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Background: Non-invasive neuroregulation techniques have been demonstrated to improve certain motor symptoms in Parkinson's disease (PD). However, the currently employed regulatory techniques primarily concentrate on stimulating single target points, neglecting the functional regulation of networks and circuits. The supplementary motor area (SMA) has a significant value in motor control, and its functionality is often impaired in patients with PD. The matching SMA-primary motor cortex (M1) paired transcranial magnetic stimulation (TMS) treatment protocol, which benefits patients by modulating the sequential and functional connections between the SMA and M1, was elucidated in this study. Methods: This was a single-center, double-blind, randomized controlled clinical trial. We recruited 78 subjects and allocated them in a 1:1 ratio by stratified randomization into the paired stimulation (n = 39) and conventional stimulation groups (n = 39). Each patient underwent 3 weeks of matching SMA-M1 paired TMS or sham-paired stimulation. The subjects were evaluated before treatment initiation, 3 weeks into the intervention, and 3 months after the cessation of therapy. The primary outcome measure in this study was the Unified Parkinson's Disease Rating Scale III, and the secondary outcome measures included non-motor functional assessment, quality of life (Parkinson's Disease Questionnaire-39), and objective assessments (electromyography and functional near-infrared spectroscopy). Discussion: Clinical protocols aimed at single targets using non-invasive neuroregulation techniques often improve only one function. Emphasizing the circuit and network regulation in PD is important for enhancing the effectiveness of TMS rehabilitation. Pairing the regulation of cortical circuits may be a potential treatment method for PD. As a crucial node in motor control, the SMA has direct fiber connections with basal ganglia circuits and complex fiber connections with M1, which are responsible for motor execution. SMA regulation may indirectly regulate the function of basal ganglia circuits. Therefore, the developed cortical pairing stimulation pattern can reshape the control of information flow from the SMA to M1. The novel neuroregulation model designed for this study is based on the circuit mechanisms of PD and previous research results, with a scientific foundation and the potential to be a means of neuroregulation for PD. [ABSTRACT FROM AUTHOR]

Objective Postoperative rehabilitation protocols, such as immobilization and non-weight-bearing periods during the acute phase after anterior cruciate ligament (ACL) surgery vary depending on the surgeon or the institution and lack clear standardization. Weight bearing (WB) after ACL reconstruction (ACLR) is critical. This study compares the results of WB immediately after surgery and partial WB with a brace after ACLR. Materials & Methods In this randomized clinical trial, the block random sampling method was used to select 84 patients who were divided into two groups. Group 1 was allowed to have full WB after surgery and Group 2 was asked to use braces after surgery, and they were divided into partial WB for one month and then full WB. Meanwhile, demographic information was recorded. The Lachman test, anterior knee pain, and kneeling pain before and one month after the surgery were also recorded. Knee function was evaluated using the international knee documentation committee, knee injury and osteoarthritis out-come score, and Lysholm scales before surgery and 1, 3, and 6 months after surgery. The data were analyzed using the SPSS software, version 20, and the Fisher exact test, the chi-square test, the Friedman test, and repeated measures analysis of variance. Results Most of the patients were men under 30 years of age. There was no statistically significant difference in the demographic information of the patients in the two groups. Kneeling pain, anterior knee pain, and the Lachman test did not differ between the two groups one month after the surgery. There was no difference between the two groups in the scores using the international knee documentation committee, knee injury and osteoarthritis outcome score, and Lysholm score in the 6-month follow-up. All the examined indicators in each group improved over time. Conclusion WB immediately after surgery compared to partial WB at 1, 3, and 6 months after ACLR do not differ; therefore, patients can bear full weight if they tolerate it. [ABSTRACT FROM AUTHOR]

Background: The pre-season preparatory period is considered key for optimizing the physical fitness levels needed to withstand congested match periods and preventing injuries during the regular soccer season. This study contrasted the effects s of neuromuscular training (NMT) versus an endurance-dominated training (ET) program conducted during the preseason on measures of physical fitness and injury occurrence in female soccer players. Methods: Twenty-four female soccer players aged 17.0 ± 1.3 years from a professional soccer club participated in this study. Players were randomly assigned to NMT (n = 12) or ET (n = 12) groups according to their playing position. The preseason intervention program lasted six weeks, with three weekly sessions with a duration of 45–60 min per session. Exercises in the NMT group included muscle strengthening exercises, plyometrics, agility and dynamic stability exercises, while the ET group practiced a traditional pre-season training program consisting of running and sprinting exercises, fartlek, and high-intensity interval training. The training volumes were similar in the two study groups. Anthropometric measurements, physical fitness tests (i.e., linear and change-of-direction speed, muscle strength and power tests) and the overall injury rate per 1000 h of exposure (training, match) were recorded throughout the season. Results: No between group differences were found at pre (T1). Significant group-by-time interactions were observed for the 5, 10, and 30-m linear sprint speed tests (p < 0.001, 2.16 < d < 2.58), the T-test (p = 0.024, d = 1.03), the squat (p < 0.001, d = 4.04), and the countermovement jump test (p < 0.001, d = 2.21), the Loughborough soccer passing test (LSPT) (p = 0.019, d = 1.08), and the 1-RM back squat test (p < 0.001, d = 2.53). Post-hoc tests indicated that NMT provided larger improvements for SJ, CMJ, 1-RM back squat, the 5-m sprint, 10-m sprint, 30-m sprint, T-test and LSPT compared to ET (1.07 > d > 2.77). The injury rate across the season was significantly lower in the NMT (5.1/1000 h exposure) compared to ET (11.8/1000 h exposure) (p = 0.014). Conclusions: The findings support that six-weeks of preseason NMT versus ET induced larger performance improvements, and significantly reduced injury occurrence in elite female soccer players. Key points: • Our results indicate that the integration of 45 to 60 min of preseason neuromuscular training, three times per week, for 6 weeks, can improve physical fitness and prevent injuries in young female soccer players. • The present study demonstrated that the neuromuscular training program can reduce the incidence injury rate by more than 50% and the burden by more than 65% compared to the endurance-dominated training. • Neuromuscular training is an effective approach during the preseason period to improve diverse measures of physical fitness and to reduce injury occurrence. • Preseason neuromuscular training appears to improve the fitness level of female soccer players and as such could allow them to compete at the high level. [ABSTRACT FROM AUTHOR]

Objective: Accurate imaging biomarkers that indicate disease progression at an early stage are highly important to enable timely mitigation of symptoms in progressive lung disease. In this context, reproducible experimental models and readouts are key. Here, we aim to show reproducibility of a lung injury rat model by inducing disease and assessing disease progression by multi-modal non-invasive imaging techniques at two different research sites. Furthermore, we evaluated the potential of fibroblast activating protein (FAP) as an imaging biomarker in the early stage of lung fibrosis. Methods: An initial lung injury rat model was set up at one research site (Lund University, Lund, Sweden) and repeated at a second site (Radboudumc, Nijmegen, The Netherlands). To induce lung injury, Sprague-Dawley rats received intratracheal instillation of bleomycin as one single dose (1,000 iU in 200 µL) or saline as control. Thereafter, longitudinal images were acquired to track inflammation in the lungs, at 1 and 2 weeks after the bleomycin challenge by magnetic resonance imaging (MRI) and [18F]FDG-PET. After the final [18F] FDG-PET scan, rats received an intravenous tracer [89Zr]Zr-DFO-28H1 (anti-FAP antibody) and were imaged at day 15 to track fibrogenesis. Upon termination, bronchoalveolar lavage (BAL) was performed to assess cell and protein concentration. Subsequently, the biodistribution of [89Zr]Zr-DFO-28H1 was measured ex vivo and the spatial distribution in lung tissue was studied by autoradiography. Lung sections were stained and fibrosis assessed using the modified Ashcroft score. Results: Bleomycin-challenged rats showed body weight loss and increased numbers of immune cells and protein concentrations after BAL compared with control animals. The initiation and progression of the disease were reproduced at both research sites. Lung lesions in bleomycin-exposed rats were visualized by MRI and confirmed by histology. [18F]FDG uptake was higher in the lungs of bleomycin-challenged rats compared with the controls, similar to that observed in the Lund study. [89Zr]Zr-DFO-28H1 tracer uptake in the lung was increased in bleomycin-challenged rats compared with control rats (p = 0.03). Conclusion: Here, we demonstrate a reproducible lung injury model and monitored disease progression using conventional imaging biomarkers MRI and [18F]FDG-PET. Furthermore, we showed the first proof-of-concept of FAP imaging. This reproducible and robust animal model and imaging experimental set-up allows for future research on new therapeutics or biomarkers in lung disease. [ABSTRACT FROM AUTHOR]

Background: Healthcare professionals appear to play a key role in shaping pregnant women's views and attitudes towards lifestyle issues, such as exercise. The aim of this study is to investigate the views and beliefs of Greek midwives and obstetricians regarding exercise during pregnancy. Methods: This is a cross-sectional study conducted during the period of January 2022–March 2023. For this study, 237 Greek midwives and obstetricians employed in healthcare settings in Attica, Greece completed an anonymous and self-report questionnaire. Four different/independent models of multivariate analyses of variance were conducted. Results: The vast majority of these healthcare professionals (88.6%) believed that exercise during pregnancy is generally beneficial. According to the multivariate analyses, healthcare professionals with postgraduate/doctoral studies were more likely to believe that (a) exercise is generally beneficial (p = 0.03), (b) pregnant women should be informed about it (p = 0.028), (c) informing pregnant women is necessary/useful (p = 0.023), and (d) pregnant women showed interest in it (p = 0.034). Also, freelance midwives were more likely to believe that pregnant women should be informed about exercise (p = 0.006), and that they showed interest in it (p = 0.034). In addition, (a) freelance midwives (p = 0.050), and those who had experience in antenatal counselling (p = 0.037), as well as (b) obstetricians who were largely experienced in monitoring normal pregnancies (p = 0.001), were less likely to associate exercise during pregnancy with the occurrence of placental abruption. Conclusion: Alongside healthcare professionals' educational level, their professional setting and professional experience emerge as key factors and need to be considered when designing innovative interventions to support exercise during pregnancy. [ABSTRACT FROM AUTHOR]

Psychiatric nurses are challenged with high levels of stress, which, in turn, lower their professional quality of life (ProQoL) and job satisfaction and increase their intention to leave jobs in psychiatric settings. An adequate level of ProQoL improves patient care provision. The purpose of this study is to assess the levels, relationships, and predictors of the professional quality of life of Jordanian psychiatric nurses and their job satisfaction and intention to leave their job. A descriptive cross-sectional design was used to collect data using the Professional Quality of Life Scale-5 from a convenience sample. Data were collected from 144 psychiatric nurses working in the largest psychiatric hospitals run by Ministry of Health, military, and university-affiliated hospitals. The results showed that the mean scores for compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) were 35.21, 27.0, and 26.36, respectively. The mean scores for intention to leave and job satisfaction were 2.33 and 3.7, respectively. The income level, educational level, intention to leave, and job satisfaction significantly differed in the CS dimension. Nurses' age, intention to leave, and job satisfaction significantly differed in BO. Nurses' age, years of experience, frequent C-shifts worked, and work affiliation were different in STS. Burnout, STS, and educational level predicted CS. CS, STS, job satisfaction, and level of education predicted BO. BO, CS, and frequently working night C-shifts predicted STS. Due to the presence of nurses reporting low levels of ProQoL, job satisfaction, and intension to leave, more studies are needed to assess the factors that affect ProQoL among psychiatric nurses and to evaluate interventional programs that improve the quality of life of psychiatric nurses. This is important in retaining nurses and increasing their job satisfaction. There is a need for interventions that enhance ProQoL. Also, longitudinal studies that measure ProQoL overtime are recommended. This study was not registered. [ABSTRACT FROM AUTHOR]

Aim: This Study Aimed to Assess the Intention to Have a Third Child among Millennial Parents (25–40 years old) with Two Children in a City in Eastern China and to Explore the Influencing Factors Related to Fertility Intention. Design: A cross‐sectional design study. Methods: A convenience sampling method was used to enrol participants of childbearing age who visited two tertiary hospitals in Hang zhou, a city in eastern China, from June 2021 to March 2022. We conducted a face‐to‐face questionnaire survey with 520 participants and calculated the prevalence of intention‐related factors. Multivariate logistic regression was used to analyse the independent influencing factors of fertility intention. Results: In total, 105 (20.2%) participants had the intention to have a third child. The results showed that 'employment status', 'age', 'reasons for wanting a third child', the considered 'biggest barrier to having a third child', 'views on the three‐child policy', 'desired free services', 'supporting work policies' and 'assistance policies' were significant independent influencing factors of intention to have a third child (p‐value < 0.05). The intention of the participants 'over 30 years old' was 2.466 times that of those '30 years old and under', and 'older age/personal health status' was considered the 'biggest barrier to having a third child'. Regarding policy and social reasons, the participants who need 'medical assistance' policy negatively affect the intention to have a third child (OR = 0.453, 95% CI = 0.247–0.830). Implications for Healthcare/Nursing: Nursing plays an important role in health promotion. Nurses can help couples make wise decisions about fertility by providing professional consultation, education, evaluation and support. They can also provide corresponding nursing and guidance to improve couples' health quality and overall reproductive success. Conclusions: The general level of intention to have a third child of Millennial parents with two children is still low. The participants who are 'housewives/househusbands', 'over 30 years old', and satisfied with the state of 'medical assistance' have higher fertility intentions. Patient or Public Contribution: It is particularly meaningful for the policymakers to improve the social support system and raise universal awareness to encourage childbirth. [ABSTRACT FROM AUTHOR]

Background: Misconceptions about male nurses not only exacerbate the gender imbalance in the nursing profession but also negatively impact male nurses embarking on their careers. Currently, no tool exists to measure the gender biases toward males in nursing among nursing students in China. Consequently, the primary objective of this study is to assess the validity and reliability of the Chinese translation of the Gender Misconceptions of Men in Nursing (GEMINI) scale among nursing students. Methods: This cross-sectional study involved 1,102 nursing students from China who participated online. We utilized the Brislin translation technique with a forward-backward approach. To determine the factor structure within the Men in Nursing Gender Misconceptions Scale's Chinese version, both exploratory (EFA) and confirmatory factor analysis (CFA) were applied. The scale's internal consistency was measured through the Cronbach's alpha coefficient, corrected item-total correlation, and a retest reliability assessment. Results: The scale showed a content validity index of 0.938 and a retest reliability of 0.844. EFA indicated a two-factor structure for the translated instrument. CFA revealed a chi-square/degree of freedom of 3.837, an incremental fit index (IFI) of 0.952, a goodness-of-fit index (GFI) of 0.910, a comparative fit index (CFI) of 0.952, and an RMSEA of 0.073, all of which were within acceptable limits. The scale's Cronbach's α was 0.953, and the corrected item-total correlations ranged between 0.539 and 0.838. Gender-based misconceptions about men in nursing among students appeared to be influenced by their gender and whether they considered a nursing program as their first choice when applying for a major. Misconceptions about male nurses are greater among men and those who do not consider nursing programs as their first choice when applying for a major. Conclusions: The Chinese adaptation of the GEMINI scale showcased high reliability and validity. It stands as a potential instrument to gauge gender misconceptions concerning male nurses among Chinese nursing students. [ABSTRACT FROM AUTHOR]

Introduction: Osteoporosis is common among postmenopausal women, and can affect their health and quality of life. However, it can be managed by physical activity. The present study aims to investigate the combined effect of core stability and dynamic resistive exercises on bone mineral density (BMD) in postmenopausal women. Material and methods: Sixty postmenopausal women diagnosed with osteoporosis, age 50 to 60, BMI < 30 kg/m², were randomly divided into two equal groups: the study group received core stability and dynamic resistance exercise (two sessions per week) in addition to 70 mg Alendronate (one tablet) per week for four months, while the control group only received 70 mg Alendronate (one tablet) per week (n = 30 each group). Both groups were assessed for BMD (dual-energy x-ray absorptiometry; DEXA), and quality of life (Oswestry Disability Index; ODI), both pre- and post-treatment. Results: Both groups demonstrated a significantly greater bone mineral density in the lumbar spine and left femoral neck and improved quality of life post-treatment compared to pre-treatment (p < 0.001). However, comparing groups, the study group demonstrated significantly higher lumbar spine (Z value = -5.588) and left femoral neck bone mineral density (Z value = -4.794), and significantly lower ODI score (F value = 243.686), compared to the control group (p < 0.001). Conclusions: Core stability and dynamic resistance exercise appear to be safe and effective methods in the treatment of osteoporosis in post-menopausal women. [ABSTRACT FROM AUTHOR]

This research discusses the correlation between the results of socialization of child-friendly pesantren program by the ministry of religion and the ministry of women's empowerment and protection on the program implementation in pesantrens in Padangpanjg City, West Sumatra. The purpose of the research was to obtain information about the correlation between the results of socialization on the implementation of the childfriendly pesantren program. The hypothesis in this study is that there is a correlation between the results of socialization and the on the implementation of child-friendly pesantren programs in Pesantrens in Padangpanjang City. The research method is descriptive method. The technique used in this research is proportionate stratified random sampling technique. The results showed that the proposed hypothesis was accepted that there was a significant correlation between the results of socialization on the implementation of the child-friendly pesantren program with he correlation coefficient calculation known that r hitung is 0,660 wheres r table with significant degree 5% for N = 62 and df = N-2 = 62 - 2 = 60 is 0,254. Thereby r hitung = rtabel or 0,660 > 0,254, thereby Ha is accepted. [ABSTRACT FROM AUTHOR]

Narcissistic managers with characteristics such as desire for fame and power seeking to protect their interests have the necessary motivation to be effective on the relationship between discretionary accruals and credit rating and, as a result, change the credit rating of companies to their desired rating. The purpose of the present study is to investigate the relationship between discretionary accruals and credit rating by considering the moderating effect of managers' narcissism. The statistical sample of the current research includes 113 companies listed on the Tehran Stock Exchange and 17 companies listed on the Iranian Foreign Exchange in the period of 2011-2021. The data of this research was collected by referring to the Kodal website, the website of the Iranian Statistics Center and Rahvard Novin software. Hypotheses were tested through multivariate regression models and generalized least squares approach using EViews 12 software. The results of the statistical test of research hypotheses confirm that discretionary accruals have a positive and significant effect on the credit rating of economic units. That is, with the increase of discretionary accrual items, the credit rating of economic units increases. Also, the findings of the research indicate that there is a moderating effect of managers' narcissism with three indicators of the size of managers' signatures, managers' cash bonus and managers' photo in the relationship between discretionary accruals and the credit rating of economic units. In other words, managers' narcissism based on the indicators of the size of managers' signatures, managers' cash bonus and managers' photos strengthens the positive relationship between discretionary accruals and credit rating. Based on these results, credit rating agencies are suggested to pay more attention to the narcissistic factors of managers and discretionary accruals in the credit rating process of economic units. [ABSTRACT FROM AUTHOR]

AIM The aim of this study was to evaluate the effects of a virtual mindfulness meditation intervention on stress and anxiety levels of 145 nursing students. BACKGROUND Because of the twin demands of classroom and clinical workloads, nursing students experience greater amounts of stress and anxiety than the average college student. Mindfulness meditation is a promisingmethod to alleviate stress and anxiety. METHOD A pretest-posttest randomized controlled design was used. Participants received either weekly mindfulness meditation recordings or recordings on nursing information. Participants completed the Perceived Stress Scale and the Generalized Anxiety Disorder-7 Scale. RESULTS A two-way mixed analysis of variance and follow-up simple main effects tests revealed that participants in the experimental group, who received meditation recordings, experienced significantly lower levels of stress and anxiety on posttest surveys than the control group. CONCLUSION Mindfulness meditation can reduce stress and anxiety levels in nursing students. This can improve students' overall mental and physical well-being. [ABSTRACT FROM AUTHOR]

As turnover intention is a strong determinant of actual turnover behavior, scholars should identify the determinants of turnover intention. In this context, the aim of this study was to assess the effect of quiet quitting on nurses' turnover intentions. Additionally, this study examined the impact of several demographic and job characteristics on turnover intention. A cross-sectional study with 629 nurses in Greece was conducted. The data were collected in September 2023. Quiet quitting was measured with the "Quiet Quitting" scale. In this study, 60.9% of nurses were considered quiet quitters, while 40.9% experienced high levels of turnover intention. Multivariable regression analysis showed that higher levels of quiet quitting increased turnover intention. Moreover, this study found that turnover intention was higher among females, shift workers, nurses in the private sector, and those who considered their workplace understaffed. Also, clinical experience was associated positively with turnover intention. Since quiet quitting affects turnover intention, organizations, policymakers, and managers should address this issue to improve nurses' intentions to stay at their jobs. [ABSTRACT FROM AUTHOR]

Sense of belongingness in the academic environment has been associated with positive student outcomes and increased student success. To cultivate belongingness, graduate nursing students were invited to participate in a virtual fitness challenge. Sense of belongingness was measured through pre-(n = 103) and post-intervention (n = 64) surveys with three subscales: other students, faculty, and the university. Students reported improved sense of belongingness following the intervention for all subscales, with statistically significant improvements related to other students (p = .007) and the university (p = .023). A virtual fitness challenge may improve sense of belongingness among graduate nursing students. [ABSTRACT FROM AUTHOR]