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Receptor-binding peptides are promising candidates for tumor target therapy. However, the inability to occupy "hot spots" on the PPI interface and rapid metabolic instability are significant limitations to their clinical application. We investigated a new strategy in which an FGFR1-binding peptide (Pep1) was site-specifically functionalized with the dinitrophenyl (DNP) hapten at the C-terminus. The resulting Pep1-DNP conjugates retained FGFR1 binding affinity and exhibited a similar potency in inhibiting FGF2-dependent cell proliferation, comparable to that of native Pep1 in vitro. In addition, three conjugates could recruit anti-DNP antibodies onto the surface of cancer cells, thereby mediating the CDC efficacy. In vivo pharmacokinetic studies and antitumor studies demonstrated that optimal conjugate 9 exhibited significantly prolonged half-lives and improved antitumor efficacy without prominent toxicity compared to those of native Pep1. This is a general and cost-effective approach for generating peptidomimetic immunotherapeutics with multiple antitumor mechanisms that may have broad applications in cancer therapy.
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Ion-solvating membranes have been gaining increasing attention as core components of electrochemical energy conversion and storage devices. However, the development of ion-solvating membranes with low ion resistance and high ion selectivity still poses challenges. In order to propose an effective strategy for high-performance ion-solvating membranes, this study conducted a comprehensive investigation on watermelon skin membranes through a combination of experimental research and molecular dynamics simulation. The micropores and continuous hydrogen-bonding networks constructed by the synergistic effect of cellulose fiber and pectin enable the hypodermis of watermelon skin membranes to have a high ion conductivity of 282.3 mS cm-1 (room temperature, saturated with 1 M KOH). The negatively charged groups and hydroxyl groups on the microporous channels increase the formate penetration resistance of watermelon skin membranes in contrast to commercially available membranes, and this is crucial for CO2 electroreduction. Therefore, the confinement of proton donors and negatively charged groups within three-dimensional microporous polymers gives inspiration for the design of high-performance ion-solvating membranes.
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[This corrects the article DOI: 10.3389/fendo.2024.1351281.].
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Background: Unexplained recurrent implantation failure and the high cost of assisted reproductive techniques for those experiencing infertility have increasingly resulted in the use of acupuncture. However, the trends and research status of acupuncture on infertility resulting in natural conception have not been systematically summarized. This scoping review and knowledge graph analysis aimed to summarize existing clinical studies on acupuncture for infertility that resulted in natural conception. Methods: Seven databases, namely, PubMed, Embase, the Cochrane Library, CNKI, VIP, Wanfang Data, and SinoMed, were searched up to August 2023 (updated on 1 April). Two authors independently identified related clinical studies and systematic reviews, and extracted data from included studies on acupuncture for infertility; any discrepancies were resolved by discussion or judged by a third author. A meta-analysis was conducted based on randomized controlled trials (RCTs), and data were synthesized using risk ratios with 95% confidence intervals. Results: Of the 310 articles meeting the inclusion criteria, 274 were primary studies, 7 were systematic reviews, and 29 were case reports. Reported adverse events included mild ovarian irritation and early signs of miscarriage. Out of the 274 primary studies, there were 40 (14.60%) cases of male infertility and 234 (85.40%) cases of female infertility. Current research highlights on acupuncture for infertility focused on female infertility caused by polycystic ovary syndrome, ovulation disorder, and luteinized unruptured follicle syndrome (LUFS), while acupuncture for male infertility was a hotspot in the early research stage. The meta-analysis also suggested that acupuncture was more effective than human chorionic gonadotropin (HCG) [RR = 1.89, 95% CI (1.47, 2.42), 11 RCTs, 662 participants]. Acupuncture combined with HCG was comparable to HCG [RR = 2.33, 95% CI (1.53, 3.55), four RCTs, 259 participants]. Compared with no treatment, acupuncture resulted in a higher pregnancy rate [RR = 22.12, 95% CI (1.39, 353.09), one RCT, 47 participants]. There was no statistical difference between acupuncture combined with HCG plus letrozole and HCG plus letrozole [RR = 1.56, 95% CI (0.84, 2.89), one RCT, 84 participants]. Conclusion: Current research highlights on acupuncture for infertility resulting in natural conception focused on female infertility caused by polycystic ovary syndrome, ovulation disorder, and LUFS, while studies on male infertility and female infertility caused by blockage in the fallopian tube, thin endometrium, and other factors were insufficient. Well-designed confirmatory clinical studies are still needed as the research hypotheses of most studies were unclear.
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Terapia por Acupuntura , Bibliometria , Infertilidade Feminina , Humanos , Terapia por Acupuntura/métodos , Terapia por Acupuntura/tendências , Feminino , Infertilidade Feminina/terapia , Masculino , Infertilidade/terapia , Gravidez , Infertilidade Masculina/terapiaRESUMO
Currently, there is no international standard for the methodology of patient versions of guideline development. In China, the development of patient versions of guidelines is still in its infancy, and there are no registered or published patient versions of guidelines in the field of acupuncture. This paper introduces two methods of developing patient versions of guidelines: directly converting clinical practice guidelines into patient versions guidelines and developing patient versions of guidelines independently. The relationship and differences between patient guidelines and clinical practice versions of guidelines are compared. By integrating the unique characteristics of acupuncture, this paper analyzes and discusses the significance, problems, and challenges of developing patient versions of guidelines in the field of acupuncture, aiming to provide methodological references for the future development of acupuncture patient versions of guidelines.
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Terapia por Acupuntura , Guias de Prática Clínica como Assunto , Humanos , Terapia por Acupuntura/normas , Terapia por Acupuntura/métodos , ChinaRESUMO
INTRODUCTION: Acupuncture and related acupoint therapies have been widely used for smoking cessation. Some relevant systematic reviews (SRs) have been published. There is a need to summarize and update the evidence to inform practice and decision-making. METHODS: Eight databases were searched from their inception to December 2023. SRs, any randomized controlled trials (RCTs) comparing acupuncture therapies with sham acupuncture, pharmacotherapy, behavioral therapy, or no treatment, were included. The primary outcome was the abstinence rate. AMSTAR-2 was employed to assess the quality of SRs. An updated meta-analysis was conducted based on SRs and RCTs. Data were synthesized using risk ratios (RR) with 95% confidence intervals (CIs). The GRADE approach was employed to assess the certainty of the updated evidence. RESULTS: Thirteen SRs and 20 RCTs outside of the SRs were identified. The SRs were of low or very low quality by AMSTAR-2. Sixteen (80%) RCTs were at high risk of performance bias. Eight acupuncture and related acupoint therapies were involved. The short-term (≤6 months) abstinence rate outcome was summarized as follows. Most SRs suggested that filiform needle acupuncture or acupressure had a better effect than sham acupuncture, but the findings were inconsistent. The updated meta-analysis also suggested that filiform needle acupuncture was more effective than sham acupuncture (RR=1.44; 95% CI: 1.02-2.02; I2 = 66%; low certainty; 9 RCTs, n=1358). Filiform needle acupuncture combined with acupressure was comparable to nicotine patches (RR=0.99; 95% CI: 0.74-1.32; low certainty; 6 RCTs, n= 524). Acupressure was superior to counseling (RR=1.46; 95% CI: 1.14-1.87; I2=5%; low certainty; 8 RCTs, n=595). No serious adverse events were reported in these SRs or RCTs. CONCLUSIONS: Low certainty evidence suggests that filiform needle acupuncture and auricular acupressure appear to be safe and effective in achieving short-term smoking cessation. However, long-term follow-up data are needed.
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We examined couples' dyadic trust profiles over the transition to parenthood and their associations with couples' attachment representations, perceptions of partner's caregiving, and parenting quality. We followed 125 couples from pregnancy to 24 months postpartum and applied the latent profile analysis (LPA) to examine whether distinct dyadic patterns of trust would emerge among couples. We then examined couples' attachment representations and perceptions of partner's caregiving as factors that might explain their trust profiles. Finally, we examined how couples' trust profiles would be related to their parenting quality 24 months postpartum. The dyadic LPA yielded three trust profiles: a both high profile (N = 64), a mother high, father moderate profile (N = 42), and a mother moderate to low, father moderate profile (N = 19). Mothers with dismissing attachment were able to hold high-stable trust when their partner also held high trust toward them, whereas mothers with preoccupied attachment, in general, were likely to have low and declining trust over time. Mothers' more positive perceptions of their husband's caregiving quality were also related to their high-stable trust over time. Mothers' high trust, in turn, was associated with their less emotionally disengaged and less role-reversed parenting. The findings highlight mothers' important role in couples' dyadic trust over the transition to parenthood. Implications of study findings are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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As an important supplementary approach to randomized controlled trial, process evaluation(PE) aims to evaluate implementation of complex intervention and contextual factors associated with variation in outcomes, in order to explain the observed results in a comprehensive manner. However, PE has not been well applied in the clinical research of acupuncture. Based on existing literature, this paper summarized the main methodological frameworks of PE, as well as the status-quo of its application in acupuncture research. Meanwhile, it explored the research perspectives and implementation factors that were potentially relevant to PE in parallel with acupuncture trials. In addition, the paper put forward preliminary considerations on key contents corresponding to each step during the development of PE for acupuncture trials, in order to provide useful reference and innovative pathway for future studies that strive for comprehensive evaluation of acupuncture's effect.
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Terapia por Acupuntura , Acupuntura , Terapia por Acupuntura/métodos , Humanos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Parenting stress reflects a discrepancy between a parent's perception of their resources, the demands of their child's needs, and the caregiving relationship and contexts (Abidin, 1992). Parenting stress can increase the risk of issues in the parent-child relationship, as well as child behavioral and emotional outcomes (Neece et al., 2012; Spinelli et al., 2021). Chronic stressors, such as living through the COVID-19 pandemic, have the potential to increase the demands of parenting and thus parenting stress. Using latent growth curve modeling, we examined parenting stress trajectories of 298 American parents with young children (Mage = 15.02 months, range = 1-34 months) over the first year of the COVID-19 pandemic. We also examined the effects of parental mental health on parenting stress, and the effects of parental mental health and parenting stress on child problem behaviors using data gathered through the Prolific survey platform. Parental mental health, measured by depressive symptoms Centre for Epidemiological Studies Depression Scale-10, anxiety symptoms Generalized Anxiety Disorder Scale (GAD-7), and overall stress levels 10-item Perceived Stress Scale, was related to higher initial parenting stress index-short form. Changes in parenting stress over time were linked with higher levels of children's problem behaviors (CBCL). Child temperament was also related to initial parenting stress. Lower levels of household income were linked with higher levels of parental mental health symptoms and higher rates of parenting stress increases over time. These results highlight the importance of considering the well-being of all family members in child outcomes, and the ways in which different experiences and resources during the COVID-19 pandemic affect parental and child well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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COVID-19 , Comportamento Problema , Testes Psicológicos , Autorrelato , Humanos , Pré-Escolar , Lactente , Poder Familiar/psicologia , Saúde Mental , Pandemias , Estresse Psicológico/etiologia , Pais/psicologia , Relações Pais-FilhoRESUMO
Diabetic kidney disease (DKD) is a significant healthcare burden worldwide that substantially increases the risk of kidney failure and cardiovascular events. To reduce the prevalence of DKD, extensive research is being conducted to determine the risk factors and consequently implement early interventions. Patients with type 2 diabetes mellitus (T2DM) are more likely to be obese. Abdominal adiposity is associated with a greater risk of kidney damage than general obesity. Abdominal adipose tissue can be divided into different fat depots according to the location and function, including visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), perirenal adipose tissue (PAT), and renal sinus adipose tissue (RSAT), which can be accurately measured by radiology techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI). Abdominal fat depots may affect the development of DKD through different mechanisms, and radiologic abdominal adipose characteristics may serve as imaging indicators of DKD risk. This review will first describe the CT/MRI-based assessment of abdominal adipose depots and subsequently describe the current studies on abdominal adipose tissue and DKD development, as well as the underlying mechanisms in patients of T2DM with DKD.
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Diabetes Mellitus Tipo 2 , Nefropatias Diabéticas , Humanos , Adiposidade , Diabetes Mellitus Tipo 2/complicações , Nefropatias Diabéticas/diagnóstico por imagem , Obesidade , Gordura Abdominal/diagnóstico por imagem , Obesidade AbdominalRESUMO
BACKGROUND: Progression of non-target lesions (NTLs) after stenting has been reported and is associated with the triggering of an inflammatory response. The perivascular fat attenuation index (FAI) may be used as a novel imaging biomarker for the direct quantification of coronary inflammation. OBJECTIVES: To investigate whether FAI values can help identify changes in inflammation status in patients undergoing stent implantation, especially in NTLs. METHODS: Patients who underwent pre- and post-stenting coronary computed tomography angiography (CCTA) examination between January 2015 and February 2021 were consecutively enrolled. The pre- and post-stenting FAIs of the full coronary arteries were compared in both the non- and stent-implanted coronary arteries. Moreover, local FAI values were measured and compared between the NTLs and target lesions in the stent implantations. We also compared changes in plaque type and volume in NTLs before and after stenting. RESULTS: A total of 89 patients (mean age 61 years; male 59) were enrolled. The perivascular FAI values in the full coronary arteries decreased after stenting in both the non- and stent-implanted coronary arteries, similar to those in the target lesions. Conversely, the perivascular FAI values in the NTLs increased after stenting (p < 0.05). In addition, the plaque volumes significantly increased in the NTLs after stenting, regardless of whether they were non-calcified, mixed, or calcified (p < 0.05). CONCLUSION: Perivascular FAI values and plaque volumes increased in the NTLs after stenting. Perivascular FAI can be a promising imaging biomarker for monitoring coronary inflammation after stenting and facilitate long-term monitoring in clinical settings. CLINICAL RELEVANCE STATEMENT: Perivascular fat attenuation index, a non-invasive imaging biomarker, may help identify coronary arteries with high inflammation in non-target lesions and facilitate long-term monitoring, potentially providing an opportunity for more targeted treatment. KEY POINTS: ⢠Perivascular fat attenuation index (FAI) values and plaque volumes increased in the non-target lesions (NTLs) after stenting, suggesting potential focal inflammation progression after stenting. However, stenting along with anti-inflammatory treatment ameliorated inflammation in the full coronary arteries. ⢠Perivascular FAI, a non-invasive imaging biomarker, may help identify coronary arteries with high inflammation in NTLs and facilitate long-term monitoring, potentially providing an opportunity for more targeted treatment.
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OBJECTIVE: To assess the use of evidence-based research (EBR) approach in randomized controlled trials (RCTs) of acupuncture-related therapies for primary dysmenorrhea (PD). METHODS: PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Database, and China Science and Technology Journal Database were searched from January 2013 to December 2022 for RCTs of acupuncture on PD. The full text and references of each RCT were read to assess whether systematic reviews (SRs) or other types of studies with similar research questions and end-users' perspectives were cited to justify and design the trial. In addition, the discussion section were analyzed to evaluate whether trials placed the new result in the existing SRs to draw a conclusion. Multivariable logistic regression was used to find variables that associated with 3 aspects of EBR approach: (1) citing clinical studies for justification, (2) citing relevant studies that obtain the perspectives of end users, and (3) citing clinical studies for results discussion. RESULTS: Of 473 RCTs included, 45.67% (216) of the trials cited relevant similar studies, 21.56% (102) referenced to the studies that collected end-users' perspectives, and 10.99% (52) placed result in the context of the previous research. Few RCTs appropriately applied EBR approach. Among all the included studies, 3.17% (15) of the trials used SRs to inform study questions but none of them used updated SRs with acceptable quality; 1.05% (5) of the trials cited SRs of end-user's perspectives in the justification and design of the study, and only 1 trial added results in existing SR to draw a conclusion. Year of publication, language, funding, registration, ethical approval and number of sites were significantly associated with 1 of the 3 aspects of EBR approach. CONCLUSIONS: Few RCTs in acupuncture-related therapies for PD used the EBR approach to minimize research redundancy. Researchers, research institutes, funding agencies, ethics committees, journals and peer reviewers in acupuncture should make efforts to use and promote the EBR approach to ensure the value of new trials.
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OBJECTIVES: To evaluate the report quality, methodological quality and evidence quality of the systematic reviews and meta-analyses (SRs/MAs) of acupuncture for in vitro fertilization-embryo transfer (IVF-ET). METHODS: The SRs/MAs of acupuncture for IVF-ET were searched electronically from databases of CNKI, Wanfang, VIP, SinoMed, PubMed, Embase, Cochrane Library, from inception of each database to September 27th, 2022. Two reviewers independently screened the literature and extracted the data. Using PRISMA statement, the AMSTAR 2 scale and the GRADE system, the report quality, methodological quality and evidence quality of the included SRs/MAs were assessed. RESULTS: A total of 28 SRs/MAs were included, with PRISMA scores ranging from 8.5 points to 27 points. The problems of report quality focused on protocol and registration, retrieval, risk of bias in studies, additional analysis, limitations and funding. The methodological quality of included studies was generally low, reflecting on items 2, 3, 7, 10, 12 and 16. A total of 85 outcome indexes were included in the GRADE system for evidence grade evaluation. Most of the evidences were low or very low in quality. The reasons for the downgrade were related to study limitations, inconsistency, imprecision and publication bias. CONCLUSIONS: Acupuncture therapy improves the outcomes of IVF-ET, but the methodological quality and evidence quality of related SRs/MAs are low. It is recommended to conduct more high-quality studies in the future to provide more reliable evidences.
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Terapia por Acupuntura , Terapia por Acupuntura/métodos , Bases de Dados Factuais , Transferência Embrionária , Fertilização in vitro , Viés de Publicação , Revisões Sistemáticas como AssuntoRESUMO
Background: Intervertebral disc degeneration (IVDD) is a leading cause of low back pain (LBP). The pathological process of IVDD is associated with inflammatory reactions and extracellular matrix (ECM) disorders. Digoxin is widely used for treating heart failure, and it has been reported to have anti-inflammatory effects. Objective: This study is to investigate the role of digoxin in the pathogenesis of intervertebral disc degeneration as well as the involved molecular mechanism, particularly the potential target protein. Methods: We exploited a rat needle model to investigate digoxin's role in intervertebral disc degeneration in vivo. Safranin O staining was used to measure cartilaginous tissue in the intervertebral disc. The morphological changes of intervertebral discs in animal models were determined by Hematoxylin-Eosin (H&E) staining and the pathological score. Primary nucleus pulposus cells (NP cells) from intervertebral discs of patients and murine were used in the present study. Western-Blotting assay, Real-time PCR assay, immunofluorescence staining, and immunochemistry were used to detect the role of digoxin in anti-TNF-α-induced inflammatory effects in vitro. Transfection of siRNA was used to regulate low-density lipoprotein receptor-related protein 4 (LRP4) expression in NP cells to investigate the potential protein target of digoxin. Results: Digoxin protected against intervertebral disc degeneration in rat needle models. Digoxin was found to exert its disc-protective effects through at least three different pathways by a) suppressing TNF-α-induced inflammation, b) attenuating ECM destruction, c) significantly promoting ECM anabolism. Additionally, LRP4 was found to be the downstream molecule of digoxin in NP cells for anti-inflammation and regulation of ECM metabolism. The knockdown of LRP4 downregulated the protective effect of digoxin in NP cells. Conclusion: These findings suggest that digoxin may be a potential therapeutic agent for intervertebral disc degeneration through anti-catabolism and pro-anabolism. Digoxin might also work as an alternative for other inflammation-related diseases.
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Degeneração do Disco Intervertebral , Humanos , Ratos , Camundongos , Animais , Degeneração do Disco Intervertebral/genética , NF-kappa B/metabolismo , Digoxina/farmacologia , Digoxina/uso terapêutico , Inibidores do Fator de Necrose Tumoral/uso terapêutico , Fator de Necrose Tumoral alfa/metabolismo , Inflamação/metabolismo , Proteínas Relacionadas a Receptor de LDLRESUMO
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread worldwide and become a major global public health concern. Although novel investigational COVID-19 antiviral candidates such as the Pfizer agent PAXLOVID™, molnupiravir, baricitinib, remdesivir, and favipiravir are currently used to treat patients with COVID-19, there is still a critical need for the development of additional treatments, as the recommended therapeutic options are frequently ineffective against SARS-CoV-2. The efficacy and safety of vaccines remain uncertain, particularly with the emergence of several variants. All 10 versions of the National Health Commission's diagnosis and treatment guidelines for COVID-19 recommend using traditional Chinese medicine. Xuanfei Baidu Decoction (XFBD) is one of the "three Chinese medicines and three Chinese prescriptions" recommended for COVID-19. This review summarizes the clinical evidence and potential mechanisms of action of XFBD for COVID-19 treatment. With XFBD, patients with COVID-19 experience improved clinical symptoms, shorter hospital stay, prevention of the progression of their symptoms from mild to moderate and severe symptoms, and reduced mortality in critically ill patients. The mechanisms of action may be associated with its direct antiviral, anti-inflammatory, immunomodulatory, antioxidative, and antimicrobial properties. High-quality clinical and experimental studies are needed to further explore the clinical efficacy and underlying mechanisms of XFBD in COVID-19 treatment.
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This longitudinal study uncovered prenatal marital antecedents of infants' attachment configurations with both mother and father at 12-15 months (n = 125). We also examined the contribution of both marital quality and infants' attachment configurations (secure with both parents, insecure with both parents, secure with mother-insecure with father, and insecure with mother-secure with father) to the quality of triadic (mother-father-toddler) interactions observed two years post-birth. Couples who displayed less negative affectivity and were more emotionally attuned were more likely to have infants securely attached with father and insecurely attached with mother (vs. insecure with both parents) and they engaged in more adaptive family interactions at two years. Also, a secure infant-father attachment relationship forecast more balanced triadic family interactions, regardless of whether the infant-mother attachment was secure or insecure. In contrast, a secure infant-mother attachment relationship was related to less controlling behavior during triadic interactions, regardless of infant-father attachment security.
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Mães , Apego ao Objeto , Gravidez , Feminino , Humanos , Lactente , Masculino , Estudos Longitudinais , Casamento/psicologia , Pai , Relações Mãe-FilhoRESUMO
Background: Intrahepatic cholangiocarcinoma (iCCA) is the second most common primary liver cancer. While multiple risk factors for iCCA have been established, metabolic diseases (obesity, diabetes, NAFLD, dyslipidemia, and hypertension) and other risk factors, including smoking and drinking, are still controversial due to their potential confounders. Here, Mendelian randomization (MR) analysis was performed to identify the causal relationship between them. Method: In this study, we obtained GWAS data related to exposures from corresponding large genome-wide association studies. Summary-level statistical data for iCCA were obtained from the UK Biobank (UKB). We performed a univariable MR analysis to identify whether genetic evidence of exposure was significantly associated with iCCA risk. A multivariable MR analysis was conducted to estimate the independent effects of exposures on iCCA. Results: Univariable and multivariable MR analysis based on the large GWAS data indicated that there is little evidence to support the genetic role of metabolic factors, smoking, drinking, and NAFLD in iCCA development (P >0.05). In contrast to most current studies, their impact on iCCA development, if any, might be smaller than we thought. The previous positive results might be due to the comorbidities between diseases and potentially unavoidable confounding factors. Conclusion: In this MR study, we found no strong evidence to support causal associations between metabolic factors, NAFLD, smoking, drinking, and iCCA risk.
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As an indicator that measures the degree of implementation of intervention measures during the implementation process, fidelity could be used for monitoring and quality evaluation of the completion degree of intervention measures, and plays an important role in improving the degree of intervention implementation and clarifying the factors that affect intervention implementation. This article aims to introduce the connotation and significance, measurement, control, and current application status of fidelity, as well as the current application status of fidelity in acupuncture-moxibustion clinical research and its inspiration for future research. Meanwhile, based on the existing evaluation tool development methods of fidelity and the characteristics of acupuncture-moxibustion clinical research, a preliminary fidelity evaluation framework is proposed. Introducing fidelity into acupuncture-moxibustion clinical research could improve the implementation quality and compliance of acupuncture-moxibustion in clinical research, increase the credibility and effectiveness of clinical research results, and promote the transformation of acupuncture-moxibustion experience into easily learnable and promotable treatment plans.
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Terapia por Acupuntura , MoxibustãoRESUMO
Stress related to the COVID-19 pandemic may pose acute threats to caregivers' capacity to cope and result in problematic parenting. However, studies have suggested that some caregivers were able to maintain high resilience when facing hardship. The goal of the present study was to examine how COVID-19-related stress affects resilience and parenting of mothers with young children and whether mothers' individual differences in emotion regulation skills lead to different resilience and parenting outcomes. We followed a sample of 298 mothers in the United States with children between 0 and 3 years old over 9 months beginning in April 2020 when most states were on lockdown. Results indicated that both COVID-19-related stress in April 2020 and greater increases/smaller decreases of COVID-19-related stress across 9 months were associated with mothers' lower resilience in January 2021. Low resilience, in turn, was associated with mothers' higher parenting stress, perceptions of parenting incompetence, and risk for child abuse. Furthermore, for mothers with low and moderate levels of cognitive reappraisal, a greater increase/smaller decrease in COVID-19-related stress was associated with their lower resilience after 9 months. In contrast, for mothers with high cognitive reappraisal, the change in COVID-19-related stress was not related to their resilience. This study demonstrates the importance of cognitive reappraisal for mothers of young children to resist and thrive against chronic and uncontrollable external stressors, which are crucial to preventing mothers' child abuse potential and maintaining positive parenting. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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COVID-19 , Mães , Feminino , Criança , Humanos , Pré-Escolar , Recém-Nascido , Lactente , Mães/psicologia , Poder Familiar/psicologia , Pandemias , Controle de Doenças Transmissíveis , CogniçãoRESUMO
OBJECTIVE: To summarize and identify the available instruments/methods assessing the adequacy of acupuncture in randomized controlled trials (RCTs) for proposing a new improved instrument. METHODS: A systematic literature search was carried out in 7 electronic databases from inception until 21st November 2022. Any study evaluating the adequacy or quality of acupuncture, specifying specific acupuncture treatment-related factors as criteria of subgroup analysis, or developing an instrument/tool to assess the adequacy or quality of acupuncture in an RCT was included. Basic information, characteristics and contents of acupuncture adequacy assessment were presented as frequencies and percentages. RESULTS: Forty studies were included in this systematic review. Thirty-five studies (87.50%) were systematic reviews, none of which used formal methods to develop the assessment instruments/methods of acupuncture adequacy; of 5 methodological studies, only 1 study used a relatively formal method. Thirty-two studies (82.05%) assessed the components of acupuncture, while 7 (17.95%) assessed the overall quality of acupuncture. An independent assessment instrument/method was used to assess acupuncture adequacy in 29 studies (74.35%), whereas as one part of a methodological quality assessment scale in 10 (25.65%). Only 9 (23.00%) studies used the assessment results for subgroup analysis, sensitivity analysis or the criteria for inclusion in the meta-analysis. CONCLUSION: Assessment contents for adequacy or quality of acupuncture in RCTs hadn't still reached consensus and no widely used assessment tools appeared. The methodology of available assessment instruments/scales is far from formal and rigorous. A new instrument/tool assessing adequacy of acupuncture should be developed using a formal method.