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Similarly, a recent study among Turkish nurses found no significant differences in oxidative stress parameters (TOS, TAS, cortisol, epinephrine, and norepinephrine) between day and NS workers, although higher perceived stress and anxiety sensitivity were associated with increased TOS and cortisol levels, suggesting that psychological stress may contribute to oxidative imbalance even in the absence of direct shift-related biochemical changes 83

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Other androgenic side effects include acne, oily skin, and mood fluctuations