by Yi Chi, Xueqin Yang, Donglin Deng, Peimao Li, Yingbiao Zhang
This study aimed to explore the relationship between circadian rhythm gene polymorphisms, specifically MTNR1A rs2119882 and CLOCK rs1801260, and the risk of acne in an occupational population. MTNR1A encodes a melatonin receptor involved in circadian rhythm regulation, while CLOCK is a core transcription factor in the molecular circadian clock. Both genes are essential in maintaining hormonal balance, sleep-wake cycles, and inflammatory responses—factors closely associated with acne pathogenesis. A case-control study was conducted among 90 participants, comprising acne-affected workers (AAG), acne-free workers (AFG), and healthy control group (HCG). Peripheral blood samples were collected, and DNA was extracted for genotyping of MTNR1A rs2119882 and CLOCK rs1801260 polymorphisms. Sociodemographic, lifestyle, and occupational data were obtained via structured interviews. Logistic regression models were used to assess the association between gene polymorphisms and acne risk, adjusting for relevant covariates. Sensitivity analyses were performed to evaluate the robustness of the findings. In the overall population, no significant association was found between MTNR1A rs2119882 polymorphisms and acne risk. However, CLOCK rs1801260 polymorphisms showed a strong association with acne susceptibility. Under the dominant model, participants carrying the AG/GG genotypes exhibited a significantly higher risk of developing acne compared to those with the AA genotype (unadjusted odds ratios (OR) = 3.79, 95% CI: 1.27–11.31; adjusted OR = 5.08, 95% CI: 1.41–18.33). In the additive model, the risk of acne increased with additional G alleles (unadjusted OR = 2.95, 95% CI: 1.22–7.13; adjusted OR = 3.51, 95% CI: 1.25–9.81). Subgroup analysis among night shift workers revealed a significant association between MTNR1A rs2119882 and acne risk, such that carriers of the CC genotype exhibited increased susceptibility (adjusted OR = 3.97, p = 0.049). Moreover, individuals with AG/GG genotypes at CLOCK rs1801260 showed an even higher risk (OR = 4.96, 95% CI: 1.22–20.14). This study suggests that circadian rhythm gene polymorphisms, particularly CLOCK rs1801260, are associated with acne risk, especially in individuals working rotating night shifts.To identify modifiable caregiver factors influencing abuse tendency in Chinese nursing homes and delineate pathways for intervention.
Discerning the risk factors associated with elder abuse is paramount for enhancing prevention and intervention strategies.
Cross sectional study.
Using validated tools (Caregiver Abuse Screen, Maslach Burnout Inventory, Fatigue Scale-14, Barthel Index), 241 caregivers from 24 nursing homes in Wenzhou City, Zhejiang Province, China were surveyed. Structural equation modelling analysed the direct/indirect pathways linking caregiving stress, caregiving difficulty, job burnout and abuse tendency.
The prevalence of abuse tendency amongst caregivers in the previous year was 40.7%. The model explained 83% of the total variance in abuse tendency. The best-fitting model indicated that abuse tendency was directly affected by job burnout. Caregiving difficulty and stress indirectly affected abuse tendency through job burnout.
This study identified job burnout as a modifiable mediator linking caregiving difficulties, caregiving stress, and abuse tendency amongst nursing home caregivers. To disrupt the pathways to abuse tendency, clinical administrators should prioritise routine burnout screening coupled with structured resilience-building programmes. Simultaneously, optimising staffing ratios and enhancing caregiving competencies may foster safer care environments for caregivers and residents.
This study identified job burnout as a direct driver of abuse tendency, providing information for clinical managers and targeted interventions to mitigate elder abuse risk. Additionally, it revealed the indirect effects of caregiving difficulty and stress via job burnout, emphasising the need to optimise staffing allocation and workflow design to foster system-level improvements in caregiver mental health and service quality.
The study adhered to the STROBE checklist of observational surveys.
Caregivers voluntarily completed questionnaires.
This study identifies job burnout, caregiving difficulty, and caregiving stress as key risk factors for abuse tendency amongst nursing home caregivers. The validated model demonstrates the direct and indirect effects of these factors on abuse tendency, emphasising the need for targeted interventions to prevent and mitigate abuse.
Necrotizing fasciitis is a clinical, surgical emergency characterized by an insidious onset, rapid progression, and a high mortality rate. The disease's mortality rate has remained high for many years, mainly because of its atypical clinical presentation, which prevents many cases from being diagnosed early and accurately, resulting in patients who may die from uncontrollable septic shock and multi-organ failure. But unfortunately, no diagnostic indicator can provide a certain early diagnosis of NF, and clinical judgement of NF is still based on the results of various ancillary tests combined with the patient's medical history, clinical manifestations, and the physician's experience. This review provides a brief overview of the epidemiological features of NF and then discusses the most important laboratory indicators and scoring systems currently employed to diagnose NF. Finally, the latest progress of several imaging techniques in the early diagnosis of NF and their combined application with other diagnostic indices are highlighted. We point out promising research directions based on an objective evaluation of the advantages and shortcomings of different methods, which provide a basis for further improving the early diagnosis of NF.
While previous research has established that resilience is affected by various factors, these studies have primarily focussed on individual variables associated with resilience, without providing insights into how to influence the rate of change in resilience.
To examine the trajectory of resilience and identify the factors associated with changes in resilience among spousal caregivers of patients with newly diagnosed advanced cancer receiving treatment during the first 6 months.
An observational longitudinal study.
A total of 312 spousal caregivers of patients with newly diagnosed advanced cancer were recruited from January 2022 to December 2022 in Yancheng, China. Three data collection points were established, spanning from the first month to 6 months after initial cancer treatment. A latent growth model was employed to depict the resilience trajectory at various time points. A latent growth model with time-invariant covariates was adopted to determine the factors influencing resilience trajectory. The study adhered to the STROBE checklist for proper reporting.
Throughout the follow-up period, the participants experienced a significant increase in resilience. Gender, family income, the patient's health status, spirituality and belief in familism were significantly associated with the baseline resilience level. Moreover, family income, the patient's health status, spirituality, caregiver burden and belief in familism were significantly associated with the rate of resilience change over time.
Spousal caregivers demonstrated a linear increase in resilience during the first 6 months after initial treatment. Meanwhile, changes in resilience were influenced by multiple factors during the early phase of cancer treatment. Thus, more attention should be paid to early identification and implementation of targeted interventions.
Healthcare professionals should understand the change in resilience among spousal caregivers and conduct timely mental health interventions to enhance the resilience of families affected by cancer.
The Guidance for Reporting Involvement of Patients and the Public-Short Form reporting checklists were used to improve patient and public involvement.