Background: The treatment of many chronic illnesses involves long-term pharmaceutical therapy, but it is an ongoing challenge to find effective ways to improve medication adherence to promote good health outcomes. Cardioprotective medications can prevent the enlargement of harmful clots, cardiovascular symptoms, and poor therapeutic outcomes, such as uncontrolled high blood pressure and hyperlipidemia, for patients with coronary heart disease. Poor adherence to cardioprotective medications, however, has been reported as a global health concern among patients with coronary heart disease, and it is particularly a concern in China. Objective: This study aimed to evaluate the efficacy of a mobile health (mHealth) intervention using 2 mobile apps to improve medication adherence and health outcomes. Methods: A randomized, placebo-controlled, 2-arm parallel study was conducted in a major university-affiliated medical center located in Chengdu, China. Participants were recruited by flyers and health care provider referrals. Each participant was observed for 90 days, including a 60-day period of mHealth intervention and a 30-day period of nonintervention follow-up. The study coordinator used WeChat and Message Express to send educational materials and reminders to take medication, respectively. Participants used WeChat to receive both the educational materials and reminders. Participants in the control group only received educational materials. This study received ethics approval from the Duke Health Institutional Review Board (Pro00073395) on May 5, 2018, and was approved by West China Hospital (20170331180037). Recruitment began on May 20, 2018. The pilot phase of this study was registered on June 8, 2016, and the current, larger-scale study was retrospectively registered on January 11, 2021 (ClinicalTrials.gov). Results: We recruited 230 patients with coronary heart disease. Of these patients, 196 completed the baseline survey and received the intervention. The majority of participants were married (181/196, 92.4%), male (157/196, 80.1%), and lived in urban China (161/196, 82.1%). Participants’ average age was 61 years, and half were retired (103/191, 53.9%). More than half the participants (121/196, 61.7%) were prescribed at least 5 medications. The mean decrease in medication nonadherence score was statistically significant at both 60 days (t179=2.04, P=.04) and 90 days (t155=3.48, P<.001). Systolic blood pressure and diastolic blood pressure decreased in the experimental group but increased in the control group. The mean decrease in diastolic blood pressure was statistically significant at both 60 days (t160=2.07, P=.04) and 90 days (t164=2.21, P=.03). The mean decrease in systolic blood pressure was significantly different in the groups at 90 days (t165=3.12, P=.002). Conclusions: The proposed mHealth intervention can improve medication adherence and health outcomes, including systolic blood pressure and diastolic blood pressure. Trial Registration: ClinicalTrials.gov NCT02793830; https://clinicaltrials.gov/ct2/show/NCT02793830 and ClinicalTrials.gov NCT04703439; https://clinicaltrials.gov/ct2/show/NCT04703439

Background: The demanding requirements of nursing education impose great stress on students, which can adversely affect their health and well‐being in terms of academic and clinical performance. Aims: This study aimed to determine the level of stress and the main causes of stress among medical and nursing students. Methods: This cross‐sectional study was conducted with medical and nursing students in Pakistan via a convenience sampling method. Sources of stress‐associated factors were assessed using online questionnaire. The data were collected between July 1 and August 31, 2024. A total of 302 medical and nursing students participated in the research. Descriptive statistics (frequency, mean) and inferential statistics were used to analyze the collected data. Results: According to the findings, medical and nursing students experience stress from multiple sources, with financial difficulties, academic workload, clinical practice, and environmental factors being the primary contributors. The most common stressors were insufficient income, pressure from clinical instructors and staff, and unfamiliarity with patient diagnoses and treatments. Multifactor logistic regression analysis revealed that stress from assignments and workload was significantly associated with fear of poor grades ( p = 0.046), while clinical practice quality also showed a significant effect ( p = 0.029). Additionally, dealing with patients with physio‐psychosocial issues ( p = 0.039) and unfamiliarity with clinical conditions ( p = 0.012) were significant predictors of stress. These findings highlight the complex and multifaceted nature of student stress. Conclusion: This study revealed that medical and nursing students experience significant levels of stress related to finances, clinical practice, and academics, which affects their performance. Medical and Nursing Implications: Educational administrators must establish policies that assist medical and nursing students. Some of these policies could include evaluating the workload of Medical and nursing students, refining curriculum design, providing financial support, and providing scholarships to students facing challenging circumstances.

Background: Virtual reality (VR) technology has emerged as a promising tool for cognitive rehabilitation in patients with neuropsychiatric disorders. These patients often endure significant cognitive impairments, which are associated with decreased quality of life and increased disease burden. Traditional treatments are limited in improving cognitive functions, making VR-based interventions an area of growing interest. Objective: This meta-analysis aims to evaluate the efficacy of VR-based interventions on cognitive function in patients with neuropsychiatric disorders by synthesizing data from randomized controlled trials (RCTs). Methods: Following PRISMA guidelines, we conducted a comprehensive search across PubMed, Web of Science, MEDLINE, EMBASE, and Cochrane Library for RCTs from January 2010 to December 2024. Studies were included if they evaluated the impact of VR-based interventions on cognitive outcomes in patients with neuropsychiatric disorders. Data extraction and risk of bias assessment were performed independently by 2 researchers. Meta-analyses were conducted using random-effects models, and standardized mean differences (SMDs) as effect size. Results: A total of 21 RCTs involving 1051 participants were included. Overall, VR-based interventions significantly improved cognitive functions of patients with neuropsychiatric disorders (SMD 0.67, 95% CI 0.33-1.01, z=3.85; P<.001). Subgroup analyses revealed significant benefits for cognitive rehabilitation training (SMD 0.75, 95% CI 0.33-1.17, z=3.53; P<.001), exergame-based training (SMD 1.09, 95% CI 0.26-1.91, z=2.57; P=.01), and telerehabilitation and social functioning training (SMD 2.21, 95% CI 1.11-3.32, z=3.92; P<.001). Conversely, immersive cognitive training, music attention training, and vocational and problem-solving skills training did not yield significant improvements (z=1.86, P=.06; z=0.35, P=.72; z=0.88, P=.38; respectively). Disease-type subgroup analyses indicated significant improvements in schizophrenia (SMD 0.92, 95% CI 0.22-1.62, z=2.58; P=.01), and mild cognitive impairment (SMD 0.75, 95% CI 0.16-1.35, z=2.47; P=.01), but not in brain injuries, Parkinson disease, or stroke (z=0.34, P=.73; z=1.26, P=.21; z=1.16, P=.24; respectively). Conclusions: This meta-analysis revealed that VR-based interventions can improve cognitive functions among individuals with neuropsychiatric disorders, with notable improvements observed in cognitive rehabilitation training, exergame-based training, and tele-rehabilitation and social functioning training. These results offer valuable evidence supporting the use of VR technology in rehabilitation for neuropsychiatric conditions and inform the optimization of future intervention approaches.

Accumulating evidence has reported that the intestinal microbiota could play important roles in the occurrence and progression of severe trauma. However, the hypothesized potential targeted intestinal microbiota to mediate and regulate the levels of inflammatory cytokines and promote rapid recovery of body after severe trauma remains unclear. This study was aimed to explore the changes and correlation of intestinal microbiota and inflammatory cytokines in rats with severe crush and fracture trauma. The controlled laboratory study design was used, and a crush and fracture severe trauma rat model was established. 16S rRNA high-throughput gene sequencing and ELISA were used to analyze the changes in intestinal microbiota and inflammatory cytokines within one week after trauma. The correlation between intestinal microbiota and inflammatory cytokines was also analyzed. Loss of overall diversity and expansion of intestinal microbiota in the rats due to severe trauma was observed. Specifically, there was a significant increase in the abundance of Muribaculaceae [LDA (Linear Discriminant Analysis)-value = 4.814, P = 0.014] after severe trauma, while Prevotella (LDA-value = 5.235, P = 0.020) and Alloprevotella (LDA-value = 4.443, P = 0.015) were slightly lower in the trauma group than in the control group. The levels of inflammatory cytokines (IL-1α, IL-6, IL-8 and TNF-α) in the trauma group decreased from the first day to the third day and continued to increase until one week after the trauma. Prevotellaceae_UCG_001 was correlated with TNF-a (R = 0.411, P = 0.033); Lactobacillus was negatively correlated with IL-6 (R = − 0.434, P = 0.024) and IL-1α (R = − 0.419, P = 0.030) and positively correlated with IL-8 (R = 0.391, P = 0.045); and Lachnospiraceae_NK4A136_group (R = − 0.559, P = 0.027) and Muribaculaceae (R = − 0.568, P = 0.024) were negatively correlated with IL-8. Severe trauma shows stress-like activities by negatively modulating intestinal microbiota and affecting certain inflammatory cytokines contributing to host health, which implies that the regulation of potentially targeted intestinal microbiota, and further mediating and maintaining the homeostasis of inflammatory cytokines, is expected to promote the accelerating recovery of the body after severe trauma.

Background: Occupational stress refers to the psychological pressure from work‐related factors. Stress overload is a key contributor to the global nursing shortage. Excessive workloads and psychological pressure further exacerbate stress among healthcare professionals. Aims: This study aims to examine the impact of psychological counseling (PC), job characteristics, and perceived respect on occupational stress among Pakistani nurses. Methods: This cross‐sectional study was carried out by nurses from Pakistan, using a random sampling method. Data were collected between April 1 and May 31, 2024. We have access to the nurses’ work‐related stress, respect, and PC through an online questionnaire. A total of 292 nurses took part in the study. Results: Out of 292 participants, 276 completed the survey, with 71.38% male and 28.62% female. The main causes of occupational stress were low income (95.56%), high workload (80.80%), occupational injury (65.95%), family factors (64.50%), strict leadership (60.50%), and physical problems (56.16%). Additionally, 36.23% of nurses had limited faith in the effectiveness of PC, followed by a moderate belief. According to multiple logistic regression analyses, a correlation between a PC high work‐related stress significantly affects nurses’ mental health, increasing the need for PC ( p = 0.0979). Stress relief methods like reading, music, or outdoor sports reduce the stress (OR 2.298–11.031, p < 0.001). At the same time, factors like nurse–patient relationships and strict leadership contribute to high‐stress levels ( p = 0.417, p = 0.682), with reducing work intensity showing minimal impact ( p = 0.993). Conclusion: Our study indicated that low salaries, a high workload, and low respect could cause occupational stress among nurses who need high PC. Implications for Nursing Management: These findings can guide hospital administrators and nurse managers in enhancing rewards, reducing work hours, and improving job satisfaction. Additionally, better working conditions and training programs can help mitigate occupational stress and support nurses’ mental health.

Aim. To compare the impact and cost effects of medical long fiber polyester drapes and cotton fabric drapes on operative sterile operation interfaces. Background. The comparison of the properties of the commonly used surgical drapes materials in terms of leakage, device slip, and prevention of intraoperative adverse events is not clear. Method. A prospective randomized controlled study was conducted in the operating room of a tertiary hospital in Chengdu, China. A total of 400 patients who underwent urology surgery were enrolled and randomly divided into two groups by computer, the study group (200 cases) selected the new long-fiber polyester cloth, while the control group (200 cases) selected conventional cotton fabric surgical drapes during the operation to maintain a sterile operating interface. The impermeability and water absorption of surgical drapes, the rate of device slip and skin scald in surgical patients, and the cost effect of the two kinds of surgical drapes were compared. Results. The long fiber polyester surgical drapes were superior to conventional cotton cloth in water absorption (g/m²) (835 ± 15.8 VS 225 ± 21.0, t = 328.261, ), preventing surgical site infections (2.5% VS 8.0%, χ² = 6.081, ), device slip (7.5% VS 17.0%, χ² = 8.396, ), patients from burning (0 VS 1, Fisher ), and total cost per use ($) (0.83 VS 0.96–1.09). Conclusion. Long fiber polyester fabric has a stronger antipenetration ability of fluid and microorganisms thus forming an effective protective barrier. It also has strong hygroscopicity, and its special design can prevent the occurrence of sliding of surface instruments and skin scald in patients. In addition, its cost effect is superior. Implications for Nursing Management. Operating room nursing managers can introduce long fiber polyester drapes into the selection of medical textiles to construct aseptic surgical barriers and prevent surgical site infection.