The impact of sleep quality on reported anxiety and fatigue among shift nurses: The mediating role of resilience

Aims:The aim of this article is to explore the relation of sleep quality,anxiety status,fatigue level and psychological resilience among rotating‑shift nurses,thus,to propose solutions and promote physical and psychological health of shift nurses.Methods:The cross‑sectional survey was performed on 263 clinical nurses recruited from three tertiary hospitals of Xinxiang City,Henan Province,China from October 2017 to June 2018.The questionnaire survey was conducted using Pittsburgh Sleep Quality Index(PSQI)for measuring nurses’sleep quality,connor‑davidson resilience scale(CD‑RISC)for measuring their psychological resilience,self‑rating anxiety scale(SAS)for measuring their anxiety status,and Fatigue‑14 Scale for measuring their fatigue.The relationship among above indicators were analysed using Pearson correlation analysis.The mediating effect of psychological resilience on the process of sleep quality impacting anxiety and fatigue was analyzed using Wen’s causual steps method and linear regression.Results:The mean CD‑RISC score of shift nurses was 57.76±11.90,which indicated that resilience level was at a medium level.The mean of PSQI,SAS and total fatigue score was(7.53±2.83),(50.56±9.57)and(7.81±9.42),respectively.Resilience could negatively predict the anxiety state(β=−0.366,P<0.01)and fatigue(β=−0.197,P<0.01).Sleep quality could positively predict anxiety(β=0.395,P<0.01)and fatigue level(β=0.495,P<0.01)for shift nurses.The mediating effects of resilience upon sleep quality and anxiety or fatigue was 0.044 and 0.026,respectively.Conclusion:The resilience could fuel sleep quality and reduce the occurrence of negative emotion and fatigue among shift nurses.

Treatment of glutaric aciduria type I(GA-I)via intracerebroventricular delivery of GCDH

Glutaric aciduria type I(GA-I)is an autosomal recessive genetic disorder caused by a deficiency in glutaryl-CoA dehydrogenase(GCDH).Patients who do not receive proper treatment may die from acute encephalopathic crisis.Current treatments for GA-I include a low-lysine diet combined with oral supplementation of L-carnitine.A mouse model of Gcdh^(c.422_428del/c.422_428del)(Gcdh^(−/−))was generated in our laboratory using CRISPR/Cas9.Gcdh^(−/−)mice had significantly higher levels of glutaric acid(GA)in the plasma,liver,and brain than those in wild-type C57BL/6 mice.When given a high-protein diet(HPD)for two days,approximately 60%of Gcdh^(−/−)mice did not survive the metabolic stress.To evaluate whether GCDH gene replacement therapy could be used to provide sustained treatment for patients with GA-1,we prepared a recombinant adeno-associated virus(rAAV)carrying a human GCDH expression cassette and injected it into Gcdh^(−/−)neonates for a proof-of-concept(PoC)study.Our study demonstrated that delivering rAAV to the central nervous system(CNS),but not the peripheral system,significantly increased the survival rate under HPD exposure.Our study also demonstrated that rAAVPHP.eB mediated a higher efficiency than that of rAAV9 in increasing the survival rate.Surviving mice showed dose-dependent GCDH protein expression in the CNS and downregulation of GA levels.Our study demonstrated that AAV-based gene replacement therapy was effective for GA-I treatment and provided a feasible solution for this unmet medical need.