Purpose: It is important to reduce stress and improve quality of life for shift nurses, who experience high levels of occupational stress. Identifying evidence-based interventions to enhance their well-being is crucial for both individual and healthcare system outcomes. This study aimed to evaluate the effects of music therapy and aromatherapy on stress, quality of life, and happiness among shift nurses. Methods: In this randomized controlled trial, participants were randomly assigned using computer-generated random numbers. A total of 78 shift nurses who met the inclusion criteria were enrolled. The experimental treatment involved providing music therapy for one week to the music group and aromatherapy for one week to the aroma group, whereas the control group followed their usual daily routines for one week. Results: No significant differences were observed among the three groups concerning general characteristics and baseline dependent variables, thereby confirming the homogeneity of the groups. Nevertheless, post-intervention analyses demonstrated significant improvements in perceived stress (F = 5.55, p = .006), stress index (F = 3.38, p = .039), quality of life (F = 11.79, p < .001), and happiness (F = 9.29, p < .001) in the experimental groups. Conclusion Both music therapy and aromatherapy were found to be effective in mitigating stress and improving quality of life and happiness among shift nurses. Therefore, these interventions can be regarded as valuable strategies for improving overall well-being within this population.

Purpose: It is important to reduce stress and improve quality of life for shift nurses, who experience high levels of occupational stress. Identifying evidence-based interventions to enhance their well-being is crucial for both individual and healthcare system outcomes. This study aimed to evaluate the effects of music therapy and aromatherapy on stress, quality of life, and happiness among shift nurses. Methods: In this randomized controlled trial, participants were randomly assigned using computer-generated random numbers. A total of 78 shift nurses who met the inclusion criteria were enrolled. The experimental treatment involved providing music therapy for one week to the music group and aromatherapy for one week to the aroma group, whereas the control group followed their usual daily routines for one week. Results: No significant differences were observed among the three groups concerning general characteristics and baseline dependent variables, thereby confirming the homogeneity of the groups. Nevertheless, post-intervention analyses demonstrated significant improvements in perceived stress (F = 5.55, p = .006), stress index (F = 3.38, p = .039), quality of life (F = 11.79, p < .001), and happiness (F = 9.29, p < .001) in the experimental groups. Conclusion Both music therapy and aromatherapy were found to be effective in mitigating stress and improving quality of life and happiness among shift nurses. Therefore, these interventions can be regarded as valuable strategies for improving overall well-being within this population.

Purpose: It is important to reduce stress and improve quality of life for shift nurses, who experience high levels of occupational stress. Identifying evidence-based interventions to enhance their well-being is crucial for both individual and healthcare system outcomes. This study aimed to evaluate the effects of music therapy and aromatherapy on stress, quality of life, and happiness among shift nurses. Methods: In this randomized controlled trial, participants were randomly assigned using computer-generated random numbers. A total of 78 shift nurses who met the inclusion criteria were enrolled. The experimental treatment involved providing music therapy for one week to the music group and aromatherapy for one week to the aroma group, whereas the control group followed their usual daily routines for one week. Results: No significant differences were observed among the three groups concerning general characteristics and baseline dependent variables, thereby confirming the homogeneity of the groups. Nevertheless, post-intervention analyses demonstrated significant improvements in perceived stress (F = 5.55, p = .006), stress index (F = 3.38, p = .039), quality of life (F = 11.79, p < .001), and happiness (F = 9.29, p < .001) in the experimental groups. Conclusion Both music therapy and aromatherapy were found to be effective in mitigating stress and improving quality of life and happiness among shift nurses. Therefore, these interventions can be regarded as valuable strategies for improving overall well-being within this population.

Purpose: It is important to reduce stress and improve quality of life for shift nurses, who experience high levels of occupational stress. Identifying evidence-based interventions to enhance their well-being is crucial for both individual and healthcare system outcomes. This study aimed to evaluate the effects of music therapy and aromatherapy on stress, quality of life, and happiness among shift nurses. Methods: In this randomized controlled trial, participants were randomly assigned using computer-generated random numbers. A total of 78 shift nurses who met the inclusion criteria were enrolled. The experimental treatment involved providing music therapy for one week to the music group and aromatherapy for one week to the aroma group, whereas the control group followed their usual daily routines for one week. Results: No significant differences were observed among the three groups concerning general characteristics and baseline dependent variables, thereby confirming the homogeneity of the groups. Nevertheless, post-intervention analyses demonstrated significant improvements in perceived stress (F = 5.55, p = .006), stress index (F = 3.38, p = .039), quality of life (F = 11.79, p < .001), and happiness (F = 9.29, p < .001) in the experimental groups. Conclusion Both music therapy and aromatherapy were found to be effective in mitigating stress and improving quality of life and happiness among shift nurses. Therefore, these interventions can be regarded as valuable strategies for improving overall well-being within this population.

Background: Hepatic steatosis, which involves the excessive accumulation of lipid droplets in hepatocytes, presents a significant global health concern due to its association with obesity and metabolic disorders. Inflammation plays a crucial role in the progression of hepatic steatosis; however, the precise molecular mechanisms responsible for this process remain unknown. Methods: This study investigated the involvement of the nucleotide-binding oligomerization domain-like receptor pyrin domain-containing-3 (NLRP3) inflammasome and the forkhead box O6 (FoxO6) transcription factor in the pathogenesis of hepatic steatosis. We monitored the NLRP3 inflammasome and lipogenesis in mice overexpressing the constitutively active (CA)-FoxO6 allele and FoxO6-null mice. In an in vitro study, we administered palmitate to liver cells overexpressing CA-FoxO6 and measured changes in lipid metabolism. Results: We administered palmitate treatment to clarify the mechanisms through which FoxO6 activates cytokine interleukin (IL)-1β through the NLRP3 inflammasome. The initial experiments revealed that dephosphorylation led to palmitate-induced FoxO6 transcriptional activity. Further palmitate experiments showed increased expression of IL-1β and the hepatic NLRP3 inflammasome complex, including adaptor protein apoptotic speck protein containing a caspase recruitment domain (ASC) and pro-caspase-1. Furthermore, thioredoxin-interacting protein (TXNIP), a key regulator of cellular redox conditions upstream of the NLRP3 inflammasome, was induced by FoxO6 in the liver and HepG2 cells. Conclusion The findings of this study shed light on the molecular mechanisms underpinning the FoxO6-NLRP3 inflammasome axis in promoting inflammation and lipid accumulation in the liver.

Background: The relationship between serum vitamin D levels and depressive symptoms has not been consistent in previous studies in Korean women. Menopause is known to be related to depression and vitamin D. Methods: This study included 11,573 women from the 5th Korea National Health and Nutrition Examination Survey. Serum vitamin D levels were divided into four groups according to quartiles, and depressive symptoms were collected into two groups. Multiple logistic regression analysis was conducted in each group of women before and after menopause. Results: Compared with the highest vitamin D group, the lowest vitamin D group did not show significant differences in all females (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.78-1.22). In premenopausal women, compared to the first quartile, ORs were presented in the second quartile (OR, 0.75; 95% CI, 0.53-1.07), third quartile (OR, 0.70; 95% CI, 0.49-1.00) and fourth quartile (OR, 0.62; 95% CI, 0.43-0.92) respectively, and they were statistically significant (P=0.016). In postmenopausal women, compared to the first quartile, ORs were presented in the second quartile (OR, 1.06; 95% CI, 0.78-1.44), third quartile (OR, 1.18; 95% CI, 0.87-1.61), and fourth quartile (OR, 1.27; 95% CI, 0.98-1.66) respectively; however, they were not statistically significant (P=0.057). Conclusions Depression symptoms increased with a decrease in serum vitamin D in premenopausal women, but the opposite trend was observed in postmenopausal women. In future studies, if the relationship between blood vitamin D and depression is studied, the menopausal status of women can be used as an important criterion.

Background: Unlike conventional T cells, innate and virtual-memory CD8 T cells in naïve mice acquire their memory phenotypes and functions in the absence of antigenic encounters in a cytokine-dependent manner. The relevant cytokines include interleukin-4 (IL-4), type I interferon, and interleukin-15 (IL-15). Moreover, exogenous IL-4 can also induce de novo generation and/or expansion of the virtual-memory CD8 T cell population. In this study, we investigated whether exogenous IL-4 could enhance the immune response to a viral infection. Results: In vivo administration of IL-4 and an anti-IL-4 antibody complex (IL-4C) increased CXCR3 expression in both memory and naïve phenotype CD8 T cells in the absence of antigenic stimulation, and protected mice from lethal influenza infection. Flow cytometric analysis of lung-infiltrating immune cells on day 5 after virus infection revealed higher numbers of antigen-specific and bystander CD8 T cells in IL-4C-treated mice than in control mice. In particular, the bystander CD8 T cells were a naïve or evident memory phenotypes. Crucially, an anti-CXCR3 blocking antibody abrogated this IL-4C effect, reflecting that the increased accumulation of CD8 T cells in the lungs after IL-4C treatment is dependent on CXCR3. Conclusions These data demonstrate that exogenous IL-4C plays a protective role by enhancing CXCR3-dependent migration of CD8 T cells into influenza-infected lungs.

Background: Influenza A viruses (IAVs) have long posed a threat to humans, occasionally causing significant morbidity and mortality. The initial immune response is triggered by infected epithelial cells, alveolar macrophages and dendritic cells. However, an exaggerated innate immune response can result in severe lung injury and even host mortality. One notable pathology observed in hosts succumbing to severe influenza is the excessive influx of neutrophils and monocytes into the lung. In this study, we investigated a strategy for controlling lung immunopathology following severe influenza infection. Results: To evaluate the impact of innate immunity on influenza-associated lung injury, we employed CB17.SCID and NOD.SCID mice. NOD.SCID mice exhibited slower weight loss and longer survival than CB17.SCID mice following influenza infection. Lung inflammation was reduced in NOD.SCID mice compared to CB17.SCID mice. Bulk RNA sequencing analysis of lung tissue showed significant downregulation of 827 genes, and differentially expressed gene analysis indicated that the cytokine-cytokine receptor interaction pathway was predominantly downregulated in NOD.SCID mice. Interestingly, the expression of the Cxcl14 gene was higher in the lungs of influenza-infected NOD.SCID mice than in CB17.SCID mice. Therefore, we induced overexpression of the Cxcl14 gene in the lung using the adeno-associated virus 9 (AAV9)-vector system for target gene delivery. However, when we administered the AAV9 vector carrying the Cxcl14 gene or a control AAV9 vector to BALB/c mice from both groups, the morbidity and mortality rates remained similar. Both groups exhibited lower morbidity and mortality than the naive group that did not receive the AAV9 vector prior to IAV infection, suggesting that the pre-administration of the AAV9 vector conferred protection against lethal influenza infection, irrespective of Cxcl14 overexpression. Furthermore, we found that pre-inoculation of BALB/c mice with AAV9 attenuated the infiltration of trans-macrophages, neutrophils and monocytes in the lungs following IAV infection. Although there was no difference in lung viral titers between the naive group and the AAV9 pre-inoculated group, pre-inoculation with AAV9 conferred lung injury protection against lethal influenza infection in mice. Conclusions Our study demonstrated that pre-inoculation with AAV9 prior to IAV infection protected mouse lungs from immunopathology by reducing the recruitment of inflammatory cells.

OBJECTIVES: Studies evaluating weight changes during the coronavirus disease 2019 (COVID-19) pandemic have yielded inconsistent results, and most of those studies were based on self-reported anthropometric measures. We investigated changes in body mass index (BMI), professionally measured waist circumference (WC), and metabolic syndrome components from before to during the pandemic in a sample of the adult population in Korea. METHODS: This retrospective study included 1,118 male and female (age≥18 years) who underwent health checkups at a university medical center between January 1, 2016 and March 31, 2022. Changes in BMI, lifestyles, and metabolic syndrome components during the pandemic were analyzed using the paired t-test, McNemar test, generalized estimating equations, and repeated-measures analysis of variance. RESULTS: Changes in body weight, BMI, and body fat percentage during the pandemic were not clinically significant. However, statistically significant results were found for decreased physical activity (p<0.001) and WC (p<0.001), and exacerbation of all metabolic syndrome components (except serum triglyceride levels). Moreover, the metabolic syndrome prevalence increased significantly from 20.2% to 31.2% during the pandemic (p<0.001). The prevalence of abdominal obesity and high fasting blood glucose levels also significantly increased from 2019 to 2021. CONCLUSIONS Metabolic syndrome, its components, and fat distribution worsened significantly after the implementation of social distancing and lockdowns, despite no clinically significant changes in body weight and BMI. Further studies on the post- pandemic period should investigate the long-term impact of social lockdowns on BMI and the prevalence of metabolic syndrome.

Purpose: This study aimed to describe nurses’ perceived needs and barriers to pediatric palliative care (PPC). Methods: Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through openended questions and analyzed with topic modeling techniques. Results: The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories: “children and adolescents,” “families,” “PPC management system,” and “community-based PPC.” Meanwhile, PPC barriers were divided into 3 categories: “healthcare delivery system,” “healthcare provider,” and “client.” The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC. Conclusion In this study, by using mixed-methods, items of nurses’ perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers.