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Sol JA, Covington AC, McCloy AD, Sessums IP, Malek EM, McGinnis GR, Quindry JC. Effects of Acute Sleep Deprivation on the Physiological Response to Woodsmoke and Exercise. J Occup Environ Med 2024; 66:381-387. [PMID: 38383951 PMCID: PMC11073906 DOI: 10.1097/jom.0000000000003071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
OBJECTIVE To evaluate sleep deprivation effects on the acute physiological response to a combined stressor of woodsmoke and exercise. METHODS Ten participants completed two exercise trials (8 hours of sleep vs 4 hours) with woodsmoke. Trials were conducted in a crossover design. Key measures examined before and after each trial included heart rate variability, pulse wave velocity, blood pressure, pulmonary function testing, and oxidative stress. RESULTS Acute sleep deprivation experienced before exercise and woodsmoke exposure did not impact metrics of heart rate variability, pulse wave velocity, pulmonary function testing, blood pressure, or oxidative stress. CONCLUSIONS Acute sleep deprivation did not amplify physiologic metrics in response to moderate-intensity aerobic exercise with inhaled woodsmoke. Although findings do not eliminate the negative impacts of inhaling woodsmoke, more research is needed to understand the acute effects of woodsmoke exposure on the cardiovascular system. 1.
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Affiliation(s)
- Joseph A. Sol
- School of Integrative Physiology and Athletic Training, University of Montana, Missoula, MT
| | - Anna C. Covington
- School of Integrative Physiology and Athletic Training, University of Montana, Missoula, MT
| | - Aidan D.A. McCloy
- School of Integrative Physiology and Athletic Training, University of Montana, Missoula, MT
| | - Izaac P. Sessums
- School of Integrative Physiology and Athletic Training, University of Montana, Missoula, MT
| | - Elias M. Malek
- School of Kinesiology and Nutrition Sciences, University of Nevada – Las Vegas, Las Vegas, NV
| | - Graham R. McGinnis
- School of Kinesiology and Nutrition Sciences, University of Nevada – Las Vegas, Las Vegas, NV
| | - John C. Quindry
- School of Integrative Physiology and Athletic Training, University of Montana, Missoula, MT
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Demareva V, Zayceva I, Viakhireva V, Zhukova M, Selezneva E, Tikhomirova E. Home-Based Dynamics of Sleepiness-Related Conditions Starting at Biological Evening and Later (Beyond Working). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6641. [PMID: 37681781 PMCID: PMC10487394 DOI: 10.3390/ijerph20176641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/17/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023]
Abstract
Shift work requires round-the-clock readiness to perform professional duties, and the workers' performance highly depends on their sleepiness level, which can be underestimated during a shift. Various factors, including the time of day, can influence sleepiness in shift workers. The objective of this study was to explore the dynamics of sleepiness-related conditions assessed through heart rate variability analysis, starting from the biological evening and continuing in vivo (at home), without the need for artificial alertness support. The participants solely performed regular evening household duties. A total of 32 recordings were collected from the Subjective Sleepiness Dynamics Dataset for analysis. At 8:00 p.m. and every 30 min thereafter, the participants completed cyclic sleepiness scales (the KSS and the SSS) until the time they went to bed, while their heart rate was recorded. The results of the study indicated that during the biological evening, high sleepiness is associated with a 'stressed' condition characterized by higher sympathetic activation. Later on, it is associated with a 'drowsy' condition characterized by higher parasympathetic activation and a decline in heart rate variability. Our findings provide evidence that the type of condition experienced during high sleepiness depends on the biological time. This should be taken into account when managing work regimes in shift work and developing alertness detectors.
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Affiliation(s)
- Valeriia Demareva
- Faculty of Social Sciences, Lobachevsky State University of Nizhny Novgorod, 603022 Nizhny Novgorod, Russia
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Steffey MA, Scharf VF, Risselada M, Buote NJ, Griffon D, Winter AL, Zamprogno H. A narrative review of occupational scheduling that impacts fatigue and recovery relevant to veterinarian well-being. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2023; 64:674-683. [PMID: 37397701 PMCID: PMC10286151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Background Sleep insufficiency is a worldwide affliction with serious implications for mental and physical health. Occupational factors play a large role in determining sleep habits. Healthcare workers are particularly susceptible to job-mediated sleep insufficiency and inadequate rest in general. Little is published on sleep practices among veterinarians, and overall recognition of the impacts of inadequate rest within the veterinary profession is poor. Objectives and procedures This review describes occupational factors affecting sufficiency of rest and recovery, reviews veterinary-specific and relevant adjacent literature pertaining to sleep patterns, and discusses potential solutions for addressing occupational schedules contributing to sleep insufficiency and inadequate rest. Online databases were searched to extract contemporary literature pertaining to sleep, insufficient rest, and occupational factors, with a focus on veterinary medicine and other healthcare sectors. Results Occupational factors leading to inadequate rest among healthcare workers include excessive workloads, extended workdays, cumulative days of heavy work hours, and after-hours on-call duty. These factors are prevalent within the veterinary profession and may contribute to widespread insufficient rest and the resulting negative impacts on health and well-being among veterinarians. Conclusion and clinical relevance Sufficient sleep quantity and quality are critical to physical and mental health and are negatively affected by many aspects of the veterinary profession. Critical review of current strategies employed in clinical practice is essential to promote professional fulfillment, health, and well-being among veterinarians.
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Affiliation(s)
- Michele A Steffey
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, 1 Shields Avenue, Davis, California 95616, USA (Steffey); Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA (Scharf ); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, 625 Harrison Street, West Lafayette, Indiana 47907, USA (Risselada); Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, Ithaca, New York 14853, USA (Buote); College of Veterinary Medicine, Western University of Health Sciences, 309 East Second Street, Pomona, California 91766, USA (Griffon); Merck Manuals Department, Merck Sharp & Dohme Corp., Rahway, New Jersey 07065, USA (Winter); Surgery Department, Evidensia Oslo Dyresykehus, Ensjøveien 14, 0655, Oslo, Norway (Zamprogno)
| | - Valery F Scharf
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, 1 Shields Avenue, Davis, California 95616, USA (Steffey); Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA (Scharf ); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, 625 Harrison Street, West Lafayette, Indiana 47907, USA (Risselada); Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, Ithaca, New York 14853, USA (Buote); College of Veterinary Medicine, Western University of Health Sciences, 309 East Second Street, Pomona, California 91766, USA (Griffon); Merck Manuals Department, Merck Sharp & Dohme Corp., Rahway, New Jersey 07065, USA (Winter); Surgery Department, Evidensia Oslo Dyresykehus, Ensjøveien 14, 0655, Oslo, Norway (Zamprogno)
| | - Marije Risselada
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, 1 Shields Avenue, Davis, California 95616, USA (Steffey); Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA (Scharf ); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, 625 Harrison Street, West Lafayette, Indiana 47907, USA (Risselada); Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, Ithaca, New York 14853, USA (Buote); College of Veterinary Medicine, Western University of Health Sciences, 309 East Second Street, Pomona, California 91766, USA (Griffon); Merck Manuals Department, Merck Sharp & Dohme Corp., Rahway, New Jersey 07065, USA (Winter); Surgery Department, Evidensia Oslo Dyresykehus, Ensjøveien 14, 0655, Oslo, Norway (Zamprogno)
| | - Nicole J Buote
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, 1 Shields Avenue, Davis, California 95616, USA (Steffey); Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA (Scharf ); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, 625 Harrison Street, West Lafayette, Indiana 47907, USA (Risselada); Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, Ithaca, New York 14853, USA (Buote); College of Veterinary Medicine, Western University of Health Sciences, 309 East Second Street, Pomona, California 91766, USA (Griffon); Merck Manuals Department, Merck Sharp & Dohme Corp., Rahway, New Jersey 07065, USA (Winter); Surgery Department, Evidensia Oslo Dyresykehus, Ensjøveien 14, 0655, Oslo, Norway (Zamprogno)
| | - Dominique Griffon
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, 1 Shields Avenue, Davis, California 95616, USA (Steffey); Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA (Scharf ); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, 625 Harrison Street, West Lafayette, Indiana 47907, USA (Risselada); Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, Ithaca, New York 14853, USA (Buote); College of Veterinary Medicine, Western University of Health Sciences, 309 East Second Street, Pomona, California 91766, USA (Griffon); Merck Manuals Department, Merck Sharp & Dohme Corp., Rahway, New Jersey 07065, USA (Winter); Surgery Department, Evidensia Oslo Dyresykehus, Ensjøveien 14, 0655, Oslo, Norway (Zamprogno)
| | - Alexandra L Winter
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, 1 Shields Avenue, Davis, California 95616, USA (Steffey); Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA (Scharf ); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, 625 Harrison Street, West Lafayette, Indiana 47907, USA (Risselada); Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, Ithaca, New York 14853, USA (Buote); College of Veterinary Medicine, Western University of Health Sciences, 309 East Second Street, Pomona, California 91766, USA (Griffon); Merck Manuals Department, Merck Sharp & Dohme Corp., Rahway, New Jersey 07065, USA (Winter); Surgery Department, Evidensia Oslo Dyresykehus, Ensjøveien 14, 0655, Oslo, Norway (Zamprogno)
| | - Helia Zamprogno
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California - Davis, 1 Shields Avenue, Davis, California 95616, USA (Steffey); Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, North Carolina 27607, USA (Scharf ); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, 625 Harrison Street, West Lafayette, Indiana 47907, USA (Risselada); Department of Clinical Sciences, Cornell University College of Veterinary Medicine, 930 Campus Road, Ithaca, New York 14853, USA (Buote); College of Veterinary Medicine, Western University of Health Sciences, 309 East Second Street, Pomona, California 91766, USA (Griffon); Merck Manuals Department, Merck Sharp & Dohme Corp., Rahway, New Jersey 07065, USA (Winter); Surgery Department, Evidensia Oslo Dyresykehus, Ensjøveien 14, 0655, Oslo, Norway (Zamprogno)
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Rodrigues MV, Pereira MRG, Monteiro DT, Oliveira PAB. Medical shift work: a narrative review. Rev Bras Med Trab 2023; 21:e2021881. [PMID: 38313097 PMCID: PMC10835396 DOI: 10.47626/1679-4435-2021-881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 02/25/2022] [Indexed: 02/06/2024] Open
Abstract
Shift and night work combine training and practice in medical education, assuming an essential character in some medical specialties. Nevertheless, it is recognized that this work schedule affects biological functions, cognitive performance, and the safety of both patients and workers. The aim of this narrative literature review was to describe current knowledge about the impact of shift and night work in medical professionals. The LILACS, MEDLINE, and SciELO databases were searched for publications between 2010 and 2020 using the terms: "shift work schedule" and "physicians". A total of 12 publications reported outcomes on sleep quality, family relationships, burnout syndrome, and cardiovascular health. Despite these outcomes, the studies highlighted the importance of shift and night work in medical training, reflecting a loss of learning opportunities when limitations are placed on work hours. The studies suggested initiatives to mitigate the effects of shift work, including increased awareness by managers, a culture of respect for resting periods, the encouragement of family support networks, and the availability of natural light in the workplace.
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Affiliation(s)
- Mauricio Vieira Rodrigues
- Medicina Social, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Daniela Trevisan Monteiro
- Medicina Social, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Corrigan SL, Roberts SSH, Warmington SA, Drain JR, Tait JL, Bulmer S, Main LC. Overnight heart rate variability responses to military combat engineer training. APPLIED ERGONOMICS 2023; 107:103935. [PMID: 36371929 DOI: 10.1016/j.apergo.2022.103935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 10/28/2022] [Accepted: 10/29/2022] [Indexed: 06/16/2023]
Abstract
The study aimed to determine if overnight heart rate variability (HRV) is reflective of workload and stress during military training. Measures of cognitive load, perceived exertion, physical activity, nocturnal HRV, cognitive performance and sleep were recorded for a 15-day assessment period in 32 combat engineers. The assessment period consisted of 4 phases, PRE, FIELD, BASE and RECOVERY that exposed trainees to periods of sleep deprivation and restriction. The FIELD phase was characterised by an increase in mood disturbance, perceived exertion, physical activity, HRV and a reduction in sleep quantity (p < 0.05). Measures of HRV returned to PRE-values quicker than subjective wellbeing responses. The combination of sleep duration (β = -0.002, F = 13.42, p < 0.001) and physical activity (metabolic equivalents, β = -0.483, F = 5.95, p = 0.017), the main stressors of the exercise, provided a significant effect in the best predictive model of HRV. The different recovery rates of HRV and subjective wellbeing suggest a different physiological and psychological response.
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Affiliation(s)
- Sean L Corrigan
- Deakin University, Centre for Sport Research, Geelong, Victoria, Australia.
| | | | - Stuart A Warmington
- Deakin University, Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
| | - Jace R Drain
- Defence Science and Technology Group, Fishermans Bend, Victoria, Australia
| | - Jamie L Tait
- Deakin University, Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
| | - Sean Bulmer
- Deakin University, Centre for Sport Research, Geelong, Victoria, Australia
| | - Luana C Main
- Deakin University, Institute for Physical Activity and Nutrition, Geelong, Victoria, Australia
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Sethi PP, Pathania M, Gupta R, Sharma P, Saini LK. Poor quality sleep is associated with greater carotid intima media thickness among otherwise healthy resident doctors. FRONTIERS IN EPIDEMIOLOGY 2023; 2:1044111. [PMID: 38455319 PMCID: PMC10910945 DOI: 10.3389/fepid.2022.1044111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/13/2022] [Indexed: 03/09/2024]
Abstract
Background Sleep is important for maintaining the metabolic processes in the body, and hence, disruption in sleep leads to metabolic derangement and accelerated atherosclerosis. The effect of sleep duration on subclinical atherosclerosis has been examined in several studies; however, data regarding sleep quality is lacking. The study aimed to assess the association between sleep quality and carotid intima-media thickness among healthy young doctors. Materials and Methods This was an observational cross-sectional study among 110 healthy young resident doctors. Anthropometric data were recorded and morning fasting venous blood samples were collected to assess fasting blood sugar, lipid profile and glycosylated haemoglobin (HbA1c). Pittsburgh Sleep Quality Index and Berlin questionnaire assessed subjective sleep quality and risk for obstructive sleep apnea, respectively. Carotid ultrasonography was done to detect the intima-media thickness. Results Average age of the participants was 26.45 (±1.43) years, and 51.8% were male. Self-reported poor sleep quality was found in 54.5%. Carotid intima-media thickness (CIMT) was increased among 44.5% of participants. In the multivariate analysis, only poor sleep quality appeared to be associated with higher CIMT (P < 0.001, OR = 7.4; 95% CI = 2.70-20.32). When different components of sleep quality was analyzed through multivariate logistic regression, subjective sleep onset latency (>30 min), sleep efficiency (<85%) and sleep disturbance was found to be associated with the increased CIMT. Conclusion Poor sleep quality, especially prolonged sleep onset latency, poor sleep efficiency, and sleep disturbance are associated with increased carotid intima-media thickness among healthy young adults.
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Affiliation(s)
| | - Monika Pathania
- Department of Internal Medicine, All India Institute of Medical Science, Rishikesh, India
| | - Ravi Gupta
- Department of Psychiatry, All India Institute of Medical Science, Rishikesh, India
| | - Pankaj Sharma
- Department of Radiodiagnosis, All India Institute of Medical Science, Rishikesh, India
| | - Lokesh Kumar Saini
- Department of Pulmonary Medicine, All India Institute of Medical Science, Rishikesh, India
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Jelmini JD, Ross J, Whitehurst LN, Heebner NR. The effect of extended shift work on autonomic function in occupational settings: A systematic review and meta-analysis. J Occup Health 2023; 65:e12409. [PMID: 37287085 PMCID: PMC10247865 DOI: 10.1002/1348-9585.12409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 04/28/2023] [Accepted: 05/12/2023] [Indexed: 06/09/2023] Open
Abstract
OBJECTIVE To examine the effect of 24-h shift work on autonomic nervous system function via heart rate variability (HRV) methodologies. METHODS Electronic databases (indexed in either PubMed, MEDLINE, CINAHL, SPORTDiscus, or OpenDissertations) were searched from January 1964 to March 2023. A modified Downs and Black checklist was used for assessing methodological quality and the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) approach was used to evaluate the quality of evidence. Study design, study population, study sample, shift work description, and assessment of HRV metrics and methods were extracted from each study. FINDINGS A total of 58 478 study articles were identified, of which 12 articles met inclusion criteria. Sample sizes varied from eight to 60 participants, with the ratio of low- to high-frequency HRV (LF/HF) as the most common frequency-domain variable reported. Of the nine included studies that observed LF/HF, three (33.3%) demonstrated a significant increase after 24-h shift work. Moreover, of the five studies that reported HF, two (40%) noted a significant decrease after 24-h shift work. When observing risk of bias, two (16.6%) studies were low quality, five (41.7%) were moderate quality, and five (41.7%) were high quality. INTERPRETATION There were inconsistent findings demonstrating an effect of 24-h shift work on autonomic function, with a suggested shift away from parasympathetic dominance. Discrepancies in HRV methodologies, such as the duration of recordings and hardware used for measurement, may have contributed to the disparity in findings. In addition, differences in roles and responsibilities across occupations may explain the incongruence in findings across studies.
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Affiliation(s)
- Jacob D. Jelmini
- College of Health Sciences, Sports Medicine Research InstituteUniversity of KentuckyLexingtonKentuckyUSA
| | - Jeremy Ross
- College of Health Sciences, Sports Medicine Research InstituteUniversity of KentuckyLexingtonKentuckyUSA
| | | | - Nicholas R. Heebner
- College of Health Sciences, Sports Medicine Research InstituteUniversity of KentuckyLexingtonKentuckyUSA
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Espejo-Antúnez L, Fernández-Morales C, Hernández-Sánchez S, Cardero-Durán MDLÁ, Toledo-Marhuenda JV, Albornoz-Cabello M. The Impact on the Stress-Associated Autonomic Response of Physiotherapy Students Receiving Interferential Current in an Electrotherapy Training Session. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13348. [PMID: 36293928 PMCID: PMC9603673 DOI: 10.3390/ijerph192013348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
Electrical currents are didactic contents widely applied in the training of physiotherapy students, but the treatment is considered a stressful situation for both the patient who receives it and the student who applies it. The aim of this study was to evaluate the stress-associated autonomic response of physiotherapy students receiving interferential current by measuring and analysing heart rate variability. An observational case-control study was conducted. Ninety healthy male volunteers, all physiotherapy degree students, were enrolled while attending laboratory practice during the 2020-2021 academic year. Participants were randomly allocated to a sham electrotherapy group (44 subjects), in which heart rate variability was recorded for 10 min, both at rest and during the application of sham technique on the lower back (10 min), and an electrotherapy group (46 subjects), applying the same procedure with the electrical current flowing. Outcome measures included baseline (seated position) and postintervention (prone position) time domain parameter, diameters of the Poincaré plot 1 and 2, stress score, and sympathetic/parasympathetic ratio. The sham electrotherapy group exhibited significant increases in time domain parameter (p = 0.027) and diameters of the Poincaré plot 1 (p = 0.032), with a small effect size (d ≤ 0.5). The electrotherapy group exhibited significant increases in time domain parameter and diameters of the Poincaré plot 1 and 2 (p < 0.001) and decreases in the stress score and sympathetic/parasympathetic ratio (p < 0.001), with a large effect size (d > 0.8) other than for the time domain parameter (d = 0.42), indicating increased parasympathetic and decreased sympathetic activity. After interventions, there were significant differences between groups in diameters of the Poincaré plot 2 (p < 0.001), stress score (p = 0.01) and sympathetic/parasympathetic ratio (p = 0.003), with moderate effect size (d > 0.5). The application of the interferential current technique produces stress-associated autonomic response characterized by greater parasympathetic activity and decreased sympathetic activity. Further studies are needed to determine possible adverse effects.
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Affiliation(s)
- Luis Espejo-Antúnez
- Department of Medical-Surgical Therapeutics, Faculty of Medicine and Health Sciences, University of Extremadura, 06006 Badajoz, Spain
| | - Carlos Fernández-Morales
- Department of Medical-Surgical Therapeutics, Faculty of Medicine and Health Sciences, University of Extremadura, 06006 Badajoz, Spain
| | - Sergio Hernández-Sánchez
- Department of Pathology and Surgery (Area of Physiotherapy), Faculty of Medicine, Miguel Hernández University, 03550 Alicante, Spain
| | | | - José Vicente Toledo-Marhuenda
- Department of Pathology and Surgery (Area of Physiotherapy), Faculty of Medicine, Miguel Hernández University, 03550 Alicante, Spain
| | - Manuel Albornoz-Cabello
- Department of Physical Therapy, Faculty of Nursing, Physical Therapy and Podiatry, University of Seville, 41009 Seville, Spain
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Jinghong Y, Junaid Irshad M, Irshad M, Khalil I, Zahoor S, Akram M, Muddasar Saeed M, Jafari-Sales A, Elbossaty WF, Said MB, Aharwal RP, Hamid GA, Mbaye EHS, El-Ashram S, Ataa AMA, Kiliç Ö. Impact of the coronavirus pandemic on mental prosperity of medical care laborers in tertiary consideration hospital: A case report. Medicine (Baltimore) 2022; 101:e29485. [PMID: 35960123 PMCID: PMC9370247 DOI: 10.1097/md.0000000000029485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 04/04/2022] [Accepted: 05/05/2022] [Indexed: 01/04/2023] Open
Abstract
Since the outbreak of the Corona pandemic in December 2019, many people affected, especially medical care laborers, who deal with the treated cases. Coronavirus disease 2019 not only affects the body parts, but also extends to the psychological symptoms. The purpose of this research is to explore the impact of the pandemic on the mental prosperity of the laborers. Clinical staff members from the administration emergency clinic, Lahore, were enlisted. A poll was used to collect data on the segment information, a sleeping disorder, despondency and stress manifestations. Correlation of the segment information and the mental factors were done among the sleeping and non-sleeping disorder samples. All 356 medical service laborers were selected for this investigation. There were manifestations of misery in 222 (62.35%), nervousness in 227 (64.76%), stress in 197 (55.33%) and sleep deprivation in 190 (53.37%) of members. Gentle to extreme side effects of melancholy (91.65% vs 28.9%), nervousness (83.1% vs 41.6%) and stress (84.26% vs 22.22%) were seen predominately in the sleep deprivation gathering (P < .001). Insomnia was more pronounced in the members with low training levels (78.08%) versus post-advanced education (30.9%). Paramedics, attendants, and medical service laborers in confinement/serious consideration units were more inclined to the sleep deprivation (P < .001). Mental prosperity of medical care laborers was influenced because of Coronavirus pandemic. Attendants, paramedics, and those working in the detachment unit showed a critical sleeping disorder. The results and indicators have proven that there is a relationship between the infection with the Corona pandemic and occurrence of disorders in psychological behavior. Therefore, the psychological rehabilitation sessions must be conducted for those infected and those in contact with the Corona cases to relieve the burden of that patients to raise their psychological conditions and support the immune system such that resist against the infection.
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Affiliation(s)
- Yao Jinghong
- Department of Primary Education, College of Humanities and Teacher Education, Wuyi University, Wuyishan City, China
| | - Muhammad Junaid Irshad
- Department of Biochemistry, Faculty of Health Sciences, Hazara University Mansehra KPK, Mansehra, Pakistan
| | - Moin Irshad
- Department of Microbiology, Faculty of Health Sciences, Hazara University Mansehra KPK, Mansehra, Pakistan
| | - Ibrahim Khalil
- Department of Biochemistry, Faculty of Health Sciences, Hazara University Mansehra KPK, Mansehra, Pakistan
| | - Shiza Zahoor
- Department of Allied Health Sciences, University of Azad Jammu and Kashmir, Muzaffarabad, Pakistan
| | - Muhammad Akram
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad, Pakistan
| | - Muhammad Muddasar Saeed
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad, Pakistan
| | - Abolfazl Jafari-Sales
- Department of Biology and Microbiology School of Basic Sciences, Kazerun Branch, Islamic Azad University, Kazerun, Iran
| | | | - Mourad Ben Said
- Service de Microbiologie et Immunologie, Ecole Nationale de Médecine Vétérinaire, University Manouba, Sidi Thabet, Tunisia
- Institut Supérieur de Biotechnologie de Sidi Thabet, Département des Sciences Fondamentales, University Manouba, Sidi Thabet, Tunisia
| | | | - Gamal Abdul Hamid
- Faculty of Medicine & Health Sciences, University of Aden, Aden, Yemen
| | - El Hadji Seydou Mbaye
- BCNet international working group, International Agency for Research on Cancer, World Health Organization, Dakar, Senegal
| | - Saeed El-Ashram
- School of Life Science and Engineering, Foshan University, Foshan, China
- Faculty of Science, Kafrelsheikh University, Kafr el-Sheikh, Egypt
| | - Asaad Mohammed A. Ataa
- Department of Biochemical Technology, Faculty of Applied Science, Thamar University, Dhamar, Yemen
| | - Ömer Kiliç
- Adiyaman University, Pharmacy Faculty, Adiyaman, Turkey
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Xu S, Arnetz JE, Arnetz BB. Applying machine learning to explore the association between biological stress and near misses in emergency medicine residents. PLoS One 2022; 17:e0264957. [PMID: 35259166 PMCID: PMC8903283 DOI: 10.1371/journal.pone.0264957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 02/19/2022] [Indexed: 01/22/2023] Open
Abstract
Physician stress is associated with near misses and adverse medical events. However, little is known about physiological mechanisms linking stress to such events. We explored the utility of machine learning to determine whether the catabolic stress hormone cortisol and the anabolic, anti-stress hormone dehydroepiandrosterone sulfate (DHEA-S), as well as the cortisol to DHEA-S ratio relate to near misses in emergency medicine residents during active duty in a trauma 1 emergency department. Compared to statistical models better suited for inference, machine learning models allow for prediction in situations that have not yet occurred, and thus better suited for clinical applications. This exploratory study used multiple machine learning models to determine possible relationships between biomarkers and near misses. Of the various models tested, support vector machine with radial bias function kernels and support vector machine with linear kernels performed the best, with training accuracies of 85% and 79% respectively. When evaluated on a test dataset, both models had prediction accuracies of around 80%. The pre-shift cortisol to DHEA-S ratio was shown to be the most important predictor in interpretable models tested. Results suggest that interventions that help emergency room physicians relax before they begin their shift could reduce risk of errors and improve patient and physician outcomes. This pilot demonstrates promising results regarding using machine learning to better understand the stress biology of near misses. Future studies should use larger groups and relate these variables to information in electronic medical records, such as objective and patient-reported quality measures.
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Affiliation(s)
- Sonnet Xu
- Troy High School, Troy, Michigan, United States of America
- * E-mail:
| | - Judith E. Arnetz
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, Michigan, United States of America
| | - Bengt B. Arnetz
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, Michigan, United States of America
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11
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El-Mallakh RS, Sampath VP, Horesh N, Lichtstein D. Endogenous Cardiac Steroids in Bipolar Disorder: State of the Art. Int J Mol Sci 2022; 23:ijms23031846. [PMID: 35163766 PMCID: PMC8836531 DOI: 10.3390/ijms23031846] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/01/2022] [Accepted: 02/01/2022] [Indexed: 02/04/2023] Open
Abstract
Bipolar disorder (BD) is a severe psychiatric illness with a poor prognosis and problematic, suboptimal, treatments. Treatments, borne of an understanding of the pathoetiologic mechanisms, need to be developed in order to improve outcomes. Dysregulation of cationic homeostasis is the most reproducible aspect of BD pathophysiology. Correction of ionic balance is the universal mechanism of action of all mood stabilizing medications. Endogenous sodium pump modulators (collectively known as endogenous cardiac steroids, ECS) are steroids which are synthesized in and released from the adrenal gland and brain. These compounds, by activating or inhibiting Na+, K+-ATPase activity and activating intracellular signaling cascades, have numerous effects on cell survival, vascular tone homeostasis, inflammation, and neuronal activity. For the past twenty years we have addressed the hypothesis that the Na+, K+-ATPase-ECS system may be involved in the etiology of BD. This is a focused review that presents a comprehensive model pertaining to the role of ECS in the etiology of BD. We propose that alterations in ECS metabolism in the brain cause numerous biochemical changes that underlie brain dysfunction and mood symptoms. This is based on both animal models and translational human results. There are data that demonstrate that excess ECS induce abnormal mood and activity in animals, while a specific removal of ECS with antibodies normalizes mood. There are also data indicating that circulating levels of ECS are lower in manic individuals, and that patients with BD are unable to upregulate synthesis of ECS under conditions that increase their elaboration in non-psychiatric controls. There is strong evidence for the involvement of ion dysregulation and ECS function in bipolar illness. Additional research is required to fully characterize these abnormalities and define future clinical directions.
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Affiliation(s)
- Rif S. El-Mallakh
- Mood Disorders Research Program, Depression Center, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY 40202, USA
- Correspondence: (R.S.E.-M.); (D.L.)
| | - Vishnu Priya Sampath
- Department of Medical Neurobiology, Faculty of Medicine, The Institute for Medical Research, Israel-Canada, Hadassah Medical School, The Hebrew University, Jerusalem 9112102, Israel; (V.P.S.); (N.H.)
| | - Noa Horesh
- Department of Medical Neurobiology, Faculty of Medicine, The Institute for Medical Research, Israel-Canada, Hadassah Medical School, The Hebrew University, Jerusalem 9112102, Israel; (V.P.S.); (N.H.)
| | - David Lichtstein
- Department of Medical Neurobiology, Faculty of Medicine, The Institute for Medical Research, Israel-Canada, Hadassah Medical School, The Hebrew University, Jerusalem 9112102, Israel; (V.P.S.); (N.H.)
- Correspondence: (R.S.E.-M.); (D.L.)
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12
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Brüggenwirth IMA, Lantinga VA, Rayar M, van den Berg AP, Blokzijl H, Reyntjens KMEM, Porte RJ, de Meijer VE. Prolonged dual hypothermic oxygenated machine preservation (DHOPE-PRO) in liver transplantation: study protocol for a stage 2, prospective, dual-arm, safety and feasibility clinical trial. BMJ Open Gastroenterol 2022; 9:bmjgast-2021-000842. [PMID: 35039326 PMCID: PMC8764996 DOI: 10.1136/bmjgast-2021-000842] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/14/2021] [Indexed: 12/20/2022] Open
Abstract
Introduction End-ischaemic preservation of a donor liver by dual hypothermic oxygenated machine perfusion (DHOPE) for 2 hours prior to transplantation is sufficient to mitigate ischaemia-reperfusion damage and fully restore cellular energy levels. Clinical studies have shown beneficial outcomes after transplantation of liver grafts preserved by DHOPE compared with static cold storage. In addition to graft reconditioning, DHOPE may also be used to prolong preservation time, which could facilitate logistics for allocation and transplantation globally. Methods and analysis This is a prospective, pseudo-randomised, dual-arm, IDEAL-D (Idea, Development, Exploration, Assessment, Long term study-Framework for Devices) stage 2 clinical device trial designed to determine safety and feasibility of prolonged DHOPE (DHOPE-PRO). The end-time of the donor hepatectomy will determine whether the graft will be assigned to the intervention (16:00–3:59 hour) or to the control arm (4:00–15:59 hour). In total, 36 livers will be included in the study. Livers in the intervention group (n=18) will undergo DHOPE-PRO (≥4 hours) until implantation the following morning, whereas livers in the control group (n=18) will undergo regular DHOPE (2 hours) prior to implantation. The primary endpoint of this study is a composite of the occurrence of all (serious) adverse events during DHOPE and up to 30 days after liver transplantation. Ethics and dissemination The protocol was approved by the Medical Ethical Committee of Groningen, METc2020.126 in June 2020, and the study was registered in the Netherlands National Trial Registry (https://www.trialregister.nl/) prior to initiation. Trial registration number NL8740.
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Affiliation(s)
- Isabel M A Brüggenwirth
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Veerle A Lantinga
- Organ Preservation and Resuscitation Unit, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Michel Rayar
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands.,Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Aad P van den Berg
- Hepatology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Hans Blokzijl
- Hepatology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Koen M E M Reyntjens
- Anesthesiology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Robert J Porte
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Vincent E de Meijer
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
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13
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Cortisol and shiftwork: A scoping review. Sleep Med Rev 2021; 64:101581. [DOI: 10.1016/j.smrv.2021.101581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 11/20/2022]
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14
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Summers SJ, Keegan RJ, Flood A, Martin K, McKune A, Rattray B. The Acute Readiness Monitoring Scale: Assessing Predictive and Concurrent Validation. Front Psychol 2021; 12:738519. [PMID: 34630249 PMCID: PMC8498198 DOI: 10.3389/fpsyg.2021.738519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/30/2021] [Indexed: 11/13/2022] Open
Abstract
To complement and enhance readiness-monitoring capability, the Acute Readiness Monitoring Scale (ARMS) was developed: a widely applicable, simple psychometric measure of perceived readiness. While this tool may have widespread utility in sport and military settings, it remains unknown if the ARMS demonstrates predictive and concurrent validity. Here, we investigated whether the ARMS is: (1) responsive to an acute manipulation of readiness using sleep deprivation, (2) relates to biological markers of readiness [cortisol/heart-rate variability (HRV)], and (3) predicts performance on a cognitive task. Thirty young adults (aged 23 ± 4 years; 18 females) participated. All participants engaged in a 24-h sleep deprivation protocol. Participants completed the ARMS, biological measures of readiness (salivary cortisol, HRV), and cognitive performance measures (psychomotor vigilance task) before, immediately after, 24-, and 48-h post-sleep deprivation. All six of the ARMS subscales changed in response to sleep deprivation: scores on each subscale worsened (indicating reductions in perceived readiness) immediately after sleep deprivation, returning to baseline 24/48 h post. Lower perceived readiness was associated with reduced awakening responses in cortisol and predicted worse cognitive performance (slower reaction time). No relationship was observed between the ARMS and HRV, nor between any biological markers of readiness (cortisol/HRV) and cognitive performance. These data suggest that the ARMS may hold practical utility in detecting, or screening for, the wide range of deleterious effects caused by sleep deprivation; may constitute a quick, cheap, and easily interpreted alternative to biological measures of readiness; and may be used to monitor or mitigate potential underperformance on tasks requiring attention and vigilance.
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Affiliation(s)
- Simon J Summers
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Canberra, ACT, Australia.,Brain Stimulation and Rehabilitation (BrainStAR) Lab, Western Sydney University, Penrith, NSW, Australia.,Research School of Biology, Australian National University, Canberra, ACT, Australia
| | - Richard J Keegan
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Canberra, ACT, Australia.,Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Andrew Flood
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia.,Discipline of Psychology, Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Kristy Martin
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Canberra, ACT, Australia.,Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Andrew McKune
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Canberra, ACT, Australia.,Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia.,School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Ben Rattray
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Canberra, ACT, Australia.,Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
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15
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Hajduczok AG, DiJoseph KM, Bent B, Thorp AK, Mullholand JB, MacKay SA, Barik S, Coleman JJ, Paules CI, Tinsley A. Physiologic Response to the Pfizer-BioNTech COVID-19 Vaccine Measured Using Wearable Devices: Prospective Observational Study. JMIR Form Res 2021; 5:e28568. [PMID: 34236995 PMCID: PMC8341091 DOI: 10.2196/28568] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/12/2021] [Accepted: 06/14/2021] [Indexed: 12/23/2022] Open
Abstract
Background The Pfizer-BioNTech COVID-19 vaccine uses a novel messenger RNA technology to elicit a protective immune response. Short-term physiologic responses to the vaccine have not been studied using wearable devices. Objective We aim to characterize physiologic changes in response to COVID-19 vaccination in a small cohort of participants using a wearable device (WHOOP Strap 3.0). This is a proof of concept for using consumer-grade wearable devices to monitor response to COVID-19 vaccines. Methods In this prospective observational study, physiologic data from 19 internal medicine residents at a single institution that received both doses of the Pfizer-BioNTech COVID-19 vaccine was collected using the WHOOP Strap 3.0. The primary outcomes were percent change from baseline in heart rate variability (HRV), resting heart rate (RHR), and respiratory rate (RR). Secondary outcomes were percent change from baseline in total, rapid eye movement, and deep sleep. Exploratory outcomes included local and systemic reactogenicity following each dose and prophylactic analgesic use. Results In 19 individuals (mean age 28.8, SD 2.2 years; n=10, 53% female), HRV was decreased on day 1 following administration of the first vaccine dose (mean –13.44%, SD 13.62%) and second vaccine dose (mean –9.25%, SD 22.6%). RHR and RR showed no change from baseline after either vaccine dose. Sleep duration was increased up to 4 days post vaccination, after an initial decrease on day 1. Increased sleep duration prior to vaccination was associated with a greater change in HRV. Local and systemic reactogenicity was more severe after dose two. Conclusions This is the first observational study of the physiologic response to any of the novel COVID-19 vaccines as measured using wearable devices. Using this relatively small healthy cohort, we provide evidence that HRV decreases in response to both vaccine doses, with no significant changes in RHR or RR. Sleep duration initially decreased following each dose with a subsequent increase thereafter. Future studies with a larger sample size and comparison to other inflammatory and immune biomarkers such as antibody response will be needed to determine the true utility of this type of continuous wearable monitoring in regards to vaccine responses. Our data raises the possibility that increased sleep prior to vaccination may impact physiologic responses and may be a modifiable way to increase vaccine response. These results may inform future studies using wearables for monitoring vaccine responses. Trial Registration ClinicalTrials.gov NCT04304703; https://www.clinicaltrials.gov/ct2/show/NCT04304703
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Affiliation(s)
- Alexander G Hajduczok
- Division of Internal Medicine, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, United States
| | - Kara M DiJoseph
- Division of Internal Medicine, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, United States
| | - Brinnae Bent
- Department of Biomedical Engineering, Duke University, Durham, NC, United States
| | - Audrey K Thorp
- Division of Internal Medicine, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, United States
| | - Jon B Mullholand
- Division of Internal Medicine, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, United States
| | - Stuart A MacKay
- Division of Internal Medicine, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, United States
| | - Sabrina Barik
- Division of Internal Medicine, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, United States
| | - Jamie J Coleman
- Department of Surgery, Denver Health Medical Center, Denver, CO, United States
| | - Catharine I Paules
- Division of Infectious Diseases, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, United States
| | - Andrew Tinsley
- Division of Gastroenterology, Department of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, United States
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16
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Bourdillon N, Jeanneret F, Nilchian M, Albertoni P, Ha P, Millet GP. Sleep Deprivation Deteriorates Heart Rate Variability and Photoplethysmography. Front Neurosci 2021; 15:642548. [PMID: 33897355 PMCID: PMC8060636 DOI: 10.3389/fnins.2021.642548] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/03/2021] [Indexed: 12/21/2022] Open
Abstract
Introduction Sleep deprivation has deleterious effects on cardiovascular health. Using wearable health trackers, non-invasive physiological signals, such as heart rate variability (HRV), photoplethysmography (PPG), and baroreflex sensitivity (BRS) can be analyzed for detection of the effects of partial sleep deprivation on cardiovascular responses. Methods Fifteen participants underwent 1 week of baseline recording (BSL, usual day activity and sleep) followed by 3 days with 3 h of sleep per night (SDP), followed by 1 week of recovery with sleep ad lib (RCV). HRV was recorded using an orthostatic test every morning [root mean square of the successive differences (RMSSD), power in the low-frequency (LF) and high-frequency (HF) bands, and normalized power nLF and nHF were computed]; PPG and polysomnography (PSG) were recorded overnight. Continuous blood pressure and psychomotor vigilance task were also recorded. A questionnaire of subjective fatigue, sleepiness, and mood states was filled regularly. Results RMSSD and HF decreased while nLF increased during SDP, indicating a decrease in parasympathetic activity and a potential increase in sympathetic activity. PPG parameters indicated a decrease in amplitude and duration of the waveforms of the systolic and diastolic periods, which is compatible with increases in sympathetic activity and vascular tone. PSG showed a rebound of sleep duration, efficiency, and deep sleep in RCV compared to BSL. BRS remained unchanged while vigilance decreased during SDP. Questionnaires showed an increased subjective fatigue and sleepiness during SDP. Conclusion HRV and PPG are two markers easily measured with wearable devices and modified by partial sleep deprivation, contradictory to BRS. Both markers showed a decrease in parasympathetic activity, known as detrimental to cardiovascular health.
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Affiliation(s)
- Nicolas Bourdillon
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,be.care SA, Renens, Switzerland
| | | | | | - Patrick Albertoni
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Pascal Ha
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
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17
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Effects of exogenous factors on spatial accuracy in neurosurgery. J Clin Neurosci 2021; 88:135-141. [PMID: 33992172 DOI: 10.1016/j.jocn.2021.03.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 01/18/2021] [Accepted: 03/23/2021] [Indexed: 11/22/2022]
Abstract
The study aimed to assess the effect of exogenous factors such as surgeon posture, surgical instrument length, fatigue after a night shift, exercise and caffeine consumption on the spatial accuracy of neurosurgical manipulations. For the evaluation and simulation of neurosurgical manipulations, a testing device developed by the authors was used. The experimental results were compared using nonparametric analysis (Wilcoxon test) and multivariate analysis, which was performed using mixed models. The results were considered statistically significant at p < 0.05. The study included 11 first-year neurosurgery residents who met the inclusion criteria. Hand support in the sitting position (Wilcoxon test p value = 0.0033), caffeine consumption (p = 0.0058) and the length of the microsurgical instrument (p = 0.0032) had statistically significant influences on the spatial accuracy of surgical manipulations (univariate analysis). The spatial accuracy did not significantly depend on the type of standing position (Wilcoxon test p value = 0.2860), whether the surgeon was standing/sitting (p = 0.1029), fatigue following a night shift (p = 0.3281), or physical exertion prior to surgery (p = 0.2845). When conducting the multivariate analysis, the spatial accuracy significantly depended on the test subject (p < 0.0001), the use of support during the test (p = 0.0001), and the length of the microsurgical instrument (p = 0.0397). To increase the spatial accuracy of microsurgical manipulations, hand support and shorter tools should be used. Caffeine consumption in high doses should also be avoided prior to surgery.
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18
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Khan WAA, Jackson ML, Kennedy GA, Conduit R. A field investigation of the relationship between rotating shifts, sleep, mental health and physical activity of Australian paramedics. Sci Rep 2021; 11:866. [PMID: 33441601 PMCID: PMC7806923 DOI: 10.1038/s41598-020-79093-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 11/27/2020] [Indexed: 12/29/2022] Open
Abstract
Paramedics working on a rotating shift are at an increased risk of developing chronic health issues due to continuous circadian rhythm disruption. The acute effects of shift rotation and objectively measured sleep have rarely been reported in paramedics. This study investigated the relationships between a rotating shift schedule and sleep (using actigraphy), subjective reports of sleepiness, mood, stress and fatigue. Galvanic Skin Response, energy expenditure and physical activity (BodyMedia SenseWear Armband) were also recorded across the shift schedule. Paramedics were monitored for a period of eight consecutive days across pre-shift, day shift, night shift, and 2 days off. Fifteen paramedics (M age = 39.5 and SD = 10.7 years) who worked rotational shifts experienced sleep restriction during night shift compared to pre-shift, day shift and days off (p < 0.001). Night shift was also associated with higher levels of stress (p < 0.05), fatigue (p < 0.05), and sleepiness (p < 0.05). One day off was related to a return to pre-shift functioning. Such shift-related issues have a compounding negative impact on an already stressful occupation with high rates of physical and mental health issues. Therefore, there is an urgent need to investigate methods to reduce rotating shift burden on the health of paramedics. This could be through further research aimed at providing recommendations for shift work schedules with sufficient periods for sleep and recovery from stress.
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Affiliation(s)
- Wahaj Anwar A Khan
- Occupational Health Department, Faculty of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
- Psychology Discipline, School of Health and Biomedical Sciences, College of Science, Engineering and Health, RMIT University, PO Box 71, Bundoora, VIC, 3083, Australia
| | - Melinda L Jackson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
| | - Gerard A Kennedy
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
- School of Health and Life Sciences, Federation University, Ballarat, Australia
- Psychology Discipline, School of Health and Biomedical Sciences, College of Science, Engineering and Health, RMIT University, PO Box 71, Bundoora, VIC, 3083, Australia
| | - Russell Conduit
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia.
- Psychology Discipline, School of Health and Biomedical Sciences, College of Science, Engineering and Health, RMIT University, PO Box 71, Bundoora, VIC, 3083, Australia.
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19
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D'Oliveira TC, Anagnostopoulos A. The Association Between Shift Work And Affective Disorders: A Systematic Review. Chronobiol Int 2020; 38:182-200. [PMID: 33222534 DOI: 10.1080/07420528.2020.1838533] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Atypical working time patterns are known to be associated with adverse physical health consequences. The impact of chronic exposure to shift work on psychological wellbeing and mental health is also reported, but not fully appreciated. We conducted a systematic review of the literature on the association between shift work and affective disorders using the electronic databases Medline, PsycINFO, Embase, Web of Science and Google Scholar. Data extracted included detailed characteristics of shift work, the affective disorders under study, and the population targeted. Some 25 extracted articles satisfied all inclusion and exclusion criteria. Findings of these articles reveal shift work is associated with increases in depressive symptoms (12 studies), anxiety (2 studies), and depression and anxiety (7 studies). Only three studies found no association between shift work and depression. The findings of this review suggest that shift work increases the symptoms of depression and anxiety.
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Abstract
INTRODUCTION Promoting physician wellness in the current environment of increasing burnout presents a great challenge to the Pediatric Orthopaedic Society and its members. Pediatric Orthopaedic Society of North America (POSNA) has been a leader in recognizing this problem and organizing to combat it. The increasing rates of job dissatisfaction, burnout, depression, and suicide demand comprehensive and focused action to identify and address the drivers of burnout. Continuing to ignore this problem endangers our organization, our members, our families, and our patients. METHODS A review of relevant literature and the work of the POSNA wellness committee was completed. RESULTS Addressing the epidemic of burnout requires a sustained effort to address intrinsic factors such as health, performance, and resilience as well as external factors that affect practice efficiency and environment. DISCUSSION AND CONCLUSIONS The goal of this effort is restoration of joy to the practitioners in medicine and more compassionate care for the patients who seek it.
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21
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Maki KA, Burke LA, Calik MW, Watanabe-Chailland M, Sweeney D, Romick-Rosendale LE, Green SJ, Fink AM. Sleep fragmentation increases blood pressure and is associated with alterations in the gut microbiome and fecal metabolome in rats. Physiol Genomics 2020; 52:280-292. [PMID: 32567509 PMCID: PMC7468692 DOI: 10.1152/physiolgenomics.00039.2020] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/08/2020] [Accepted: 06/16/2020] [Indexed: 12/11/2022] Open
Abstract
The gut microbiota, via the production of metabolites entering the circulation, plays a role in blood pressure regulation. Blood pressure is also affected by the characteristics of sleep. To date, no studies have examined relationships among the gut microbiota/metabolites, blood pressure, and sleep. We hypothesized that fragmented sleep is associated with elevated mean arterial pressure, an altered and dysbiotic gut microbial community, and changes in fecal metabolites. In our model system, rats were randomized to 8 h of sleep fragmentation during the rest phase (light phase) or were undisturbed (controls) for 28 consecutive days. Rats underwent sleep and blood pressure recordings, and fecal samples were analyzed during: baseline (days -4 to -1), early sleep fragmentation (days 0-3), midsleep fragmentation (days 6-13), late sleep fragmentation (days 20-27), and recovery/rest (days 28-34). Less sleep per hour during the sleep fragmentation period was associated with increased mean arterial pressure. Analyses of gut microbial communities and metabolites revealed that putative short chain fatty acid-producing bacteria were differentially abundant between control and intervention animals during mid-/late sleep fragmentation and recovery. Midsleep fragmentation was also characterized by lower alpha diversity, lower Firmicutes:Bacteroidetes ratio, and higher Proteobacteria in intervention rats. Elevated putative succinate-producing bacteria and acetate-producing bacteria were associated with lower and higher mean arterial pressure, respectively, and untargeted metabolomics analysis demonstrates that certain fecal metabolites are significantly correlated with blood pressure. These data reveal associations between sleep fragmentation, mean arterial pressure, and the gut microbiome/fecal metabolome and provide insight to links between disrupted sleep and cardiovascular pathology.
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Affiliation(s)
- Katherine A Maki
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
- Nursing Department, Nursing Research and Translational Science, National Institutes of Health, Clinical Center, Bethesda, Maryland
| | - Larisa A Burke
- Office of Research Facilitation, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Michael W Calik
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Miki Watanabe-Chailland
- NMR-Based Metabolomics Core, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Dagmar Sweeney
- Genome Research Core, Research Resources Center, University of Illinois at Chicago, Chicago, Illinois
| | | | - Stefan J Green
- Genome Research Core, Research Resources Center, University of Illinois at Chicago, Chicago, Illinois
| | - Anne M Fink
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
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Ballesio A, Lombardo C, Lucidi F, Violani C. Caring for the carers: Advice for dealing with sleep problems of hospital staff during the COVID-19 outbreak. J Sleep Res 2020; 30:e13096. [PMID: 32515084 PMCID: PMC7300547 DOI: 10.1111/jsr.13096] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/07/2020] [Accepted: 05/08/2020] [Indexed: 12/26/2022]
Abstract
Hospital staff are at the frontline in the COVID‐19 outbreak. The stressors they experience may induce sleep problems in a population already at risk. Sleep deprivation, long shifts and insomnia in hospital staff have been associated with individual, organizational and public health hazards. These include increased risk of mental and somatic disorders, altered immune responses, medical errors, misunderstandings, drowsy driving and burnout. In March 2020, the World Health Organization called for providing access to mental health and counselling for health professionals involved in the COVID‐19 outbreak. To answer this call, we propose practical advice for the management of sleep problems (sleep deprivation, insomnia and shift work) that can be included in supportive interventions. The advice is based on psychobiological principles of sleep regulation and on guidelines for the treatment of insomnia and was implemented within an initiative offering psychological support to the staff of three university hospitals in Rome.
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Affiliation(s)
- Andrea Ballesio
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.,Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Caterina Lombardo
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Fabio Lucidi
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Cristiano Violani
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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23
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Navarro‐Pérez MP, Suller‐Marti A, Bellosta‐Diago E, Roche‐Bueno JC, Santos‐Lasaosa S. Impact of 24‐Hour On‐Call Shifts on Headache in Medical Residents: A Cohort Study. Headache 2020; 60:1427-1431. [DOI: 10.1111/head.13861] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/30/2020] [Accepted: 04/30/2020] [Indexed: 01/05/2023]
Affiliation(s)
- María Pilar Navarro‐Pérez
- Neurology Department Hospital Clínico Universitario Lozano Blesa Zaragoza Spain
- Aragon Institute for Health Research (IIS Aragón) Zaragoza Spain
| | - Ana Suller‐Marti
- Clinical Neurological Sciences Department Schulich School of Medicine and Dentistry Western University London ON Canada
| | - Elena Bellosta‐Diago
- Neurology Department Hospital Clínico Universitario Lozano Blesa Zaragoza Spain
- Aragon Institute for Health Research (IIS Aragón) Zaragoza Spain
| | | | - Sonia Santos‐Lasaosa
- Neurology Department Hospital Clínico Universitario Lozano Blesa Zaragoza Spain
- Aragon Institute for Health Research (IIS Aragón) Zaragoza Spain
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24
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St-Onge MP, Campbell A, Aggarwal B, Taylor JL, Spruill TM, RoyChoudhury A. Mild sleep restriction increases 24-hour ambulatory blood pressure in premenopausal women with no indication of mediation by psychological effects. Am Heart J 2020; 223:12-22. [PMID: 32135337 DOI: 10.1016/j.ahj.2020.02.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 02/06/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Studies assessing the impact of sleep restriction (SR) on blood pressure (BP) are limited by short study length, extreme SR (<4 hours a night), and lack of attention to psychological distress as a possible mediator. METHODS A community-based cohort was assembled with 237 women (age 34.1 ± 13.5 years; body mass index 25.4 ± 5.4 kg/m2), and a randomized, crossover, intervention study was conducted in 41 women (24 completed: age 30.2 ± 6.5 years; body mass index 24.3 ± 2.8 kg/m2) to determine the causal effect of SR on BP. Sleep was maintained as usual (HS) or reduced by 1.5 hours a night (SR) for 6 weeks. In the cohort, associations between sleep and psychosocial factors were evaluated using multivariable models adjusted for demographic and clinical confounders. In the intervention study, in-office BP was measured weekly; ambulatory BP was measured at end point. Psychological factors were assessed at baseline and end point. Mixed-model analyses with total sleep time (TST, main predictor), week and fraction of time spent in physical activity (covariates), and subject (random effect) were performed. RESULTS Among the community cohort, higher perceived stress, stressful events and distress, and lower resilience were associated with shorter sleep, worse sleep quality, and greater insomnia symptoms (P < .05). In the intervention, systolic BP increased as TST decreased (TST × week interaction, [coefficient ± standard error] -0.0097 ± 0.0046, P = .036). Wake ambulatory diastolic blood pressure (-0.059 ± 0.022, P = .021) and mean arterial pressure (-0.067 ± 0.023, P = .018) were higher after SR versus HS. Psychological distress variables were not affected by TST and did not mediate the effects of SR on BP. CONCLUSIONS These results suggest that SR influences CVD risk in women via mechanisms independent of psychological stressors.
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Affiliation(s)
- Marie-Pierre St-Onge
- Sleep center of excellence, Department of Medicine, Columbia University Irving Medical Center, New York, NY; Institute of Human Nutrition, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, NY.
| | - Ayanna Campbell
- Sleep center of excellence, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Brooke Aggarwal
- Sleep center of excellence, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | - Jasmine L Taylor
- Institute of Human Nutrition, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, NY; Tulane Medical Center, New Orleans, LA
| | - Tanya M Spruill
- Department of Population Health, NYU School of Medicine, New York, NY
| | - Arindam RoyChoudhury
- Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, NY
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25
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Bykanov AE, Pitskhelauri DI, Grachev NS, Semenov DE, Sufianov RA, Yashin KS, Matuev KB. Endogenous and Exogenous Factors Affecting the Surgical Technique (Review). Sovrem Tekhnologii Med 2020; 12:93-99. [PMID: 34513059 PMCID: PMC8353673 DOI: 10.17691/stm2020.12.2.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Indexed: 11/20/2022] Open
Abstract
In this review, we analyzed essential factors affecting precise manual movements in microsurgery described in the medical literature. The search for publications in English and Russian languages was conducted in the PubMed database without limitation by the date of publication. The search was carried out according to the following descriptors: surgical procedures, dexterity, microsurgery, caffeine, alcohol, nicotine, physical exercise, sleep deprivation, posture. Only randomized and cohort studies involving doctors and students with surgical specialties were included in the analysis. We did not include papers in which only psychological (non-motor) aspects were studied. Due to the limited number of publications meeting the inclusion criteria and conflicting results in some of them, the presented review does not allow us to formulate unambiguous conclusions and recommendations. Further studies (deep and fundamental) of endogenous and exogenous factors affecting the microsurgical technique are needed.
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Affiliation(s)
- A E Bykanov
- Researcher, N.N. Burdenko National Medical Research Center for Neurosurgery, Ministry of Health of the Russian Federation, 16, 4 Tverskaya-Yamskaya St., Moscow, 125047, Russia
| | - D I Pitskhelauri
- Professor, Head of the 7 Neurosurgical Department, N.N. Burdenko National Medical Research Center for Neurosurgery, Ministry of Health of the Russian Federation, 16, 4 Tverskaya-Yamskaya St., Moscow, 125047, Russia
| | - N S Grachev
- PhD Student, N.N. Burdenko National Medical Research Center for Neurosurgery, Ministry of Health of the Russian Federation, 16, 4 Tverskaya-Yamskaya St., Moscow, 125047, Russia
| | - D E Semenov
- Student, Faculty of Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Malaya Trubetskaya St., Moscow, 119991, Russia
| | - R A Sufianov
- Clinical Resident, 7 Neurosurgical Department, N.N. Burdenko National Medical Research Center for Neurosurgery, Ministry of Health of the Russian Federation, 16, 4 Tverskaya-Yamskaya St., Moscow, 125047, Russia
| | - K S Yashin
- Assistant, Department of Traumatology, Orthopedics, and Neurosurgery, Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - K B Matuev
- Professor, Head of the Scientific and Educational Department, N.N. Burdenko National Medical Research Center for Neurosurgery, Ministry of Health of the Russian Federation, 16, 4 Tverskaya-Yamskaya St., Moscow, 125047, Russia
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