Search Results (105)

Background/Objectives: Shift work is associated with circadian disruption, sleep disturbances, and psychological distress, all of which may influence both reflux-related symptoms and temporomandibular disorder (TMD)-related complaints. However, the relationships among reflux-related symptom burden, TMD severity, oral parafunctional behaviors, and psychological distress in healthcare professionals remain insufficiently understood. To evaluate the association between reflux-related symptom burden, assessed using the Gastroesophageal Reflux Disease Health-Related Quality of Life (GERD-HRQL) questionnaire, and TMD severity among healthcare professionals, and to investigate the potential roles of shift work, oral parafunctional behaviors, and psychological distress in this relationship. Methods: This cross-sectional observational study included healthcare professionals working at a tertiary hospital. Data were collected using validated questionnaires, including the GERD-HRQL, Fonseca Anamnestic Index, Oral Behavior Checklist (OBC), Depression Anxiety Stress Scale-21 (DASS-21), and Epworth Sleepiness Scale (ESS). Participants were categorized as shift workers (≥4 night shifts/month) and non-shift workers. Correlation and multivariable regression analyses were performed. Results: A total of 240 participants were included. Higher GERD-HRQL scores were positively correlated with TMD severity (r = 0.31, 95% CI: 0.19 to 0.42, p < 0.001), oral parafunctional behavior scores (r = 0.28, 95% CI: 0.16 to 0.39, p < 0.001), and DASS-21 stress scores (r = 0.35, 95% CI: 0.23 to 0.46, p < 0.001). Shift workers demonstrated significantly higher GERD-HRQL scores and TMD severity scores than non-shift workers, with small-to-moderate effect sizes. In multivariable analysis, higher TMD severity, OBC score, stress score, and shift-work exposure showed adjusted associations with higher GERD-HRQL scores. The model explained 32% of the variance in reflux-related symptom burden (R² = 0.32; adjusted R² = 0.29). Conclusions: Higher GERD-HRQL scores, reflecting reflux-related symptom burden rather than objectively confirmed GERD, showed weak to small-to-moderate associations with TMD severity, oral parafunctional behaviors, psychological distress, and shift-work exposure among healthcare professionals. These findings indicate co-occurrence of gastrointestinal, temporomandibular, behavioral, and psychosocial symptom domains within this occupational population. Longitudinal studies using objective diagnostic methods are required to clarify the directionality and clinical significance of these associations. Full article

Major depressive disorder (MDD) is not reducible to a single neurotransmitter deficit. Current explanations commonly involve monoaminergic dysfunction, hypothalamic–pituitary–adrenal axis dysregulation, immune-inflammatory activation, impaired neuroplasticity and synaptic dysfunction, together with metabolic and neurovascular abnormalities. Lipidomic studies have repeatedly identified glycerophospholipid abnormalities in MDD, but their mechanistic meaning remains unresolved because changes in bulk lipid abundance do not explain how altered lipid metabolism becomes a receptor-level neural signal. This review develops a testable interpretation of the lysophosphatidylcholine (LPC)–autotaxin (ATX)–lysophosphatidic acid (LPA)–LPA receptor (LPAR) axis in which LPC species generated during phospholipid turnover provide ATX substrates, ATX activity determines local LPA generation, LPA production and inactivation shape ligand availability, and LPAR signaling links the lipid product to neural output. This structure shifts the focus from total lipid abundance to matched assessment of lipid species, enzyme activity, anatomical site and receptor subtype. Human studies report lower serum and cerebrospinal fluid (CSF) ATX in MDD, lower CSF LPA 22:6 in MDD and schizophrenia, and negative total LPA findings that caution against biomarker oversimplification. Depression-relevant and broader stress- or anxiety-related experimental studies show that ATX, LPA and LPAR perturbation can affect hippocampal function, synaptic physiology, emotional behavior and stress resilience. The key unresolved issue is whether brain-accessible LPC species, active ATX, locally generated LPA, LPA inactivation capacity and receptor-specific output can be demonstrated within the same MDD-relevant fluid, brain-interface site or neural circuit. Future work should therefore move from fluid-level association toward pathway closure through targeted and spatial lipidomics, anatomical ATX activity mapping, LPA inactivation assays, blood–brain barrier (BBB)/interface analysis, LPAR perturbation and matched circuit or behavioral readouts. Full article

Returning to work (RTW) following sickness absence due to common mental disorder (CMD) symptoms, such as anxiety, depression and stress, is increasingly recognised as a critical yet complex phase of recovery. Despite this, individuals do not always experience the process as supportive or straightforward. This study explored the factors shaping RTW by examining the perspectives of service users, employment advisors (EAs) and human resource (HR) professionals. In a qualitative study, using purposive sampling, we recruited 17 participants across the three stakeholder groups. Data were collected through semi-structured interviews and analysed using thematic analysis. The findings suggest that RTW is shaped by a dynamic interplay between individual experiences, workplace relationships and organisational structures. Participants described returning to work as an ongoing and often uncertain process, influenced by shifts in confidence, expectations of support and the extent to which workplaces were able to respond flexibly to individual needs. While some accounts reflected collaborative and supportive environments, others highlighted disconnection, misalignment and unmet expectations across stakeholders. Overall, the findings point to RTW as a negotiated process, requiring alignment between employees, managers and organisational systems. The study highlights the importance of consistent, flexible and context-sensitive approaches to support sustainable RTW following CMD-related absence. Full article

Background: Burn injuries are increasingly being recognized as chronic conditions with long-term physical, emotional, and social consequences. As survival after acute burn trauma improves, greater attention has shifted toward health-related quality of life (QoL) in survivors, particularly in regions where data remain limited. Methods: This study included burn survivors treated between January 2022 and December 2023 in the Department of Plastic Surgery and Reconstructive Microsurgery of the Emergency Clinical Hospital “Bagdasar-Arseni,” Bucharest, Romania. Patients who survived hospitalization and follow-up were invited to complete a Romanian-adapted version of the Burn Specific Health Scale-Brief (BSHS-B). Demographic and clinical data were collected from medical records, including burn type, total body surface area (TBSA), burn depth, burn localization, and access to rehabilitation services. Statistical analysis included descriptive methods, chi-square tests, t-tests, Kendall’s tau-b, Cramer’s V, Cronbach’s alpha, and exploratory factor analysis. Results: Thirty-eight patients were included. Most burns were thermal (94.74%), while burns involving <10% TBSA were most frequent (60.53%). Functional outcomes were generally favorable, with most patients reporting no difficulty in basic daily activities such as bathing, dressing, and writing. However, fine motor activities and return to previous work were more frequently affected. Emotional recovery appeared less complete, with persistent mild-to-moderate loneliness, sadness, and emotional distress reported by many participants. Women reported higher levels of loneliness (p = 0.015), while third-degree burns were associated with more frequent depressive symptoms (p = 0.008). Depressive symptoms were also significantly associated with functional limitations (such as getting dressed, p = 0.002) and work impairment (p < 0.001). The adapted functional and emotional subscales showed excellent internal consistency. Conclusions: Post-burn recovery extends beyond physical healing. Although most patients regained functional independence, emotional distress and occupational difficulties often persisted. These findings support the need for multidisciplinary long-term burn care integrating physical rehabilitation, psychological screening, and psychosocial support. Full article

Growing evidence indicates that the gut microbiota is not a static ecosystem but a rhythmic metabolic organ whose oscillatory activity is tightly coordinated with host circadian biology. Disruption of this temporal alignment, through irregular diet, sleep disturbance, shift work, or social jet lag, may profoundly alter microbial composition and the production of neuroactive metabolites. These alterations have emerged as potential contributors to the pathophysiology of mood disorders. This review introduces the concept of chrono-metabolic psychiatry, a framework integrating circadian rhythms, gut microbiota dynamics, and host metabolic signaling in the development and course of depressive and bipolar disorders. In this framework, the term “chrono-metabolic” refers to the integration of biological timing, host metabolic regulation, and microbiota-derived metabolic signaling. Chrono-metabolic psychiatry therefore shifts the focus from static dysbiosis or neurotransmitter imbalance alone to the time-dependent interactions among circadian misalignment, microbial rhythmicity, immune regulation, metabolite production, and affective instability. Diurnal fluctuations in short-chain fatty acids, tryptophan–kynurenine metabolites, bile acids, and microbial-derived neurotransmitters interact with clock gene regulation, hypothalamic–pituitary–adrenal axis activity, neuroinflammation, and synaptic plasticity. Chrono-disruption may represent a transdiagnostic vulnerability factor and may confirm the bidirectional relationship between mood instability and microbiota rhythmicity. Emerging therapeutic implications, including chrono-nutrition, time-restricted feeding, targeted probiotic administration (“chronobiotics”), and the microbiota-modulating effects of psychotropic medications are discussed. By shifting from a compositional to a temporal–metabolic perspective, this model highlights the importance of microbial oscillations rather than static dysbiosis alone. Integrating circadian biology into microbiota research may enable metabolomic stratification and pave the way for precision psychiatry approaches grounded in host–microbe metabolic crosstalk. Future longitudinal and time-resolved multi-omics studies are needed to validate this framework and to translate it into clinically actionable interventions. Full article

Domestic Violence affects 1 in 3 women worldwide. Empirical evidence from India suggests that women and girls experience a continuum of violence and discrimination from prenatal stages till death in families that largely continue to operate within a dominantly patriarchal framework. However, the literature on domestic violence in India suffers from problems pertaining to reductive and episodic framing, focusing on short-term prevalence, and frames the impact on survivors largely in terms of clinical constructs such as anxiety, depression, and PTSD. This work argues for a broader, thematic framing of domestic and familial violence and contends that the psychological sequelae of this kind of chronic and systemic discrimination and violence cannot be captured using rigid clinical constructs that dominate psychological literature. We propose a conceptual framework, i.e., SPECTRA (Socially and Psychologically Embedded Continuous Trauma in Relational Architecture), which is partially aligned with the propositions of complex trauma. However, we also critique the origin of complex trauma within hegemonic psychiatry and highlight the need for creating a culturally adapted expansion—to shift the emphasis from an individually rooted, diagnostic framework to a culturally contextualized continuous trauma framework. We utilize seven illustrative case studies to define the tenets of the SPECTRA model. Full article

This study investigates sodium polyacrylate (NaPA) as a rheology modifier and selective depressant in the flotation of Cu²⁺-activated kaolin–chalcopyrite under industrial water (IW) and seawater (SW) conditions. The work addresses a critical gap in saline systems: how an anionic polymer simultaneously influences clay activation, sulfide floatability, aggregate dispersion, and pulp rheology by varying the medium’s ionic composition. Microflotation, zeta potential, adsorption, yield strength, and Focused Beam Reflectance Measurement (FBRM) assays were used to establish structure–property–response relationships. In IW, Cu²⁺ strongly promoted NaPA adsorption onto both minerals, shifting them toward more negative potentials and significantly reducing selectivity: kaolin recovery decreased from 86.5% to 40.0% at 50 ppm NaPA. In comparison, chalcopyrite recovery fell below 30% at 100 ppm NaPA. In SW, NaPA maintained its depressant effect on kaolin without affecting chalcopyrite flotation, which remained above 90%. This behavior is consistent with reduced polymer adsorption at high ionic strength, where ionic shielding and coiling limit its interaction with chalcopyrite but allow sufficient adsorption onto kaolin to inhibit the collector’s action. Rheological and FBRM results support this interpretation, showing a decrease in yield strength and aggregate size after NaPA addition, with a more pronounced effect in IW than in SW. Full article

A high prevalence of psychological distress and unmet mental health needs among youth, combined with a preference for self-reliance and informal support (e.g., peers), poses a major public health challenge. Growing reliance on digital platforms highlights the potential of anonymized online peer support forums as accessible first-line avenues of support. In India, research on peer support interventions remains scarce. This study aimed to identify the concerns for which Indian youth engage in an anonymized, moderated online peer support forum, as well as the purposes for posting. A retrospective qualitative design was employed, analyzing all 137 posts of 124 unique users received between February 2024 and October 2025 on the forum using hybrid thematic analysis. Findings revealed that user posts encompassed diverse concerns across personal, relational, social, and achievement domains. Feeling states emerged as the most prominent theme, frequently co-occurring with other themes, followed by self-related concerns. Several posts explicitly mentioned mental health concerns such as depression and social anxiety, often without mention of professional help-seeking suggestions. Family-related issues, romantic relationship concerns, academic pressures, social comparisons, and unmet needs for approval were some of the other themes that emerged. Shifting from content to motivations for posting, the analysis identified purposes such as venting distress, seeking suggestions, sharing reflections, engaging in meaning-making, and seeking reassurance or validation. Future work needs to examine whether such forums can function not only as spaces for strengthening self-help and peer support processes but also as avenues for improving professional help-seeking through normalization and encouragement of the same when appropriate. Full article

Background and Objectives: Burnout is highly prevalent among emergency and acute care healthcare workers (HCWs), yet biological correlates remain debated because candidate biomarkers are strongly shaped by circadian timing, shift work, sleep loss, and overlapping affective symptoms. We mapped post-2018 evidence of biological biomarkers assessed alongside validated burnout measures in emergency department (ED), emergency medical services (EMS), and related acute care settings. Specifically, we asked whether reproducible biological correlates of burnout can be identified in emergency and acute-care healthcare workers when biomarker endpoint class and sampling context are systematically considered. Materials and Methods: We conducted a systematic scoping review with evidence mapping (PRISMA-ScR). PubMed/MEDLINE and the MDPI platform were searched for English-language studies published from 2018 onward (through January 2026). Eligible quantitative studies enrolled ED/EMS or acute care HCWs, assessed burnout using validated instruments, and reported at least one biological biomarker. Evidence was charted by biomarker domain and endpoint class (basal measures, stress reactivity paradigms, and chronic indices such as hair-based markers). Results: Overall, 19 studies were included in mapping/synthesis. Biomarker selection clustered around the hypothalamic–pituitary–adrenal axis (cortisol; n = 10/19), with fewer studies focused on autonomic function (heart rate variability; n = 2/19) and immune–inflammatory markers (n = 2/19), and single-study coverage for oxidative stress (n = 1/19), cardiometabolic candidates (n = 1/19), cellular aging (n = 1/19), neuroglial/multi-system candidates (n = 1/19), and feasibility-oriented multi-marker designs (n = 1/19). Reported associations with burnout were heterogeneous in direction and magnitude, but were more interpretable when endpoint class, timing anchors, and shift/sleep-related covariates were explicitly reported. Rates of confounder adjustment were low across studies (e.g., only 3/19 reported multivariable adjustment, and none systematically measured sleep or circadian factors), substantially limiting interpretability. Conclusions: The 2018+ literature does not support a single reproducible biomarker for burnout in emergency and acute care workforces. Evidence instead suggests multi-system dysregulation that is highly sensitive to endpoint class, sampling timing, and contextual confounding. Future studies should prioritize timing-anchored repeated-measures protocols across shift and recovery windows, jointly model sleep/circadian factors and depressive symptoms, and evaluate multi-marker panels and intervention responsiveness. Full article

Background and Objectives: Emergency physicians practice in high-pressure environments and face occupational stressors that may affect their mental health. This study was designed to evaluate the prevalence of depression among emergency physicians in South Korea and examined environmental, sociolegal, and individual factors associated with depressive symptoms in the post-pandemic period. Materials and Methods: This nationwide cross-sectional study analyzed data from the 2025 Korean Emergency Physician Survey. Screening positive for depressive symptoms was defined as a Patient Health Questionnaire-9 (PHQ-9) score ≥ 10, indicating moderate-to-severe depressive symptom severity. Measures included the PHQ-9, the Korean Epworth Sleepiness Scale (KESS), and the Adult APGAR, a brief self-administered instrument assessing overall wellness. Multivariable logistic regression was performed to identify factors associated with depression after adjusting for demographic, clinical, and work-related variables. Results: Of the 1050 physicians who responded (response rate: 37.5%), 743 emergency physicians completed the PHQ-9 section (completion rate: 70.8%; mean age, 43.2 ± 7.78 years; 86.5% male), and 111 (14.9%) screened positive for depressive symptoms. Objective workload indicators, including total work hours and number of night shifts, did not differ between physicians with and without depression. However, emergency physicians screening positive for depression reported higher perceived burdens related to staffing shortages and patient-related stressors. Protective factors included being married (adjusted odds ratio [AOR], 0.22; 95% confidence interval [CI], 0.08–0.58), longer sleep duration (AOR, 0.65; 95% CI, 0.50–0.86), better sleep quality (AOR, 0.45; 95% CI, 0.27–0.74), fixed mealtimes (AOR, 0.60; 95% CI, 0.39–0.93), and higher Adult APGAR scores (AOR, 0.72; 95% CI, 0.60–0.86). Factors associated with increased odds of depression included a history of cancer (AOR, 14.63, 95% CI, 2.53–84.61), current alcohol consumption (AOR, 2.54, 95% CI, 1.14–5.68), daytime sleepiness (AOR, 1.17; 95% CI, 1.04–1.31), and more frequent verbal abuse during the previous 12 months (AOR, 1.25; 95% CI, 1.08–1.44). Conclusions: Depression was prevalent and was associated with perceived work burden, sleep health, lifestyle regularity, and psychosocial factors. Interventions should address sleep quality, workplace safety, and social support. Full article

The coronavirus disease 2019 (COVID-19) pandemic has disrupted both health and occupational functioning in participants with multiple sclerosis (PwMS). This review synthesizes evidence from 55 studies (30,830 PwMS) on psychological, social, and work-related outcomes during the pandemic. The findings indicate elevated depression and stress, variable anxiety, and substantial employment disruption, including job loss, reduced hours, and shifts to remote work. Socioeconomic stressors compound these effects, while workplace accommodations are rarely assessed. There are gaps in evidence regarding occupation-specific hazards, lived experiences, and long-term outcomes. These results underscore the need for disability-inclusive employment policies, mental health support, and longitudinal research to guide interventions for PwMS in crisis contexts. Full article

To elucidate the refractory depression of serpentine in a Jinchuan copper-nickel ore (Located in Gansu Province), this study compared the effects of serpentine from Gansu and Liaoning on chalcopyrite flotation via single/mixed mineral flotation, zeta potential, micro-polarity detection, XPS, ToF-SIMS, and EPMA. Single mineral flotation showed chalcopyrite recovery reached ~90% at pH < 8 with 60 mg/L DDTC, while Gansu serpentine had slightly higher recovery than Liaoning serpentine. In mixed mineral flotation, chalcopyrite recovery dropped to ~70% (pH = 8), and Gansu serpentine recovery rose to ~45% (vs. ~35% for Liaoning). When 40 mg/L CMC inhibitor was added, chalcopyrite recovery restored to ~80%, and both serpentines’ recovery fell below 20%—but serpentine (Gansu) still had marginally higher recovery. The zeta potential and micro-polarity experiments collectively indicate that the collector exhibits selective adsorption on the surface of chalcopyrite; compared between the two serpentine samples, the collector adsorption is stronger on the surface of Gansu serpentine. In contrast, the depressant shows selective adsorption on the surface of serpentine, but when comparing the two serpentine samples, the depressant adsorption is stronger on the surface of exotic serpentine. This finding to a certain extent explains the reason why Gansu serpentine is difficult to depress. EPMA showed Gansu serpentine had lower MgO (38.668% vs. 41.012% for Liaoning), and XPS exhibited smaller Mg 1s shifts (1.93 eV vs. 4.46 eV) with CMC. This study explains Gansu serpentine’s poor depressibility, providing critical support for optimizing Cu-Ni ore flotation reagents and processes, gradually bridging to industrial application. This work provides a universal framework for global low-grade copper-nickel ores with silicate gangues. Full article

Background/Objectives: Shift-working healthcare professionals are exposed to high psychophysiological demands associated with occupational stress, anxiety, and depressive symptoms. Salivary chromogranin A (sCgA) and secretory immunoglobulin A (sIgA) are non-invasive biomarkers reflecting sympathetic nervous system activation and mucosal immune function, respectively, and are increasingly used to assess biological stress responses. This study examined changes in these biomarkers and their associations with anxiety and depression. Methods: This cross-sectional comparative observational study was conducted among healthcare professionals working 12-h shifts (n = 95) and non-shift-working controls (n = 95) and included a within-shift pre-post assessment, with saliva samples collected before and after the work shift. Salivary biomarkers were determined using ELISA methods. Anxiety and depression were assessed using the State–Trait Anxiety Inventory and the Zung Self-Rating Depression Scale. Data were analyzed with t-tests, correlation, and multiple linear regression. Statistical analyses included between- and within-group comparisons, correlation analyses, and multiple linear regression models to examine independent associations between salivary biomarkers and psychological outcomes. Results: After a 12-h shift, healthcare professionals showed increased sCgA (3.82 ± 0.95 vs. 4.68 ± 1.02 ng/mL; p < 0.001) and decreased sIgA (165.3 ± 32.4 vs. 142.6 ± 29.8 mg/dL; p < 0.001). Psychological scores were higher in healthcare professionals than in controls (p < 0.001). Salivary sCgA correlated positively with anxiety and depression (r = 0.41 to 0.45), while sIgA correlated negatively (r = −0.29 to −0.36). Regression analysis confirmed occupational group (healthcare professionals vs. controls) as the strongest predictor, with independent contributions of sCgA and sIgA to psychological scores. Conclusions: A 12-h work shift in healthcare professionals leads to increased salivary chromogranin A, indicating sympathetic activation, and decreased secretory IgA, reflecting reduced mucosal immune activity. The combined assessment of sCgA and sIgA provides a sensitive and non-invasive approach for monitoring occupational stress and identifying early risks of anxiety and depressive symptoms among shift-working healthcare professionals. Full article

During the Great Recession, labor markets often exhibit a slow unemployment recovery and persistent outward shifts in the Beveridge curve, which suggests a decline in the efficiency of the job-matching process. While it is often explained by worker search intensity, we argue that the direction of search behavior also matters by proposing a stylized theoretical model based on the Free Energy Principle. Through modeling agents who actively divide their effort between applying for jobs and learning about the market’s new state, our framework shows that agents endogenously shift effort from applications to learning when their uncertainty is high. Building on this micro-foundation, we design a macroeconomic model where matching efficiency is no longer an external parameter but is instead governed by two cognitive factors: the share of unemployed workers with misaligned beliefs and the average learning effort of the informed. Simulation results show that a structural shock will divert effort to learning and depress matching by creating widespread uncertainty, and the subsequent slow recovery is governed by the realignment of collective beliefs. Our work provides a cognitive explanation for this observed persistence of unemployment and the shift of the Beveridge curve. Full article

Shift workers face a heightened risk of insomnia. Recent research has yielded promising insights, but further progress is necessary to better treat insomnia in this group. The present pilot study evaluates how different characteristics impact sleep in shift workers to develop an innovative therapeutic approach. An online survey was administered to an ad hoc sample of N = 225 (112 shift workers), and correlations were calculated between sleep variables and specific characteristics (e.g., psychological impairment, personality traits, sleep-related behavior, attitudes towards sleep and shift work). Group differences between good/poor sleepers and day/shift work were determined using Mann–Whitney U-tests and Kruskal–Wallis H-tests. Regression was used to identify appropriate predictors. All factors (except perfectionism, chronotype, and importance of sleep) yielded significant results in both correlations and group differences (good/poor sleepers). The two groups of day/shift workers showed only minor differences. Dysfunctional beliefs about sleep, pre-sleep arousal, and depression were identified as predictors of poorer sleep. We conclude that interventions on psychological constraints (anxiety and depression), personality traits (anxiety, concern, emotional instability, and tension), social integration, sleep-related factors (dysfunctional beliefs, especially cognitive pre-sleep-arousal, sleep hygiene) and the attitude toward shiftwork, can replace those on regularity and will build an innovative therapy for shift workers on this basis. Once the newly developed treatment manual is finalized, its efficacy will be assessed through a randomized controlled trial. Full article