19S) questionnaire was administered to HCPs participating in the post-emergency MBSR program. Baseline distress results were moderate in all groups. No differences between baseline distress were observed between the groups of HCPs beginning the MBSR courses in the pre or post pandemic period. Total PGWBI lowered with aging. Additionally, FCV-19S positively correlated with age. MBSR was able to lower distress levels, except for depersonalization, which increased, while emotional exhaustion decreased in the group enrolled in the last post-pandemic MBSR course. Levels of fear of COVID-19 in HCPs significantly decreased after MBSR training. The lack of change in baseline distress over time indicates that it is more influenced by work-related distress than by the pandemic in our HCPs. In view of its beneficial effects on psycho-emotional status, MBSR training may represent an effective strategy to reduce distress in emergency periods as well as an essential part of HCPs’ general training.

The Link between Activities of Hepatic 11beta-Hydroxysteroid Dehydrogenase-1 and Monoamine Oxidase-A in the Brain Following Repeated Predator Stress: Focus on Heightened Anxiety

We investigated the presence of a molecular pathway from hepatic 11-βHSD-1 to brain MAO-A in the dynamics of plasma corticosterone involvement in anxiety development. During 14 days following repeated exposure of rats to predator scent stress for 10 days, the following variables were measured: hepatic 11-βHSD-1 and brain MAO-A activities, brain norepinephrine, plasma corticosterone concentrations, and anxiety, as reflected by performance on an elevated plus maze. Anxiety briefly decreased and then increased after stress exposure. This behavioral response correlated inversely with plasma corticosterone and with brain MAO-A activity. A mathematical model described the dynamics of the biochemical variables and predicted the factor(s) responsible for the development and dynamics of anxiety. In the model, hepatic 11-βHSD-1 was considered a key factor in defining the dynamics of plasma corticosterone. In turn, plasma corticosterone and oxidation of brain ketodienes and conjugated trienes determined the dynamics of brain MAO-A activity, and MAO-A activity determined the dynamics of brain norepinephrine. Finally, plasma corticosterone was modeled as the determinant of anxiety. Solution of the model equations demonstrated that plasma corticosterone is mainly determined by the activity of hepatic 11-βHSD-1 and, most importantly, that corticosterone plays a critical role in the dynamics of anxiety following repeated stress.

Towards Higher Psychometric Properties: Testing the Psychological Strain Scales with Larger Samples

This study aimed to further test the psychometric properties of the Psychological Strain Scales (PSS) with larger samples. A cluster sampling method was employed to recruit 13,250 college students from seven provinces in China. Descriptive statistics, item statistics, Cronbach's alpha, factor analysis, and correlation analysis were evaluated. Cronbach's alpha coefficient was 0.958 and Guttman's split-half coefficient was 0.866. All the item-total correlations were larger than 0.45 except one. Results from Exploratory Factor Analysis and Confirmatory Factor Analysis supported the four dimensions of psychological strains (value strain, aspiration strain, deprivation strain, and coping strain). The PSS was strongly correlated to the Depression, Anxiety, and Stress Scale (DASS-21), which was commonly used to measure risk for suicide and was predictive ofsuicidality as measured by the SBQ-R. The PSS was a self-report instrument with high reliability and validity which could be applied for extensive use in research to measure psychological strains.HighlightsThis is the first study testing the psychometric properties of the PSS in an unusually large sample.Confirmatory factor analysis was applied to provide empirical evidence to the four-factor structure of the PSS.Psychological strains were found to be significantly correlated with depression, anxiety, and stress symptoms and predictive of suicidality.

Psychological Stress and Salivary Cortisol Levels in Patients with Plaque Psoriasis

Psychological stress has long been recognized as a trigger for plaque psoriasis, and preliminary evidence suggests that psoriasis could be associated with alterations in the hypothalamic-pituitary-adrenal (HPA) axis, resulting in impaired cortisol response to stress. This study aimed to investigate psychological stress, anxiety, depression and salivary cortisol in psoriatic patients. A cross sectional study involving 126 adult patients with plaque psoriasis and 116 adult healthy controls was conducted. Demographic, clinical data, Perceived Stress Scale (PSS) and Hospital Anxiety and Depression Scale (HADS) were collected. Cases and controls were asked whether they felt stressed in the last month, whilst psoriatic patients were also interrogated whether they found that psoriasis could have been worsened by stress. Moreover, 54 randomly selected subjects (27 psoriasis patients and 27 controls) underwent salivary cortisol testing at 8 am. PSS, HADS depression and anxiety subscales were significantly higher in psoriatic patients than in controls (17.2 ± 0.6 vs. 15.1 ± 0.8 p = 0.0289), (9.5 ± 0.3 vs. 6.2 ± 0.3 p < 0.001) and (8.2 ± 0.4 vs. 4.2 ± 0.3 p < 0.001), respectively. A higher rate of psoriatic patients reported feeling stress over the last month (45% vs. 19%, p < 0.001), and stress was considered a potential trigger for psoriasis flare-ups in 69% of cases. Psoriasis was strongly associated with higher PSS and HADS scores independently of sex, body mass index, diabetes, hypertension, dyslipidemia, and occupational status. Salivary cortisol was significantly lower in psoriatic patients compared to controls (9.6 ± 0.5 vs. 14.0 ± 1.1 nmol/L, p < 0.001). In conclusion, psoriasis was associated with higher psychological stress, anxiety and depressive symptoms, and with impaired cortisol response to stress.

Suspended MoS2 Photodetector Using Patterned Sapphire Substrate

The introduction of patterned sapphire substrates (PSS) has been regarded as an effective method to improve the photoelectric performance of 2D layered materials in recent years. Molybdenum disulfide (MoS₂ ), an intriguing transition metal 2D materials with splendid photoresponse owing to a direct-indirect bandgap transition at monolayer, shows promising optoelectronics applications. Here, a large-scale, continuous multilayer MoS₂ film is prepared on a SiO₂ /Si substrate and transferred to flat sapphire substrate and PSS, respectively. An enhanced dynamic distribution of local electric field and concentrated photon excitons across the interface between MoS₂ and patterned sapphire substrates are revealed by the finite-difference time-domain simulation. The photoelectric performance of the MoS₂ /PSS photodetector is improved under the three lasers of 365, 460, and 660 nm. Under the 365 nm laser, the photocurrent increased by 3 times, noise equivalent power (NEP) decreases to 1.77 × 10^-14 W/Hz^1/2 and specific detectivity (D*) increases to 1.2 × 10¹⁰ Jones. Meanwhile, the responsivity is increased by 7 times at 460 nm, and the response time of the MoS₂ /PSS photodetector is also shortened under three wavelengths. The work demonstrates an effective method for enhancing the optical properties of photodetectors and enabling simultaneous detection of broad-spectrum emissions.

Early enteral nutrition combined with PSS-based nursing in the treatment of organophosphorus pesticide poisoning

OBJECTIVE

To investigate the administration of early enteral nutrition combined with poisoning severity score (PSS)-based nursing in the treatment of organophosphorus pesticide poisoning (OPP).

METHODS

A total of 99 OPP patients treated in our hospital between June 2019 and June 2020 were enrolled in this study and were divided into the conventional group (n=46, early enteral nutrition support + routine care) and the combined group (n=53, PSS-based nursing + early enteral nutrition support + routine care). The nutritional status indicators, the hemoglobin (Hb) and blood glucose levels, the Glasgow coma scale (GCS) scores, and the complications were compared between the two groups.

RESULTS

The total protein (TP), albumin (ALB), and prealbumin (PAB) levels were reduced in the conventional group after the intervention (P<0.05) but were significantly lower than they were in the combined group (P<0.05). The Hb and blood glucose levels were decreased in the conventional group after the intervention (P<0.05) and were significantly higher than they were in the combined group (P<0.05). The GCS scores increased significantly as the treatment progressed (P<0.05), and the GCS scores in the combined group were significantly higher than the GCS scores in the conventional group at 3 and 5 days after the treatment (P<0.05). The time to the recovery of 60% cholinesterase (CHE) activity, the durations of the mechanical ventilation, the lengths of the hospital stays, and the hospital costs in the combined group were significantly lower than they were in the conventional group (P<0.05). The complication rate in the combined group (9.43%) was significantly lower than the complication rate in the conventional group (32.61%) (P<0.05).

CONCLUSION

Early enteral nutrition combined with PSS-based nursing can effectively control the blood glucose, improve the nutritional disorders, promote recovery, and reduce complications in OPP patients.

The streamlined allostatic load index is associated with perceived stress in life - findings from the MIDUS study

The wear and tear of the body caused by stressful events is subject of extensive research and can be measured by the allostatic load index (ALI). The aim of this cross-sectional study was to replicate an ALI-5 score in a population sample in the USA and to compare these findings with the original ALI-10 score. Data from the Midlife in the United States Study (MIDUS) assessed between 2004 and 2016 were used to calculate different ALI risk scores with 5 and 10 variables, respectively. Examinations included anthropometric data, heart rate variability (HRV), and blood and urine samples. Questionnaires assessed information on perceived stress and medical history. Logistic regression models estimated odds ratios (OR) with corresponding 95% confidence intervals (CIs) for the association between ALI indices and perceived stress, controlling for various confounders. Subgroup analysis explored the difference in gender and in three age clusters. Data of 1421 participants (43% male, 50.4 ± 9.3 years) were included in the analysis. Adjusted logistic regression models showed an odds ratio of 1.37 ± 0.19 (CI 1.05, 1.80; p=.022) for the association of ALI-5 with perceived stress. This association was stronger in females (OR = 1.62 ± 0.28, CI 1.15, 2.28; p = .006) and did not significantly differ between age clusters. Results for the original ALI-10 score did not reach significance. The streamlined ALI-5 score seems to be a reliable risk score and is strongly associated with perceived stress in life. Longitudinal studies should further elaborate this association in different samples.Lay summary: Stress from different sources can lead to serious diseases. A short composite index comprising of five medical variables is highly associated with perceived stress. This index is able to serve as an early indicator to detect people who are at risk to develop stress-related diseases.

Stress at work is associated with intima media thickness in older male employees, independent of other sources of stress perception

Chronic stress at work shows a moderate but robust longitudinal association with cardiovascular disease (CVD). Atherosclerosis is a pathophysiological process of most CVD, for which intima media thickness (IMT) of the carotid artery is used as an early marker. Its relationship with stress at work has remained largely unexplored, and the present study therefore aimed to elucidate the association between stress at work, assessed as effort-reward imbalance (ERI), and IMT. This cross-sectional study comprised of 501 male German employees aged 42 (19-64) years at enrollment into the Mannheim Industrial Cohort Study. Clinical assessments used fasting blood samples and IMT measurement. Self-report questionnaires assessed sources of perceived stress. Analyses adjusted for medical history, life style, and socio-economic status (SES) indicators as well as general perceived stress and worries to determine the specificity of ERI. Linear regression models estimated the association of ERI with IMT, stratifying for age groups and adjusting for potential confounders. ERI ratio increased until the age of 50 years and abated thereafter. In participants younger than 50 years IMT measurements were not associated with ERI ratios. However, despite lower mean ERI ratios in participants older than 50 years, this age group showed a significant relationship with IMT (standardized Beta = .36, p < .01), adjusting for multiple confounders including general perceived stress and worries. These analyses suggest that atherosclerosis in older employees is specifically related to stress at work. Longitudinal studies will help to elucidate the temporal relationship between stress exposure and downstream biological mechanisms.Lay summaryOur study explored the association of job stress and the calcification of the carotid artery in German employees. We found out that this association is stronger in employees older than 50 years. In addition, it is independent of medical risk factors and stress caused by private issues.

Feelings of guilt and loss of control dominate in stress and depression inventories from women with recurrent pregnancy loss

PURPOSE

Which feelings on the major depression inventory (MDI) and the perceived stress scale (PSS) are predominant among women with recurrent pregnancy loss (RPL)?

MATERIALS AND METHODS

Prospective cohort study of women with RPL referred to the tertiary RPL Unit at Copenhagen University Hospital, Rigshospitalet, Denmark, from 2010-2013. All women answered the MDI and PSS at time of referral.

RESULTS

In total, 298 women completed the MDI and the PSS, of which 162 had primary RPL and 136 secondary RPL. The most common feelings were low in energy (42%), loss of interest (35%), sadness (35%), and guilt (29%). Twenty-six (8.6%) women fulfilled the criteria for moderate to severe depression. Of the remaining 272 women, nine felt that life was not worth living. Among all women feeling angered of things outside their control (35%) and unable to control important things (27%) were predominant. Women with primary RPL compared to secondary RPL more often felt less self-confident and that life wasn't worth living (p = 0.007 and p = 0.002).

CONCLUSIONS

Feelings of guilt and loss of control were predominant in women with RPL. Women with primary RPL could represent a particularly sensitive group. Addressing these specific feelings could help treating the psychological aspects of RPL.

Titanium-Based Alloy Surface Modification with TiO2 and Poly(sodium 4-styrenesulfonate) Multilayers for Dental Implants

Implant placement is an important repair method in dentistry and orthopedics. Increasing efforts have focused on optimizing the biocompatibility and osseointegration properties of titanium (Ti) and Ti-based alloys. In this work, Ti-based alloys were modified by the layer-by-layer (LbL) technique, which is a simple and versatile method for surface modification. The morphology and chemical structure of LbL films of poly(sodium 4-styrenesulfonate) (PSS) and Ti dioxide (TiO₂) nanoparticles were first characterized employing ultraviolet-visible and Fourier-transform infrared spectroscopies as well as atomic force microscopy for further application in Ti-based alloy implants. The changes provoked by the LbL PSS/TiO₂ film on the Ti-based alloy surfaces were then investigated by scanning electron microscopy and micro-Raman techniques. Finally, in vivo tests (immunolabeling and biomechanical analysis) performed with screw implants in rats suggested that PSS/TiO₂ multilayers promote changes in both topography and chemical surface properties of the screw, providing beneficial effects for osteoblast activity. This simple and relatively low-cost growth process can open up possibilities to improve dental implants and, probably, bone implants in general.

Perceived Stress in a Gender Perspective: A Survey in a Population of Unemployed Subjects of Southern Italy

Stressful life events, are differently handled by women and men. This study evaluates gender differences in perceived stress and health status among a sample of subjects going through a transition period from unemployment to work. This cross-sectional study enrolled 395 participants, 245 men (62%) and 150 (38%) women, between 19 and 67 years, that were going to be hired for a 6-month contract. Before being employed, all participants underwent a mandatory protocol consisting in a general medical check. Stress assessment was performed by using the Perceived Stress Scale (PSS). Most of the participants (68%) showed normal to low perceived stress level. But dividing the sample by gender, out of the remaining 32% with medium to high stress level, 11% male subjects and 22.7% females reported high perceived stress values. We found mean PSS values that are overlapping with those in the general population of developed countries. This study does not suggest an association between perceived stress and health or social parameters. However, our results highlight that the female gender is associated with higher stress level, pointing out the relevance of specific and designed interventions in the context of health promotion programs, especially in order to mitigate stress in more susceptible subjects.

Water Content of Polyelectrolyte Multilayer Films Measured by Quartz Crystal Microbalance and Deuterium Oxide Exchange

Water content of natural and synthetic, thin, polymer films is of considerable interest to a variety of fields because it governs properties such as ion conductivity, rigidity, porosity, and mechanical strength. Measuring thin film water content typically requires either complicated and expensive instrumentation or use of multiple instrumental techniques. However, because a quartz crystal microbalance (QCM) is sensitive to changes in mass and viscosity, deuterated solvent exchange has emerged as a simple, single-instrument, in situ method to quantify thin film water content. Relatively few studies, though, have employed this technique to measure water content of polyelectrolyte multilayers formed by layer-by-layer (LbL) assembly. In this work, poly (allyl amine) (PAH) and poly (styrene sulfonate) (PSS) films of up to nine layers were formed and the water content for each layer was measured via QCM with deuterium oxide exchange. The well-characterized nature of PAH/PSS films facilitated comparisons of the technique used in this work to other instrumental methods. Water content results showed good agreement with the literature and good precision for hydrated films thicker than 20 nm. Collectively, this work highlights the utility, repeatability, and limitations of this deuterated exchange technique in measuring the solvent content of thin films.

Perceived Stress Scale Among Adolescents with Polycystic Ovary Syndrome

Introduction

Polycystic ovary syndrome (PCOS) is a common disorder that affects women during their reproductive age. Previous studies have suggested that PCOS may be linked to some mental disorders.

Aim

The study aimed to estimate the perceived stress among adolescents with PCOS and investigate the relationship between PCOS symptoms and perceived stress scale (PSS) in adolescents.

Methods

This was a case control study with 72 participants (between 11 and 19 years); 36 adolescents with PCOS and 36 matched controls were recruited from family medicine and gynecological outpatient clinics at Cairo University hospitals. They participated in a structured interview using a pre-designed questionnaire. Full general examination was conducted, including anthropometric measures, acne staging, and hirsutism staging using the Ferriman–Gallwey score. We assessed the severity of stress over the previous month of interview using the 10-item perceived stress scale (PSS-10).

Results

There was a statistically significant difference in PSS scores among adolescents with and without PCOS; most cases with severe PSS scores were found to have PCOS. The mean score of PSS was higher in PCOS adolescents (20.416) than in the non-PCOS control group (18.8), but with no statistical significance. There was no significant correlation between the severity of PSS in PCOS adolescents and BMI, WC, acne or hirsutism severity; there was only weak positive correlation between PSS score and DBP (r=0.167).

Conclusion

PCOS adolescents have higher incidence of severe perceived stress; however, degree of PSS was independent of BMI, WC, acne or hirsutism severity and shows only weak correlations with DBP. Our results urge the need for implementing a holistic approach that should include stress reduction programs to help adolescents get ready for their adult life.

Perceived Stress Scale (PSS-10) psychometric properties in migrants and native Germans

BACKGROUND

With the increasing diversity of the German population, it is important to test the psychometric validity and reliability of the German version Perceived Stress Scale (PSS-10) specifically between German natives and residents with a migration background.

METHODS

Using nationally representative data (N = 2527), this study conducted an Exploratory Factor Analysis (EFA) to determine the most appropriate factor structure, a Multi-Group Confirmatory Factor Analysis (MGCFA) to compare the validity of the two-factor structure and tested the PSS-10 measurement invariance between the German native and migrant sub-samples. Lastly, reliability of the PSS-10 was examined via Cronbach's alpha, omega and individual item analyses across the two sub-samples.

RESULTS

The EFA results support a two-factor structure in the migrant sample. The MGCFA showed adequate model fit for both sub-samples and the PSS-10 is strict invariant between German natives and migrants. Cronbach's alpha and omega for Perceived Helplessness (PHS: factor 1) and Perceived Self-Efficacy (PSES: factor 2) demonstrate good internal consistency in both German and migrant sub-samples.

CONCLUSIONS

The key conclusions are: (1) the German version PSS-10 is suitable for German residents with a migration background. (2) Despite good internal consistency for the total scale, the PSS-10 measures two aspects: (a) perceived helplessness and (b) perceived self-efficacy. Future research would profit from analyzing the two subscales separately, not only using the total score.

Association between the Inflammatory Potential of Diet and Stress among Female College Students

A pro-inflammatory diet may have an adverse influence on stress and inflammatory biomarker levels among college students. The dietary inflammatory index (DII^®) is a tool used to assess the inflammatory potential of a diet. However, evidence for the association between DII and stress is limited. We examined the association between energy-adjusted DII (E-DII^TM), high sensitivity-C-reactive protein [hs-CRP], and stress among female college students. This cross-sectional study included 401 randomly selected female students, aged 19–35 years. Data collection included blood, anthropometric measurements, a healthy-history questionnaire, the perceived stress scale (PSS-10), the Saudi food frequency questionnaire (FFQ), and E-DII. Multiple linear regression analyses were used to examine the association between FFQ-derived E-DII score, hs-CRP, and PSS. A higher E-DII score per 1SD (1.8) was associated with a 2.4-times higher PSS score (95% CI: 1.8, 3.1). Higher hs-CRP per 1SD (3.3 mg/L) was associated with a 0.9 (95% CI: 0.7–1.1) times higher PSS score, independent of lifestyle and dietary factors. Our findings indicate that pro-inflammatory diets were highly prevalent among Saudi college students and were associated with higher stress levels. Consideration of the role of stress and focusing on anti-inflammatory foods may be key for healthier dietary habits.

Canine intrahepatic portosystemic shunt insertion into the systemic circulation is commonly through primary hepatic veins as assessed with CT angiography

Congenital intrahepatic portosystemic shunts (IHPSS) in dogs are traditionally classified as right, left, or central divisional. There are few descriptive studies regarding the variation of IHPSS within these categories. This multicenter, analytical, cross-sectional study aimed to describe a large series of dogs with CT angiography (CTA) of IHPSS, hypothesizing that there would be variation to the existing classification. Ninety CTA studies were assessed for IHPSS type, insertion, and the relationship of the insertion to the primary hepatic veins. Ninety-two percent of IHPSS inserted into a primary hepatic vein (HV) or phrenic vein, 8% inserted directly into the ventral aspect of the intrahepatic caudal vena cava. The most common IHPSS type was a single right divisional (44%), including those inserting via the right lateral HV or the caudate HV. Left divisional IHPSS (33%) inserted into the left HV or left phrenic vein. Central divisional IHPSS (13%) inserted into the quadrate HV, central HV, dorsal right medial HV, or directly into the ventral aspect of the intrahepatic caudal vena cava. Multiple sites of insertion were seen in 9% of dogs. Within left, central, and right divisional types, further subclassifications can therefore commonly be defined based on the hepatic veins with which the shunting vessel communicates. Relating IHPSS morphology to the receiving primary HV could make IHPSS categorization more consistent and may influence the type and method of IHPSS attenuation recommended.

Adsorption Behavior of Polyelectrolyte onto Alumina and Application in Ciprofloxacin Removal

This study aims to investigate the adsorption behavior of a strong polyelectrolyte poly(styrenesulfonate) (PSS) onto alumina particles. Adsorption of PSS onto positively charged alumina surface increased with increasing ionic strength, indicating that non-electrostatic and electrostatic interaction controlled the adsorption. The removal of an emerging antibiotic ciprofloxacin (CFX) from water environment using PSS-modified alumina (PMA) was also studied. The removal of CFX using PMA was much higher than that using alumina particles without PSS modification in all pH ranges of 2–11. The removal of CFX reached 98% under the optimum conditions of pH 6, contact time of 120 min, adsorbent dosage of five milligrams per milliliter and ionic strength 10⁴-M NaCl. The adsorption isotherms of CFX at different salt concentrations fit well with a two-step adsorption model, while the adsorption kinetic fit well with a pseudo-second-order model with a good correlation coefficient (R² > 0.9969). The CFX-removal from a hospital wastewater using PMA was more than 75%. Our study demonstrates that adsorption of PSS onto alumina to modify the particle surface is important to form a novel adsorbent PMA for CFX-removal from water environments.

Psychometric properties of the three versions of the Perceived Stress Scale in Ecuador

BACKGROUND

. The Perceived Stress Scale (PSS) is the most well-known self-report measure to assess perceived psychological stress.

OBJECTIVE

. The objective of the study was to analyze the psychometric properties of three versions of the Perceived Stress Scale (PSS-4, PSS-10 and PSS-14) in Ecuador.

METHODS

. A sample of 7905 university students (46% men and 54% women) from Ecuador were surveyed using all three versions of PSS.

RESULTS

. All three versions showed a satisfactory adjustment with a bifactorial structure based on the item structure rather than underlying dimensions of psychological stress. The reliability was also adequate, with Alpha and Omega coefficients [α = 0.85 and ω = 0.80 for PSS-14; α = 0.85 and ω = 0.87 for PSS-10; α = 0.74 and ω = 0.78 for PSS-4] respectively. Psychological stress scores positively correlated with multiple health indicators such as loneliness, psychological inflexibility, alcohol consumption, and presence of anxiety and depression symptoms, and negatively with resilience.

CONCLUSIONS

. The use of PSS-10 based on its best goodness of fit and PSS-4 as the shortest version are recommended to measure psychological stress, rather than the original PSS-14 version. Psychological stress was significantly higher in women than men.

The Effect of Coronavirus (COVID-19) on Breast Cancer Teamwork: A Multicentric Survey

BACKGROUND/AIM

Despite the large amount of clinical data available of Coronavirus-19 (COVID-19), not many studies have been conducted about the psychological toll on Health Care Workers (HCWs).

PATIENTS AND METHODS

In this multicentric descriptive study, surveys were distributed among 4 different Breast Cancer Centers (BCC). BCCs were distinguished according to COVID-19 tertiary care hospital (COVID/No-COVID) and district prevalence (DP) (High vs. Low). DASS-21 score, PSS score and demographic data (age, sex, work) were evaluated.

RESULTS

A total of 51 HCWs were analyzed in the study. Age, work and sex did not demonstrate statistically significant values. Statistically significant distribution was found between DASS-21-stress score and COVID/No-COVID (p=0.043). No difference was found in the remaining DASS-21 and PSS scores, dividing the HCWs according to COVID-19-hospital and DP.

CONCLUSION

Working in a COVID-19-hospital represents a factor that negatively affects psychosocial well-being. However, DP seems not to affect the psychosocial well-being of BCC HCWs. During the outbreak, psychological support for low risk HCWs should be provided regardless DP.

Reliability, validity, and the ability to detect change of the Psoriasis Symptom Scale (PSS) in patients with plaque psoriasis

Introduction: The primary objective of the study was to evaluate the measurement properties of the patient-reported four-item Psoriasis Symptom Scale (PSS).Methods: Analysis of phase-III data on the efficacy of risankizumab to assess psychometric characteristics of the PSS in patients with moderate-to-severe psoriasis.Results: PSS items had a good range of symptom severity coverage. The PSS had good test-retest reliability (ICCs >0.90). Convergent and discriminant validity was indicated by moderate-to-strong correlations between the PSS and Dermatology Life Quality Index (DLQI), PSS pain item and EQ-5D pain/discomfort item at week 12 (0.63), and moderate negative correlation with EQ-Visual Analog Scale score at week 12 (-0.37). Known groups validity demonstrated as mean PSS total scores varied by Psoriasis Area and Severity Index (PASI) and Static Physician's Global Assessment (sPGA) defined groups (p < .0001). PSS total scores were responsive to changes in PASI score (p < .0001) and sPGA (p < .0001). PSS minimal, clinical, and meaningful change is estimated to be 1 to 2 points; a preliminary responder definition is a total change score of 3 to 4 points.Conclusions: The PSS is a short, valid unidimensional measure of psoriasis symptom severity, well suited for use in clinical trials.

Determinants of Suicide-related Ideation in Late Life Depression: Associations with Perceived Stress

Objectives: Perceived stress is emerging as a potential contributing factor in suicide-related ideation in older adults. We hypothesized higher levels of perceived stress would be associated with increased self-reported suicidal ideation independent of depressive symptom severity.Methods: This study used data from community-dwelling older adults aged ≥65 with a current diagnosis of major depression. Eligible participants completed measures of depression symptom severity (Hamilton Depression Rating Scale-17 item), current suicidal ideation (Geriatric Suicide Ideation Scale), and perceived stress (Perceived Stress Scale).Results: Participants were 225 older adults with a mean age of 71.4 (SD = 5.6). Sixty-five percent of the sample was female. Fifteen percent of the variance in suicidal ideation was accounted for by lower education (p = .03), male sex (p = .03) and higher current perceived stress (p < .001). Specifically, stress accounted for 12% of the variance.Conclusions: Perceived stress is an important avenue to increase identification of individuals with a higher risk of suicide-related ideation among older adults with a current diagnosis of major depression.Clinical Implications: Screening for perceived stress may allow for improved screening and prevention of suicidal activity in depressed older adults.

Psychometric Analysis of the Perceived Stress Scale Among Healthy University Students

BACKGROUND

There is a gradual increase in the prevalence of stress during professional courses. Previous studies reported a high incidence of stress among university students. The psychometric properties of the perceived stress scale-10 (PSS-10) have been established in different populations. The current study aimed to assess psychometric properties of the PSS-10 in Saudi university students.

METHODS

Healthy university students (n= 192) participated in this cross-sectional study. All the participants were explained about the aim and procedures of the study. Participants were requested to complete the English version of the PSS, the generalized anxiety disorder-7 (GAD-7), the sleep hygiene index (SHI), and demographic details.

RESULTS

The range of the PSS-10 total score was 0-35; 1% reported minimum score of 0, but none reported maximum score of 40. Therefore, there was no issue of ceiling or floor effect in the PSS-10 total score. Positive and significant correlations of the PSS total and the PSS Factor-1 (distress perception) with the GAD-7 total score, SHI item-8 and SHI item-13 score support its convergent validity. Negative or no correlation of the PSS Factor-2 score (coping perception) with the GAD-7 total score, SHI item-8 and SHI item-13 scores demonstrate its divergent validity. The internal homogeneity test indicated moderate to strong positive correlations (r=0.60-0.82) between the PSS Factors and the items loading on them. The internal consistency test showed a good agreement for the PSS Factor-1 and the PSS Factor-2 scores (Cronbach's alpha 0.78 and 0.71, respectively), suggesting an acceptable level of consistency. Factor analysis favored a 2-Factor model of the PSS in the Saudi students.

CONCLUSION

The current study supported the use of the PSS-10 to assess the perceived stress among Saudi university students.

Safety Evaluation of Protective Equipment for the Forearm, Shin, Hand and Foot in Taekwondo

The objective of the study was to evaluate and compare different brands of forearm, shin, hand and foot protective equipment used in Taekwondo. The most popular brands of large forearm, shin, hand and foot protectors (D^®, A^®, K ^®), approved by the World Taekwondo and Korean Taekwondo Association, were examined. A drop test was used to test the protective equipment using impact levels of 3J, 9J, 12J and 15J for the forearm and shin guards, and 3J and 9J for the hand and foot protectors. The protective equipment was hit ten times from each of the designated drop heights. The drop test is described in the European standards manual of protective equipment for martial arts (SRPS EN 13277-2). The maximum force (MF) and impulse were lowest for brand K^® (2610.3 ± 1474.1 N), and brand A^® (9.6 ± 3.1 Ns), respectively, for the forearm guards; for brand A^® (2053.4 ± 1267.1 N) and brand K^® (9.8 ± 3.5 Ns), respectively, for the shin guards; for brand K^® (4486.5 ± 1718.4 N), and brand A^® (6.3 ± 1.1 Ns), respectively for the hand protectors; and for brand A^® (3733.7 ± 2465.3 N), and brand D^® (6.8 ± 0.6 Ns), respectively, for the foot protectors. For the forearm guard brand and impact level, there was a significant interaction effect for the MF (F=42.44, η²=.677, p <0.001) and impulse (F = 33.97, η² = 0.626, p <0.001). Based on the MF, brand K^® performed the best for the forearm guards and hand protectors, and brand A^®, for the shin guards and foot protectors. The best results for the impulse were for brand A^® (forearm guards and hand protectors), brand K^® (shin guards) and brand D^® (foot protectors).

Psychometric properties of the perceived stress scale in Ethiopian university students

Background

Stress is a common psychological condition usually associated with many psycho-physical disorders. Stress and its risk factors are frequently seen in Ethiopians including university students. In such circumstances, a valid measure to screen for stress in Ethiopians is necessary. Therefore, we assessed the psychometric properties of the Perceived Stress Scale (PSS) in Ethiopian university students.

Methods

A cross-sectional study with a simple random sampling method was performed on students of Mizan-Tepi University, Mizan-Aman, Ethiopia. The study presents a psychometric investigation on a sample of 387 students (age = 21.8 ± 3.8 years, and body mass index = 20.8 ± 3.2 kg/m²) who completed PSS, Generalized anxiety disorder-7 scale (GAD-7), and a socio-demographics tool. McDonald’s Omega (internal consistency), factor validity for ordinal data and convergent validity (Spearman’s correlation) were assessed.

Results

No ceiling/floor effect was seen for the total or factor scores of the PSS-10 and PSS-4. Two factor model of the PSS-10 was favored by fit indices with Comparative Fit Index> 0.95, Weighted root mean square residual<.05 and root mean square error of approximation<.08. McDonald’s Omega was 0.78 and 0.68 for the PSS-10: Factor-1 and PSS-10: Factor-2, respectively. McDonald’s Omega was 0.70 and 0.54 for the PSS-4: Factor-1 and PSS-4: Factor-2, respectively. There were moderate-strong correlations (r = 0.62–0.83) between PSS factors and respective items loading on them. PSS scores were correlated with GAD-7 (r = .27–.40, p < .01).

Conclusion

The psychometric measures support the validity of the PSS-10 in Ethiopian university students.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-6310-z) contains supplementary material, which is available to authorized users.

Structure-activity relationship of propylene glycol alginate sodium sulfate derivatives for blockade of selectins binding to tumor cells

Selectins dominate the formation of the metastasis niche and are considered important targets for exploring antimetastatic drugs. In this study, we evaluated the effect of the marine drug propylene glycol alginate sodium sulfate (PSS) and a series of PSS derivatives on P-, L- or E-selectin-mediated binding with tumor cells. We found that PSS effectively prevented the binding of P- or L-selectin with tumor cells. Moreover, the structure-activity relationship study indicated that the activity of PSS is related to the sulfate group at the C-2/C-3 position, the propylene glycol substituent at the C-6 position, the ratio of guluronic acid to mannuronic acid, and the molecular weight. Additionally, PSS derivatives significantly suppressed lung metastasis in vivo. Our results demonstrated that PSS and its derivatives are potential antimetastatic drugs candidates.

Transparent Tunable Acoustic Absorber Membrane Using Inkjet-Printed PEDOT:PSS Thin-Film Compliant Electrodes

Window glasses can block noise from outdoor, but they reverberate sound within a large indoor space. Microperforated glass absorbers have been developed to absorb sound over a fixed but narrow bandwidth. To tune the frequency spectrum of acoustic absorption, we developed a transparent tunable acoustic absorber based on microperforated dielectric elastomer actuator (MPDEA) and transparent compliant electrodes. Such transparent compliant electrodes were inkjet printed from Triton X-plasticized poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) ink, which shows improved wettability on the acrylate dielectric elastomer substrate. These transparent polymeric electrodes are softer with uptake of moisture while being self-clearable and durable. A single layer of MPDEA using two inkjet-printed electrodes is 78.64% clear, but the clarity of a two-layer MPDEA decreases to 61.8%. Among the two designs, the two-layer MPDEA exhibits a broader acoustic absorption bandwidth of 444 Hz for absorbing more than 80% of the sound energy. Inactivated resonant frequency of this MPDEA is 1170 Hz, whereas the 6 kV activation can reduce the resonant frequency for 15.2% by causing 9% hole-diameter contraction. This transparent tunable acoustic absorber can be fitted to window glass; its acoustic performance is better than that of translucent curtains.

Children's Environmental Health Indicators in Context of the Sustainable Development Goals for Small Island Developing States

The unique environmental vulnerability of small island developing states (SIDS) is likely to impact negatively on children’s health. Children’s environmental health indicators (CEHI) are standardized measures that can be used to assess the environmental exposures and their resulting health outcomes in children. This study sought to utilize the United Nations (UN) global Sustainable Development Goals (SDGs), with their associated targets and indicators, as a framework for a CEHI proposal for SIDS. Exposure-side indicators were taken from key themes from the 2012 Rio+20 UN Conference on Sustainable Development, and health-side indicators were selected based on the most significant contributors to the burden of disease in children. The multiple-exposures–multiple-effect (MEME) framework was then used to show the relationships between environmental exposures and children’s health outcomes. The framework was populated with available data from the World Bank’s DataBank. Whilst there was some data available at a population level, major gaps in both exposure-side and health-side indicators were revealed. In order to progress children’s environmental health in SIDS, a further piece of work is required to propose a fully prioritized set of exposure-side and health-side CEHIs; based on, but not exclusively linked to, the SDGs.

Sensitive and Selective NH₃ Monitoring at Room Temperature Using ZnO Ceramic Nanofibers Decorated with Poly(styrene sulfonate)

Ammonia (NH₃) gas is a prominent air pollutant that is frequently found in industrial and livestock production environments. Due to the importance in controlling pollution and protecting public health, the development of new platforms for sensing NH₃ at room temperature has attracted great attention. In this study, a sensitive NH₃ gas device with enhanced selectivity is developed based on zinc oxide nanofibers (ZnO NFs) decorated with poly(styrene sulfonate) (PSS) and operated at room temperature. ZnO NFs were prepared by electrospinning followed by calcination at 500 °C for 3 h. The electrospun ZnO NFs are characterized to evaluate the properties of the as-prepared sensing materials. The loading of PSS to prepare ZnO NFs/PSS composite is also optimized based on the best sensing performance. Under the optimal composition, ZnO NFs/PSS displays rapid, reversible, and sensitive response upon NH₃ exposure at room temperature. The device shows a dynamic linear range up to 100 ppm and a limit of detection of 3.22 ppm and enhanced selectivity toward NH₃ in synthetic air, against NO₂ and CO, compared to pure ZnO NFs. Additionally, a sensing mechanism is proposed to illustrate the sensing performance using ZnO NFs/PSS composite. Therefore, this study provides a simple methodology to design a sensitive platform for NH₃ monitoring at room temperature.

ICP and Antihypertensive Drugs

OBJECTIVES

Arterial hypertension is among the leading risks for mortality. This burden requires in hypertensive patients the use of single, double or more antihypertensive drugs. The relationship between intracranial pressure (ICP) and arterial blood pressure is complex and still under debate. The impact of antihypertensive drugs on ICP is unknown. We wanted to understand whether the use of antihypertensive drugs has a significant influence on ICP and cerebrospinal fluid (CSF)/brain related parameters.

MATERIALS AND METHODS

In a cohort of 95 patients with suspected normal pressure hydrocephalus, we prospectively collected drug details according to the Anatomical Therapeutic Chemical (ATC) classification. Lumbar infusion studies were performed. Using ICM+ software, we calculated at baseline and plateau ICP and pulse amplitude, resistance to CSF outflow, elastance, and pressure in the sagittal sinus and CSF production rate. We studied the influence of the administration of 1, 2, 3 or more antihypertensive drugs on ICP-derived parameters. We compared the data using Student's and Mann-Whitney tests or Chi-squared and Fisher's exact test.

RESULTS

Elastance is significantly higher in patients with at least one antihypertensive drug compared with patients without medication. On the contrary, pressure volume index (PVI) is significantly decreased in patients with antihypertensive drugs compared with patients not on these medications. However, the number of antihypertensive drugs does not seem to influence other ICP parameters.

CONCLUSIONS

Patients on antihypertensive drugs seem to have a stiffer brain than those not on them.

The content validity of the PSS in patients with plaque psoriasis

BACKGROUND

The primary objective of this study was to evaluate the content validity of the Psoriasis Symptom Scale (PSS), with a specific focus on understanding of the content of the PRO measure by conducting one-on-one interviews with patients with moderate to severe plaque psoriasis. This was a cross-sectional, qualitative study conducted with 20 patients with plaque psoriasis who participated in in-person, one-on-one interviews. Participants were asked to describe their psoriasis symptoms, completed the PSS, and were cognitively debriefed on its content. Interviews were conducted in two separate rounds. Following Round 1, the study data were examined to determine if modifications to the PSS were required. All interviews were audio-recorded and transcribed. Sociodemographic and clinical data were collected for sample descriptive purposes.

RESULTS

The 20 study participants had a mean age of 50.2 ± 12.0 years (range: 25.0-73.0), and 55% were female. Thirty-five percent of the sample reported their psoriasis severity as moderate or severe. The average time since diagnosis of plaque psoriasis was almost 18 years, ranging from less than one to over 38 years. The most frequently reported symptoms and signs during the concept elicitation portion of the interviews included redness (N = 20, 100%), itching (n = 20, 100%), pain (n = 15, 75%), burning (n = 13, 65%), and flaking (n = 11, 55%). Overall, participants provided positive feedback on the PSS and felt that it was comprehensive and relevant to their experience with psoriasis. The item meaning and response options were well-understood for the majority of the items. Findings indicate that for the patient-reported symptom of redness, which is also a sign that can be reported by clinicians, redness or the perception of redness is most accurately captured by patient report. Study results did not support modifications to the instrument and no changes to the PSS were recommended.

CONCLUSION

The evidence gained in this study provided support for the content validity of the PSS for use as clinical trial endpoint among patients with plaque psoriasis. This study found that the symptoms included in the PSS are important to and well-understood by patients with plaque psoriasis. The PSS is appropriate for inclusion in future studies designed to measure the effect of treatment on psoriasis-related symptoms.

Bottom-Up Electrochemical Deposition of Poly(styrene sulfonate) on Nanoarchitectured Electrodes

The cathodic deposition of poly(styrene sulfonate) on nanoarchitectured TiO₂ electrodes is explored by cyclic voltammetry and potentiostatic and galvanostatic experiments, showing a diffusion-controlled deposition described by Cottrell's law. The structure and composition of the polymer is evidenced by various spectroscopic techniques, including nuclear magnetic resonance, Fourier transform infrared, and X-ray photoelectron spectroscopy, and its morphology is studied by scanning electron microscopy. The average chain length can be estimated from the NMR spectra. The electropolymerization mechanism initiates by radical anion formation. The cycling behavior in half-cell batteries against Li metal is excellent, especially at high rates explored up to 10 C. The areal insertion capacity is above recent literature results, up to 80 μA h cm^-2. The combination of normalized areal power density and areal energy density is one of the best reported in the literature.

Propylene Glycol Alginate Sodium Sulfate Alleviates Cerulein-Induced Acute Pancreatitis by Modulating the MEK/ERK Pathway in Mice

Previous studies have focused on the effects of propylene glycol alginate sodium sulfate  (PSS)  against  thrombosis,  but  the  anti-inflammatory  potential  is  unknown.  Therefore,  we  specifically focused on the protective effects of PSS on cerulein-induced acute pancreatitis (AP)  using a mouse model, and investigated the mechanism of PSS on autophagy and apoptosis via the  Mitogen-activated  protein  kinase  (MEK)/extracellular  signal-regulated  kinase  (ERK)  pathway.  Cerulein (100 ug/kg) was used to induce AP by ten intraperitoneal injections at hourly intervals in  Balb/C mice. Pretreatment with vehicle or PSS was carried out 1 h before the first cerulein injection  and two doses (25 mg/kg and 50 mg/kg) of PSS were injected intraperitoneally. The severity of AP was  assessed by pathological score, biochemistry, pro-inflammatory cytokine levels, myeloperoxidase  (MPO) activity and MEK/ERK activity. Furthermore, pancreatic histological scores, serum amylase  and lipase activities, tumor necrosis factor-α (TNF-α), interleukin (IL)-1β interleukin (IL)-6 levels, and  MPO activity were significantly reduced by PSS via up-regulated MEK/ERK activity. The representative  molecules of apoptosis and autophagy, such as Bcl-2, Bax, Lc-3, Beclin-1, P62, were remarkably reduced.  Taken together, these results indicate that PSS attenuates pancreas injury by inhibiting autophagy and  apoptosis through a mechanism involving the MEK/ERK signaling pathway.

Poly(styrenesulfonate)-Modified Ni-Ti Layered Double Hydroxide Film: A Smart Drug-Eluting Platform

Drug-eluting stents (DESs) are widely used in the palliative treatment of many kinds of cancers. However, the covered polymers used in DESs are usually associated with stent migration and acute cholecystitis. Therefore, developing noncovered drug-loading layers on metal stents is of great importance. In this work, Ni-Ti layered double hydroxide (Ni-Ti LDH) films were prepared on the surface of nitinol via hydrothermal treatment, and the LDH films were further modified by poly(styrenesulfonate) (PSS). The anticancer drug doxorubicin could be effectively loaded onto the modified films, and drug release could be smartly controlled by the pH. Besides, the drug absorption amounts of cancer cells cultured on the films could be effectively improved. These results indicate that the PSS-modified LDH film may become a promising drug-loading platform that can be used in the design of DESs.

Dual-Charged Hollow Fiber Membranes for Low-Pressure Nanofiltration Based on Polyelectrolyte Complexes: One-Step Fabrication with Tailored Functionalities

A new nanofiltration (NF) hollow fiber membrane is developed by using two oppositely charged polyelectrolytes coagulating into a polyelectrolyte complex (PEC) onto polyether sulfone base polymer. The particular membrane architecture emerges during a single-step procedure, allowing setting both the porous negatively charged support of the hollow fiber and the separation layer containing also the positive polyelectrolyte (PEI/PDADMAC) through a single layer dry-jet wet spinning process. The novelty is two-pronged: the composition of the hollow fiber membrane itself and its fabrication procedure (one-step fabrication of membranes employing polyelectrolytes). These result in highly permeable hollow fiber membranes with a stable separation layer and performance at par with the membranes reported in literature obtained by multistep processes. More importantly, the membranes are obtained through a simple, very fast (one-step), and less expensive procedure. The best performance among these newly obtained hollow-fiber membranes is achieved by PD5% hollow fiber (MWCO of 300 Da), which showed 7.6 L/m(2)·h·bar permeability and ∼90% rejection of MgCl2, MgSO4, and Na2SO4 at 2 bar pressure. Thus, the resulting membranes not only have the advantages of the hollow-fiber configuration, but perform very well at extremely low pressures (the lowest reported in the literature). The broad impact of the results presented in this Article lies in the potential to dramatically reduce both the fabrication (duration and complexity) and the price and desalination costs of highly performing NF hollow fiber membranes. These might result in interesting potential applications and open new directions toward designing efficient functional NF hollow fibers for water desalination.