Avaliação da qualidade do sono em profissionais de saúde da emergência / Evaluación de la calidad del sueño en profesionales de la salud de emergencia / Sleep quality assessment in emergency health professionals

Resumo Objetivo Avaliar a qualidade do sono de profissionais dos serviços de emergência e sua associação com o nível de fadiga e qualidade de vida. Métodos Estudo descritivo, transversal e correlacional, realizado nas unidades do Serviço de Atendimento Móvel de Urgência (SAMU) e na Unidade de Pronto Atendimento (UPA), no ano de 2021, com 108 participantes. Para avaliação da qualidade do sono, foi utilizado o Índice de Qualidade do Sono de Pittsburgh versão Brasileira (PSQI-BR); para avaliação da Fadiga, foi utilizada a Escala de Fadiga de Chalder, em conjunto com a Escala de Necessidade de Descanso (ENEDE); e para avaliação da qualidade de vida, foi utilizado o World Health Organization Quality of Life Brief Version (WHOQOL-bref), sendo que os instrumentos utilizados foram adaptados para a língua portuguesa em estudos anteriores. Foram aplicados testes de associação para a análise estatística, tendo sido utilizados o Teste Qui-Quadrado de Pearson, o Teste U Mann-Whitney ou Kruskal Wallis e a correlação de Spearman. Valores de p <0,05 foram considerados como significativos. Resultados Foi identificado que 72,2% dos participantes apresentaram má qualidade do sono e 75,9% estavam fadigados. Foi observada associação significativa entre a qualidade do sono e a fadiga, a necessidade de descanso e a qualidade de vida. Conclusão Foi identificado que os profissionais de saúde que trabalham em serviço de urgência e emergência apresentam má qualidade do sono e de vida e níveis elevados de fadiga e necessidade de descanso, o que pode impactar diretamente suas atividades pessoais e profissionais.

Resumen Objetivo Evaluar la calidad del sueño de profesionales de los servicios de emergencia y su relación con el nivel de fatiga y calidad de vida. Métodos Estudio descriptivo, transversal y correlacional, realizado en las unidades del Servicio de Atención Móbil de Urgencia (SAMU) y en la Unidad de Pronta Atención (UPA), en el año 2021, con 108 participantes. Para evaluar la calidad del sueño, se utilizó el Índice de Calidad del Sueño de Pittsburgh, versión brasileña (PSQI-BR). Para evaluar la fatiga, se utilizó la Escala de Fatiga de Chalder, junto con la Escala de Necesidad de Descanso (ENEDE). Para evaluar la calidad de vida, se utilizó el World Health Organization Quality of Life Brief Version (WHOQOL-bref). Los instrumentos utilizados fueron adaptados al idioma portugués en estudios anteriores. Se aplicaron pruebas de asociación para el análisis estadístico, para lo cual se utilizó la Prueba χ2 de Pearson, la Prueba U de Mann-Whitney o la prueba de Kruskal-Wallis y la correlación de Spearman. Se consideraron valores de p<0,05 como significativos. Resultados Se identificó que el 72,2 % de los participantes presentó una mala calidad de sueño y el 75,9 % tenía fatiga. Se observó una asociación significativa entre la calidad del sueño y la fatiga, la necesidad de descanso y la calidad de vida. Conclusión Se identificó que los profesionales de la salud que trabajan en servicios de urgencia y emergencia presentaron mala calidad de sueño y de vida y niveles elevados de fatiga y necesidad de descanso, lo que puede impactar directamente en sus actividades personales y profesionales.

Abstract Objective To assess emergency service professionals' sleep quality and its association with the level of fatigue and quality of life. Methods A descriptive, cross-sectional and correlational study, carried out in the units of the Mobile Emergency Care Service (SAMU) and in the Emergency Care Unit (ECU), in 2021, with 108 participants. To assess sleep quality, the Pittsburgh Sleep Quality Index, Brazilian version (PSQI-BR), was used; to assess fatigue, the Chalder Fatigue Scale was used, together with the Need for Recovery Scale (NFR); and to assess quality of life, the World Health Organization Quality of Life Brief Version (WHOQOL-bref) was used, and the instruments used were adapted to Portuguese in previous studies. Association tests were applied for statistical analysis, using Pearson's chi-square test, Mann-Whitney U test or Kruskal Wallis and Spearman's correlation. P-values <0.05 were considered significant. Results It was identified that 72.2% of participants had poor sleep quality and 75.9% were fatigued. A significant association was observed between sleep quality and fatigue, the need for recovery and quality of life. Conclusion It was identified that health professionals working in emergency services have poor sleep quality and life, and high levels of fatigue and need for recovery, which can directly impact their personal and professional activities.

The evolution and application progress of non-modified drug target discovery CETSA technology / 药学学报

Understanding the research methods for drug protein targets is crucial for the development of new drugs, clinical applications of drugs, drug mechanisms, and the pathogenesis of diseases. Cellular thermal shift assay (CETSA), a target research method without modification, has been widely used since its development. Now, there are various CETSA-based technology combinations, such as mass spectrometry-based cellular thermal shift assay (MS-CETSA), isothermal dose response-cellular thermal shift assay (ITDR-CETSA), amplified luminescent proximity homogeneous assay-cellular thermal shift assay (Alpha-CETSA), etc., which combine their respective advantages and further expand the application scope of CETSA. These technologies are suitable for the entire drug development chain, from drug screening to monitoring the target binding and off-target toxicity of drugs in patients. Based on the author's research experience, this paper reviews the principles of CETSA and related binding technologies, their application in target discovery, and the progress of data processing and analysis in recent years, aiming to provide reference and reference for the further application of CETSA.

La comunicación efectiva para mejorar la interacción del personal de enfermería durante el enlace de turno / Effective communication to improve the interaction of nursing staff during shift change

La razón del ser y del saber que es objeto de estudio de la enfermería es el cuidado de las personas. Para garantizar la continuidad en el cuidado de las personas, el personal de enfermería realiza el enlace de turno en los diversos escenarios clínicos, durante el cual es imprescindible una actitud de compromiso, empatía y habilidad de comunicación efectiva para compartir ­transferir­ el estado de las personas que son sujetos de cuidados. Se han desarrollado herramientas que ayudan a reducir errores durante la transferencia de pacientes y el enlace de turno, como el protocolo Escuchar-escribir-leer-confirmar y la técnica SAER (Situación, antecedentes, evaluación y recomendaciones) o SBAR por sus siglas en inglés.

The entire purpose which is the object of study of nursing is the care of individuals. To guarantee continuity on this task, the nursing staff performs the shift change in the various clinical scenarios, during which an attitude of commitment, empathy and effective communication skills is essential to share ­transfer­ the status of the individuals under care. Tools that help reducing errors during patient transfer and shift change have been developed, such as the Listen-Write-Read-Confirm protocol, and the SBAR technique

Z score analysis: A novel approach to interpretation of an erythrogram

Context: Z score defines the shift of an observed value from the mean. Aims: By determining the direction of this shift and its absolute value for mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC), one can quickly screen the hemogram for any spurious results in RBC parameters and also predict the type of anemia. This is because MCH and MCHC are derived parameters (from Hb, RBC, MCV) and thereby reflect the true as well as false changes in an erythrogram. Materials and Methods: A total of 975 hemograms were studied retrospectively. Basic statistical formulae using mean and standard deviation were applied to calculate z scores for MCH and MCHC. Results obtained were compared with the standard method and validated by an independent cohort of 100 random samples run on a different machine. Results and Statistical Analysis: Z score was found to be statistically significant (p <.001) in diagnosing iron deficiency anemias, megaloblastic anemias, hemolytic anemias, regenerative anemias, anemia of chronic disease and spurious findings. Z score was not significant (p = 0.9) in predicting beta thalassemia trait. The sensitivity was low for the differentials of microcytic hypochromic anemias. Conclusions: Despite this, Z score can be of immense help to the clinicians and pathologists in making quick interpretation of the underlying red cell abnormalities. Also, it can be used as a quality assessment tool in hematology laboratories taking pre analytical and analytical factors into account.

Factors Associated With Elevated Blood Pressure in Nursing Workers

Abstract Introduction Nurses from the night shift are exposed to sleep deprivation, which is associated with circadian rhythm alteration, lifestyle changes, psychosocial stress, and, consequently, increased risk of blood pressure (BP) deregulation and hypertension. Objective To analyze risk factors associated with elevated BP levels in nursing workers. Methods A transversal, quantitative study was conducted with 172 nursing professionals of a large hospital in the state of Minas Gerais, Brazil. The following data were collected: anthropometric and BP measurements, sociodemographic characteristics, clinical variables, and lifestyle habits. Results were evaluated by bivariate analysis and logistic regression. The level of significance adopted in the statistical analysis was 5%. Results Participants' average age was 42.7 ± 9.6 years old; 86.6% (n = 149) were female, and 20.3% (n = 35) had previous diagnosis of hypertension. Overweight and obesity (odds ratio [OR]: 2.187, 95% confidence interval [CI]: 1.060 - 4.509) and night shift (OR: 2.100, CI 95%: 1.061 - 4.158) were statistically significant (p < 0.05) for increased risk of elevated BP level. Conclusion Excessive weight and night shift were significant factors for increased BP in nursing workers.

Transtorno de trabalho em turnos entre enfermeiros durante a pandemia da COVID-19 na Arábia Saudita / Shift work disorder among nurses during the COVID-19 pandemic in Saudi Arabia

RESUMO Objetivo avaliar a prevalência de sintomas de transtorno de trabalho em turnos entre enfermeiros em vários turnos por longas horas durante a pandemia da COVID-19. Métodos estudo descritivo de corte transversal com 120 enfermeiros em hospitais governamentais na Arábia Saudita. Utilizaram-se questionários estruturados: Escala Hospitalar de Ansiedade e Depressão, para medir ansiedade e depressão, Escala de Sonolência de Epworth, para sonolência e insônia, e Escala de Gravidade da Fadiga, para fadiga. Resultados Mostrou-se alta prevalência de sintomas de transtorno de trabalho em turnos, como sonolência diurna (59,2%), fadiga e ansiedade (42,5%) em todos os departamentos durante a pandemia da COVID-19. Também, registrou-se depressão limítrofe de 30,5%. Evidenciou-se diferença significativa entre nível de escolaridade, horas de trabalho e departamentos de trabalho com ansiedade, e entre nível de escolaridade e horas de trabalho com depressão. Conclusão enfermeiros apresentaram sintomas de transtorno de jornada de trabalho em turnos durante a pandemia da COVID-19. Contribuições para a prática: trabalho em turnos altera estilo de vida e saúde dos enfermeiros. Poucas pesquisas foram realizadas sobre transtorno do trabalho em turnos entre enfermeiros sobre a prevalência e seus efeitos. Os resultados são úteis para identificar problemas, superar dificuldades e manter os fundamentos da qualidade do atendimento

ABSTRACT Objective to assess the prevalence of shift work disorder symptoms among nurses who work multiple shifts for long hours during COVID-19 pandemic. Methods descriptive cross-sectional study was utilized in this study of 120 nurses working in governmental hospitals in Saudi Arabia. The study used structured questionnaires: Hospital Anxiety and Depression Scale, to measure anxiety and depression, Epworth Sleepiness Scale to measure sleepiness and insomnia, and Fatigue Severity Scale to measure fatigue. Results this study showed high prevalence shift work disorder symptoms such as daytime sleepiness (59.2%), fatigue and anxiety (42.5%) across all departments during the COVID-19 pandemic. Also, it showed a 30.5% borderline depression. Significant difference between the educational attainment, hours of working and working departments with Anxiety was identified. Significant difference was found between educational attainment and hours of working with depression. Conclusion the nurses suffered shift work disorder symptoms during the COVID-19 pandemic. Contributions to practice: shift work alters the nurses' lifestyle and their health. Little research has conducted on shift work disorder among the nurses on the prevalence and its effects. The results are useful to identify the issues and to overcome the difficulties, which will help to keep the essentials of quality of care.

O trabalho terceirizado e por turnos está associado ao aumento do risco de COVID-19? Descobertas de um estudo com trabalhadores da mineração / Is outsourced and shift work associated with an increased risk of COVID-19? Findings from a study about mining workers

Resumo Objetivos: investigar os fatores de risco sociodemográficos e ocupacionais associados à infeção por COVID-19 em trabalhadores da mineração. Métodos: estudo de coorte retrospectivo com dados secundários dos trabalhadores de uma empresa multinacional de mineração, de março de 2020 a abril de 2021. Casos de COVID-19 foram definidos por meio do resultado do teste reação em cadeia da polimerase (PCR) positivo para SARS-CoV-2. Riscos relativos (RR) para testes positivos foram obtidos por regressão de Poisson. Resultados: dos 10.484 trabalhadores testados, 2.578 (24,6%) tiveram pelo menos um resultado positivo. Foi realizada uma média de 4,0 (desvio-padrão: 3,6) testes para cada trabalhador, totalizando 41.962 testes. A maioria dos trabalhadores eram do sexo masculino (88,3%), com idade entre 30 e 39 anos (38,7%), terceirizados (74,1%) e que não trabalhavam em turnos (70,5%). No modelo múltiplo, os trabalhadores terceirizados (RR: 1,39; intervalo de confiança de 95% [IC95%]: 1,27;1,51) e trabalhadores por turnos (RR: 1,10; IC95%: 1,01;1,20) apresentavam maior risco de infecção quando comparados com seus homólogos. Conclusões: os trabalhadores terceirizados e por turnos exibiram maior risco de infecção pelo SARS-CoV-2 quando comparados com seus homólogos. Portanto, é necessário fornecer monitoramento contínuo com oferta regular e adequada de testes para mitigação e prevenção da COVID-19 nestes grupos ocupacionais.

Abstract Objectives: to investigate the sociodemographic and occupational risk factors associated with COVID-19 infection in mining workers. Methods: a retrospective cohort study, using secondary workers' health data from a multinational mining company, from March 2020 to April 2021. A COVID-19 case was defined based on a SARS-CoV-2 positive result in a polymerase chain reaction (PCR) test. Risk ratios (RRs) for positive testing were estimated using Poisson's regression model. Results: of 10,484 workers, 2,578 (24.6%) had at least one positive result for COVID-19. Each worker underwent an average of 4.0 (standard deviation: 3.6) tests, totaling 41,962 PCR tests. Most of the evaluated workers were male (88.3%), aged from 30 to 39 years (38.7%), outsourced (74.1%) and non-shift workers (70.5%). Our multivariate model showed that outsourced (RR: 1.39; 95% confidence interval [95%CI]: 1.27;1.51) and shift workers (RR: 1.10; 95%CI: 1.01;1.20) had a higher risk of SARS-CoV-2 infection than their counterparts. Conclusions: outsourced and shift workers have a higher risk of COVID-19 infection than their counterparts. Therefore, it is necessary to provide continuous monitoring with regular and adequate testing for mitigation and prevention of COVID-19 in these occupational groups.

Research progress on the relation and related mechanism of night shift work and cardiovascular disease / 中华劳动卫生职业病杂志

Cardiovascular disease is a class of diseases involving the heart or blood vessels, which accounts for about one-third of all deaths worldwide each year. Unhealthy diet, lack of physical activity, smoking and excessive alcohol consumption are all risk factors for cardiovascular disease. With the increasing number of night shift workers, the number of patients with cardiovascular disease has increased, and night shift work has gradually become a risk factor of cardiovascular disease. At present, the mechanism of cardiovascular disease caused by night shift work is still unclear. This review summarizes the relationship between night shift work and cardiovascular disease and its related biochemical indicators, and discusses the research on related mechanisms.

Analysis of the rectum and bladder changes in prostate precise radiotherapy under the bowel and bladder preparation / 中华放射肿瘤学杂志

Objective:To analyze the clinically acceptable and reproducible bladder and rectum volumes of prostate cancer patients during radiotherapy under bladder and bowel preparation, aiming to provide quantitative indicators for bowel and bladder preparation before and after radiotherapy.Methods:Clinical data of 275 prostate cancer patients with strict bladder and bowel preparation and completion of whole course radical radiotherapy at Sun Yat-sen University Cancer Center from April 2015 to December 2020 were retrospectively analyzed. Patients were scanned with cone beam CT (CBCT) before each treatment and the setup error was recorded. Sixty-six patients were selected by simple random sampling and the bladder and rectum on daily CBCT was outlined using MIM software. The relationship between the ratio of daily bladder or rectum volume to the planned bladder or rectum volume (relative value of volume) and setup error was analyzed. Quantitative data were expressed as mean±SD. Normally distributed data were analyzed by paired t-test while non-normally distributed data were assessed by Kruskal-Wallis test.Results:The bladder and rectum volume on planning CT were (370.87±110.04) ml and (59.94±25.07) ml of 275 patients. The bladder and rectum volumes on planning CT were (357.51±107.38) ml and (65.28±35.37) ml respectively of the 66 selected patients with 1611 sets of CBCT images. And the bladder and rectum volumes on daily CBCT were (258.96±120.23) ml and (59.95 ± 30.40) ml. The bladder volume of patients was decreased by 3.59 ml per day on average during the treatment and 0.37 ml for the rectum volume. According to the bladder volume on planning CT, all patients were divided into three groups: <250 ml, 250-450 ml and >450 ml groups. The relative value of volume in the 250-450 ml group during the course of radiotherapy was the smallest. And the setup error in the superior and inferior (SI) direction was (0.28±0.24) cm and (0.19±0.17) cm in the left and right (LR) direction, significantly lower than those in the other two groups (both P≤0.027). According to the rectum volume on planning CT, all patients were divided into four groups: <50 ml, 50-<80 ml, 80-120 ml and >120 ml groups. The <50 ml group had the smallest relative value of volume during radiotherapy, and the setup error in the SI direction was (0.26±0.22) cm and (0.24±0.22) cm in the anterior and posterior (AP) direction, significantly smaller than those in the other groups (both P≤0.003). The setup errors in the SI, LR, AP directions of the enrolled 66 patients were (0.30±0.25) cm, (0.20±0.18) cm and (0.28±0.27) cm, respectively. Among them, the relative value of bladder volume in the AP direction was (0.73±0.37) in the setup error <0.3 cm group, which was statistically different from those in the setup error 0.3-0.5 cm and >0.5 cm groups (both P<0.05). Conclusion:Under the bladder and bowel preparation before planning CT, the appropriate bladder and rectum volumes are in the range of 250-450 ml and <50 ml, which yields higher reproducibility and smaller setup error.

Preliminary study on the value of fetal MRI lung volume and mediastinal shift angle for predicting prognosis of left congenital diaphragmatic hernia / 中华放射学杂志

Objective:To explore the value of fetal lung volume and mediastinal shift angle (MSA) based on fetal MRI in predicting the prognosis of congenital diaphragmatic hernia (CDH).Methods:Fetuses with left CDH that did fetal MRI in Xinhua Hospital Affiliated with Shanghai Jiao Tong University School of Medicine from September 2016 to January 2022 were retrospectively collected. There were 65 patients, and their gestational age was 29 (26, 35) weeks when they were diagnosed with left CDH by MRI. Observed fetal lung volume and MSA were measured based on fetal MRI, and observed/expected lung volume (o/eFLV) based on gestational age was calculated. The clinical data were collected from birth to discharge, and patients were divided into survival group and death group in case of prognosis at discharge, with 54 cases in the survival group and 11 cases in the death group. The student′s t test was used to compare the difference of o/eFLV and MSA between the survival group and the death group, and the receiver operating characteristic (ROC) curve was used to evaluate the value of o/eFLV and MSA in predicting the prognosis of left CDH. Results:The o/eFLV of the survival group was 51.5%±18.3%, higher than that of the death group (27.8%±4.4%), and the difference was significant ( t=8.29, P<0.001). The MSA of the survival group was 33.1°±1.2°, lower than that of the death group (41.8°±2.7°), and the difference was significant ( t=-11.15, P<0.001). The area under the ROC curve (AUC) of o/eFLV to predict the fetal survival or death was 0.939 (95%CI 0.851-0.983), the cutoff value was 33.8%, the sensitivity was 100%, the specificity was 88.9%. The AUC of MSA was 0.998 (95%CI 0.941-1.000), the cutoff value was 37.2°, the sensitivity was 100%, the specificity was 98.2%. Conclusions:The o/eFLV and MSA that were measured based on fetal MRI can effectively predict the fetus′s prognosis with left CDH.

Effects of life satisfaction and shift work and their interaction on cumulative fatigue in petrochemical employees / 环境与职业医学

Background Cumulative fatigue without intervention will seriously threaten the physical and mental health of workers. Shift work and life satisfaction are strongly associated with fatigue accumulation. Objective To explore the effects of life satisfaction, shift work, and their interaction on cumulative fatigue in petrochemical employees, and to provide a scientific basis for preventing cumulative fatigue. Methods All staff of a petrochemical enterprise were selected by cluster sampling for a cross-sectional study from July to October 2021 in Jiangsu Province. A questionnaire designed by the project team was used to collect information on shift work; and life satisfaction and cumulative fatigue were investigated by the World Health Organization Five-item Well-Being Index and the Self-diagnosis Checklist for Assessment of Worker’s Fatigue Accumulation respectively. A logistic regression model was used to analyze the influences of life satisfaction and shift work on cumulative fatigue. Multiplicative and additive models were applied to analyze the interaction effect of life satisfaction and shift work. Results A total of 4066 questionnaires were returned, of which 3763 were valid, with an effective recovery rate of 92.5%. The percentage of cumulative fatigue in the petrochemical employees was 63.2% (2377/3763), and the percentages of low life satisfaction and shift work in the petrochemical employees were 53.6% (2016/3763) and 54.2% (2041/3763), respectively. The results of univariate analysis showed no significant difference in cumulative fatigue among different marital status groups (P=0.176), and there were statistically significant differences in cumulative fatigue among the petrochemical employees in different groups of age, gender, educational level, average monthly income, job title, length of service, working hours, night shift, smoking, drinking, physical exercise, life satisfaction, and shift work (P<0.001). After adjustment for covariates such as age, gender, educational level, average monthly income, job title, length of service, working hours, night shift, smoking, drinking, and physical activity, the unconditional logistic regression model showed that the risk of reporting cumulative fatigue in high life satisfaction participants was 0.129 (95%CI: 0.109, 0.154) times of that in participants of low life satisfaction; the risk of reporting cumulative fatigue in shift work participants was 3.792 (95%CI: 2.713, 5.300) times of that in no shift work participants; and the risk of reporting cumulative fatigue in participants with both high life satisfaction and shift work was 0.105 (95%CI: 0.081, 0.135) times of that in participants with low life satisfaction and shift work. The relative excess risk due to interaction, the attributable proportion due to interaction, and the synergy index of coexisting life satisfaction and shift work were −5.504 (95%CI: −7.247, −3.760), −4.728 (95%CI: −7.575, −1.880), and 0.029 (95%CI: 0.002, 0.351) respectively, which suggested that life satisfaction and shift work have an additive interaction effect on cumulative fatigue. A significant multiplicative interaction was also found between life satisfaction and shift work (OR=0.688, 95%CI: 0.476, 0.936). Conclusion Life satisfaction and shift work are the influencing factors of cumulative fatigue among petrochemical employees, and they interact with each other on the risk of cumulative fatigue. High life satisfaction can reduce the risk of accumulated fatigue associated with shift work.

The Shift and Way Out for Health Science Popularization Lectures in the New Media Era / 中国医学伦理学

Currently, the public’s concern for health has unprecedentedly increased, while some institutions find it difficult to carry out health lectures. Overall, health lectures play an important role, but they face some practical challenges at the operational level, involving lecture objectives, public demands, communication methods, dissemination channels, and foothold methods. In the era of new media, health science popularization lectures are still an effective means of persuasion today, but traditional lecture methods need to be endowed with new connotations, and made shifts and adjustments. Health science popularization lectures should make the following shifts. First, the lecture objectives should turn to "extensive use", stepping out of the limitations of popular science knowledge, and promoting the public to proactively seek health knowledge and information. Second, the lecture content should turn to the integration of physical and mental, designing courses from the perspective of physical and mental, enhancing communication among people, and promoting trust between individuals. Third, the lecture effect should turn to enjoyment, breaking the prejudice against the lecture effect and taking the enjoyment and interest stimulation as the important goal of health science popularization. Fourth, the speaker should turn to "professionalization", establishing a team of professional health lecturers. At the operational level, it is necessary to strictly control the entry and exit of health lecturers to create a lecture brand, segment the audience to organize homogeneous audiences, tell good stories and enhance emotional narration, plan holistically and achieve full-media three-dimensional communication, and scientifically evaluate and emphasize long-term effects.

Imbalance between myopic shift and the minimum amplitude of accommodation: a hypothesis for the pathogenesis of ocular hypertension secondary to drug-induced bilateral acute ciliochoroidal effusion / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To report 5 cases with drug-induced bilateral acute ciliochoroidal effusion(DBACE)and myopic shift, with or without ocular hypertension(OHT), summarize patients' clinical characteristics and recovery process of DBACE, and investigate the possible pathophysiological mechanism.METHODS:A retrospective observational case study conducted from June 2017 to February 2021. The included patients were subjected to a series of ocular examinations listed as follows: 1)best corrected visual acuity; 2)intraocular pressure(IOP); 3)slit-lamp microscopy; 4)fundus photography; 5)ultrasound biomicroscopy(UBM); 6)subjective optometry; 7)axial length and anterior chamber depth. All patients were followed up every 2d until the diopters were completely restored to the state before the disease onset.RESULTS:In total, 5 patients aged 10-45 years old, including 3 female and 2 male patients, were enrolled in this study. All patients were bilaterally involved(5/5), and had myopic shift(5/5), of whom 3 patients had OHT(3/5). With the increase of age, myopic shift decreased, while OHT increased. Based on OHT, the dynamic aggravation process of DBACE was subdivided into 2 stages, stage 1(myopic shift without OHT)and stage 2(myopic shift with OHT). With the deterioration of DBACE, when myopic shift approached or exceeded the minimum amplitude of accommodation(MAA), IOP gradually rose, and DBACE progressed from stage 1 to stage 2. With the recovery of DBACE after discontinuing the suspicious drugs, DBACE in stage 2 first returned to stage 1, and then returned to normal.CONCLUSION:Pathophysiological mechanism of DBACE was subdivided into 2 stages, including stage 1(myopic shift without OHT)and stage 2(myopic shift with OHT). The transition between the two stages depends on the imbalance between myopic shift and MAA.

Machine Learning-based Identification of the Sites of DNA Double-Strand-Break in the Human Genome / 中国生物化学与分子生物学报

DNA double-strand break(DSB) is a serious form of DNA damage in cells, which is closely related to a variety of genomic instability diseases, including cancer, abnormal recombination and neuronal development. Due to the limitations of cost and technical threshold, high-resolution DSB mapping by high-throughput sequencing technology is very limited. This hinders our understanding of the DSB situation in the genomes of different species. Therefore, we developed a classification prediction model based on random Forest(RF), support vector machine(SVM) and logistic regression(LR) classifiers to predict DSB loci in the whole genome of human NHEK cells. In addition to the epigenetic features and DNA shape features commonly used in previous prediction studies, we found that DNA sequence features(kmer frequency, GC content, GC-skew, Mutual Information) can also characterize DSB sites. At the same time, the prediction accuracy is improved after considering DNA physical properties, chemical shifts and autocorrelation information. After combining all the above features, logistic regression(LR) has the best prediction performance(AUC = 0. 97), which is comparable to previous prediction(AUC = 0. 964). In addition, the optimal feature collection consisting of 294 features was obtained by the incremental feature search method, and the corresponding AUC value reached 0. 974.

Effect of night shift work and overweight/obesity on blood pressure of workers in chemical fiber industry / 中国职业医学

{L-End}Objective To analyze the effects of night shift work and overweight/obesity on blood pressure of workers in chemical fiber industry. {L-End}Methods A total of 1 004 workers of a chemical fiber factory were selected as the study subjects using convenient sampling method, and their blood pressure and body mass index were measured. Multiple linear regression model was used to analyze the relationship between night shift work and blood pressure, and multiple logistic regression was used to assess the independent impact and combined impact of night shifts and overweight/obesity on the risk of hypertension. {L-End}Results Compared with the non-night shift workers, the prevalence of hypertension in night shift workers was increased (5.3% vs 13.0%, P<0.05), with elevated systolic and diastolic blood pressure (both P<0.05). The results of multiple linear regression analysis showed that the systolic blood pressure and diastolic blood pressure of the night shift workers were higher than those of the non-night shift workers (both P<0.05), and the systolic blood pressure and diastolic blood pressure of overweight/obesity workers were higher than those of non-overweight/obesity workers (both P<0.01). The results of multiple logistic regression analysis showed that the risk of hypertension in night shift workers and overweight/obesity workers was higher than that in non-night shift workers and non-overweight/obesity workers [odds ratio (OR) and 95% confidence interval (CI) were 2.49 (1.04-5.99) and 2.65 (1.77-3.95), both P<0.05]. Night shift work and overweight/obesity showed a synergistic effect on blood pressure of workers. Compared to non-overweight/obesity non-night shift workers, overweight/obesity night shift workers had a higher risk of hypertension (OR=4.93, 95%CI: 1.70-14.29, P<0.01). {L-End}Conclusion Night shift work could lead to elevated blood pressure in workers in the chemical fiber industry, which is a potential risk factor for hypertension. The synergistic effect of night shift work and overweight/obesity may contribute to the increased risk of hypertension.

Correlation between insomnia and job performance in shift nurses / Монголын Анагаах Ухаан

@#Sleep and wakefulness are physiological processes in our lives that are regulated by circadian rhythms. The level of melatonin, the "sleep hormone", increases with the onset of darkness, and its production slows down in the morning. Exposure to artificial light at night disrupts our circadian rhythm and the processes it controls. Shift work is when an individual works from 9 am to 5 pm. But the night shift refers to the time when a group of workers who work at night in factories and enterprises work in the evening or at night, especially from 4 p.m. to 8 a.m. according to a regular schedule. One in five people in industrialized countries work night shifts, and studies in America and Europe show that between 15 and 30% of adult workers have some form of shift work. Between 10% and 30% of shift workers meet the diagnosis of shift work disorder (SWD). 5-10% of shift workers experience severe shift insomnia and sleepiness. At least ¾ of shift workers suffer from insomnia. Excessive sleepiness usually occurs during shifts (mainly at night) and is associated with impaired cognitive ability due to the need for sleep and reduced alertness, and decreased alertness reduces performance. Job performance is influenced by many workplace environmental factors, including workload, coworker relationships, stress levels, and extended hours. A nurse specialist provides nursing care by monitoring and evaluating 24 hours a day, and by working night shifts, the circadian system of sleep is disturbed, causing sleep problems and insomnia. When examining how night shift work affects nurses' ability to concentrate, the decline in concentration (33.3%) was twice as high as that of day shift nurses (16.7%). found that shift nurses who worked the night shift had higher rates of insomnia and chronic fatigue compared to nurses who stopped working the night shift. Lack of sleep manifests as a decline in cognitive functions such as attention, decision making, and reaction time. These cognitive and functional declines can negatively affect quality of life and lead to impaired job performance. An Australian study by Winwood et al found that fatigue associated with night shifts increases the risk of human error and injury, and negatively affects the quality of patient care. Lack of sleep significantly affects nurses' alertness, concentration, and job performance. This review article discusses the relation between shift work-related sleep and job performance based on international research findings.

Association of long working hours and shift work with occupational stress in level A tertiary hospitals / 预防医学

Objective@#To examine the association of long working hours and shift work with occupational stress among medical staff in level A tertiary hospitals, so as to provide insights into promotion of physical and mental health among medical personnel. @*Methods@#One level A tertiary hospital was sampled using a stratified cluster sampling method from southern and northern Xinjiang Uygur Autonomous Region, and all medical personnel were recruited from these two hospitals. Participants' demographics, working duration, and working in shifts were collected using questionnaires, and occupational stress was measured using the Core Scale for Measurement of Occupational Stress proposed by National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention. The associations of long working hours (weekly working duration of >40 hours) and shift work with occupational stress were examined using a multiple linear regression model.@*Results@#A total of 2 529 questionnaires were allocated, and 2 262 were valid, with an effective rate of 89.44%. The respondents had a mean age of (35.12±8.71) years, and included 1 696 women (74.98%). Of all respondents, there were 722 doctors (31.92%), 1 033 nurses (45.67%), 361 medical or pharmaceutical technicians (15.96%), 1 808 with long working hours (79.93%) and 1 264 with shift work (55.88%). The score of occupational stress was (44.79±8.49) points, and the prevalence of occupational stress was 28.69% among respondents. Multiple linear regression analysis showed that after adjustment for age, marital status, length of service, position, smoking and physical exercise, long working hours (>40 h, β'=0.124; >48 h, β'=0.175; ≥55 h, β'=0.323) and shift work (β'=0.203) were influencing factors for occupational stress among medical personnel（P<0.05）; however, there was no interaction between long working hours and shift work (P>0.05). @*Conclusion@#Long working hours and shift work may increase the risk of occupational stress among medical personnel in level A tertiary hospitals.

Refractive outcomes after intrascleral fixation of posterior intraocular lens / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the refractive outcomes after intrascleral fixation of posterior intraocular lens(IOL).METHODS: Retrospective clinical study. A total of 55 patients(55 eyes)who had undergone intrascleral fixation of posterior IOL in Peking University International Hospital from March 2017 to December 2021 were enrolled. Patients were assigned to conventional group(35 eyes)and modified group(20 eyes)according to different surgical procedures. IOL Master combined with SRK/T formula were applied to calculate the diopter of IOL and the residual refractive power, as well as acquiring preoperative values of corneal astigmatism. Optometry, IOL Master and Pentacam were performed 1 and 3mo postoperatively to obtain the postoperative corneal astigmatism, total ocular astigmatism and spherical equivalent which was calculated as the actual diopter. The Image-pro plus analyzer was used to measure the values of IOL tilt and decentration.RESULTS: The 55 eyes that underwent intrascleral fixation of posterior IOL presented hyperopic shift in refraction after operation and the refractive error was 0.75±0.63D at 3mo postoperatively. There was significant difference between the actual diopter and the residual diopter at 3mo after operation(t=2.553, P=0.011). Both conventional group and modified group showed hyperopic shift postoperatively. The refractive error at 1 and 3mo after operation were 0.80±0.43 and 0.84±0.46D in the conventional group and 0.43±0.39 and 0.47±0.26D in the modified group respectively, with significant differences between two groups(1mo: t=3.500, P=0.001; 3mo: t=3.311, P=0.002). There was no significant difference in corneal astigmatism between two groups both at 1 and 3mo postoperatively(all P<0.05). Total ocular astigmatism in the modified group was significantly lower than that in the conventional group(1mo: t=3.884, P<0.001; 3mo: t=3.314, P=0.002). In addition, IOL tilt and decentration in the modified group were significantly less than that in the conventional group at 1 and 3mo postoperatively(all P<0.05). No significant difference was found in IOL tilt and decentration for intra-group comparison at 1 and 3mo postoperatively(P<0.05). Complications of 55 eyes included 2 eyes of transient intraocular pressure elevation, 2 eyes of transient hypotony which recovered after topical medication and 1 eye of vitreous hemorrhage which resolved spontaneously.CONCLUSION: Intrascleral fixation of posterior IOL is proved to be a safe and effective surgical technique, with hyperopic shift easily present after operation. Increasing the refractive power of IOL and targeting mild myopia during IOL power calculation can prevent postoperative hyperopia, but long-term outcomes still need further observation.

Research on magneto-acoustic-electrical tomography method based on liquid metal contrast agent and M sequence coded excitation / 生物医学工程学杂志

Magneto-acoustic-electric tomography (MAET) boasts high resolution in ultrasound imaging and high contrast in electrical impedance imaging, making it of significant research value in the fields of early tumor diagnosis and bioelectrical monitoring. In this study, a method was proposed that combined high conductivity liquid metal and maximum length sequence (M sequence) coded excitation to improve the signal-to-noise ratio. It was shown that, under rotational scanning, the liquid metal significantly improved the signal-to-noise ratio of the inter-tissue magneto-acoustic-electric signal and enhanced the quality of the reconstructed image. The signal-to-noise ratio of the signal was increased by 5.6, 11.1, 21.7, and 45.7 times under the excitation of 7-, 15-, 31-, and 63-bit M sequence code, respectively. The total usage time of 31-bit M sequence coded excitation imaging was shortened by 75.6% compared with single-pulse excitation when the same signal-to-noise ratio was improved. In conclusion, the imaging method combining liquid metal and M-sequence coding excitation has positive significance for improving MAET image quality.

Condições de saúde, qualidade do sono e concentração sérica de interleucinas e metabólitos em trabalhadores de enfermagem hospitalar / Health conditions, sleep quality and serum concentration of interleukins and metabolites in hospital nursing workers

Introdução: O trabalho em turnos expõe os profissionais de enfermagem hospitalar à privação do sono podendo levar a Sonolência Diurna Excessiva (SDE), estar associada à resposta imunológica e metabólica e ao adoecimento físico, mental e emocional dos trabalhadores. As interleucinas pró-inflamatórias e os metabólitos podem ser potenciais biomarcadores para a avaliar a qualidade do sono e as alterações de saúde. Objetivo: Verificar a ocorrência de SDE nos trabalhadores de enfermagem que atuam com pacientes adultos em estado crítico e possíveis associações com as condições de saúde, com a concentração sérica de interleucinas e metabólitos expressos conforme o turno de trabalho. Método: é um estudo de corte transversal, correlacional, com abordagem quantitativa, realizado em um hospital federal de ensino do interior de Minas Gerais, Brasil. A população foi constituída pelos trabalhadores de enfermagem das Unidades de Terapia Intensiva de adultos. Entre 172 profissionais, 124 cumpriram os critérios de inclusão e participaram da pesquisa divididos em três grupos: diurno, noturno e duplo ou triplo vínculos. Foram utilizados três instrumentos para coleta dos dados: questionário de características sociodemográficas, questionário de condições de saúde e a Escala de Sonolência Diurna de Epworth e, além disso, procedeu-se a coleta de sangue venoso para a dosagem de interleucinas e metabólitos. Os dados foram tabulados e analisados no StatisticalPackage for the Social Sciences-SPSS 22.0. Entre os testes utilizados estão: Fator de Inflação da Variância (VIF), Critério de Informação de Akaike (AIC), multicolinearidade, regressão linear múltipla, regressão logística, qui-quadrado, Mann-Whitney, Shapiro-Wilk e Kruskal-Wallis, além do softwere GraphPadPrism 7.0 e Mass Hunter Qualitative v. 10.0. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da EERP-USP, conforme parecer nº 3.950.501/2020. Resultados: 81,5% dos participantes eram mulheres que trabalhavam em média 49h59min. semanais e dormiam a média de 5h50min. 37,1 % referiram doenças pré-existentes com destaque para cardiovasculares, endócrino metabólicas e neuropsiquiátricas. 70,2% apresentaram SDE associada a nove variáveis com destaque para o "sono não restaurador", "episódios de choro e vontade chorar", "alterações de memória e concentração" e "diminuição dos reflexos". Foram testadas IL-6, TNF?- e IL-10, contudo estatisticamente inexpressivas. Quanto à metabolômica, esta apresentou 6 metabólicos diferencialmente expressos entre os turnos com destaque para a C-16 esfinganina e o PI (0-20:0/21:0) mais concentrados no noturno e duplo ou triplo vínculos associados ao "sono não restaurador", "alteração da memória e da concentração" e "diminuição dos reflexos". O metabólito PC(2:0/O-16:0)[U], predominante no diurno, apresentou associação com "alteração da memória e da concentração" e "episódios de choro e vontade chorar". Conclusões: Os resultados comprovaram a associação da SDE com os sinais e sintomas de privação do sono e com metabólitos diferencialmente expressos conforme o turno de trabalho.

Introduction: Shift work exposes hospital nursing professionals to sleep deprivation, which can lead to Excessive Daytime Sleepiness (EDS) and is associated with the immunological response, metabolism and physical, mental and emotional illness of workers. Pro-inflammatory interleukins and metabolites can be potential biomarkers for assessing sleep quality and health changes. Objective: To verify the occurrence of EDS in nursing workers who work with critically ill adult patients and possible associations with the conditions of health, with the serum concentration of interleukins and metabolites expressed according to the work shift. Method: it is a cross-sectional, correlational study, with a quantitative approach, carried out in a federal teaching hospital in the interior of Minas Gerais, Brazil. The population consisted of nursing workers from adult Intensive Care Units. Among 172 professionals, 124 met the inclusion criteria and participated in the research divided into three groups: daytime, nighttime and double or triple bonds. Three instruments were used to collect data: sociodemographic characteristics questionnaire, health conditions questionnaire and the Epworth Daytime Sleepiness Scale and, in addition, venous blood was collected to measure interleukins and metabolites. The data were tabulated and analyzed using the Statistical Package for the Social Sciences-SPSS 22.0. Among the tests used are: Variance Inflation Factor (VIF), Akaike Information Criterion (AIC), multicollinearity, multiple linear regression, logistic regression, chi-square, Mann-Whitney, Shapiro-Wilk and Kruskal-Wallis, in addition of Graph Pad Prism 7.0 software and Mass Hunter Qualitative v. 10.0. The study was approved by the EERP-USP Research Ethics Committee, according to opinion no. 3,950,501/2020. Results: 81.5% of participants were women who worked an average of 49h59min per week and slept an average of 5h50min. 37.1% reported pre-existing diseases, especially cardiovascular, endocrine, metabolic and neuropsychiatric diseases. 70.2% had EDS associated with nine variables, highlighting "non-restorative sleep", "episodes of crying and wanting to cry", "changes in memory and concentration" and "decreased reflexes". IL-6, TNF?- and IL-10 were tested, but they were statistically insignificant. As for metabolomics, this presented 6 metabolic variables differentially expressed between shifts, with emphasis on C-16 sphinganine and PI (0-20:0/21:0) more concentrated at night and double or triple bonds and associated with "sleep not restorative", "change in memory and concentration" and "decrease in reflexes". The metabolite PC (2:0/O-16:0)[U], predominant in the daytime, was associated with "change in memory and concentration" and "episodes of crying and wanting to cry". Conclusions: The results confirmed the association of EDS with the signs and symptoms of sleep deprivation and with metabolites differentially expressed according to the work shift.