Nursing students, as the reserve force of the nursing workforce, often experience transition shock during clinical internships, which negatively impacts their physical and mental health and may lead to presenteeism. Self-efficacy, a modifiable psychological resource, offers a key intervention target for improving this situation.

To examine self-efficacy's mediating role between transition shock and presenteeism in nursing students and to guide management.

This study adopted a descriptive cross-sectional design. A convenience sampling survey was conducted on 421 nursing students in Shenyang City, China. The questionnaire included demographic characteristics, the General Self-Efficacy Scale (GSES), the Transition Shock Scale for Undergraduate Nursing Students (UNSTS), and Stanford Presenteeism Scale (SPS-6). Descriptive statistics, correlation analysis, and multiple linear regression were performed using IBM SPSS 27.0. The structural equation model was used to test the mediating effect hypothesis of self-efficacy between transition shock and presenteeism, and AMOS 28.0 was used to estimate the path coefficients and evaluate the model fit.

The research found that the presenteeism, transition shock, and self-efficacy level of nursing students in Shenyang were all at a moderately high level. Transition shock showed statistically significant positive correlations with presenteeism (r = 0.646) and negative correlations with self-efficacy (r = -0.576), while self-efficacy was negatively correlated with presenteeism (r = -0.636). The SEM showed satisfactory model fit. The results indicated that self-efficacy played a partial mediating role between transition shock and presenteeism (effect = 0.212, [0.149.0.294], p < 0.001), accounting for 29.04% of the total effect (total effect = 0.73, [0.615.0.823], p < 0.001).

This study has confirmed that self-efficacy plays a mediating role between the transition shock and presenteeism among nursing students in Shenyang City, China.

This study offers nursing managers a new way to address presenteeism among nursing students and a reference for improving clinical internship quality and talent cultivation models.

Objective: Dementia caregiving is associated with elevated psychological distress, yet limited research has examined how caregiving demands shape mental health among East Asian American caregivers, a rapidly growing but understudied population. Guided by the stress process framework, this study examined three temporal dimensions of objective caregiving demands - time intensity, frequency, and chronicity - and their associations with subjective caregiving demands and depressive symptoms among older East Asian American caregivers of individuals living with Alzheimer's disease and related dementias (AD/ADRD).Design: Survey data were collected from 82 East Asian American caregivers aged 50 years or older who were providing care to individuals with dementia in the United States. Participants were recruited through community-based organizations and ethnic community settings. Ordinary least squares regression models were estimated to examine associations among temporal caregiving demands, subjective caregiving demands, and depressive symptoms. An exploratory post hoc structural equation model was also estimated to examine indirect associations.Result: Caregivers in this sample reported substantial caregiving involvement, averaging more than 10 hours of care per day, five days per week, over a period exceeding five years. In adjusted regression models, time intensity and chronicity were not directly associated with depressive symptoms, while caregiving frequency was negatively associated with depressive symptoms. Subjective caregiving demands were strongly and positively associated with depressive symptoms. Temporal caregiving demands were positively associated with subjective caregiving demands when examined separately. An exploratory post hoc analysis suggested that chronicity was indirectly associated with depressive symptoms through subjective caregiving demands.Conclusion: Findings suggest that the mental health implications of dementia caregiving may depend less on objective time exposure alone and more on caregivers' subjective appraisal of caregiving demands. Culturally and linguistically responsive interventions should address perceived caregiving burden, improve access to formal support, and attend to the long-term caregiving experiences of East Asian American dementia caregivers.

This study aims to comprehensively examine the interrelationships among physical activity, stress, and oral health status in university students to provide empirical evidence for targeted oral health promotion strategies. A survey was conducted among current university students in mainland China. Physical activity was evaluated via the International Physical Activity Questionnaire Short Form, and stress was measured through the 14-item Perceived Stress Scale. Oral health status was evaluated through self-reported indicators, including gingival bleeding, toothache, and oral ulcer. Data were analyzed using multivariable logistic regression and structural equation modeling. A P value < .05 was considered statistically significant. A total of 1578 participants were included. Findings revealed that 47.7% of students had insufficient physical activity, while 38.7% reported high or excessive stress. Multivariable logistic regression showed that insufficient physical activity and elevated stress levels were associated with an increased risk of gingival bleeding and oral ulcers (P < .05). Structural equation modeling showed that physical activity was negatively associated with perceived stress (standardized coefficient = -0.360, P < .05), and perceived stress was positively associated with self‑reported oral symptoms (standardized coefficient = 0.411, P < .05). However, the direct association between physical activity and oral symptoms was not statistically significant (standardized coefficient = -0.009, P = .765). Physical activity, stress, and oral health are closely intertwined. Insufficient activity and high stress are critical determinants of poor oral health among university students. The observed association between physical activity and oral symptoms was mediated primarily through perceived stress rather than a direct effect. Universities should implement integrated interventions that encourage regular exercise and provide mental health support to enhance the holistic and oral well-being of the student population.

Substance abuse among university students is a significant public health concern that is typically linked to underlying mental health issues such as depression, stress, and a lack of social support networks. Thus, the study's goal was to investigate the link between social support, depression, and substance abuse. A cross-sectional design was used. Students were given 3 measures to complete for the current study: the Multidimensional Scale of Perceived Social Support, the Beck Depression Inventory, and the Alcohol, Smoking, and Substance Involvement Screening Test. The study included 257 regular undergraduate students from Addis Ababa Institute of Technology. As a result, the multivariate test of significance demonstrates that parents' marital status, monthly income, and the presence or absence of intimate friends all have a significant influence on student substance abuse and depression. The Pearson correlation demonstrated a substantial positive relationship between depression and substance abuse; however, higher levels of social support are associated with a decreased likelihood of substance abuse and depression among students. Finally, depression has a mediating role in the relationship between social support and substance abuse. These findings suggest that investing in supportive relationships and communities might be an effective way to improve mental health while simultaneously lowering risky behavior like substance abuse. Furthermore, the researchers proposed that the institution establish its own substance abuse prevention and treatment center, available to psychologists, therapists, and other health practitioners.

To compare early radiographic bone healing 45 days after tibial plateau levelling osteotomy performed with popliteus muscle detachment versus a modified technique preserving the muscle and to determine whether muscle preservation influences post-operative osteotomy stability through measurement of rock-back.

In this prospective, blinded, randomised clinical study (2022 to 2025), 100 client-owned dogs with unilateral cranial cruciate ligament rupture were allocated to traditional surgery (n = 50) or popliteus-sparing surgery (n = 50). Radiographic assessment was performed preoperatively, immediately post-operatively and 45 days after surgery. Bone healing was evaluated using two validated radiographic scoring systems. Osteotomy stability was assessed by measuring the change in tibial plateau angle between the immediate post-operative and 45-day radiographs. Multivariable linear regression models were used to adjust for baseline clinical variables. A P-value <.05 was considered statistically significant.

Dogs undergoing popliteus-sparing surgery demonstrated higher bone healing scores at 45 days, with an adjusted mean difference of 1.95 (95% confidence interval 0.91 to 2.99) on the 10-point bone healing scale and 1.87 (95% confidence interval 0.88 to 2.86) on the modified radiographic union scale. There was no clinically relevant difference in post-operative tibial plateau angle change between groups, with an adjusted mean difference of 0.26 degrees (95% confidence interval -0.10 to 0.63). No major intraoperative vascular complications were recorded.

Tibial plateau levelling osteotomy performed without detachment of the popliteus muscle represents a safe and effective alternative to the traditional technique. Popliteus muscle preservation during tibial plateau levelling osteotomy was associated with higher radiographic bone healing scores at 45 days, without evidence of increased osteotomy instability. Whether this radiographic difference translates into improved clinical recovery or limb function remains unknown.

Peripheral facial paralysis (PFP) is a nonspecific inflammatory disease of the facial nerve, and the resulting sequelae seriously affect social function and mental health. Bibliometric analysis determines the focus and status of current research. However, no comprehensive bibliometric study has yet focused on PFP treatment.

Relevant publications from 2004 to 2024 were retrieved from the Web of Science. Visualization and bibliometric analyses were conducted using VOSviewer, CiteSpace, and Scimago Graphica to explore collaborative networks among countries, institutions, and authors, as well as key journals and references.

A total of 2426 publications were identified, authored by 10,111 researchers from 2749 institutions across 84 countries/regions. Publication output has shown a general upward trend. The United States led in publication volume and international collaborations. The institution and author with the most publications were Kyung Hee University and Hadlock TA, respectively. Plastic and Reconstructive Surgery ranked highest in both publication count and citations, while Terzis JK was the most frequently co-cited author. Over the years, the research hotspots in PFP treatment shifted from antivirals, steroids, and muscle transplantation therapies to include nerve transplantation, acupuncture, electrical stimulation, and other rehabilitation therapies.

This analysis captured the research hotspots and frontiers in PFP therapy. This study highlights the developmental trajectory and emerging trends in PFP therapy, providing a comprehensive reference for future research directions in the field.

The prevalence of sleep disorders has been rising over recent decades. Sleep disorders are frequently associated with disruptions in resting-state functional brain networks. Despite these associations, the direction and genetic basis of the relationships between brain functional networks and sleep disorders remain unclear. Utilizing bidirectional two-sample Mendelian randomization (MR), we examined bidirectional associations between 191 resting-state functional magnetic resonance imaging (rsfMRI) phenotypes (n = 34,691 individuals) and 8 sleep disorder phenotypes (N = 307,843-410,385 individuals). Forward MR identified 14 rsfMRI traits that showed significant associations with sleep disorder phenotypes. Notably, the inverse variance-weighted method showed that increased amplitude in the precuneus or occipital regions within the default mode or central executive network was associated with 13.2% higher odds of sleep disorders (combined; odds ratio = 1.132, 95% confidence interval: 1.064-1.204, P = 8.30 × 10-5). In addition, reverse MR identified 6 sleep disorder phenotypes with significant associations involving 18 rsfMRI traits. For example, higher genetic liability to sleep disorders (combined) was associated with a 14.2% lower strength of functional connectivity between precentral, frontal, or supplementary motor and frontal networks (odds ratio = 0.858, 95% confidence interval: 0.795-0.927, P = 9.62 × 10-5). This study identified 32 bidirectional MR associations between sleep disorders and brain functional networks, providing candidate neural circuits for future mechanistic and interventional studies of sleep disorders.

Endurance exercise, characterized by sustained low-to-moderate intensity training, enhances physiological performance during prolonged physical activity and is widely used in sports training and the rehabilitation of chronic diseases. Central fatigue, a key issue in endurance sports, arises from fatigue mechanisms within the central nervous system, affecting both performance and emotional well-being. Although endurance training can improve performance and mood by modulating neurotransmitter balance, the onset and exacerbation of central fatigue remain unresolved challenges.

A bibliometric approach was employed, using the Web of Science Core Collection (WoSCC) database to retrieve literature published between 2005 and 2024 on endurance exercise and central fatigue. Data analysis and visualization were conducted using CiteSpace, VOSviewer, and the R-Bibliometrix tool to explore research trends, hotspots, and future directions.

The study reveals a year-on-year increase in publications on endurance exercise and central fatigue, especially since 2014. Research has progressively focused on exercise performance, fatigue mechanisms, and neurotransmitter regulation. Keyword analysis highlights growing interest in the impact of prolonged exercise on central fatigue and the rising focus on psychological fatigue and cognitive function. Increasing interdisciplinary collaboration, international cooperation, and citation bursts from seminal works in exercise neurobiology and psychology are evident.

The mechanistic literature mapped in this analysis suggests that endurance exercise may influence performance and emotional well-being via neurotransmitter modulation; however, as a bibliometric study, the present analysis cannot itself establish causal biological mechanisms, and this interpretation should be corroborated by dedicated experimental and clinical research. The onset and progression of central fatigue remain significant challenges. Future research should focus on the neurobiological mechanisms of endurance exercise, particularly neurotransmitter regulation and neuroprotection, and explore its clinical potential in treating chronic fatigue syndrome, mental health disorders, and cognitive impairments.

Objective: To investigate the prevalence of sleep disturbance in outpatients with chronic pain and evaluate the mediating effect of depressive symptoms on the association between sleep disturbance and pain severity. Methods: A cross-sectional survey was conducted in 2023 in outpatients with chronic pain from medical institutions in Beijing, Jiangxi, and Chongqing based on multistage stratified sampling. The patients who were aged ≥45 years and had pain duration ≥3 months were included. The information about their sociodemographic characteristics, pain severity, sleep status, and depressive symptoms were collected by using structured questionnaires. Correlation analysis and multiple linear regression models were applied to evaluate the association between sleep disturbance and pain severity. After controlling for potential confounders, a mediation effect model was used to analyze the mediating effect of depressive symptoms. Results: A total of 4 151 study participants were included. Sleep disturbance was identified in 1 784 participants (42.98%), and depressive symptoms were identified in 378 participants (9.11%). Moderate pain was reported by 2 535 participants (61.07%), mild pain by 1 079 participants (25.99%), and severe pain by 537 participants (12.94%). Sleep disturbance was positively associated with pain severity (r=0.239, P<0.001), and sleep disturbance was also positively associated with depressive symptoms (r=0.186, P<0.001); depressive symptoms were likewise positively associated with pain severity (r=0.235, P<0.001). After adjustment for covariates, each one-point increase in the sleep disturbance score was associated with a 0.287-point increase in the Patient Health Questionnaire-2 (PHQ-2) score (β=0.287), and each one-point increase in the sleep disturbance score was associated with a 0.156-point increase in the pain score (β=0.156). After depressive symptoms were added to the model, the direct effect of sleep disturbance on pain severity remained significant (β=0.143), and each one-point increase in the PHQ-2 score was associated with a 0.048-point increase in the pain score (β=0.048). Depressive symptoms partially mediated the association between sleep disturbance and pain severity, accounting for 8.75% of the total effect. Conclusions: The prevalence of sleep disturbance was high in outpatients with chronic pain in Beijing, Jiangxi, and Chongqing. Sleep disturbance was associated with pain severity and might be also indirectly associated with pain severity through depressive symptoms. In clinical practice, more attention should be paid to the comprehensive assessment and management of sleep quality and emotional status in patients with chronic pain to mitigate pain severity and improve overall health outcomes.

Objective: To analyze the prevalence of chronic obstructive pulmonary disease (COPD) and its change trend in residents aged ≥40 years in Hubei Province from 2014 to 2024, and provide data support for COPD prevention and control. Methods: The COPD prevalence data were from three cross-sectional surveys of the China COPD surveillance from 2014 to 2024. Complex weighted sampling were used to analyze the prevalence of COPD and the changing trend of related factors in people with different demographic characteristics. A multivariate logistic regression model was used to analyze the correlated factors of COPD in Hubei. Results: The prevalence rates of COPD in people aged ≥40 years in Hubei in 2014-2015, 2019-2020 and 2024 were 12.5% (95%CI: 10.1%-14.8%), 10.7% (95%CI: 7.8%-13.6%) and 8.1% (95%CI: 5.8%-10.5%), respectively, with no statistical significance in downward trend (t=-2.06, P=0.079). The exposure rates of occupational dust and/or harmful gases, the use rate of coal fuel for household heating, the exposure rate of low BMI, the prevalence of dyspnea and any respiratory symptom decreased significantly. The protection rate against occupational exposure to dust or harmful gas increased significantly. The results of multivariate Logistic regression showed that the COPD risk was higher in rural population (OR=1.38, 95%CI: 1.06-1.81), men (OR=3.45, 95%CI: 1.80-6.61), those with older age (50- years old: OR=2.81, 95%CI: 2.05-3.85; 60- years old: OR=3.04, 95%CI: 1.29-7.16; ≥70 years old: OR=8.43, 95%CI: 4.51-15.73), retired group (OR=2.60, 95%CI: 1.12-6.02), smokers (OR=2.48, 95%CI: 1.75-3.52), people with family history of chronic respiratory diseases (OR=1.54, 95%CI: 1.29-1.84).The unemployed (OR=0.73, 95%CI: 0.54-0.97), middle-high per capita annual income (OR=0.46, 95%CI: 0.27-0.79), people with normal BMI (OR=0.21, 95%CI: 0.11-0.42), overweight people (OR=0.19, 95%CI: 0.10-0.33), and obese people (OR=0.07, 95%CI: 0.02-0.30) had lower risk for COPD. Conclusions: From 2014 to 2024, there was no statistically significant downward trend in the prevalence of COPD in residents aged ≥40 years in Hubei. Rural residents, men, the elderly, smokers, and those with a family history of chronic respiratory diseases were the population at high risk for COPD. It is necessary to further strengthen the surveillance for COPD and associated factors.