Stress urinary incontinence (SUI) is a serious disease for females. This study attempts to explore the role of activating transcription factor 4 (ATF4) in mechanical trauma-induced SUI fibroblast cell proliferation and apoptosis, thereby finding a candidate target for SUI treatment. A cell model simulating the condition of SUI was established for the assessment of ATF4, miR−93-3p and Smad7 expression. Cellular biological behaviors were evaluated, and levels of PCNA and Caspase−3 were measured. Mechanically, the enrichment of ATF4 on the miR−93-3p promoter was analyzed. The binding relation between ATF4 and miR−93-3p promoter and between miR−93-3p and Smad7 3’UTR was verified. The mechanism of the ATF4/miR−93-3p/Smad7 pathway in mechanical trauma-induced fibroblast proliferation and apoptosis was validated. ATF4 was upregulated in mechanical trauma-induced fibroblast, and ATF4 silencing promoted mechanical trauma-induced fibroblast proliferation and inhibited apoptosis. ATF4 bound to the miR−93-3p promoter and inhibited miR−93-3p expression. miR−93-3p targeted Smad7 3’UTR to downregulate Smad7 expression. miR−93-3p depletion or Smad7 overexpression could partially neutralize the role of ATF4 knockdown in mechanical trauma-induced fibroblast proliferation and apoptosis. ATF4 promotes apoptosis and inhibits the proliferation of mechanical trauma-induced fibroblasts via the miR-93-3p/Smad7 axis, providing a potential candidate therapeutic target for mechanical trauma-induced SUI.

Functional hypothalamic amenorrhea (FHA) is a form of hypogonadotropic hypogonadism that accounts for approximately 30−35% of secondary amenorrhea in women of reproductive age. This condition is characterized by anovulation due to a reduced gonadotropin-releasing hormone (GnRH) drive, activation of the hypothalamic‒pituitary‒adrenal (HPA) axis and sick euthyroid syndrome, resulting in nonorganic hypoestrogenemia, hypercortisolemia, and hypothyroidism. The stressors contributing to FHA include psychological factors such as perfectionism and mood disorders; psychosocial factors such as adverse life events and relationship conflicts; and metabolic factors such as excessive exercise and undernutrition. Stress-induced behaviors and energy deficiency may then result in the neuroendocrine triad of HPA activation, hypothalamic–pituitary–thyroid suppression, and hypothalamic–pituitary–gonadal suppression. FHA has been associated with endothelial dysfunction, a preclinical form of cardiovascular disease (CVD) characterized by physiological yet asymptomatic changes in the blood vessels that can progress to CVD. Research suggests that hypoestrogenism alone does not explain the risk for preclinical CVD in women with FHA. The combined neuroendocrine and metabolic alterations in women with FHA may predispose them to endothelial dysfunction and increase long-term CVD risk. Hypercortisolemia may be a key mediator in linking stress physiology with both reproductive suppression and cardiometabolic risk in women with FHA. This narrative review explores the psychological, psychosocial, and metabolic factors contributing to stress in young women with FHA and their potential impact on cardiovascular health.

The Trier Social Stress Test (TSST) reliably induces psychosocial stress, but its high resource demands limit its applicability in many research contexts. We evaluated a single‐person videoconference TSST (vcTSST) delivered via Zoom using pre-recorded “jury” members. Forty-one healthy, German‐speaking students were randomized to vcTSST (n = 21) or a structurally matched control (n = 20). Continuous heart rate and root mean square of successive interbeat differences (RMSSD) were recorded alongside visual analog scales for stress and mood across baseline, anticipation, speech, and arithmetic phases. In the vcTSST, stress and heart rate increased sharply (partial η² = .59 and .60) while mood and RMSSD decreased (partial η² = .23 and .31; all p < .001). Phase × condition interactions revealed significantly higher stress, negative affect, and heart rate in vcTSST versus control (p < .01), with no group difference in RMSSD. No participant detected the pre-recorded jury, confirming deception fidelity. The vcTSST provides a cost‐effective, standardized stress paradigm, which can be used in laboratory settings and is easily adaptable for remote applications. Future studies should include neuroendocrine measures, recruit more diverse samples, and validate the protocol in online contexts.

Background: Korean nurses face high levels of occupational stress due to staff shortages and work overload. This stress varies depending on each individual’s cognitive appraisal and coping strategies and affects both the quality of nursing care and the well-being of the nurses themselves. Therefore, this study is intended to conduct a comprehensive investigation into the cognitive appraisal, coping strategies, and occupational stress outcomes of Korean nurses.Methods: This integrative review study was based on Lazarus and Folkman’s transactional model of stress and coping. Literature published in Korean or English between March 1984 and July 2025 was reviewed using the RISS, KISS, DBpia, PubMed, and CINAHL databases.Results: Fourteen studies (13 quantitative descriptive and 1 qualitative) were analyzed regarding occupational stress and coping strategies among nurses. Three key attributes were identified: a high level of occupational stress related to various factors, the use of active and passive coping strategies, and outcomes from coping with occupational stress. No study to date has specifically examined occupational stress appraisal.Conclusions: It is important to develop strategies that help nurses actively cope with occupational stress, allowing for adaptive outcomes, rather than inefficient ones. These findings are expected to serve as foundational data for the development of occupational stress management programs. Future studies on nurses’ occupational stress will also need to include the concept of cognitive appraisal.

Background: This study aimed to examine temporal trends in mental health issues in South Korea from the onset of the coronavirus disease (COVID-19) pandemic through to the post-pandemic endemic phase. Using large-scale online data, this study sought to identify key mental health concerns at different stages and offer foundational evidence for future public health policy development.Methods: A total of 13,797 textual data entries, —comprising 8,664 Naver blog posts and 5,133 news articles, —were collected between January 20, 2020, and April 17, 2024. The data were segmented into five distinct periods based on critical milestones in South Korea’s pandemic response. Text mining and network analysis were employed to extract and examine the following mental health-related keywords: depression, anxiety, and stress.Results: During the early phase of the pandemic, negative psychological states, such as anxiety, stress, and depression, were highly prevalent, reflecting widespread fear and uncertainty among the public. Although the frequency of these keywords gradually declined, they remained significant even after the transition to the endemic phase. In contrast, the later stages showed an increased frequency of keywords related to recovery and adaptation, such as education, environment, and support, indicating ongoing societal adjustment.Conclusions: These findings underscore the prolonged psychological effects of COVID-19, with mental health concerns persisting into the endemic phase. Continuous mental health support and adaptive public health strategies are essential to mitigate the enduring impact of global health emergencies.

Background: This preliminary study explored the stigma surrounding suicide loss in survivors in South Korea and develops a scale for measuring this stigma.Methods: An open-ended survey (N=57; 18 men, 39 women) and a structured questionnaire (N=250; 94 males, 156 females) were administered to adults who had experienced bereavement due to the suicide of a close family member or partner (e.g., parent, child, spouse, or significant other). Preliminary items were generated based on open-ended responses. The items were then subjected to content validation and revision by a panel of experts, resulting in 70 preliminary items. The questionnaire was administered based on these items.Results: The exploratory factor analysis yielded a stigma scale comprising four factors and 15 items. The four factors were labeled as follows: &lt;i&gt;Vulnerable Individual, Responsibility for Suicide, Relational Discomfort&lt;/i&gt;, and &lt;i&gt;Relational Distancing&lt;/i&gt;. The scale demonstrated acceptable internal consistency.Conclusions: This study is relevant because it developed a culturally relevant scale to assess the stigma experienced by survivors of suicide loss in Korean society.

Background: This study evaluated the psychometric properties of the Korean version of the Suicide Rumination Scale [K-SRS], which assesses fixations on suicidal thoughts, intentions, and plans.Methods: Between July 2024 and March 2025, 124 adults (aged 18 years and older) with suicidal ideation completed an online self-report survey and a behavioral task.Results: Factor analysis supported a two-factor structure—Intrusive Rumination about Suicide and Contemplation of Suicide Methods—demonstrating excellent internal consistency (α=.96 and .93, respectively). Convergent validity was supported by significant correlations with brooding, reflective pondering, depressive rumination, and intrusive rumination (rs=.19 to .57). Discriminant validity was indicated by non-significant correlations with deliberate rumination (rs=−.01 to .01). The K-SRS demonstrated concurrent validity via associations with suicidal risk, suicidal ideation intensity, depression, and anxiety (rs=.34 to .65), and incremental validity by predicting suicide risk beyond established factors. Higher K-SRS scores among individuals with clinical levels of depression and anxiety confirmed known-group validity. The K-SRS showed acceptable discriminatory ability for past suicide attempts (AUC=.77), with a cut-off score of 13.5 (sensitivity=0.68, specificity=0.75).Conclusions: The K-SRS is a reliable and valid measure of suicide-specific rumination and risk assessment.

Background: This study examines the influence of school maladjustment on non-suicidal self-injury among adolescents and the moderated mediating effect of anxiety according to single-parent family status.Methods: Regression analyses were performed using raw data from a survey of teenagers’ mental health and the PROCESS Macro method.Results: Adolescents’ school maladjustment had a positive effect on non-suicidal self-injury. In addition, the partial mediating effect of anxiety was confirmed. In other words, adolescents’ level of school maladjustment increased their level of anxiety, which in turn increased the likelihood of non-suicidal self-injurious behavior. Furthermore, the mediating effect of anxiety was moderated by single-parent family status. Specifically, the mediating effect of school maladjustment leading on non-suicidal self-injury through anxiety was more pronounced among adolescents from single-parent families than those from two-parent families.Conclusions: Intervention plans to deal with school maladjustment and anxiety among adolescents are proposed based on these findings.

Background: This study aimed to understand the attributes and concepts of role conflict among nurses.Methods: Using Walker &amp; Avant’s (2014) concept analysis framework, a literature search was conducted in the PubMed, cumulative index to nursing and allied health literature (CINAHL), PsycINFO&lt;sup&gt;®&lt;/sup&gt;, regional information sharing systems (RISS), and DBpia databases using the search terms ‘Nurse’ or ‘Nursing’ and ‘Role conflict’ or ‘Role ambiguity’ or ‘Role strain.’ A total of 55 articles were included in this study.Results: Role conflict among nurses was defined as conflicts occurring across various dimensions, including individual, interpersonal, role- and system-related. The antecedents of role conflict included excessive workload, job stress, and manpower shortages. The consequences of role conflict included lower quality of nursing care, emotional burnout, and increased turnover.Conclusions: This concept analysis provides a clear definition of role conflict among nurses, enhances understanding of the concept, and provides foundational data for nursing practice and systems.

Post-traumatic stress disorder (PTSD) affects approximately one in 11 people throughout their lifetime yet current treatment options, such as behavioral therapies or pharmaceuticals, suffer from low medical adherence and often fail to fully address all the symptoms. Therefore, it is necessary to better understand maladaptive behaviors in PTSD to guide new treatments. Single-prolonged stress (SPS) is a rodent model of stress that parallels certain human neurophysiological and neurobehavioral changes occurring in PTSD. SPS is a single-day sequential stressor exposure—restraint stress, group forced swim, predator odor exposure, and isoflurane until loss of consciousness—followed by 7 days of stress incubation. Here, we investigated multiple cohorts of male C57BL/6J mice early after SPS and stress incubation (8–10 days) on behavioral tasks (elevated plus maze (EPM), three-chamber sociability, cost-benefit conflict (CBC), home cage behavior, scent avoidance and defensive burying tasks) that test multiple PTSD-related symptoms. Behavioral assessment included efforts to replicate published findings (i.e., EPM) and introducing newer tasks (i.e., CBC) that have not yet been tested in the SPS mouse model. While most of these tasks and standardized metrics failed to capture behavioral differences in SPS-treated male C57BL/6J mice, we did observe deficits in social novelty preference in the stressed mice. These studies add to a growing literature on inconsistencies in behavioral outcomes produced by the mouse SPS paradigm that could be potentially explained by mouse strain or procedural differences. Overall, this study demonstrated that behavior in male C57BL/6J mice were not affected after SPS apart from social novelty preference.