OBJECTIVE: To observe the effects of Tiaoshen (regulating the spirit) acupuncture on cognitive function and sleep quality in patients with primary insomnia (PI). METHODS: Sixty patients with PI were randomly divided into an observation group (30 cases, 2 cases dropped off) and a control group (30 cases, 2 cases dropped off, 1 case was excluded). The patients in the observation group were treated with acupuncture at Baihui (GV 20), Shenting (GV 24), Sishencong (EX-HN 1), and bilateral Benshen (GB 13), Shenmen (HT 7), Neiguan (PC 6), Sanyinjiao (SP 6). The patients in the control group were treated with shallow needling at non-effective points. Each treatment was provided for 30 min, once every other day, 3 treatments per week for 4 weeks. The Montreal cognitive assessment (MoCA), digit span test (DST), trail making test (TMT)-A, Pittsburgh sleep quality index (PSQI), and fatigue scale-14 (FS-14) were used to assess cognitive function and sleep quality before and after treatment, as well as in follow-up of 4-week after treatment completion. Correlation analysis was conducted between the differences in PSQI scores and differences in MoCA scores before and after treatment in the observation group. RESULTS: Compared with before treatment, the total score, visuospatial and executive function score and delayed memory score of MoCA as well as DST backward score were increased (P<0.01), while TMT-A time, PSQI and FS-14 scores were significantly reduced (P<0.01) after treatment and in follow-up in the observation group. Compared with before treatment, the PSQI score in the control group was reduced (P<0.01, P<0.05). After treatment and in follow-up, the observation group had significantly higher total score, visuospatial and executive function score, delayed memory score of MoCA, and DST backward score compared to the control group (P<0.05, P<0.01). In the observation group, the TMT-A time was significantly shorter than that in the control group (P<0.05, P<0.01), and the PSQI and FS-14 scores were significantly lower than those in the control group (P<0.01). In the observation group, there was a negative correlation between the difference in PSQI scores (post-treatment minus pre-treatment) and the difference in MoCA scores (post-treatment minus pre-treatment) (r=-0.481, P<0.01). A similar negative correlation was found between the difference in PSQI scores (follow-up minus pre-treatment) and the difference in MoCA scores (follow-up minus pre-treatment) (r=-0.282, P<0.05). CONCLUSION Tiaoshen acupuncture could improve cognitive function, enhance sleep quality, and alleviate daytime fatigue in patients with PI. The improvement in cognitive function in patients with PI is correlated with the improvement in sleep quality.
Humans ; Pilot Projects ; Sleep Initiation and Maintenance Disorders/therapy* ; Acupuncture Therapy ; Cognition ; Fatigue

Aiming at the human-computer interaction problem during the movement of the rehabilitation exoskeleton robot, this paper proposes an adaptive human-computer interaction control method based on real-time monitoring of human muscle state. Considering the efficiency of patient health monitoring and rehabilitation training, a new fatigue assessment algorithm was proposed. The method fully combined the human neuromuscular model, and used the relationship between the model parameter changes and the muscle state to achieve the classification of muscle fatigue state on the premise of ensuring the accuracy of the fatigue trend. In order to ensure the safety of human-computer interaction, a variable impedance control algorithm with this algorithm as the supervision link was proposed. On the basis of not adding redundant sensors, the evaluation algorithm was used as the perceptual decision-making link of the control system to monitor the muscle state in real time and carry out the robot control of fault-tolerant mechanism decision-making, so as to achieve the purpose of improving wearing comfort and improving the efficiency of rehabilitation training. Experiments show that the proposed human-computer interaction control method is effective and universal, and has broad application prospects.
Humans ; Exoskeleton Device ; Muscle Fatigue ; Muscles ; Algorithms ; Electric Impedance

Background: The Coronavirus Disease (COVID-19) pandemic significantly disrupted regular health care services, mainly in the hospitals. Nurses soldiering on the battlefront of care of disaster response in the Philippines during the disease outbreak are at high risk of developing rapid-onset compassion fatigue. Notably, research is still needed to investigate the impact of compassion fatigue on various clinical areas and further develop a theory of compassion fatigue within the nursing context. Objectives: The study explored the concept of compassion as experienced by nurses directly caring for COVID-19 patients. The study further explored the experiences of nurses on compassion fatigue. Methods: This study employed qualitative methodology, specifically the constructivist grounded theory. Results: Thirty-four participants were included in the study. The narratives and voices of the nurses unfolded the following themes: (1) Acts of Compassion, (2) COVID-19 Pandemic: Nursing Challenges and Detours, (3) Nurses’ Compassion Fatigue, (4) Narratives of Opportunities: Thriving at the outset of COVID-19. All four concepts are linked to the multidimensional concept of compassion fatigue. A substantive theory, “Remon’s CF Theory in Nursing," is proposed based on the grounded experiences of nurses caring for COVID-19 patients related to compassion fatigue. Conclusion: Compassion Fatigue (CF) is a psycho-social phenomenon and occupational hazard affecting nurses directly caring for or in contact with COVID-19 patients. CF is a process that develops over time brought by prolonged enactment of compassion, the experience of empathic distress, and concurrence of organizational, contextual, and psychosocial factors. Nurses' CF can potentially affect safety and lead to poor nursing care, compromised work relations, and burnout. Nurse leaders' organizational and leadership commitment and support through up-to-date policies and continuous research on the topic are necessary to regain compassion among nurses. Likewise, reframing nurse compassion fatigue as an organizational and collective problem provides the larger perspective to further improve clinical practice and nurses’ welfare. Recommendations Nurse leaders, hospital and COVID-19 facility administrators must ensure specific policies and priorities that address issues causing and fueling nurse compassion fatigue, including frequency of exposure to traumatic events, lack of resources, and inadequate support system. The study further suggests conducting quantitative research to test the proposed theory and explore the relationship between organizational, psychosocial, and environmental context, compassion fatigue, and compassion-driven factors.
Compassion Fatigue ; Nurses ; Grounded Theory

Based on the joint analysis of EMG spectrum and amplitude method (JASA), a study on muscle fatigue assessment of spinal surgical instruments based on surface EMG signals was carried out, and a comparative evaluation of the operating comfort before and after the optimization of spinal surgical instruments was completed. A total of 17 subjects were recruited to collect the surface EMG signals of their brachioradialis and biceps. Five surgical instruments before and after optimization were selected for data comparison, and the operating fatigue time proportion of each group of instruments under the same task was calculated based on the RMS and MF eigenvalues. The results showed that when completing the same operation task, the operation fatigue time of the surgical instruments before optimization was significantly higher than that after optimization (P<0.05); there was no significant difference in the fatigue status of brachioradialis and biceps when operating the same instrument (P>0.05). These results provide objective data and reference for the ergonomic design of surgical instruments and fatigue damage protection.
Humans ; Muscle Fatigue/physiology* ; Muscle, Skeletal ; Electromyography ; Ergonomics

INTRODUCTION: Increased healthcare demands due to the COVID-19 pandemic have overwhelmed nurses worldwide. Resilience of nurses has been impacted due to many factors (e.g., longer work shifts) causing psychological distress. The study aimed to determine the correlation of burnout, compassion fatigue, and moral injury with resilience among nurses assigned in COVID-19 wards. METHODS: Virtual survey tools were sent to nurses of a public hospital to obtain data. Data were analyzed using JAMOVI and SPSS. RESULTS: Levels of burnout showed moderate burnout in personal burnout (f=44) (65.7%); Moderate burnout in work-telated burnout (f=36) (53.7%); no/low level of burnout in client-related burnout (f=48) (71.6%). Level of compassion fatigue showed job burnout (f=59) (88.1%). Level of moral injury indicated “requiring clinical attention” (f=52) (77.6%). Level of resilience showed medium resilience (f=45) (67.2%). Correlation between burnout and resilience yielded negligible negative correlations between personal burnout and resilience (r=-0.160, p=0.031), work-related burnout and resilience (r=-0.222, p=0.008), and client-related burnout and resilience (r=-0.120, p=0.741). Correlation yielded weak negative correlations between compassion fatigue and resilience (r=-0.254, p=0.038) and between moral injury and resilience (r=-0.318, p=0.009). The linear regression showed no significant correlations between personal burnout and resilience (p=0.063), work-related burnout and resilience (p=0.070), client-related burnout and resilience (p=0.331), compassion fatigue and resilience (p=0.080), moral injury and resilience (p=0.227). CONCLUSION The findings showed significant correlations between personal burnout and resilience, work- related burnout and resilience, compassion fatigue and resilience, and moral injury and resilience. There were no significant correlations between client-related burnout and resilience. Multiple linear regression indicated burnout, compassion fatigue, and moral injury are not predictive factors for resilience.
Resilience ; burnout ; compassion fatigue ; moral injury

Background: Compassion fatigue is a true phenomenon experienced by overworked and exhausted nurses. Objective: This study assessed frontline nurses' compassion fatigue, stress, mental health, and turnover intention during the second year of the COVID-19 outbreak. Methods: Using a cross-sectional design, an online survey was administered in the first quarter of 2021 to 259 hospital nurses in the Central Philippines using standardized scales to gather the necessary data. Results: Nurses were found to have moderate levels of compassion fatigue and turnover intention, high stress, and good mental health. Results revealed that compassion fatigue was associated with poor mental health (r = −5.05, p = 0.01), higher stress levels (r = 0.54, p = <0.001), and turnover intention (r = 0.27, p = <0.001). Conclusion Pandemic-related compassion fatigue in nurses increases their stress, worsens their mental health, and heightens their intentions to leave their jobs. Organizations should address compassion fatigue through a supportive work climate.
Compassion Fatigue ; mental health ; nursing ; stress

OBJECTIVE: To observe the clinical efficacy of bamboo-based medicinal moxibustion for chronic fatigue syndrome (CFS), and to preliminarily explore its action mechanism. METHODS: Sixty-four patients with CFS were randomly divided into a moxibustion group (32 cases, 1 case dropped off, 1 case excluded) and an acupuncture group (32 cases, 2 cases dropped off). The patients in the moxibustion group were treated with bamboo-based medicinal moxibustion, while the patients in the acupuncture group were treated with routine acupuncture. Both groups were treated once a day, 6 days as a course of treatment with 1 day interval, for a total of 2 courses of treatment. Before treatment, 1 and 2 courses into treatment and in the follow-up of 14 days after treatment, the fatigue scale-14 (FS-14) and somatic and psychological health report (SPHERE) scores were observed in the two groups. Before and after treatment, the contents of CD⁺₃, CD⁺₄, CD⁺₈ of peripheral blood T lymphocyte subsets were measured and CD⁺₄/CD⁺₈ ratio was calculated; the clinical efficacy of the two groups was compared. RESULTS: Compared before treatment, the FS-14 and SPHERE scores in the two groups were decreased 1 and 2 courses into treatment and in the follow-up (P<0.01), and the FS-14 and SPHERE scores in the moxibustion group were lower than those in the acupuncture group (P<0.01, P<0.05). Compared before treatment, the contents of CD⁺₃, CD⁺₄ and CD⁺₄/CD⁺₈ ratio in the moxibustion group were increased after treatment (P<0.01). There was no significant difference of CD⁺₃, CD⁺₄, CD⁺₈ and CD⁺₄/CD⁺₈ ratio between before and after treatment in the acupuncture group (P>0.05). After treatment, the contents of CD⁺₃ and CD⁺₄ in the moxibustion group were higher than those in the acupuncture group (P<0.05). The total effective rate was 93.3% (28/30) in the moxibustion group, which was higher than 73.3% (22/30) in the acupuncture group (P<0.05). CONCLUSION Bamboo-based medicinal moxibustion could improve the physical and mental fatigue symptoms and psychological status in patients with CFS. Its effect may be related to regulating the contents of CD⁺₃, CD⁺₄ of peripheral blood T lymphocyte subsets and CD⁺₄/CD⁺₈ ratio.
Humans ; Moxibustion ; Fatigue Syndrome, Chronic/therapy* ; Acupuncture Therapy ; Physical Examination

OBJECTIVE: To observe the effects of acupuncture at "umbilical four-acupoints" on chronic insomnia and its comorbid symptoms. METHODS: A total of 120 patients with chronic insomnia were randomly divided into an observation group (60 cases, 8 cases dropped off) and a control group (60 cases, 5 cases dropped off). The patients in the observation group were treated with acupuncture at regular acupoints (Baihui [GV 20] and bilateral Shenmen [HT 7], Neiguan [PC 6], Anmian [Extra]) and "umbilical four-acupoints", while the patients in the control group were treated with acupuncture at regular acupoints. Acupuncture was given once a day, 6 times a week, for a total of 3 weeks in the two groups. The Pittsburgh sleep quality index (PSQI), insomnia severity index (ISI) scores were observed before treatment, after treatment and in follow-up of one month after treatment completion; the Beck anxiety inventory (BAI), Beck depression inventory (BDI), fatigue severity scale (FSS), and Epworth sleepiness scale (ESS) scores were observed before and after treatment; the sleep parameters of polysomnography (PSG), including sleep latency (SL), awake-up time (AT), sleep efficiency (SE) and total sleep time (TST), were observed before and after treatment using polysomnography monitor in the two groups. RESULTS: Compared with those before treatment, the PSQI and ISI scores in both groups were reduced after treatment and in follow-up (P<0.05), and the PSQI and ISI scores in the observation group were lower than those in the control group after treatment and in follow-up (P<0.05). Compared with those before treatment, the BAI, BDI, FSS and ESS scores in both groups were reduced after treatment (P<0.05), and the BAI, BDI, FSS and ESS scores in the observation group were lower than those in the control group after treatment (P<0.05). Compared with those before treatment, the SL and AT in both groups were reduced after treatment (P<0.05), while SE and TST were increased after treatment (P<0.05); after treatment, the SL and AT in the observation group were lower than those in the control group (P<0.05), while SE and TST in the observation group were higher than those in the control group (P<0.05). CONCLUSION On the basis of regular acupoint selection, acupuncture at "umbilical four-acupoints" could improve sleep quality, alleviate the severity of insomnia, and improve the comorbid symptoms i.e. anxiety, depression, fatigue and lethargy in patients with chronic insomnia.
Humans ; Sleep Initiation and Maintenance Disorders/therapy* ; Acupuncture Points ; Acupuncture Therapy ; Sleep ; Fatigue

INTRODUCTION: Our aim was to study the prevalence of frailty and its associated factors in a subacute geriatric ward. METHODS: This was a cross-sectional study of 167 participants between June 2018 and June 2019. Baseline demographics and participants' Mini Nutritional Assessment, Geriatric Depression Scale, Mini Mental State Examination, Charlson's Comorbidity Index and LACE index scores were obtained. Functional measurements such as modified Barthel's Index scores and hand grip strength (HGS) were taken. Frailty was assessed using the Clinical Frailty Scale (CFS) and the FRAIL scale. Data on history of healthcare utilisation, medications, length of stay, selected blood investigations and presence of geriatric syndromes were also collected. RESULTS: The prevalence of pre-frailty (CFS 4) and frailty (CFS ≥ 5) was 16.2% and 63.4%, respectively. There were significant associations between CFS and age (pre-frail vs. non-frail: odds ratio [OR] 1.14, 95% confidence interval [CI] 1.04-1.25, P = 0.006; frail vs. non-frail: OR 1.08, 95% CI 1.01-1.15, P = 0.021), HGS at discharge (frail vs. non-frail: OR 0.90, 95% CI 0.82-0.99, P = 0.025), serum albumin (frail vs. non-frail: OR 0.90, 95% CI 0.82-0.99, P = 0.035) and the presence of urinary incontinence (frail vs. non-frail: OR 3.03, 95% CI 1.19-7.77, P = 0.021). CONCLUSION Frailty is highly prevalent in the subacute geriatric setting and has many associated factors. In this study, independent factors associated with frailty were age, HGS at discharge, serum albumin and urinary incontinence. This has implications for future resource allocation for frail older inpatients and may help direct further research to study the effectiveness of frailty-targeted interventions.
Humans ; Aged ; Frailty/epidemiology* ; Frail Elderly ; Hand Strength ; Prevalence ; Singapore/epidemiology* ; Cross-Sectional Studies ; Fatigue Syndrome, Chronic ; Geriatric Assessment ; Urinary Incontinence ; Serum Albumin

In this study, a new Bacillus velezensis strain Bv-303 was identified and its biocontrol effect against rice bacterial-blight (BB) disease caused by Xanthomonas oryzae pv. oryzae (Xoo) was investigated. Cell-free supernatant (CFS) of strain Bv-303 under different growth conditions were prepared to test the antagonistic activity and stability against Xoo by the Oxford-cup method in vitro. The antibacterial effect of strain Bv-303 to BB disease in rice were further analyzed in vivo by spraying the cell-culture broth (CCB), CFS and cell-suspension water (CSW), respectively, on the rice leaves inoculated with Xoo. Additionally, rice seeds germination rate and seedling growth under the strain Bv-303 CCB treatment were tested. The results showed that the strain Bv-303 CFS significantly inhibited Xoo growth by 85.7%‒88.0% in vitro, which was also stable under extreme environment conditions such as heat, acid, alkali and ultraviolet light. As tested in vivo, spraying the CCB, CFS or CSW of strain Bv-303 on the Xoo-infected leaves enhanced rice plant resistance to BB disease, with CCB showing the highest increase (62.7%) in disease-resistance. Notably, CCB does not have negative effects on rice seed germination and seedling growth. Therefore, strain Bv-303 has great potential for biocontrol of the rice BB disease.
Oryza ; Fatigue Syndrome, Chronic ; Bacillus ; Xanthomonas ; Plant Diseases/microbiology*