Advances in research on relationship between indoor artificial light at night and human health / 环境与职业医学

With the acceleration of global urbanization, the intensity and coverage of artificial light at night (ALAN) are increasing, and its service duration is obviously prolonged. ALAN exposure is not only related to the occurrence and development of cardiovascular, metabolic, sleep, myopia, and mental diseases, but also may induce cancer. Previous studies have focused on the health effects of outdoor ALAN, but people spend more than 80% of their lives indoors, hence it is of great significance to understand the relationship between indoor ALAN and population health to create a healthy indoor environment and protect the health of the population.

Night eating syndrome among university students: are aspects of academic life associated with eating disorders? / Síndrome do comer noturno entre estudantes universitários: aspectos da vida acadêmica estariam associados ao distúrbio alimentar?

Introduction: the critical period in the lives of college adults implies lifestyle changes such as reducing physical activity and adopting unhealthy eating habits that can result in increased body fat. Thus, college students may represent a population at increased risk for Night Eating Syndrome. Objective: to analyze aspects of university students' academic life, work and housing that could be associated with Night Eating Syndrome. Methods: cross-sectional study carried out with 900 students from Architecture, Engineering, Medicine and Psychology courses at a higher education institution located in Cajazeiras, Paraíba, Brazil. Self-administered questionnaires were used for data collection: the Night Eating instrument Questionnaire (NEQ) to quantify Night Eating Syndrome (NCS) behaviors and a form for variables on demographic, health, academic life, work and housing aspects. Results: the prevalence of NES determined by the NEQ≥25 score was 16.8%. In the Engineering course, the prevalence of SCN was higher in women than in men, and in the Psychology course, it was higher in men than in women. Among students with a job and who lived at home, the prevalence of the syndrome was higher for those who worked in the afternoon and lower for those who worked at night. Conclusion: the prevalence of NES found among Brazilian university students was high (16.8%), particularly in two situations: (1) being enrolled in an undergraduate course with a predominance of students of the other sex; and (2) live with parents and work in the afternoon. These observations may be helpful in identifying subpopulations of students at increased risk for eating disorders.

Introdução: o período crítico da vida de adultos universitários implica mudanças do estilo de vida como a diminuição da atividade física e a adoção de hábitos alimentares pouco saudáveis que podem resultar em aumento da gordura corporal. Assim, estudantes universitários podem representar uma população com risco aumentado para a Síndrome do Comer Noturno. Objetivo: analisar aspectos da vida acadêmica, do trabalho e da moradia de estudantes universitários que poderiam se associar à Síndrome do Comer Noturno. Método: estudo transversal realizado com 900 estudantes dos cursos de Arquitetura, Engenharia, Medicina e Psicologia de uma instituição de ensino superior localizada em Cajazeiras, Paraíba, Brasil. Para a coleta de dados foram usados questionários autoaplicados: o instrumento Night Eating Questionnaire (NEQ) para quantificar comportamentos da Síndrome do Comer Noturno (SCN) e um formulário para variáveis sobre aspectos demográficos, de saúde, vida acadêmica, trabalho e moradia. Resultados: a prevalência da SCN determinada pelo escore NEQ≥25 foi 16,8%. No curso de Engenharia a prevalência da SCN foi maior nas mulheres em relação aos homens, e no curso de Psicologia, foi maior nos homens em relação as mulheres. Entre os estudantes com emprego e que moravam na casa dos pais, a prevalência da síndrome foi maior para aqueles que trabalham no período da tarde e menor para aqueles que trabalham à noite. Conclusão: a prevalência da SCN encontrada entre os estudantes universitários brasileiros foi alta (16,8%), particularmente em duas situações: (1) estar matriculado um curso de graduação com predominância de estudantes do outro sexo; e (2) morar com os pais e trabalhar no período da tarde. Estas observações podem ser úteis na identificação de subpopulações de estudantes com risco aumentado de distúrbios de alimentação

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 outdoor artificial light at night exposure with overweight and obesity among children and adolescents aged 9 to 18 years in China / 北京大学学报(医学版)

OBJECTIVE@#To analyze the association between outdoor artificial light-at-night (ALAN) exposure and overweight and obesity among children and adolescents aged 9 to 18 years in China.@*METHODS@#Using follow-up data of 5 540 children and adolescents aged 9 to 18 years conducted from November 2019 to November 2020 in eight provinces of China, latitude and longitude were determined based on school addresses, and the mean monthly average nighttime irradiance at the location of 116 schools was extracted by the nearest neighbor method to obtain the mean outdoor ALAN exposure [unit: nW/(cm2·sr)] for each school. Four indicators of overweight and obesity outcomes were included: Baseline overweight and obesity, persistent overweight and obesity, overweight and obesity progression and overweight and obesity incidence. Mixed effects Logistic regression was used to explore the association between ALAN exposure levels (divided into quintiles Q1-Q5) and baseline overweight and obesity, persistent overweight and obesity, overweight and obesity progression and overweight and obesity incidence. In addition, a natural cubic spline function was used to explore the exposure response association between ALAN exposure (a continuous variable) and the outcomes.@*RESULTS@#The prevalence of baseline overweight and obesity, persistent overweight and obesity, overweight and obesity progression and overweight and obesity incidence among the children and adolescents in this study were 21.6%, 16.3%, 2.9% and 12.8%, respectively. The OR value for the association between ALAN exposure and baseline overweight and obesity was statistically significant when ALAN exposure levels reached Q4 or Q5, 1.90 (95%CI: 1.26-2.86) and 1.77 (95%CI: 1.11-2.83), respectively, compared with the children and adolescents in the Q1 group of ALAN exposure. Similar to the results for baseline overweight and obesity, the OR values for the association with persistent overweight and obesity were 1.89 (95%CI: 1.20-2.99) and 1.82 (95%CI: 1.08-3.06) when ALAN exposure levels reached Q4 or Q5, respectively, but none of the OR values for the association between ALAN and overweight and obesity progression and overweight and obesity incidence were statistically significant. Fitting a natural cubic spline function showed a non-linear trend between ALAN exposure and persistent overweight and obesity.@*CONCLUSION@#There is a positive association between ALAN exposure and overweight and obesity in children and adolescents, and the promotion of overweight obesity in children and adolescents by ALAN tends to have a cumulative effect rather than an immediate effect. In the future, while focusing on the common risk factors for overweight and obesity in children and adolescents, there is a need to improve the overweight and obesity-causing nighttime light exposure environment.

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.

Identification of novel variants in retinitis pigmentosa genes by whole-exome sequencing

SUMMARY OBJECTIVE: Retinitis pigmentosa is an inherited degenerative disorder causing severe retinal dystrophy and visual impairment, mainly with onset in the first or second decades. The next-generation sequencing has become an efficient tool to identify disease-causing mutations in retinitis pigmentosa. The aim of this retrospective study was to investigate novel gene variants and evaluate the utility of whole-exome sequencing in patients with retinitis pigmentosa. METHODS: The medical records of 20 patients with retinitis pigmentosa at Eskişehir City Hospital between September 2019 and February 2022 were analyzed retrospectively. Peripheral venous blood was obtained, followed by the extraction of genomic DNAs. The medical and ophthalmic histories were collected, and ophthalmological examinations were performed. Whole-exome sequencing was performed to determine the genetic etiology of the patients. RESULTS: The proportion of genetically solved cases was 75% (15/20) in the patients with retinitis pigmentosa. Molecular genetic testing identified 13 biallelic and 4 monoallelic mutations in known retinitis pigmentosa genes, including 11 novel variants. According to in silico prediction tools, nine variants were predicted as pathogenic or possibly pathogenic. We identified six previously reported mutations to be associated with retinitis pigmentosa. The age of onset of the patients ranged from 3 to 19, with a mean age of onset of 11.6. All patients had a loss of central vision. CONCLUSION: As the first study of the application of whole-exome sequencing among patients with retinitis pigmentosa in a Turkish cohort, our results may contribute to the characterization of the spectrum of variants related to retinitis pigmentosa in the Turkish population. Future population-based studies will enable us to reveal the detailed genetic epidemiology of retinitis pigmentosa.

Comparison of the effect between night-wearing orthokeratology lens and frame glasses on the treatment of juvenile myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the effects of night-wearing orthokeratology lenses and frame glasses on the treatment of juvenile myopia, and provide reference for the selection of myopia treatment methods in adolescents.METHODS: A prospective study was conducted on 106 adolescent myopia patients who received treatment in our hospital from June to November 2020. According to the wishes of patients, they were divided into two groups with 53 cases in each group. The control group was given regular frame glasses after optometry, while the observation group was given night-wearing orthokeratology lenses. The uncorrected visual acuity(LogMAR), refractive index(spherical equivalent and cylindrical lens power), and ocular biological parameters(axial length, central corneal thickness, anterior chamber depth and lens thickness)were compared between the two groups.RESULTS: The uncorrected visual acuity(LogMAR)of the observation group was lower than that of the control group at 1a after treatment(0.51±0.12 vs. 0.73±0.15), and the spherical equivalent(-0.23±0.05 vs. -5.32±1.35D)and cylindrical lens power(-1.53±0.22 vs. -1.97±0.35DC)were smaller than those of the control group(P&#x0026;#x003C;0.001). The axial length of the eyes in the two groups increased at 1a after treatment and the axial length in the control group was longer(25.53±0.84 vs. 25.95±0.83 mm); the lens thickness of the observation group was increased compared with that before treatment(3.39±0.19 vs. 3.31±0.15 mm; P&#x0026;#x003C;0.05). After 1a treatment, the accommodative amplitude(14.29±1.37 vs. 12.90±1.07D), accommodative facility(11.05±2.09 vs. 7.59±1.82cpm), and total staining rate of corneal epithelium in the observation group were higher than those in the control group(15.1% vs. 1.9%), and the accommodative lag was lower than that in the control group(0.55±0.11 vs. 0.97±0.30D; P&#x0026;#x003C;0.05). There were no significant differences in corneal cell density(3197.23±249.66 vs. 3207.41±258.14 cells/mm2), corneal endothelial cell area(309.27±28.04 vs. 312.62±24.95mm2)and the incidence of complications between the two groups before and after treatment(5.7% vs. 9.4%; P&#x0026;#x003E;0.05).CONCLUSION: Night-wearing orthokeratology lenses can improve uncorrected visual acuity in adolescent patients with myopia, reduce the spherical equivalent and cylindrical lens power, and improve the accommodation-related parameters, but has no significant effect on the corneal function.

Review on health effects of indoor and outdoor artificial light at night / 环境与职业医学

A growing number of urban dwellers are being exposed to excessively bright artificial night light induced by the development of high-intensity, high-density cities around the world. The adverse health effects of artificial light at night (ALAN) are increasingly becoming a global public health issue. Investigating the effects of built environment, especially ALAN, on public health has progressively developed into a cross-disciplinary research hotspot since the World Health Organization launched the Healthy Cities Project. Numerous studies found the links between ALAN and multiple negative health outcomes. However, to date, no review has summarized the health impacts of ALAN in China. This article systematically outlined the progress of research on the health effects of indoor and outdoor ALAN, including sleep disorders, obesity, cancers, cardiovascular diseases, metabolic diseases, cognitive function, and mental health. We pointed out the limitations of current research such as errors in exposure assessment, lack of research in developing countries, weak causal argument, and difficulty in controlling confounding factors. Future research should improve study design, conduct quantitative studies, and explore potential mechanisms, so as to provide scientific evidence for improving urban lighting planning and urban architectural design.

Lesiones del manguito rotador con dolor nocturno y calidad de sueño antes y después del tratamiento / Rotator cuff injuries with nighttime pain and sleep quality before and after treatment

Resumen: Introducción: Evidencia creciente sugiere que las lesiones del hombro que involucran al manguito rotador causan dolor severo y deterioro de la calidad de vida y del sueño. Objetivo: Presentar los resultados de una revisión sistemática sobre la asociación de lesiones del manguito rotador con dolor nocturno y calidad de sueño antes y después del tratamiento. Material y métodos: Se realizó una búsqueda en PubMed limitada a humanos, sin límite de idioma, edad y período de tiempo con los siguientes términos: [rotator cuff tear and (nocturnal pain OR sleep)]. Se utilizaron los criterios PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) para revisiones sistemáticas. Se extrajo información sobre la frecuencia de dolor nocturno y calidad del sueño en pacientes con lesiones del manguito rotador. Resultados: De 123 registros encontrados, 10 estudios fueron incluidos por cumplir criterios, incluyendo 1,516 pacientes. El dolor nocturno afectó de 91-93% de los pacientes; su intensidad media fue de 5.5 puntos de la escala visual análoga (EVA). Cien por ciento de los estudios reportaron alteraciones en la calidad de sueño asociado a lesión del manguito rotador. Tras la reparación, en todos los estudios se reportó disminución de dolor a puntuaciones inferiores a 2 y mejoría de la calidad del sueño. Conclusión: Las lesiones del manguito rotador producen dolor nocturno y alteraciones de la calidad del sueño que mejoran con el tratamiento. Las alteraciones de la calidad del sueño se deben no sólo a dolor, sino a alteraciones en la funcionalidad del hombro.

Abstract: Introduction: Growing evidence suggests that shoulder injuries involving the rotator cuff cause severe pain and deterioration of quality of life and sleep. Objective: To present the results of a systematic review on the association of rotator cuff injuries with nighttime pain and sleep quality before and after treatment. Material and methods: We searched PubMed limited to humans, with no language, age and time period limit with the following terms: [rotator cuff tear and (nocturnal pain OR sleep)]. We used the PRISMA criteria for systematic reviews. Information was extracted on the frequency of nighttime pain and sleep quality in patients with rotator cuff injuries. Results: Of 123 records found, 10 studies were included for meeting criteria, including 1,516 patients. Nighttime pain affected 91-93% of patients; its average intensity was 5.5 points of the EVA. 100% of the studies reported alterations in sleep quality associated with rotator cuff injury. After repair, a decrease in pain to inferior scores of 2 and improvement in sleep quality were reported. Conclusion: Rotator cuff injuries produce nighttime pain and sleep quality disturbances that improve with treatment. Alterations in sleep quality are due not only to pain but to alterations in shoulder functionality.

Association between fixed night work and obesity: a systematic literature review

This systematic review aimed to evaluate the association between fixed night work and overweight or weight gain. PubMed and EMBASE were searched until October 2021 for studies evaluating the association between fixed night work patterns and the risk of overweight or obesity (for cross-sectional designs) or weight gain (for longitudinal designs). The outcomes extracted were mean body mass index (BMI), mean BMI difference, overweight %, obesity %, odds ratio, relative risk, and prevalence ratio. The quality of the report was evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. The protocol was registered at PROSPERO (# 42017080515). In total, 25 studies met the inclusion criteria. All studies were observational, 16 were cross-sectional, three were cohorts (two also had baseline cross-sectional data), and the other eight were cross-sectional at baseline and had longitudinal follow-up studies (six prospective cohorts, one retrospective, one interventional). Most had good reporting quality. The fixed night work definition and weight outcomes varied according to the different studies. Most of them found an association between fixed night work and overweight, obesity, or weight gain. This systematic review reinforces the evidence that fixed night work is associated with overweight or obesity, and prolonged night work exposure leads to weight gain. Future research should be conducted with more accurate measures and a prospective design. Fixed night workers should be monitored and advised, especially those with prolonged exposure.

Repercussions of night shift work on nursing professionals' health and sleep quality / Repercusiones del trabajo nocturno en la calidad del sueño y la salud de profesionales de enfermería / Repercussões do trabalho noturno na qualidade do sono e saúde de trabalhadores de enfermagem

ABSTRACT Objective: to analyze the association between sleep quality, health symptoms and the physical, psychological and social effects of work in Nursing professionals working the night shift. Method: a cross-sectional study conducted with Nursing professionals working the night shift of a hospital institution. The instruments used were a socio-occupational and health symptoms questionnaire, the Assessment Scale for Work-Related Harms, and the Pittsburgh Sleep Quality Index. Data were collected between September 2017 and April 2018.The analysis was performed by means of descriptive and analytical statistics. Results: a total of 139 workers took part in the study and a statistical difference was identified between poor sleep quality and the female gender and physical illness variables and health symptoms such as appetite disorder, sensation of indigestion, flatulence, insomnia, difficulty concentrating, unhappiness, sensation of decreased self-esteem and mood lability. Conclusion: it was verified that Nursing professionals working the night shift experienced poor sleep quality, and that this relationship exerts an impact on physical, psychological and social health. Interventions targeted at raising awareness about sleep hygiene can promote better outcomes in these individuals' health.

RESUMEN Objetivo: analizar la asociación entre la calidad del sueño, síntomas de salud y los efectos físicos, psicológicos y sociales del trabajo en profesionales de Enfermería que se desempeñaban en el turno nocturno. Método: estudio transversal, realizado con trabajadores de Enfermería que se desempeñaban en el turno nocturno de una institución hospitalaria. Se utilizaron los siguientes instrumentos: un cuestionario sociolaboral y de síntomas de salud, la Escala de Evaluación de los Daños Relacionados al Trabajo y el Índice de Calidad del Sueño de Pittsburgh. Los dados se recopilaron entre septiembre de 2017 y abril de 2018. El análisis se realizó por medio da estadística descriptiva y analítica. Resultados: se contó con la participación de 139 trabajadores y se identificó una diferencia estadística entre calidad de sueño deficiente y las variables sexo femenino y padecimiento físico, síntomas de salud como trastornos del apetito, sensación de indigestión, flatulencia, insomnio, dificultad para concentrarse, desdicha, sensación de disminución de la autoestima y labilidad en el estado de ánimo. Conclusión: se verificó que los trabajadores de Enfermería que se desempeñaban en el turno nocturno presentaron calidad de sueño deficiente, y esa relación afecta la salud física, psicológica y social. Intervenciones con el objetivo de generar conciencia sobre la higiene del sueño pueden promover mejores resultados en la salud de estas personas.

RESUMO Objetivo: analisar a associação entre a qualidade do sono, sintomas de saúde e os efeitos físicos, psicológicos e sociais do trabalho em trabalhadores de enfermagem que atuavam no turno noturno. Método: estudo transversal, realizado com trabalhadores de enfermagem que atuavam em instituição hospitalar no turno noturno. Utilizaram-se como instrumentos questionário sociolaboral e de sintomas de saúde, Escala de Avaliação dos Danos Relacionados ao Trabalho e o Índice de Qualidade do Sono de Pittsburgh. Os dados foram coletados entre setembro de 2017 e abril de 2018. A análise foi realizada por meio da estatística descritiva e analítica. Resultados: participaram 139 trabalhadores e identificou-se diferença estatística entre qualidade do sono ruim e as variáveis sexo feminino, adoecimento físico e sintomas de saúde como distúrbio de apetite, sensação de má digestão, flatulência, insônia, dificuldade de concentração, infelicidade, sensação de diminuição autoestima e labilidade de humor. Conclusão: constatou-se que os trabalhadores de enfermagem que atuavam no turno noturno experimentavam qualidade do sono ruim, e essa relação impacta na saúde física, psicológica e social. Intervenções visando à conscientização sobre a higiene do sono podem promover melhores resultados na saúde dessas pessoas.

Quality of sleep among shift work nurses at the Baguio General Hospital: A Pilot Cross - Sectional study

Objective@#The primary objective of this study was to determine the quality of sleep among 12-hour shift-work nurses at the Baguio General Hospital using the Pittsburg Sleep . Quality Index (PSQI)@*Methods@#This was a preliminary cross-sectional study with a primary endpoint of assessing the sleep quality of the participants using the PSQI. The association of sleep quality with individual and work factors was also determined. Design:Cross - Sectional . Setting:Tertiary Government Training Hospital. Patient:154 12-hour shiftwork nurses. @*Results@#The majority (88.96%) of the participants self-reported having poor sleep quality. Among the components of the PSQI, current shift was significantly associated with habitual sleep efficiency (Fisher exact test p < .049). No significant associations were found between demographic characteristics and PSQI Global score, with most respondents having poor sleep quality regardless of participant characteristics. @*Conclusion@#Majority of nurses working in 12-hour shifts had poor sleep quality. Night shift nurses had higher habitual sleep efficiency scores compared to day shift nurses indicating that those working in the night shift had poorer habitual sleep efficiency.

Epidemiological research progress on effects of night shift work on female reproductive health / 环境与职业医学

The International Agency for Research on Cancer (IARC) defines shift work as any arrangement of daily working hours other than the standard daylight hours (typically 7:00/8:00 am–5:00/6:00 pm). To meet the needs of rapid socioeconomic development, shift work is becoming more and more common. The impact of shift work, especially night shift work, on human health cannot be ignored. Female's health is not only important to the well-being of themselves, but also has a far-reaching impact on their children and even their entire family. Increasing epidemiological studies have focused on the effects of night shift work on female's reproductive health. This article reviewed epidemiological evidence of the associations between night shift work and reproductive outcomes, e.g. menstrual cycle, endometriosis, pregnancy rate, adverse pregnancy outcomes, and ovarian cancer. The potential biological mechanisms connecting night shift work to female reproductive health were also introduced, e.g. melatonin regulation, clock gene regulation, and sex hormone regulation. Through this review, we propose to provide a reference for determining occupational risk factors, conducting subsequent relevant studies, and formulating rational health promotion strategies.

Analysis of the influence of night-wear aspheric orthokeratology lens on ocular surface microenvironment / 国际眼科杂志(Guoji Yanke Zazhi)

@#Night-wear aspheric orthokeratology lens(refers to OK lens)is used to correct vision while sleeping at night, which is one of the few ways to prevent myopic children from wearing glasses during the day, so often recommended as the first choice in clinical practice for the myopic population of 8-16 years old. The main effect of OK lens is producing reasonable compression on the surface of the eye to reduce the curvature of the cornea. At present, as a recognized non-surgical method for the treatment of juvenile myopia, the lens material and the optometry level of OK lens have been continuously innovated and upgraded. Meanwhile,because OK lens directly cover the ocular surface, so long-term wearing definitely affects the ocular surface microenvironment, including meibomian glands, tear film, conjunctiva, cornea, ocular surface microorganisms and so on, and even causes the imbalance of these ocular surface microenvironments, thereby leading to the occurrence and development of ocular surface diseases. In order to expect clinicians to give comprehensive consideration when wearing OK lens for teenagers and increase the safety and effectiveness of wearing OK lens, this article analyzed the effects of wearing OK lens on ocular surface meibomian gland morphology, tear film morphology and function, conjunctival microcirculation, corneal cell morphology, ocular surface microorganisms and other factors.

A retrospective case-control study on fast tract laparoscopic transcystic common bill duct exploration: ambulatory surgery versus over-night surgery / 国际外科学杂志

Objective:In order to explore the possibility of expanding the surgical indications of the ambulatory laparoscopic transcystic common bill duct exploration(LTCBDE).Methods:A retrospective case-control study analysis was performed on the clinical data of 585 patients who underwent laparoscopic transcystic common bill duct exploration in the Beijing Friendship Hospital Affiliated to Capital Medical University from January 2015 to December 2018, including 155 cases of the ambulatory LTCBDE (study group) and 430 cases of the overnight LTCBDE (control group). The propensity score was used to match the related variables, and 144 pairs were successfully matched. The two groups were compared in surgery-related indicators, such the preoperative tests, history of acute exacerbation in the last one month, history of upper abdominal surgery, concomitant diseases (high blood pressure, diabetes mellitus, coronary heart disease, cerebrovascular disease and respiratory diseases), american society of anesthesiology (ASA) score, intraoperative bleeding, operation time, total medical costs, unplanned readmission rate. Measurement data with normal distribution were expressed as mean±standard deviation( ± s), chi-square test was used for comparison between groups, and M( Q1, Q3) was used for measurement data with non-normal distribution. Fisher exact probability test and Wilcoxon rank-sum test were used for comparison between groups. Results:The indexes of aspartate aminotransferase (AST), alanine aminotransferase(ALT), total bilirubin, direct bilirubin (DBIL), alkaline phosphatase (ALP), gamma glutamyl transpeptidase (GGT), ASA score, intraoperative bleeding and total medical costs of the study group were 21.8(18.0, 31.0) U/L, 21.5(15.0, 42.5) U/L, 14.2(11.2, 18.6) umol/L, 2.6(2.1, 3.5) μmol/L, 91.0(73.3, 118.5) U/L, 44.5(22.0, 109.8) U/L, 2.0(2.0, 2.0) grade, 7.5(5.0, 10.0) mL, 9 659.0(8 704.8, 10 640.2) yuan respectively, and the control group were 26.0(17.7, 45.3) U/L, 29.5(16.0, 85.5) U/L, 17.2(13.0, 27.5) μmol/L, 3.8(2.4, 8.7) μmol/L, 105.0(81.0, 156.0) U/L, 86.5(25.0, 224.8) U/L, 2.0(2.0, 2.0) grade, 10.0(6.3, 20.0) mL, 14 366.6(11 766.4, 16 764.4) yuan, which the differences between the two groups were statistically significant ( P<0.05). In two groups of the surgery-related indicators, such as the history of acute exacerbation in the last one month, history of upper abdominal surgery, hypertension are significant statistical differences ( P<0.05). Then there were no significant differences in diabetes, coronary heart diseases, cerebrovascular disease, respiratory diseases, surgical time and unplanned readmission rate. Conclusion:The concomitant diseases may not be the absolute contraindications of the ambulatory LTCBDE. More patients can be treated with ambulatory LTCBDE in experienced centers if relevant outpatient assay and examinations can be further improved, risks of surgery and anesthesia can be fully evaluated, and surgical contraindications can be clearly excluded.

Pseudoretinitis pigmentosa due to syphilis: a case report and literature review / Pseudorretinose pigmentária por sífilis: relato de caso e revisão de literatura

ABSTRACT Syphilis is a sexually transmitted infection caused by the spirochete Treponema pallidum. Ocular involvement can occur at any time, and it may affect 10% of patients in the secondary stage, and from 2% to 5% in the tertiary stage. Uveitis is the most common presentation of ocular syphilis, affecting 0.4% to 8% of patients with systemic disease. Chorioretinitis is the most common posterior alteration. We present the case of a 53-year-old male patient, presenting with bilateral low visual acuity and nyctalopia for 3 years. His physical examination revealed decreased pupillary reflex, anterior vitreous cells, physiologic papillae, arteriolar attenuation, reduced foveal reflex, diffuse retinal pigment epithelium atrophy, peripapillary and perivascular punctate pigment accumulation and peripheral chorioretinitis. Full-field electroretinogram was extinct in both eyes. Treponemal syphilis test was positive. Previously diagnosed as retinitis pigmentosa, evolved to blindness, despite proper treatment. Our case shows syphilis as a significant cause of blindness. Atypical presentations of retinitis pigmentosa must warn ophthalmologists to etiologies of pseudoretinitis pigmentosa, such as syphilis.

RESUMO A sífilis é uma infecção sexualmente transmissível causada pela espiroqueta Treponema pallidum. A sífilis ocular pode ocorrer em qualquer estágio da doença, chegando a 10% na forma secundária e a 2% a 5% em sua forma terciária. A uveíte é a manifestação ocular mais comum, ocorrendo em 0,4% a 8% dos pacientes com a doença sistêmica. A coriorretinite é a manifestação mais comum do segmento posterior. Apresentamos o caso de um paciente do sexo masculino, 53 anos, com queixa de baixa acuidade visual e nictalopia há ٣ anos. Seu exame físico revelou lentificação dos reflexos pupilares, celularidade no vítreo anterior, papilas fisiológicas, atenuação arteriolar, redução do reflexo foveal, atrofia difusa do epitélio pigmentar da retina, acúmulo punctato de pigmento em regiões peripapilar e perivascular e coriorretinite periférica. Eletrorretinograma de campo total extinto em ambos os olhos. O teste treponêmico foi positivo. Foi previamente diagnosticado como portador de retinose pigmentar, evoluindo com cegueira, a despeito do tratamento correto instituído. Esse caso mostra a sífilis como importante causadora de cegueira. Casos atípicos de retinose pigmentar devem alertar o oftalmologista para causas de pseudorretinose pigmentar, como a sífilis.

Genetic analysis of the CACNA1F gene in a family affected with incomplete form Schubert-Bornschein type congenital stationary night blindness / 中华眼底病杂志

Objective:To determine the pathogenic gene mutation in a family with incomplete congenital quiescent night blindness (CSNB) of Schubert-Bornschein type.Methods:A retrospective clinical study. In February 2021, one patient and his parents and elder brother from a Han Chinese incomplete CSNB of Schubert-Bornschein type family diagnosed by clinical and genetic examination at Henan Provincial People's Hospital were included in the study. The patient’s medical history, family history were inquired; best corrected visual acuity (BCVA), color vision, fundus color photography, full-field electroretinogram (ERG), and frequency domain optical coherence tomography (OCT) were examined in detail. Five ml of the subject’s peripheral venous blood was collected and the whole genome DNA was extracted. The genomic DNA of the subject was library constructed, and all-exon probes were polymerized for capture. The suspected pathogenic mutation site was verified by Sanger, and the pathogenicity of the gene mutation site was determined by parallel bioinformatics analysis.Results:The BCVA of both eyes of the proband (Ⅱ2) was 0.4; the color vision test could not recognize the red color. Fundus examination showed no obvious abnormalities. The retina thickness in the macular area of both eyes was slightly thinned. ERG examination of the whole field showed that the amplitude of ERG b wave was significantly reduced under the stimulation of binocular dark adaptation 3.0 and showed a negative waveform. The mother of the proband (Ⅰ2) had normal BCVA, color vision, fundus color photography, and frequency domain OCT examination. The full-field ERG examination showed that the amplitude of each eye reaction was slightly reduced, and the amplitude of the dark adaptation shock potential was significantly reduced. Genetic testing showed that the proband (Ⅱ2) had a c.1761dupC hemizygous mutation in exon 14 of the voltage-dependent calcium channel α1F subunit gene ( CACNA1F gene). The results of protein sequence homology analysis showed that the site was highly conserved in multiple species; the results of bioinformatics analysis showed that the CACNA1F gene c.1761dupC (pY588fs) subsequently had a frameshift mutation and became a stop at position 10. Codons appear translational termination in the conserved regions of the protein. According to the standards and guidelines of the American College of Medical Genetics and Genomics, the mutation was judged to be a possible pathogenic variant. The mother of the proband (Ⅰ2) was a carrier of this site mutation. The clinical and genetic test results of the father and elder brother of the proband were not abnormal. Conclusion:CACNA1F gene c.1761dupC is the pathogenic mutation site of the Schubert-Bornschein type incomplete CSNB family.

The impact of sleep deprivation on work performance towards night-shift healthcare workers: An evidence-based case report

Background@#Poor sleep and excessive fatigue among workers can reduce well-being and physical fitness. However, not many studies have mentioned how sleeping deprivation among night-shift healthcare workers impacted their work performance in multiple aspects. @*Method@#We conducted an evidence-based case report (EBCR) of a night shift nurse who was worried about the impact of her sleep deprivation on her work performance in the future due to prior history of needle-stick injuries. We aimed to determine whether sleeping deprivation caused by regular night shifts leads to decreased work performance among night-shift healthcare workers by formulating a clinical question. Evidence was searched systematically using five major journal databases (Proquest, EBSCO-Host, PubMed, ScienceDirect, and Cochrane) and was assessed thoroughly using inclusion and exclusion criteria. @*Results@#Eleven eligible studies were obtained with a medium level of evidence (III-IV), three systematic reviews with meta-analyses (SR-MA), three SR without MA, and five observational studies. All of them were analyzed and critically appraised using Oxford Evidence-Based Medicine and Joanna Briggs Institute tools. We found that reduced quantity and quality of sleep impacted all dimensions of work performance among healthcare professionals, be it in task performance (e.g., skill proficiency), contextual performance (e.g., communication skill and mental health issues), and patient and health worker safety (accident and medication error). It could also encourage counterproductive work behavior, such as absenteeism. Furthermore, sleep deprivation changes circadian rhythms, causing decreased information processing and affective recognition functions in some vital brain areas, ultimately affecting several work dimensions. @*Conclusion@#In conclusion, stakeholders need to adjust proper shift scheduling for health care workers, practice sleep hygiene, maintain physical fitness, and consume nutritional food, positively correlated to health and productivity.