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INTRODUCTION: Very little is known about daily life dynamics and mutual influences that tie together well-being and psychobiological stress responses in persons with spinal cord injury (SCI) and their romantic partners in particular. The role of social support and physical activity in the associations between emotional well-being and stress has not been investigated in the context of SCI yet and studies applying a dyadic approach, exploring the role of a romantic partner, are currently unavailable. The overall objective is thus to better understand the interplay between emotional well-being and the psychobiological stress marker cortisol, and to investigate the potentially moderating role of social support and physical activity in the well-being-stress association among persons with SCI and their romantic partners using a dyadic perspective. METHODS AND ANALYSIS: The stRess and Health Among romantic couPles with Spinal cOrD injurY study, funded by the Swiss National Science Foundation (10001C_204739), aims to recruit N=150 community-dwelling persons with SCI and their romantic partners including three phases of data collection. The first phase includes a baseline questionnaire. The second phase, the time sampling phase, comprises an ecological momentary assessment design in the everyday life of couples where both partners provide concurrent salivary cortisol samples five times a day and complete assessments four times a day over seven consecutive days. Wrist-worn accelerometers record physical activity during this period. The third phase is an observational study in the laboratory, where a couples' discussion on the SCI management in their everyday life is recorded and coded to identify a couple-specific coping with SCI to enrich data. The dyadic data will be analysed using multilevel modelling, based on the actor-partner interdependence model framework. ETHICS AND DISSEMINATION: The study was approved by the ethics committee of Northwest and Central Switzerland (2022-01072) and findings will be disseminated through peer-reviewed publications and conference presentations.

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OBJECTIVE: Less than half of servicewomen report loss of menses during initial military training. However, self-reported menstrual status may not accurately reflect hypothalamic-pituitary-ovarian (HPO) axis suppression and may underestimate reproductive health consequences of military training. Our aim was to characterise HPO axis function during US Army Basic Combat Training (BCT) in non-hormonal contraceptive-using women and explore potential contributors to HPO axis suppression. METHODS: In this 10-week prospective observational study, we enrolled multi-ethnic women entering BCT. Trainees provided daily first-morning voided urine, and weekly blood samples during BCT. Urinary luteinising hormone, follicle stimulating hormone, and metabolites of estradiol and progesterone were measured by chemiluminescent assays (Siemens Centaur XP) to determine hormone patterns and luteal activity. We measured body composition, via dual-energy X-ray absorptiometry, at the beginning and end of BCT. RESULTS: Trainees (n=55) were young (mean (95% CI): 22 (22, 23) years) with average body mass index (23.9 (23.1, 24.7) kg/m2). Most trainees (78%) reported regular menstrual cycles before BCT. During BCT, 23 (42%) trainees reported regular menses. However, only seven trainees (12.5%) had menstrual cycles with evidence of luteal activity (ELA) (ie, presumed ovulation), all with shortened luteal phases. 41 trainees (75%) showed no ELA (NELA), and 7 (12.5%) were categorised as indeterminant. Overall, women gained body mass and lean mass, but lost fat mass during BCT. Changes in body mass and composition appear unrelated to luteal activity. CONCLUSIONS: Our findings reveal profound HPO axis suppression with NELA in the majority of women during BCT. This HPO axis suppression occurs among women who report normal menstrual cycles.

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OBJECTIVE: There is a lack of prospective data on mental health of elite Para athletes. The objective was to identify and follow elite Para athletes at risk of mental health problems. METHODS: In a 124-week prospective cohort study, mental health of German elite Para athletes was monitored using the Patient Health Questionnaire-4 (PHQ-4). In case of positive screening (PHQ-4≥5) over 2 weeks, a follow-up contact was conducted by a sports psychiatrist, who asked the athletes about their mental condition and sources for their mental distress and offered support. RESULTS: 7543 PHQ-4 scores were obtained from 122 Para athletes with a mean weekly response rate of 84%. The PHQ-4 screening was considered positive for symptoms of depression or anxiety with a prevalence of 6.7%, affecting 48.4% (n=59) of all participants at some point during the study period. In 76.6% (n=49) of all follow-up contacts, athletes (n=34) reported at least one mental health problem, most frequently mental distress (n=31), followed by symptoms of depression (n=19) including acute suicidality (n=1). The most common mental stressors cited were related to education and problems with the team, coaches or federation. At follow-up, almost two-thirds of the athletes were either already in professional psychiatric or psychological care (25%) or were recommended to seek such care (32.8%). CONCLUSION: Our screening and follow-up system revealed high rates of mental health problems in elite Para athletes. Programmes for early identification with mental health monitoring under the supervision of mental health professionals should be considered by sports federations for Para athletes.

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INTRODUCTION: Black emerging adults (18-28 years) have the highest risk of short sleep duration and obesity. This increased risk may be partly explained by greater stress levels, which may result from race-related stress (racial discrimination and heightened race-related vigilance) or living in more disadvantaged home and neighbourhood environments. Insufficient sleep may also impact obesity risk via several weight-related mechanisms including energy balance, appetite and food reward, cortisol profiles and hydration status. This paper describes the rationale, design and methods for the Sleep, Health Outcomes and Body Weight (SHOW) study. This study aims to prospectively assess the effects of sleep, race-related stress and home/neighbourhood environments on weight-related mechanisms and obesity markers (body weight, waist circumference and fat mass) in 150 black emerging adults. METHODS AND ANALYSIS: The SHOW study follows a measurement burst design that includes 3, 7-day data collection bursts (baseline, 6-month and 12-month follow-ups). Sleep is measured with three methods: sleep diary, actigraphy and polysomnography. Energy balance over 7 days is based on resting and postprandial energy expenditure measured via indirect calorimetry, physical activity via accelerometry and self-reported and ad libitum energy intake methods. Self-reported methods and blood biomarkers assess fasting and postprandial appetite profiles and a behavioural-choice task measures food reward. Cortisol awakening response and diurnal cortisol profiles over 3 days are assessed via saliva samples and chronic cortisol exposure via a hair sample. Hydration markers are assessed with 24-hour urine collection over 3 days and fasting blood biomarkers. Race-related stress is self-reported over 7 days. Home and neighbourhood environments (via the Windshield Survey) is observer assessed. ETHICS AND DISSEMINATION: Ethics approval was granted by the University of North Carolina at Greensboro's Institutional Review Board. Study findings will be disseminated through peer-reviewed publications, presentations at scientific meetings and reports, briefs/infographics for lay and community audiences.

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Several International Federations (IFs) employ specific policies to protect athletes' health from the danger of heat. Most policies rely on the measurement of thermal indices such as the Wet Bulb Globe Temperature (WBGT) to estimate the risk of heat-related illness. This review summarises the policies implemented by the 32 IFs of the 45 sports included in the Paris 2024 Olympic Games. It provides details into the venue type, measured parameters, used thermal indices, measurement procedures, mitigation strategies and specifies whether the policy is a recommendation or a requirement. Additionally, a categorisation of sports' heat stress risk is proposed. Among the 15 sports identified as high, very high or extreme risk, one did not have a heat policy, three did not specify any parameter measurement, one relied on water temperature, two on air temperature and relative humidity, seven on WBGT (six measured on-site and one estimated) and one on the Heat Stress Index. However, indices currently used in sports have been developed for soldiers or workers and may not adequately reflect the thermal strain endured by athletes. Notably, they do not account for the athletes' high metabolic heat production and their level of acclimation. It is, therefore, worthwhile listing the relevance of the thermal indices used by IFs to quantify the risk of heat stress, and in the near future, develop an index adapted to the specific needs of athletes.

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Elevated stress levels are related to diminished mental health, potentially leading to decreased well-being and performance of nursing students. While researchers have focused on developing stress management interventions, there is a need to synthesize the evidence. A systematic review with meta-analysis was conducted to assess the evidence for the effectiveness of stress management interventions in nursing students. A systematic literature search identified controlled stress management interventions employing a validated psychological or physiological stress measure. Forty-one studies were included, with 36 forming a pool of 2715 participants in the meta-analysis. The overall effect on psychological stress was positive. Intervention type, delivery modality, intervention duration in weeks, and number of sessions were moderators of intervention effectiveness, with more significant effects for mind-body programs, on-site delivery methods, durations of 9-12 weeks, and 15-30 sessions. For physiological stress, the biomarkers of blood pressure, heart rate, and cortisol levels decreased significantly. Future research is necessary for promising outcomes related to currently underrepresented indicators and to investigate the long-term effects of interventions.

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INTRODUCTION: In the USA, Black birthing people and infants experience disproportionately worse pregnancy-related health outcomes. The causes for these disparities are unknown, but evidence suggests that they are likely socially and environmentally based. Efforts to identify the determinants of these racial disparities are urgently needed to elucidate the highest priority targets for intervention. The Birth and Beyond (BABY) study evaluates how micro-level (eg, interpersonal and family) and macro-level (eg, neighbourhood and environmental) risk and resiliency factors transact to shape birth person-infant health, and underlying psychobiological mechanisms. METHODS AND ANALYSIS: The BABY study will follow 350 Black families (birthing parents, non-birthing parents and infants) from pregnancy through the first postpartum year, with research visits during pregnancy and at infant ages 6 and 12 months. Research visits comprise a combination of interview about a range of recent and life course stress and resiliency exposures and supports, psychophysiological (sympathetic, parasympathetic and adrenocortical) assessment and behavioural observations of parent-infant coregulatory behaviours. Spatial analyses are completed by mapping parent current and past residential addresses onto archival public data (eg, about neighbourhood quality and racial segregation). Finally, EMRs are abstracted for information about birthing parent relevant medical history, pregnancy conditions and infant birth outcomes. Analyses will evaluate the risk and resiliency mechanisms that contribute to pregnancy and birth-related outcomes for Black birthing people and their infants, and the protective role of individual, familial, cultural, and community supports. ETHICS AND DISSEMINATION: The BABY study has been approved by the Institutional Review Board at Albany Medical Centre. The study team consulted with local organisations and groups comprised of stakeholders and community leaders and continues to do so throughout the study. Research results will be disseminated with the scientific and local community as appropriate.

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INTRODUCTION: The non-intoxicating plant-derived cannabinoid, cannabidiol (CBD), has demonstrated therapeutic potential in a number of clinical conditions. Most successful clinical trials have used relatively high (≥300 mg) oral doses of CBD. Relatively few studies have investigated the efficacy of lower (<300 mg) oral doses, typical of those available in over-the-counter CBD products. METHODS: We present a protocol for a randomised, double-blind, placebo-controlled, parallel-group clinical trial investigating the effects of a low oral dose (150 mg) of CBD on acute psychosocial stress, situational anxiety, motion sickness and cybersickness in healthy individuals. Participants (n=74) will receive 150 mg of CBD or a matched placebo 90 min before completing three virtual reality (VR) challenges (tasks) designed to induce transient stress and motion sickness: (a) a 15 min 'Public Speaking' task; (b) a 5 min 'Walk the Plank' task (above a sheer drop); and (c) a 5 min 'Rollercoaster Ride' task. The primary outcomes will be self-reported stress and nausea measured on 100 mm Visual Analogue Scales. Secondary outcomes will include salivary cortisol concentrations, skin conductance, heart rate and vomiting episodes (if any). Statistical analyses will test the hypothesis that CBD reduces nausea and attenuates subjective, endocrine and physiological responses to stress compared with placebo. This study will indicate whether low-dose oral CBD has positive effects in reducing acute psychosocial stress, situational anxiety, motion sickness and cybersickness. ETHICS AND DISSEMINATION: The University of Sydney Human Research Ethics Committee has granted approval (2023/307, version 1.6, 16 February 2024). Study findings will be disseminated in a peer-reviewed journal and at academic conferences. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ACTRN12623000872639).

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Cancer cells, which divide indefinitely and without control, are frequently exposed to various stress factors but manage to adapt and survive. The mechanisms by which cancer cells maintain cellular homeostasis and exploit stress conditions are not yet clear. Here, we elucidate the roles of diverse cellular metabolism and its regulatory mechanisms, highlighting the essential role of metabolism in cellular composition and signal transduction. Cells respond to various stresses, including DNA damage, energy stress, and oxidative stress, thereby causing metabolic alteration. We provide profound insight into the adaptive mechanisms employed by cancer cells to ensure their survival among internal and external stressors through a comprehensive analysis of the correlation between metabolic alterations and cellular stress. Furthermore, this research establishes a robust framework for the development of innovative therapeutic strategies that specifically target the cellular adaptations of cancer cells.

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Objective:To evaluate the effect of esketamine on cerebral ischemia-reperfusion (I/R) injury and the association with mitochondrial stress in mice.Methods:The experiment was performed in two parts. Part Ⅰ Eighteen SPF male C57BL/6 mice, aged 8-12 weeks, with body mass index of 28-30 g, were divided into 3 groups ( n=6 each) by a random number table method: sham operation group (S group), cerebral I/R group (IR group), and esketamine plus cerebral I/R group (E+ IR group). Cerebral I/R was produced by occlusion of middle cerebral artery for 1 h followed by 24-h reperfusion in anesthetized mice.Esketamine 10 mg/kg was intraperitoneally injected at 20 min before developing the model in E group. Neurological function was evaluated using the Zea Longa score and balance beam test (Feeney score). The cerebral infarct size was determined by TTC staining. Part Ⅱ Primary cortical neurons were isolated and cultured and then divided into 3 groups ( n=42 each) using a random number table method: control group (group C), oxygen-glucose deprivation-reoxygenation (OGD/R) group, and esketamine plus OGD/R group (group E+ OGD/R). Cells were subjected to O 2-glucose deprivation for 1 h followed by restoration of O 2-glucose supply for 24 h. The cells were treated with 25 μmol/L esketamine for 40 min before preparing the model in E+ OGD/R group. The neuronal viability was measured by the CCK-8 assay. The ultrastructure of neurons was observed with a transmission electron microscope. The levels of reactive oxygen species (ROS), glutathione peroxidase (GSH-px) and malondialdehyde (MDA) were determined, and the mitochondrial membrane potential was determined by JC-1 kit. The neuronal apoptosis was detected by TUNEL staining, and the apoptosis rate of neurons was calculated. The expression of Bax, cytochrome C (CytC), cleaved-caspase-9, caspase-3 and cleaved-caspase-3 was detected by Western blot. Results:Part Ⅰ Compared with S group, the Zea Longa score, Feeney score and cerebral infarct size were significantly increased in IR group ( P<0.01). Compared with IR group, the Zea Longa score, Feeney score and cerebral infarct size were significantly decreased in E+ IR group ( P<0.01). Part Ⅱ Compared with C group, the cell viability and activity of GSH-px were significantly decreased, the apoptosis rate of neurons, levels of ROS and MDA, mitochondrial membrane potential, and cleaved-caspase-3/caspase-3 ratio were increased, and the expression of Bax, Cyt C and cleaved-caspase-9 was up-regulated in OGD/R group ( P<0.01). Compared with OGD/R group, the cell viability and activity of GSH-px were significantly increased, the apoptosis rate of neurons, levels of ROS and MDA, mitochondrial membrane potential, and cleaved-caspase-3/caspase-3 ratio were decreased, and the expression of Bax, Cyt C and cleaved-caspase-9 was down-regulated in E+ OGD/R group ( P<0.01). Conclusions:Esketamine can alleviate cerebral I/R injury in mice, and the mechanism may be related to inhibition of mitochondrial stress in neurons, improvement in mitochondrial function, and inhibition of mitochondria-dependent apoptosis in neurons.

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Objective:To evaluate the clinical efficacy of ultrasound-guided superior laryngeal nerve block combined with cricothyroid membrane puncture for awake tracheal intubation in difficult airways.Methods:A total of 80 patients scheduled for general anesthesia surgery owing to difficult airways at Marine Police Corps Hospital of Chinese People's Armed Police Force from August 2019 to February 2023 were included in this prospective study. These patients were randomly divided into a control group and an observation group ( n = 40 per group). Both groups of patients underwent fiberoptic bronchoscope-guided awake tracheal intubation through the nasal route. Before intubation, the control group received surface anesthesia combined with cricothyroid membrane puncture anesthesia, while the observation group received superior laryngeal nerve block combined with cricothyroid membrane puncture anesthesia. During the intubation process, hemodynamic indicators of the patients were monitored, the duration of the intubation operation was recorded, and the degree of sedation and cough response was evaluated. Before and after intubation, the levels of serum stress response factors were determined, and the satisfaction level of patients with the intubation operation was investigated. Results:At the time points T1 (immediately after the tracheal tube enters the glottis) and T2 (after the tracheal tube enters the trachea), the heart rate in the observation group was (84.08 ± 8.25) times/minute and (82.64 ± 7.81) times/minute, respectively, and the mean arterial pressure in the observation group was (92.57 ± 8.32) mmHg (1 mmHg = 0.133 kPa) and (103.27 ± 9.16) mmHg, respectively, which were significantly lower compared with those in the control group ( t = 5.92-12.56, all P < 0.001). At T1 and T2, there was no significant difference in blood oxygen saturation (SpO 2) between the observation and control groups ( t = 0.34-0.43, P = 0.652-0.726). The duration of the intubation operation in the observation group was (8.96 ± 1.15) minutes, which was significantly shorter than (11.47 ± 1.39) minutes in the control group ( t = 6.84, P < 0.001). The Ramsay sedation score during intubation in the observation group was 3 (2,3) points, which was significantly higher than 2 (1,3) points in the control group ( Z = 9.26, P < 0.001). The cough response score in the observation group was 1 (0,1) point, which was significantly lower than 1 (0, 2) points in the control group ( Z = 4.37, P < 0.001). The serum levels of stress response factors norepinephrine and adrenaline in the observation group were significantly lower than those in the control group ( t = 14.58-25.94, both P < 0.05). The overall patient satisfaction in the observation group was 97.50%, which was significantly higher than that in the control group ( χ2 = 4.51, P = 0.034). Conclusion:Superior laryngeal nerve block combined with cricothyroid membrane puncture can be used for anesthetic management of awake nasal tracheal intubation in difficult airways. This combined approach can improve patient hemodynamic stability and sedation, shorten the duration of intubation, reduce stress responses during intubation, and enhance patient satisfaction.

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Objective:To investigate the analgesic effect of ultrasound-guided transversus abdominis plane block versus ultrasound-guided quadratus lumborum block in older adult patients undergoing inguinal hernia repair surgery. Methods:A total of 150 older adult patients who underwent inguinal hernia repair surgery at the Marine Police Corps Hospital of Chinese People's Armed Police Force from April 2019 to May 2022 were included in this study. They were randomly divided into a control group ( n = 75) and a study group ( n = 75) using a random number table method. All patients underwent elective laparoscopic tension-free inguinal hernia repair surgery. Patients in the control group received ultrasound-guided transversus abdominis plane block after inguinal hernia repair surgery, while those in the study group received ultrasound-guided quadratus lumborum block. The changes in Visual Analog Scale (VAS) score and Ramsay score within 48 hours after surgery were compared between the two groups. Inflammatory factors and stress factors including serum tumor necrosis factor alpha, interleukin-6, norepinephrine, and cortisol, were measured at 24 and 48 hours after surgery. The use of analgesics, drug-related adverse reactions, and incidence of nerve block-related complications within 48 hours after surgery were also compared between the two groups. Results:There was no significant difference in Ramsay score between the two groups at 4, 8, 12, 24, and 48 hours after surgery (all P > 0.05). There was no significant difference in VAS score between the two groups at 4 and 8 hours after surgery (both P > 0.05). At 12, 24, and 48 hours after surgery, the VAS score in the study group was (1.36 ± 0.57) points, (2.05 ± 0.56) points, and (1.79 ± 0.55) points, respectively, which were significantly lower than (1.92 ± 0.59) points, (2.68 ± 0.62) points, and (2.36 ± 0.59) points in the control group ( t = 6.65, 7.31, 5.86, all P < 0.001). At 24 and 48 hours after surgery, serum tumor necrosis factor alpha, interleukin-6, norepinephrine, and cortisol levels in the study group [24 hours: (63.89 ± 4.65) ng/L, (156.59 ± 8.62) ng/L, (97.02 ± 6.95) g/L, (36.95 ± 3.26) g/L; 48 hours: (49.66 ± 3.74) ng/L, (131.45 ± 7.73) ng/L, (74.63 ± 5.91) g/L, (30.41 ± 2.96) g/L] were significantly lower than those in the control group [24 hours: (76.42 ± 5.17) ng/L, (189.32 ± 10.41) ng/L, (105.53 ± 7.83) g/L, (45.16 ± 3.74) g/L; 48 hours: (58.15 ± 3.94) ng/L, (162.74 ± 8.49) ng/L, (89.51 ± 6.37) g/L, (36.92 ± 3.31) g/L, t = 10.49-26.38, all P < 0.001]. The proportion of patients who received analgesics within 48 hours after surgery in the study group was 8.00% (6/75), which was significantly lower than 25.33% (19/75) in the control group ( χ2 = 8.11, P = 0.004). The overall incidence of drug-related adverse reactions within 48 hours after surgery in the study group [6.67% (3/75)] was significantly lower than that in the control group [11% (11/75), χ2 = 4.61, P = 0.032]. Conclusion:Compared with ultrasound-guided transversus abdominis plane block, ultrasound-guided quadratus lumborum block better helps alleviate postoperative pain in older adult patients undergoing inguinal hernia repair surgery, inhibits inflammation and stress reactions, reduces the dosage of analgesic drugs, and decreases the incidence of adverse drug reactions.

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Resumo Este estudo tem como objetivo entender e interpretar a ocorrência de angústia moral entre médicos intensivistas pediátricos que atuam em uma Unidade de Terapia Intensiva Pediátrica. Trata-se de uma pesquisa exploratória e descritiva, de abordagem quantitativa e recorte transversal, com foco na aplicação de um instrumento de pesquisa baseado na Moral Distress Scale Revised para levantamento da presença de angústia moral em 43 médicos de determinada unidade de terapia. A maioria das respostas do instrumento de pesquisa quanto à presença de angústia moral esteve relacionada a questões de fim de vida, situações de prolongamento penoso da vida, comunicação deficiente entre a equipe, problemas de saúde do profissional, desconforto com prognósticos incertos, necessidade de visitas multiprofissionais e sofrimento do paciente. O intuito foi buscar evidências na pesquisa sobre determinadas situações que podem ser desencadeadoras de angústia moral com intensidades e frequências distintas entre os profissionais, de acordo com algumas variáveis.

Abstract This study investigates and interprets the occurrence of moral distress among pediatric physicians working in a Pediatric Intensive Care Unit. A cross-sectional, exploratory, descriptive research was conducted to survey the presence of moral distress among 43 physicians from a specific therapy unit assessed by the Moral Distress Scale Revised. Most responses regarding the presence of moral distress revolved around end-of-life issues, painful life-prolonging situations, poor team communication, professional health problems, discomfort with uncertain prognoses, need for multidisciplinary visits and patient suffering. We sought evidence in research on certain situations that can trigger moral distress at different intensities and frequencies among professionals, according to some variables.

Resumen Este estudio tiene como objetivo comprender e interpretar la angustia moral entre los médicos en cuidados intensivos pediátricos que trabajan en una Unidad de Cuidados Intensivos Pediátricos. Se trata de una investigación exploratoria, descriptiva, de enfoque cuantitativo y transversal, centrada en la aplicación de una herramienta basada en la Moral Distress Scale Revised para identificar la presencia de angustia moral en 43 médicos(as) de una unidad específica. La mayoría de las respuestas a la herramienta de evaluación sobre la presencia de sufrimiento moral giraron en torno a cuestiones del final de la vida, situaciones dolorosas que prolongan la vida, mala comunicación entre el equipo, problemas de salud profesional, malestar ante pronósticos inciertos, necesidad de visitas multidisciplinarias y sufrimiento del paciente. El objetivo fue buscar evidencias sobre determinadas situaciones que pueden desencadenar angustia moral con diferentes intensidades y frecuencias entre los profesionales según algunas variables.

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Introducción. El estrés agudo se relaciona con la enérgica liberación de catecolaminas, citoquinas y cortisol, las cuales afectan la percepción dolorosa. La masticación estimula neuronas serotoninérgicas, dichas neuronas modulan a las vías neurales del dolor; sin embargo, la relación entre dichas variables aún está en proceso de entendimiento. Objetivo. Determinar el efecto del estrés agudo y del estímulo masticatorio sobre el dolor. Métodos. Experimento que se desarrolló en el bioterio de la Facultad de Medicina de la UNMSM. 40 ratones Balb/c machos de 8 semanas de edad. Los ratones fueron asignados aleatoriamente en 5 grupos iguales. A: semana 1 sin ningún estímulo y semana 2 estimulo masticatorio + estrés. B: semana 1 sin ningún estímulo y semana 2 estrés. C: semana 1 estrés y semana 2 sin ningún estímulo. D: semana 1 estímulo masticatorio + estrés y semana 2 sin ningún estímulo. E: control, sin ningún estimulo. El dolor se evaluó en los 5 grupos a los 7 y 14 días mediante la prueba de tiempo de retirada de la cola ante estímulo térmico. Resultados. Se empleó la prueba de ANOVA para la evaluación intergrupo, no hallándose diferencia significativa. Mediante la prueba de t student para muestras relacionadas se hizo la evaluación intragrupo donde se encontró diferencia significativa entre los 7 vs los 14 días tanto en el grupo A (p=0,029) como en el grupo C (p=0,03). Conclusión. El efecto del estrés agudo sobre la percepción dolorosa fue disminuida por el estímulo masticatorio en ratones Balb/c.

Introduction. Acute stress is related to the energetic release of catecholamines, cytokines, and cortisol, which trigger pain perception. Chewing stimulates serotonergic neurons, these neurons modulate the neural pathways of pain; however, the relationship between these variables is still in the process of understanding. Objective. To determine the effect of acute stress and chewing stimulus on pain. Methods. an experiment that was developed in the Faculty of Medicine of the UNMSM. 40 eight-week-old male Balb/c mice were randomly assigned into 5 equal groups. A: week 1 without any stimulus and week 2 chewing stimulus + stress. B: week 1 without any stimulus and week 2 stress. C: week 1 stress and week 2 without any stimulus. D: week 1 masticatory stimulus + stress and week 2 without any stimulus. E: control, without any stimulus. Pain was assessed in the 5 groups at 7 and 14 days using the tail-withdrawal time test before thermal stimulation. Results. The ANOVA test was used for the intergroup evaluation, finding no significant difference. Using the t student test for related samples, the intragroup evaluation was made, where a significant difference was found between 7 vs. 14 days, both in group A (p=0.029) and in group C (p=0.03). Conclusion. The effect of acute stress on pain perception was decreased by chewing stimulus in Balb/c mice.

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Background: Hypertension in the second trimester of pregnancy is accompanied by proteinuria that is called Preeclampsia Syndrome (PES). Body relaxation is a technique which makes harmony between mind and body. The aim of this study was to investigate the effect of Body Relaxation Technique (BRT) on some symptoms of Preeclampsia Syndrome (PES). Materials and Methods: This clinical trial was conducted on 96 high-risk pregnant women who were selected by random sampling method from among women referring to community health centers of Isfahan city. The samples were divided into intervention and control groups by even and odd numbers. The intervention group members received BRT during 16 sessions. Blood pressure and proteinuria were measured and recorded before and after the intervention in both groups at the beginning and in the 36th week of pregnancy. The collected data were analyzed. Result: According to the Chi-square test, the frequency of PES was 11.10% and 23.50% in the intervention and control groups, respectively (χ2 = 3.95, df = 1, p = 0.046). After the intervention, there was no significant difference between the two groups in terms of the diastolic blood pressure and proteinuria. Systolic blood pressure and stress were also significantly reduced in the intervention group. However, proteinuria was not significantly different between the two groups. Conclusions: Based on the results, the relaxation technique, as an easy technique, is recommended for pregnant women who are susceptible to pregnancy hypertension and preeclampsia. Moreover, as a clinical complementary method, it can be recommended for preventing the symptoms of PES.

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Introduction: Various stressors have been identified in patients in the intensive care unit (ICU), including postoperative pain, ventilatory management, and nursing care. However, sedated patients are less responsive, and nurses have difficulty capturing their stressors. Objective: To investigate patient stress caused by nursing care performed in the ICU on sedated patients based on changes in physiological indices. Methods: We observed nursing care performed on patients with postoperative esophageal cancer under sedation in the ICU. This included endotracheal suctioning and turning, the time required for the care, and the patients' behavioral responses. Information on arousal levels, autonomic nervous system indices, and vital signs were also obtained. The changes in indicators before and after care were then compared and analyzed. Results: There were 14 patients in the study. The mean age of the patients was 68 years. Ninety-nine scenes of nursing care were observed, and in six of these, additional bolus sedation was administered because of the patient's significant body movements. In endotracheal suctioning, no significant changes were observed in all indicators. In turning, vital signs changed significantly, and when both were continued, all indicators changed significantly. Conclusion: Our study found that different types and combinations of nursing care may cause different stresses to the patients. Moreover, the autonomic nervous system indices may be more likely to react to stresses in a variety of nursing care, while arousal levels may be more likely to react to burdensome stresses. If the characteristics of these physiological indicators can be understood and effectively utilized during care, it may be possible to better identify and reduce patient stress during sedation management.

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Introducción: El estrés académico surge de una interacción entre factores estresantes ambientales y las reacciones de los estudiantes, asociándose con frustración y fracaso académico. Además, algunos factores demográficos y familiares influyen en el estrés. Objetivo: Analizar estrés académico, factores demográficos y familiares en estudiantes de Odontología en Escuela privada de Cartagena. Materiales y métodos: Estudio descriptivo de corte transversal, en 158 estudiantes. Se aplicó cuestionario sociodemográfico, APGAR familiar e inventario SISCO. Se analizó los datos mediante estadística descriptiva y prueba X2. Resultados: Se encontró disfuncionalidad familiar y mal soporte de amigos en casi la mitad de los participantes, niveles de preocupación moderada cercana a 70%, alta frecuencia de demandas del entorno (estresores), reacciones comportamentales y presencia de síntomas ante estímulo estresor. Hubo asociación entre alta frecuencia de inquietud en situaciones cotidianas y pertenecer a semestres básicos, baja frecuencia de uso de estrategias de afrontamiento y sexo femenino, alta frecuencia de reacciones comportamentales y disfunción familiar. Conclusiones: Los principales factores identificados fueron pertenecer a semestres básicos, ser mujer y presencia de disfuncionalidad familiar. Los niveles de estrés y disfuncionalidad familiar sugieren una alerta para intervenir desde bienestar universitario, previniendo condiciones desfavorables en la salud y rendimiento académico de los estudiantes.

Introduction: Academic stress arises from an interaction between environmental stressors and student reactions, which are associated with academic frustration and academic failure. Likewise, there are demographic and family factors that affect stress. Objective: To analyze academic stress, demographic and family factors in Dentistry students at a private school in Cartagena. Materials and methods: A descriptive cross-sectional study with 158 students. The APGAR family sociodemographic questionnaire and SISCO inventory were used. Descriptive statistics and the X2 test were applied to analyze data. Results: Family dysfunction and low friend support were observed in almost half of the participants, 70% displayed moderate anxiety levels. Also, a high frequency of environmental demands (stressors), behavioral reactions, and the presence of symptoms in response to the stressors were found. There were associations between: high frequency of restlessness in everyday situations and belonging to initial semesters; low frequency of using coping strategies and female gender; and high frequency of behavioral reactions and family dysfunction. Conclusions: The main factors identified were belonging to initial semesters, being a woman, and family dysfunction. Levels of stress and family dysfunction can be used as a signal for university welfare services to intervene and prevent unfavorable student health and academic performance conditions.

Introdução: O estresse acadêmico surge de uma interação entre os estressores ambientais e as reações dos alunos, associados à frustração e ao fracasso acadêmico. Além disso, alguns fatores demográficos e familiares influenciam o estresse. Objetivo: Analisar o estresse acadêmico, fatores demográficos e familiares em estudantes de odontologia de uma escola particular de Cartagena. Materiais e métodos: Estudo transversal descritivo, em 158 estudantes. Questionários sociodemográficos, APGAR familiar e inventário SISCO foram aplicados. Os dados foram analisados por meio de estatística descritiva e teste X2. Resultados: Disfunção familiar e pouco apoio dos amigos foram encontrados em quase metade dos participantes, níveis de preocupação moderada próximos a 70 %, alta frequência de demandas do ambiente (estressores), reações comportamentais e presença de sintomas diante de estímulos estressantes. Houve associação entre alta frequência de inquietação em situações cotidianas e pertencimento aos semestres básicos, baixa frequência do uso de estratégias de enfrentamento e sexo feminino, alta frequência de reações comportamentais e disfunção familiar. Conclusões: Os principais fatores identificados foram pertencer aos semestres básicos, ser mulher e a presença de disfunção familiar. Os níveis de estresse e disfuncionalidade familiar sugerem um alerta para intervir da unidade de bem-estar da universidade para prevenir condições desfavoráveis na saúde e desempenho acadêmico dos estudantes.

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Introducción. El estrés agudo altera la memoria y aprendizaje espacial y la expresión de la interleuquina 6 (IL-6), mientras que el estímulo masticatorio evitaría dichos efectos. Objetivo. Determinar el efecto del estímulo masticatorio y el estrés agudo sobre la expresión de interleuquina 6, la memoria y el aprendizaje espacial en ratones. Métodos. Experimento con 70 ratones albinos machos de 2 meses de edad de la cepa Balb/c que fueron distribuidos aleatoriamente en grupo A1: estrés agudo 1 hora; grupo A2: estrés agudo 1 hora + estímulo masticatorio 1 hora; grupo B1: estrés agudo 2 horas; grupo B2: estrés agudo 2 horas + estímulo masticatorio 2 horas; grupo C1: estrés agudo 3 horas; grupo C2: estrés agudo 3 horas + estímulo masticatorio 3 horas; y grupo D: sin intervención. Durante 3 días, se evaluó la memoria y el aprendizaje espacial en el laberinto acuático de Morris. La IL-6 fue determinada mediante ELISA. Resultados. La IL-6 fue mayor en el grupo B2 vs los demás grupos (p < 0,001). Además, en el primer día de evaluación, la adquisición de memoria y aprendizaje espacial fue menor en el grupo A1 vs A2 (p = 0,042). Conclusión. Solo en el primer día de evaluación encontramos que el estímulo masticatorio previno la disminución de la adquisición de memoria y aprendizaje espacial en ratones sometidos a estrés agudo de baja intensidad. Los resultados en general no fueron concluyentes sobre el efecto del estímulo masticatorio. Además, la IL-6 fue mayor en el estrés + el estímulo masticatorio (grupo B2) sobre el resto.

Introduction. Acute stress alters memory and spatial learning and the expression of interleukin 6, the chewing stimulus would prevent these effects. Objective. To determine the effect of chewing stimulation and acute stress on the expression of interleukin 6 and memory and spatial learning in mice. Methods. Experiment where 70 male albino mice of the Balb/c of age 2 month were randomly distributed into: Group A1: acute stress 1 hour; Group A2: acute stress 1 hour + chewing stimulus 1 hour; Group B1: acute stress 2 hours; Group B2: acute stress 2 hours + chewing stimulus 2 hours; Group C1: acute stress 3 hours; C2: acute stress 3 hours + chewing stimulus 3 hours; Group D: without intervention. For 3 days, spatial memory and learning were tested in the Morris water maze. Interleukin 6 (IL-6) was analyzed by ELISA test. Results. IL-6 was higher in the B2 group vs the other groups (p<0.0001). In addition, on the first day of evaluation, the acquisition of spatial memory and spatial was lower in the A1 vs. A2 group (p=0.042). Conclusión. Only on the first day of evaluation, we found that the masticatory stimulus prevented the decrease in memory acquisition and spatial learning in mice subjected to low-intensity acute stress. The results were generally inconclusive on the effect of masticatory stimulation. In addition, IL-6 was higher in the stress + masticatory stimulus (group B2) over the rest.