White-collar workers experience a unique dual burden of high psychological demands and prolonged static loading, creating a need to understand how physical resilience may mitigate these stressors. This study investigated the moderating role of specific muscle fitness components in the associations between work stress, burnout, and well-being among white-collar workers. To address the gap in task-specific physical resilience, we employed a cross-sectional design involving 321 full-time employees.

Work stress (job control and demands), burnout, and well-being were assessed via structured questionnaires, while grip strength, abdominal endurance, and back muscle endurance were objectively measured.

Results indicated that the muscle fitness components were not directly associated with either burnout or well-being. However, the moderation model for burnout was significant (F = 15.837, p < 0.001; adjusted R² = 0.278), where back muscle endurance significantly moderated the association between psychological job demands and burnout (β = -0.121, p < 0.05), whereas no such moderating effect was observed for well-being. In contrast, no such moderating effect was observed for well-being, nor did grip strength or abdominal endurance exhibit significant buffering effects on either psychological outcome.

These findings demonstrate the relevance of task-specific physical resources in sedentary environments, specifically that back endurance functions as a buffer against burnout but may be insufficient to directly enhance overall well-being. The results suggest that while integrating task-specific physical assessments is vital for burnout prevention, psychosocial organizational support remains essential for fostering comprehensive well-being.

Intimate partner violence (IPV) represents a major global public health concern with profound psychological and social consequences for women. This review synthesizes contemporary evidence (2020-2025) on IPV prevalence, mental health outcomes, and healthcare implications among female populations worldwide.

18 peer-reviewed studies, encompassing approximately 62,000 women across various countries, were analyzed for study design, sample characteristics, IPV prevalence, and associated outcomes.

IPV prevalence varied widely across studies, ranging from 15% in population-based antenatal samples to over 85% among incarcerated or trauma-exposed groups. Across studies reporting mental health outcomes, depression prevalence ranged from 20% to over 50%, while PTSD prevalence ranged from approximately 30% to 70%, depending on measurement tools and population characteristics. No pooled estimates were calculated. IPV survivors showed higher emergency department use (2.6-fold), inpatient admissions (2.2-fold), and healthcare costs (2.2-fold) compared with non-exposed women. Emerging interventions, such as digital safety programs, behavioral antenatal packages, and validated screening tools, demonstrated encouraging effectiveness.

IPV remains widespread and linked to psychological distress and elevated healthcare burden. Integration of routine screening, trauma-informed mental health services, and multisectoral prevention frameworks is essential to mitigate its enduring impact on women's health and well-being.

Background: Recurrent pregnancy loss (RPL) and infertility are associated with significant psychological morbidity, including stress, anxiety, and depression. While these impacts are well-documented globally, their prevalence and severity in the Omani population remain unexplored. This study investigates the mental health outcomes of Omani women with RPL and infertility compared to fertile controls. Objectives: The objectives of this study are to assess the prevalence of stress, anxiety, and depression in women with recurrent pregnancy loss (RPL) and infertility and compare these rates to women with no fertility concerns in an Omani population. Design: This is a prospective, cross-sectional study. Setting: This study's setting consisted of Sultan Qaboos University Hospital and Royal Hospital in Muscat, Oman. Participants: This study included 111 women with RPL, 131 women with infertility, and 210 antenatal controls with no fertility issues. Interventions: No clinical interventions were administered as this was an observational study. Participants completed validated psychological assessments (DASS-42 and BDI-II). Primary and secondary outcome measures: Primary outcomes were the prevalence rates of stress, anxiety, and depression assessed using DASS-42 and BDI-II. Secondary outcomes included sociodemographic correlates and risk factors Results: This study included 111 women in the RPL group, 131 in the infertility group, and 210 controls. Among RPL patients, 31% reported stress, ranging from mild to extremely severe, while 35.9% of infertility patients reported stress, compared to 17.1% in the control group (p = 0.003). Anxiety was present in 45% of RPL patients, 45.5% of infertility patients, and 28.1% of controls (p = 0.019). Depression, measured by DASS-42, was the most prevalent in the RPL group (34.2%), followed by the infertility group (33.6%) and controls (13.8%) (p < 0.001). Similar results were observed with BDI-II, with depression rates of 23.4% in the RPL group, 19.1% in the infertility group, and 7.6% in controls (p = 0.02). Conclusions: Women with RPL and infertility in Oman experience significantly higher levels of stress, anxiety, and depression compared to women without fertility concerns. This study did not assess the mental health of male partners, highlighting the need for further research on the psychological impact on both partners. Future studies should focus on developing psychological support interventions and evaluating their impact on patient outcomes.

Introduction: Emotional intelligence (EI) is increasingly acknowledged as a component that may influence nurses' job performance (JP), particularly in high-stress contexts. This study examined the relationship between emotional intelligence and job performance among critical care nurses at King Salman Specialist Hospital in Hail, Saudi Arabia. Design/Methods: The cross-sectional study included 50 registered nurses working in the critical care unit, following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Data were gathered using validated tools. The data were collected between October and December 2024. Point-biserial correlation (rpb), one-way ANOVA and simple linear regression were employed. Results: This study found that neither gender (r_pb = 0.095, p = 0.514) nor age group (F = 0.945; p = 0.423) had a significant impact on EI or JP scores. Meanwhile, the linear regression model was highly significant (F [1, 48] = 45.829; p < 0.001), indicating that EI is a robust predictor of performance in this cohort. Contrary to common assumptions, a significant negative (inverse) relationship was identified. For every one-unit increase in EI, job performance decreased by 0.541 units (β = -0.699; t = -6.77; p < 0.001). Conclusions: This study confirms that EI serves as a notable inverse predictor of JP of critical care nurses. This shows that there could be high levels of emotional labor in the demanding clinical environment, which could hinder technical performance. This finding, irrespective of age or gender, defies the 'more is better' generalization of EI in the healthcare industry. Therefore, it is essential that there be available supportive mechanisms in the workplace to assist nurses with high EI in managing their emotional involvement with clinical work. This should be done to avoid a compromise in job performance.

Background: Medical students are a vulnerable population with elevated cardiometabolic and mental health risks. Dietary habits are key modifiable behaviors that may mitigate these risks, yet social and contextual determinants such as internal migration, social disconnection, and alcohol use remain underexplored, particularly in middle-income settings. This study examined dietary habits among Peruvian medical students and evaluated the associations of internal migration, mealtime social disconnection, and alcohol consumption with poor habits. Methods: We conducted a cross-sectional study of 223 medical students in Peru. Dietary habits were assessed using a validated nutritional habits questionnaire adapted for the target population (Diet History Questionnaire test, Peruvian adaptation-DHQ-P). The score ranged from 0 to 58, with poor habits defined as <30 based on previous studies and the sample median. Mealtime social disconnection, internal migration, and alcohol use were explored as associated factors. Multivariable Poisson regression models with robust standard errors were used to estimate adjusted prevalence ratios (aPRs), controlling for age, gender, medical school semester, and income. Causal mediation analysis evaluated whether mealtime social disconnection mediated the association between internal migration and dietary habits. Sensitivity to unmeasured confounding was assessed using E-values. Results: Poor dietary habits affected approximately 47% of students. Internal migrants comprised 44% of the sample, 35.8% reported eating all meals alone, and 67% reported alcohol use more than once per month. Each additional meal eaten alone was associated with a higher prevalence of poor habits (aPR 1.17, 95% CI 1.02-1.38), and eating all meals alone also increased the prevalence (aPR 1.14, 95% CI 1.02-1.28). Similarly, recent internal migration (aPR 1.38, 95% CI 1.04-1.83), lifetime internal migration (aPR = 1.85; 95% CI, 1.16-2.95), and higher frequency of migration (aPR = 1.17; 95% CI, 1.01-2.38) were linked to poor dietary habits. Moreover, alcohol consumption (aPR 2.06, 95% CI 1.60-2.67) was independently associated with poor dietary habits. Mealtime social disconnection partially mediated 19% of the migration-dietary habits association (p = 0.03). Associations were robust to unmeasured confounding (E-values 1.34-2.23). Conclusions: Poor dietary habits are highly prevalent among Peruvian medical students and are independently associated with internal migration, mealtime social disconnection, and alcohol use. Addressing social eating contexts and migration-related vulnerabilities may offer novel opportunities to improve dietary behaviors among future physicians.

Tuberculosis and sarcoidosis can present with similar clinical and radiological features, especially intrathoracic lymphadenopathy, complicating differential diagnosis. This study explored the potential utility of QuantiFERON-TB Gold (QFT), serum High Mobility Group Box 1 protein (HMGB1), and microRNA-221 (miRNA-221) relative expression as biomarkers to aid in distinguishing tuberculosis-related intrathoracic lymphadenopathy (TBIL) from sarcoidosis-related intrathoracic lymphadenopathy (SAIL). The study included 27 patients with TBIL, 27 patients with SAIL, and 27 healthy controls. QFT results, serum HMGB1 levels, and miRNA-221 relative expression were measured and compared across groups using univariable and exploratory multivariable analyses. Significant differences were observed among the study groups for serum HMGB1 levels, miRNA-221 expression, and QFT results (p < 0.001). Both TBIL and SAIL patients had significantly higher HMGB1 levels compared with healthy controls, consistent with inflammatory activity. In contrast, miRNA-221 expression was significantly elevated in TBIL patients compared with both SAIL patients and controls. Exploratory analyses suggested a potential contribution of miRNA-221 to differentiating TBIL from SAIL, whereas the effects of HMGB1 and QFT were less pronounced after adjustment. The findings suggest that miRNA-221, alongside HMGB1 and QFT, may contribute to the differentiation of TBIL from SAIL, although validation in larger cohorts is necessary.

Opioid-related iatrogenic harms, including opioid use disorder, overdose, and opioid-induced respiratory depression, constitute a major patient safety challenge. Although clinicians document key safety signals in unstructured clinical narratives, many of these indicators are not readily captured by conventional surveillance approaches that rely on structured administrative data. This clinically focused narrative review synthesizes 47 empirical studies published between 2009 and 2025 that applied artificial intelligence (AI) methods to identify opioid-related harms from clinical text and to address the resulting ascertainment gap. Across studies, administrative coding systems, including ICD-10, often under-ascertain opioid-related events, whereas text-based AI can identify additional cases and contextual details often documented primarily in narrative records, such as fluctuating mental status, suspected drug causality, and responses to naloxone. Methodologically, the literature has progressed from interpretable rule-based lexicons to machine learning and deep learning models and, more recently, to transformer-based approaches, including large language models (LLMs) for classification and schema-driven extraction. Rule-based systems established the feasibility of transparent surveillance and frequently recovered clinically documented cases missed by billing codes. Subsequent supervised and deep learning approaches expanded scalability and, in a smaller subset of studies, were integrated into electronic health record workflows with operational metrics reported. More recent transformer- and LLM-based studies emphasize richer extraction schemas and benchmark development, including characterization of overdose context and intentionality and identification of potential prodromal neurocognitive signals, although external validation, calibration, and prospective outcome evaluation remain inconsistently reported. Given that the evidence base is predominantly retrospective and that clinical workflow studies remain comparatively few, a pragmatic near-term clinical role is to provide detection-to-triage decision support rather than autonomous diagnosis, in which systems surface candidate cases with reviewable evidence for clinician adjudication. Future progress will require greater standardization of phenotype definitions, routine equity auditing and subgroup reporting, stronger external validation and calibration at operational thresholds, and a shift from retrospective discrimination metrics toward prospective assessments of the clinical workflow impact, clinical utility, and patient-centered outcomes.

Background/Objectives: Intranasal esketamine has emerged as an effective treatment for patients with treatment-resistant depression (TRD), providing rapid symptom relief when conventional antidepressant strategies fail. While its pharmacological efficacy has been demonstrated in randomized controlled trials, less attention has been paid to the organizational, relational, and multidisciplinary aspects that influence its real-world implementation and clinical effectiveness. While practical recommendations for intranasal esketamine services exist, an implementation-ready framework integrating psychiatry, nursing, and psychotherapy across treatment phases is still lacking. This narrative review synthesizes the clinical and real-world evidence and proposes a phase-based integration framework with explicit role delineation and measurable implementation/fidelity indicators. Methods: We conducted a narrative review informed by a structured literature search in major databases from inception to the most recent update. Search terms combined 'esketamine'/'Spravato' with 'treatment-resistant depression', 'nursing', 'psychotherapy', 'multidisciplinary', and 'implementation'. Outcomes prioritized in the synthesis included depressive symptom severity/response, relapse prevention, safety/tolerability, anhedonia, suicidality monitoring, functional outcomes, and patient-reported experience/retention. Based on this evidence, an integrated, phase-based multidisciplinary framework for esketamine treatment was developed. Results: Available evidence supports the efficacy of intranasal esketamine in reducing depressive symptoms in TRD, with growing real-world data confirming its effectiveness and safety. Beyond global symptom improvement, studies highlight benefits on clinically relevant domains such as anhedonia and suicidality trajectories, as well as meaningful patient-reported outcomes. However, the complexity of esketamine delivery requires structured clinical pathways. The proposed model delineates complementary roles for medical supervision, nursing care, and psychotherapy across pre-treatment assessment, induction and session delivery, post-session integration, and maintenance phases, emphasizing safety, continuity of care, and patient-centred monitoring. Conclusions: Intranasal esketamine represents not only a pharmacological innovation but also a treatment that necessitates an integrated multidisciplinary approach. A structured phase-based multidisciplinary approach may support safer, more acceptable delivery of intranasal esketamine and potentially improve retention and patient experience; however, prospective implementation and comparative studies are needed to evaluate clinical effectiveness, feasibility, and cost-effectiveness.

The success of heart transplantation (HTX) is profoundly influenced by various psychosocial factors, underscoring the necessity of a multidisciplinary approach throughout the patient's journey. Relevant psychosocial factors, such as adherence to complex post-transplant regimens, psychological status (e.g., risk of anxiety, depression), and the long-term goal of social and professional reintegration (return to work), significantly impact post-transplant outcomes. Current guidelines strongly recommend a multidisciplinary team, including psychologists, social workers, and other specialized non-medical professionals, as their involvement is associated with better quality of care and improved long-term outcomes. This paper synthesizes the evidence underlying psychologically informed heart transplantation care, highlighting the integration of fundamental psychological principles into routine medical practice. This approach features a genuine transdisciplinary collaboration, extending beyond traditional medical care. The implementation framework includes adopting the World Health Organization's Multidimensional Adherence Model, tailored to the HTX population, and a spectrum approach to mental health, facilitating unified assessment and care aligned with the competencies of different team members. Furthermore, the collaborative team is trained in Low-Intensity Psychological Interventions, which are simple and effective; these can be embedded into routine clinical pathways by various healthcare staff to quickly address anxiety, adherence, and suboptimal health behaviors. By applying the concept of psychologically informed care, HTX centers can facilitate the genuine integration of interdisciplinary collaboration, ensuring comprehensive physical and psychosocial support for recipients.

Background/Objectives: Therapeutic exercise (TE) has been shown to be an effective tool for slowing physical and cognitive decline in patients with dementia. However, its true impact on physical and functional variables, as well as the duration of its effects once therapy is discontinued, remains unclear. The aim was to analyze the short- and medium-term effects of a structured and monitored TE program on motor function in patients with dementia. Methods: A pre-post clinical trial was conducted in individuals with a medical diagnosis of mild-to-moderate cognitive impairment (Mini-Mental State Examination scores between 10 and 23) who had not engaged in regular exercise during the previous 6 months. The study variables and their measurement tools included general motor function (Short Physical Performance Battery), trunk control (Trunk Control Test), balance (Berg Balance Scale), overall mobility and gait (Timed Up and Go Test), and degree of independence in activities of daily living (ADLs) (Barthel Index). Participants completed a 12-week TE intervention at moderate intensity, 3 days per week for 45 min sessions. The program included aerobic training and strength, coordination, flexibility, and balance exercises. TE intensity was monitored through heart rate and dynamic maximal resistance. Assessments were conducted at baseline (t0), immediately after the program (t1), and 6 months after completion (t2). Results: Significant global longitudinal effects of time were observed for general motor function, balance, trunk control, and mobility and gait, whereas no significant global effect was detected for independence in activities of daily living. Post-intervention changes were non-significant; however, several pairwise comparisons showed moderate-to-large effect sizes. Follow-up assessments revealed shifts in performance distributions consistent with functional decline. Conclusions: A structured TE program performed at moderate intensity may help slow or attenuate the physical decline experienced by individuals with dementia.