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Alshammari B, Alkubati SA, Alrasheeday A, Pasay-An E, Edison JS, Madkhali N, Al-Sadi AK, Altamimi MS, Alshammari SO, Alshammari AA, Alshammari F. Factors influencing fatigue among patients undergoing hemodialysis: a multi-center cross-sectional study. Libyan J Med 2024; 19:2301142. [PMID: 38194427 PMCID: PMC10786431 DOI: 10.1080/19932820.2023.2301142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/28/2023] [Indexed: 01/11/2024] Open
Abstract
Fatigue has been reported to be the most common symptom experienced by patients receiving hemodialysis (HD) therapy. Fatigue can lead to a reduction in their ability to engage in both routine and self-care activities, which can negatively affect their self-confidence and quality of life. This study aimed to determine the level of fatigue and the factors that affecting its level among patients receiving uHD. METHODS A cross-sectional design was utilized to explore the level of fatigue among patients receiving maintenance HD using the Mul-tidimensional Assessment of Fatigue (MAF) scale. Data were collected from four dialysis centers in two Saudi Arabia cities, Hail and Al-Qassim, between January 2022 and October 2022. RESULTS The questionnaire was completed by 236 patients. Older patients, male patients, and retired pa-tients reported significantly higher levels of fatigue (p < 0.001). In contrast, marital status, educational level, and financial status did not significantly affect the level of fatigue among patients (p = 0.193, 0.285, and 0.126, respectively). Patients who had seven or more dependents reported more fatigue than those who had lower levels of fatigue or who did not have dependents (p = 0.004). In addition, patients who had a regular exercise regimen reported significantly lower fatigue than those who did not have an exercise regimen (p = 0.011). Multiple linear regression demonstrated that employment status (student), comorbidity condition (one chronic disease), dialysis duration, satisfaction with dialysis time, and dialysis time were found to affect the fatigue scores (R2 = 0.302, p ˂ 0.001). CONCLUSION The findings of this study gives a broader understanding of factors influencing fatigue among patients with HD that will help to develop strategies of more focused interventions to reduce fatigue among patients with HD.
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Affiliation(s)
- Bushra Alshammari
- Medical Surgical Nursing Department, College of Nursing, University of Hail, Hail, Saudi Arabia
| | - Sameer A. Alkubati
- Medical Surgical Nursing Department, College of Nursing, University of Hail, Hail, Saudi Arabia
- Department of Nursing, Faculty of Medicine and Health Sciences, Hodeidah University, Hodeida, Yemen
| | - Awatif Alrasheeday
- Nursing Administration Department, College of Nursing, University of Hail, Hail, Saudi Arabia
| | - Eddieson Pasay-An
- Medical Surgical Nursing Department, College of Nursing, University of Hail, Hail, Saudi Arabia
| | - J. Silvia Edison
- Medical Surgical Nursing Department, College of Nursing, University of Hail, Hail, Saudi Arabia
| | - Norah Madkhali
- Department of Nursing, College of Nursing, Jazan University, Jazan, Saudi Arabia
- Oncology Center, Mohammed bin Nasser Hospital, Ministry of Health, Jazan, Saudi Arabia
| | - Ahmed K. Al-Sadi
- Medical Surgical Nursing Department, College of Nursing, University of Hail, Hail, Saudi Arabia
| | | | - Sahar Obeid Alshammari
- Nursing Administration Office, King Salman Specialist Hospital, Hail Health Cluster, Hail, Saudi Arabia
| | - Areej A. Alshammari
- Nursing Administration Office, Aja Long Term Care Hospital, Hail health Cluster, Hail, Saudi Arabia
| | - Farhan Alshammari
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail, Saudi Arabia
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McIntosh MC, Ruple BA, Kontos NJ, Mattingly ML, Lockwood CM, Roberts MD. The effects of a sugar-free amino acid-containing electrolyte beverage on 5-kilometer performance, blood electrolytes, and post-exercise cramping versus a conventional carbohydrate-electrolyte sports beverage and water. J Int Soc Sports Nutr 2024; 21:2296888. [PMID: 38131124 PMCID: PMC10763896 DOI: 10.1080/15502783.2023.2296888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE The purpose of this study was to examine the acute effects of a multi-ingredient, low calorie dietary supplement (MIDS, XTEND® Healthy Hydration) on 5-kilometer (5-km) time trial performance and blood electrolyte concentrations compared to a carbohydrate-electrolyte beverage (CE, GATORADE® Thirst Quencher) and distilled water (W). METHODS During visit 1 (V1), participants (10 men and 10 women, 20-35 years old, BMI ≤ 29 kg/m2, recreationally active) reported to the laboratory whereby the following tests were performed: i) height and weight measurements, ii) body composition analysis, iii) treadmill testing to measure maximal aerobic capacity, and iv) 5-km time trial familiarization. The second visit (V2) was one week after V1 in the morning (0600 - 0900) and participants arrived 12-14 h fasted (no food or drink). The first battery of assessments (V2-T1) included nude body mass, urine specific gravity (USG), a profile of mood states (POMS) questionnaire, and the completion of a visual analogue scale (VAS) questionnaire to quantify cramping. Then heart rate (HR), blood pressure (BP), total body hydration (via bioelectrical impedance spectroscopy [BIS]) were examined. Finally, a measurement of blood markers via finger stick was performed. Participants consumed a randomized beverage (16 fl. oz. of MIDS, 16 fl. oz. of W, or 16 fl. oz. of CE) within 3 min followed by a 45-min rest. Following the rest period, a second battery (V2-T2) was performed whereby participants' USG was assessed and they completed the POMS and VAS questionnaires, and HR, BP, and blood markers were measured. The participants then performed a 5-km treadmill time trial. Immediately following the 5-km time trial, participants completed a third testing battery (V2-T3) that began with blood markers, HR and BP assessments, followed by nude body weight assessment, and the POMS and VAS questionnaires. After 60 min, a fourth battery (V2-T4) was performed that included HR, BP, and blood markers. After sitting quietly for another 60 min a fifth battery assessment was performed (V2-T5) that included participants' USG, POMS and VAS questionnaires, HR, BP, blood markers, and total body hydration. Visits 3 (V3) and 4 (V4) followed the same protocol except a different randomized drink (16 oz. of CE, MIDS, or W) was consumed; all of which were separated by approximately one week. RESULTS No differences occurred between conditions for 5-km time trial completion, indirect calorimetry outcomes during 5-km time trials, USG, or nude mass measurements (p > 0.05 for all relevant statistical tests). However, blood potassium and the sodium/potassium ratio displayed significant interactions (p < 0.05), and post hoc testing indicated these values were better maintained in the MIDS versus other conditions. Post-exercise cramp prevalence was greater in the CE (p < 0.05) and trended higher with W (p = 0.083) compared to the MIDS condition. Post-exercise cramp severity was also elevated with the W and CE beverages (p < 0.05) but not the MIDS (p = 0.211). CONCLUSIONS The MIDS did not affect 5-km time trial performance but exhibited favorable effects on blood electrolyte and post-exercise self-reporting cramp outcomes compared to the CE and W drinks.
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Affiliation(s)
- Mason C. McIntosh
- Nutrabolt Applied and Molecular Sciences Laboratory, Auburn University, School of Kinesiology, Auburn, AL, USA
| | - Bradley A. Ruple
- Nutrabolt Applied and Molecular Sciences Laboratory, Auburn University, School of Kinesiology, Auburn, AL, USA
| | - Nicholas J. Kontos
- Nutrabolt Applied and Molecular Sciences Laboratory, Auburn University, School of Kinesiology, Auburn, AL, USA
| | - Madison L. Mattingly
- Nutrabolt Applied and Molecular Sciences Laboratory, Auburn University, School of Kinesiology, Auburn, AL, USA
| | | | - Michael D. Roberts
- Nutrabolt Applied and Molecular Sciences Laboratory, Auburn University, School of Kinesiology, Auburn, AL, USA
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Sakurada Y, Matsuda Y, Motohashi K, Hasegawa T, Otsuka Y, Nakano Y, Tokumasu K, Yamamoto K, Sunada N, Honda H, Hagiya H, Ueda K, Otsuka F. Clinical characteristics of female long COVID patients with menstrual symptoms: a retrospective study from a Japanese outpatient clinic. J Psychosom Obstet Gynaecol 2024; 45:2305899. [PMID: 38270210 DOI: 10.1080/0167482x.2024.2305899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/07/2024] [Indexed: 01/26/2024] Open
Abstract
PURPOSE To elucidate the impact of long COVID on menstruation and mental health, medical records of patients with long COVID were evaluated. METHODS Symptoms of long COVID, QOL, mental health, and related endocrine data were compared between two groups with and without menstrual disturbances. RESULTS Of 349 female patients who visited our clinic between February 2021 and March 2023, 223 patients with long COVID (aged 18-50 years) were included. Forty-four (19.7%) of the patients had menstrual symptoms associated with long COVID. The patients with menstrual symptoms were older than those without menstrual symptoms (42.5 vs. 38 years). The percentage of patients with menstrual symptoms was higher during the Omicron phase (24%) than during the Preceding (13%) and Delta (12%) phases. Cycle irregularity was the most frequent (in 63.6% of the patients), followed by severe pain (25%), heavy bleeding (20.5%), perimenopausal symptoms (18.2%), and premenstrual syndrome (15.9%). Fatigue and depression were the most frequent complications. Scores for fatigue and for QOL were significantly worse in long COVID patients with menstrual symptoms. Results of endocrine examinations showed significantly increased cortisol levels in patients with menstrual complaints. CONCLUSION Long COVID has an impact on menstrual conditions and on QOL related to menstrual conditions.
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Affiliation(s)
- Yasue Sakurada
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yui Matsuda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kanon Motohashi
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Toru Hasegawa
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yuki Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuhiro Nakano
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kazuki Tokumasu
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Koichiro Yamamoto
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Naruhiko Sunada
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroyuki Honda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hideharu Hagiya
- Department of Infectious Diseases, Okayama University Hospital, Okayama, Japan
| | - Keigo Ueda
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Fumio Otsuka
- Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Department of Infectious Diseases, Okayama University Hospital, Okayama, Japan
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Gervais C, Hjeij D, Fernández-Puerta L, Arbour C. Non-pharmacological interventions for sleep disruptions and fatigue after traumatic brain injury: a scoping review. Brain Inj 2024; 38:403-416. [PMID: 38402580 DOI: 10.1080/02699052.2024.2318599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 02/09/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE The aim of this study was to conduct a scoping review to determine the nature, variety, and volume of empirical evidence on nonpharmacological interventions for sleep disturbances with potential implications for fatigue in adults sustaining a traumatic brain injury (TBI). METHODS A systematic literature search was conducted across four databases to identify primary studies testing a single non-pharmacological intervention or a combination of non-pharmacological interventions for sleep disturbances and fatigue in community-dwelling adults with TBI. RESULTS Sixteen studies were reviewed addressing six non-pharmacological interventions for sleep disruptions and fatigue after TBI including light therapy, cognitive-behavioral therapy, warm footbath application, shiatsu, and sleep hygiene protocol. Non-pharmacological interventions involving light or cognitive-behavioral therapy were reported in 75% of the studies. Actigraphy-based estimation of total sleep time and subjective level of fatigue were frequent outcomes. CONCLUSION While this scoping review has utility in describing existing non-pharmacological approaches to manage sleep and fatigue after TBI, the findings suggest that interventions are often developed without considering TBI individuals' source of motivation and the need for support in self-administration. Future studies may achieve greater sustainability by considering the evolving needs of TBI patients and their families and the drivers and barriers that might influence non-pharmacological intervention use at home.
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Affiliation(s)
- Charles Gervais
- Department of Psychology, Université de Montréal, Montreal, Canada
| | - Danny Hjeij
- Faculty of Nursing, Université de Montréal, Montreal, Canada
| | | | - Caroline Arbour
- Faculty of Nursing, Université de Montréal, Montreal, Canada
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Bergmans RS, Clauw DJ, Flint C, Harris H, Lederman S, Schrepf A. Chronic overlapping pain conditions increase the risk of long COVID features, regardless of acute COVID status. Pain 2024; 165:1112-1120. [PMID: 38112577 PMCID: PMC11017744 DOI: 10.1097/j.pain.0000000000003110] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 12/21/2023]
Abstract
ABSTRACT Chronic overlapping pain conditions (COPCs) refer to conditions that have similar central nervous system pathophysiologic mechanisms driving widespread pain as well as common comorbid symptoms such as fatigue and problems with sleep, memory, and mood. If COPCs predict the onset of long COVID, this could offer a valuable orientation for long COVID-related research and clinical care. This retrospective cohort study aimed to determine whether having a COPC predicts the onset of long COVID features using US electronic health records and 1:1 propensity score matching without replacement. The study cohorts included (1) people with acute COVID (n = 1,038,402), (2) people with acute influenza (n = 262,092), and (3) a noninfected cohort comprising people with a routine healthcare encounter (n = 1,081,593). Having a COPC increased the risk of long COVID features in all 3 study cohorts. Among those with COVID, having a pre-existing COPC increased the risk by 1.47 (95% CI = 1.46, 1.47). In the influenza cohort, COPCs increased the risk by 1.39 (95% CI = 1.38, 1.40). In the noninfected cohort, COPCs increased the risk by 1.57 (95% CI = 1.56, 1.59). These findings reinforce the likelihood that nociplastic mechanisms play a prominent role in long COVID. Recognizing that this ubiquitous nonspecific syndrome occurs frequently in the population can inform precision medicine therapies that avoid the pitfalls of viewing long COVID exclusively in the framework of postinfectious disease.
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Affiliation(s)
- Rachel S. Bergmans
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | - Daniel J. Clauw
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | | | - Herb Harris
- Tonix Pharmaceuticals, Chatham, NJ, United States
| | | | - Andrew Schrepf
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
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Burger D, Vidondo B, Gerber V, Deillon D, Müller A, Scheidegger M, Käser R, Ramseyer A. High-level competition exercise and related fatigue are associated with stride and jumping characteristics in eventing horses. Equine Vet J 2024; 56:631-641. [PMID: 37694590 DOI: 10.1111/evj.13999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 08/10/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Fatigue and related injuries to the musculoskeletal system are among the most frequent reasons for the withdrawal of high-level eventing horses from the sport. The safety of both horse and rider is very important, and early detection of fatigue is crucial. OBJECTIVES To investigate elite eventing horses in competitive events focusing on biomechanical, cardiovascular and metabolic variables across the cross-country test and to identify their potential associations with fatigue. STUDY DESIGN Prospective observational exploratory field study. METHODS Observations on 54 cross-country tests of 33 horses at five competitive, high-level events were evaluated using sternal accelerometric analysis of stride parameters between and at the jumps. Blood lactate concentration and heart rate were determined 10 min after finishing. The differences in kinematic parameters between the course start and end were analysed with mixed models for repeated measures. Associations between blood lactate and heart rate recovery with the kinematic variables were quantified with Pearson correlation coefficients. RESULTS We observed numerous stride characteristics between the jumps and the jumps changing over time during the courses. Blood lactate concentrations were positively correlated with the mean maximal strike power at the jumps in the last minute of the course (r = 0.41; p < 0.001), and the latter was negatively correlated with the mean stride height over the jumps (r = -0.41; p = 0.003). MAIN LIMITATIONS The sample contained horses of varying breeds, sexes and ages, and different horses participated in different events. CONCLUSIONS We identified several kinematic changes during a cross-country test depending on event, speed and fatigue.
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Affiliation(s)
- Dominik Burger
- Swiss Institute of Equine Medicine ISME, University of Bern, Avenches, Switzerland
| | - Beatriz Vidondo
- Veterinary Public Health Institute, University of Bern, Liebefeld, Switzerland
| | - Vinzenz Gerber
- Swiss Institute of Equine Medicine ISME, University of Bern, Avenches, Switzerland
| | | | - Antonia Müller
- Swiss Institute of Equine Medicine ISME, University of Bern, Avenches, Switzerland
| | - Milena Scheidegger
- Swiss Institute of Equine Medicine ISME, University of Bern, Avenches, Switzerland
| | - Rebekka Käser
- Swiss Institute of Equine Medicine ISME, University of Bern, Avenches, Switzerland
| | - Alessandra Ramseyer
- Swiss Institute of Equine Medicine ISME, University of Bern, Avenches, Switzerland
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Ramos-Mejia R, Isoldi G, Ireland PJ, Rodriguez Celin M, Fano V. Evaluation of functionality-mobility in patients with skeletal dysplasias. Application of the STEMS tool ("everyday symptoms and mobility screening tool for skeletal dysplasias"). Am J Med Genet A 2024; 194:e63538. [PMID: 38214061 DOI: 10.1002/ajmg.a.63538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/14/2023] [Accepted: 12/30/2023] [Indexed: 01/13/2024]
Abstract
Individuals with differing forms of skeletal dysplasias (SD) frequently report impaired mobility and symptoms. With the objetive to evaluate mobility and associated symptoms in people with SD at an Argentinian pediatric hospital, using an Argentinian version of the Screening Tool for Everyday Mobility and Symptoms (STEMS), a simple questionnaire that allows clinicians to quickly identify the presence of symptoms associated with mobility in people with SD, while considering different environmental settings and the use of assistive devices, an analytical study of a consecutive sample of patients older than 5 years with SD and their affected relatives was carried out.Diagnosis, comorbidities, socioenvironmental, therapeutic, auxological and mobility variables were recorded. The presence and intensity of symptoms was noted through use of both the STEMS and validated scales. Descriptive, association and correlation analyzes were performed. One hundred and nineteen individuals with SD were enrolled in the study and divided into groups: Osteogenesis Imperfecta (OI, n = 55), Achondroplasia (ACH, n = 36) and Other SD resulting in disproportionate short stature (n = 28). Mobility assistive devices were almost exclusively used by individuals with OI. They were more frequently used by individuals with overweight and obesity, more severe form of the disease and in the outdoor settings. Two thirds (66.4%) of the individuals assessed in this study reported pain, 87.4% reported fatigue, and 58.8% reported both pain and fatigue. The intensity of symptoms was similar between groups and correlated with age and auxological variables. The STEMS was clear, easy and quick to use for identifying presence of pain and fatigue in this population group. The STEMS proved to be a simple and useful tool for evaluating functional mobility and associated symptoms in our population of individuals with SD.
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Affiliation(s)
- Rosario Ramos-Mejia
- Growth and Development Department, Hospital Garrahan, Buenos Aires, Argentina
| | - G Isoldi
- Growth and Development Department, Hospital Garrahan, Buenos Aires, Argentina
| | - P J Ireland
- Queensland Paediatric Rehabilitation Service, Queensland Children's Hospital, South Brisbane, Australia
| | - M Rodriguez Celin
- Shriners Hospital for Children, Chicago, Illinois, USA
- Medical College of Wisconsin Marquette University, Milwaukee, Wisconsin, USA
| | - V Fano
- Growth and Development Department, Hospital Garrahan, Buenos Aires, Argentina
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Barbi C, Temesi J, Giuriato G, Laginestra FG, Martignon C, Moro T, Schena F, Venturelli M, Vernillo G. Skeletal muscle fiber type and TMS-induced muscle relaxation in un fatigued and fatigued knee-extensor muscles. Am J Physiol Regul Integr Comp Physiol 2024; 326:R438-R447. [PMID: 38525536 DOI: 10.1152/ajpregu.00174.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 03/26/2024]
Abstract
The force drop after transcranial magnetic stimulation (TMS) delivered to the motor cortex during voluntary muscle contractions could inform about muscle relaxation properties. Because of the physiological relation between skeletal muscle fiber-type distribution and size and muscle relaxation, TMS could be a noninvasive index of muscle relaxation in humans. By combining a noninvasive technique to record muscle relaxation in vivo (TMS) with the gold standard technique for muscle tissue sampling (muscle biopsy), we investigated the relation between TMS-induced muscle relaxation in unfatigued and fatigued states, and muscle fiber-type distribution and size. Sixteen participants (7F/9M) volunteered to participate. Maximal knee-extensor voluntary isometric contractions were performed with TMS before and after a 2-min sustained maximal voluntary isometric contraction. Vastus lateralis muscle tissue was obtained separately from the participants' dominant limb. Fiber type I distribution and relative cross-sectional area of fiber type I correlated with TMS-induced muscle relaxation at baseline (r = 0.67, adjusted P = 0.01; r = 0.74, adjusted P = 0.004, respectively) and normalized TMS-induced muscle relaxation as a percentage of baseline (r = 0.50, adjusted P = 0.049; r = 0.56, adjusted P = 0.031, respectively). The variance in the normalized peak relaxation rate at baseline (59.8%, P < 0.001) and in the fatigue resistance (23.0%, P = 0.035) were explained by the relative cross-sectional area of fiber type I to total fiber area. Fiber type I proportional area influences TMS-induced muscle relaxation, suggesting TMS as an alternative method to noninvasively inform about skeletal muscle relaxation properties.NEW & NOTEWORTHY Transcranial magnetic stimulation (TMS)-induced muscle relaxation reflects intrinsic muscle contractile properties by interrupting the drive from the central nervous system during voluntary muscle contractions. We showed that fiber type I proportional area influences the TMS-induced muscle relaxation, suggesting that TMS could be used for the noninvasive estimation of muscle relaxation in unfatigued and fatigued human muscles when the feasibility of more direct method to study relaxation properties (i.e., muscle biopsy) is restricted.
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Affiliation(s)
- Chiara Barbi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - John Temesi
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Gaia Giuriato
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Camilla Martignon
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Tatiana Moro
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Federico Schena
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Massimo Venturelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
| | - Gianluca Vernillo
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
- Department of Social Sciences, University of Alberta, Camrose, Alberta, Canada
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Miyazaki K, Ikenaga M, Sato T, Ueshima K, Nawata S, Horimatsu T, Komori E, Kirishima T, Kawabata K, Kawamura T, Kasai H, Suzukamo Y, Matsuzaki K, Kuwabara Y, Nakayama T. A Randomized Controlled Trial of Betamethasone on Fatigue in Patients With Advanced Cancer. J Pain Symptom Manage 2024; 67:393-401.e1. [PMID: 38331232 DOI: 10.1016/j.jpainsymman.2024.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 01/30/2024] [Accepted: 01/31/2024] [Indexed: 02/10/2024]
Abstract
CONTEXT Fatigue is one of the most uncomfortable physical symptoms seen in patients with advanced cancer. Previous studies have reported on the efficacy of corticosteroids from Western countries. OBJECTIVES To assess the effectiveness of 4mg betamethasone improving fatigue among Japanese patients with advanced cancer. METHODS A randomized, double-blind, placebo-controlled trial enrolled eligible patients with advanced cancer expected to survive 1-2 months, with an Eastern Cooperative Oncology Group Performance Status of 2-3, and experiencing fatigue according to the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-15-palliative criteria. Participants received twice-daily oral administration of 2 mg betamethasone (4 mg/d) or placebo for seven days, with fatigue assessed using EORTC QLQ-C15-PAL subscale and numerical rating scale (NRS) score (at baseline and day seven). The trial was registered under the University Hospital Medical Information Network (UMIN)000011913. RESULTS Among the 267 screened patients, 81 were eligible, of which 70 were evaluable (betamethasone, 33; placebo, 37). The mean difference in the EORTC-QLQ-C15-PAL fatigue subscale was -8.2 (95% CIs: -22.3, 0.0; P = 0.178) and in a NRS for fatigue was -1.2 (95% CIs: -2.5, -0.01; P = 0.048), respectively. Emotional function, appetite loss, and global-health were slightly better in the betamethasone group than in the placebo group. CONCLUSION The impact of betamethasone 4 mg/d on alleviating fatigue in patients with advanced cancer in the last weeks of life did not reach statistical significance in the EORTC-QLQ-C15-PAL as the primary endpoint, however, it was significant in the NRS, the secondary endpoint.
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Affiliation(s)
- Kikuko Miyazaki
- Department of Health Informatics (K.M., T.N.), Kyoto University School of Public Health, Kyoto, Japan.
| | - Masayuki Ikenaga
- Department of Palliative Medicine (M.I.), Yodogawa Christian Hospital, Higashiosaka, Japan
| | - Tosiya Sato
- Department of Biostatistics (T.S.), Kyoto University School of Public Health, Kyoto, Japan
| | - Kenji Ueshima
- Institute for Advancement of Clinical and Translational Science (K.U., T.H., H.K., Y.K.), Kyoto University Hospital, Kyoto, Japan
| | - Shuichi Nawata
- Showa University School of Pharmacy (S.N.), Yokohama, Japan
| | - Takahiro Horimatsu
- Institute for Advancement of Clinical and Translational Science (K.U., T.H., H.K., Y.K.), Kyoto University Hospital, Kyoto, Japan
| | | | | | - Kunihiro Kawabata
- Palliative Care Center (K.K.), Tokai Central Hospital, Kagamihara, Japan
| | | | - Hiroi Kasai
- Institute for Advancement of Clinical and Translational Science (K.U., T.H., H.K., Y.K.), Kyoto University Hospital, Kyoto, Japan
| | - Yoshimi Suzukamo
- Department of Physical Medicine and Rehabilitation (Y.S.), Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Keiichi Matsuzaki
- Department Public Health (K.M.), School of Medicine, Kitasato University, Sagamihara, Japan
| | - Yoshihiro Kuwabara
- Institute for Advancement of Clinical and Translational Science (K.U., T.H., H.K., Y.K.), Kyoto University Hospital, Kyoto, Japan; Cancer Control Center (Y.K.), Osaka International Cancer Institute, Osaka, Japan
| | - Takeo Nakayama
- Department of Health Informatics (K.M., T.N.), Kyoto University School of Public Health, Kyoto, Japan
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10
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Tyagi O, Mehta RK. Sex-specific Neural Strategies During Fatiguing Work in Older Adults. Hum Factors 2024; 66:1490-1503. [PMID: 36898850 DOI: 10.1177/00187208231159526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
BACKGROUND Historical biases in ergonomics-related studies have been attributed to lack of participant diversity and sensitivity of measurements to capture variability between diverse groups. We posit that a neuroergonomics approach, that is, study of brain-behavior relationships during fatiguing work, allows for unique insights on sex differences in fatigue mechanisms that are not available via traditional "neck down" measurement approaches. OBJECTIVE This study examined the supraspinal mechanisms of exercise performance under fatigue and determined if there were any sex differences in these mechanisms. METHODS Fifty-nine older adults performed submaximal handgrip contractions until voluntary fatigue. Traditional ergonomics measures, namely, force variability, electromyography (EMG) of arm muscles, and strength and endurance times, and prefrontal and motor cortex hemodynamic responses were recorded. RESULTS There were no significant differences observed between older males and females in fatigability outcomes (i.e., endurance times, strength loss, and EMG activity) and brain activation. Effective connectivity from prefrontal to motor areas was significant for both sexes throughout the task, but during fatigue, males had higher interregional connectivity than females. DISCUSSION While traditional metrics of fatigue were comparable between the sexes, we observed distinct sex-specific neuromotor strategies (i.e., information flow between frontal-motor regions) that were adopted by older adults to maintain motor performance. APPLICATION The findings from this study offer insights into the capabilities and adaptation strategies of older men and women under fatiguing conditions. This knowledge can facilitate in the development of effective and targeted ergonomic strategies that accommodate for the varying physical capacities of diverse worker demographics.
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Affiliation(s)
- Oshin Tyagi
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, USA
| | - Ranjana K Mehta
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, USA
- Department of Mechanical Engineering, Texas A&M University, College Station, TX, USA
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11
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Bock KJ, Kelly K, Pospichal DR, Siengsukon CF, Peltzer J. The Impact of Sleep on the Lives of Women Who Have Breast Cancer-Related Lymphedema: A Qualitative Exploration. Lymphat Res Biol 2024. [PMID: 38648290 DOI: 10.1089/lrb.2023.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
Background: Breast cancer survivors (BCSs) have many lifelong symptoms of anxiety, depression, lymphedema, and fatigue that can be exacerbated by sleep disturbance. However, little is known about unique factors contributing to sleep disturbance among BCSs with lymphedema; this requires further investigation to offer appropriate support and treatment to these individuals. Therefore, the objective of this study was to capture perceptions and experiences of lymphedema and sleep among BCSs with lymphedema. Methods and Results: Qualitative description guided data collection and analysis as part of a mixed-methods investigation to characterize sleep disturbance among BCSs with and without lymphedema. The participants were interviewed one-on-one using a semistructured interview guide. Inductive content analysis was completed using an iterative coding approach, condensing, and categorizing to develop four themes. Seven BCSs with lymphedema participated. From their narratives, four themes were developed: (1) mind and body fatigue are exacerbated by sleep disturbance; (2) fatigue impacted fragile coping and support systems; (3) fatigue influenced self-identity and roles in society; and (4) self-management strategies were used for sleep health. Conclusion: The participants' perceptions of sleep disturbances' impact on their lives endorse further investigation into optimal interventions to improve sleep quality and modify these impactful findings to create a higher quality of life for survivorship.
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Affiliation(s)
- Karen J Bock
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kristen Kelly
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Delainey R Pospichal
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Catherine F Siengsukon
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Jill Peltzer
- School of Nursing, University of Kansas Medical Center, Kansas City, Kansas, USA
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12
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Ippolito M, Einav S, Giarratano A, Cortegiani A. Effects of fatigue on anaesthetist well-being and patient safety: a narrative review. Br J Anaesth 2024:S0007-0912(24)00149-1. [PMID: 38641516 DOI: 10.1016/j.bja.2024.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/19/2024] [Accepted: 03/21/2024] [Indexed: 04/21/2024] Open
Abstract
The elements that render anaesthesia a captivating profession can also foster stress and fatigue. Professionals considering anaesthesia as a career choice should have a comprehensive understanding of the negative consequences of fatigue and its implications for clinical performance and of the available preventive measures. Available evidence suggests that factors unrelated to patient characteristics or condition can affect clinical outcomes where anaesthetists are involved. Workload, nighttime work, and fatigue are persistent issues in anaesthesia and are perceived as presenting greater perioperative risks to patients. Fatigue seems to negatively affect both physical and mental health of anaesthetists. Existing evidence justifies specific interventions by institutions, stakeholders, and scientific societies to address the effects of anaesthetist fatigue. This narrative review summarises current knowledge regarding the effects of fatigue on anaesthetist well-being and patient safety, and discusses potential preventive solutions.
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Affiliation(s)
- Mariachiara Ippolito
- Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy; Department of Anaesthesia Intensive Care and Emergency, University Hospital Policlinico 'Paolo Giaccone', Palermo, Italy
| | - Sharon Einav
- Maccabi Healthcare Services Regional Director Hod HaSharon, Jerusalem, Israel; Hebrew University Faculty of Medicine, Jerusalem, Israel
| | - Antonino Giarratano
- Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy; Department of Anaesthesia Intensive Care and Emergency, University Hospital Policlinico 'Paolo Giaccone', Palermo, Italy
| | - Andrea Cortegiani
- Department of Precision Medicine in Medical, Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Palermo, Italy; Department of Anaesthesia Intensive Care and Emergency, University Hospital Policlinico 'Paolo Giaccone', Palermo, Italy.
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Cheng KC, Chiu YL, Tsai CL, Hsu YL, Tsai YJ. Fatigue Affects Body Acceleration During Vertical Jumping and Agility Tasks in Elite Young Badminton Players. Sports Health 2024:19417381241245908. [PMID: 38634629 DOI: 10.1177/19417381241245908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Badminton is a sport demanding both high aerobic and anaerobic fitness levels, and fatigue can significantly impact game performance. However, relevant studies are limited, and none have employed a wearable inertial measurement unit (IMU) to investigate the effects of fatigue on athletic performance in the field. HYPOTHESIS Overall performance and body acceleration in both time and frequency domains during the fundamental badminton skills of vertical jumping and changes of direction will be affected by fatigue. STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 3. METHODS A total of 38 young badminton players competing at the Division I level participated. Body accelerations while performing vertical jump and agility-T tests before and immediately after undergoing a fatigue protocol were measured by an IMU, positioned at the L4 to L5 level. RESULTS Jumping height decreased significantly by 4 cm (P < 0.01) after fatigue with greater downward acceleration (1.03 m/s2, P < 0.05) during the squatting subphase. Finishing time increased significantly by 50 ms only during the 10-m side-shuffling of the agility-T test (P = 0.02) after fatigue with greater peak and mean accelerations (3.83 m/s2, P = 0.04; 0.43 m/s2, P < 0.01), and higher median and mean frequency (0.38 Hz, P = 0.04, 0.11 Hz, P = 0.01). CONCLUSION This study using a wearable IMU demonstrates the effects of fatigue on body acceleration in badminton players. The frequency-domain analysis further indicated that fatigue might lead to loss of voluntary control of active muscles and increased impacts on the passive elastic elements. CLINICAL RELEVANCE The findings imply that fatigue can lead to diminished athletic performance and highlight the potential for an increased risk of sports injuries. Consequently, maintaining precision in monitoring fatigue is crucial for elite young badminton players.
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Affiliation(s)
- Kai-Chia Cheng
- Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan
| | - Ya-Lan Chiu
- Department of Physical Therapy, National Chung Kung University, Tainan, Taiwan
| | - Chia-Liang Tsai
- Institute of Physical Education, Health and Leisure Studies, National Chung Kung University, Tainan, Taiwan
| | - Yu-Liang Hsu
- Department of Mechanical and Electro-Mechanical Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Yi-Ju Tsai
- Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan
- Department of Physical Therapy, National Chung Kung University, Tainan, Taiwan
- Physical Therapy Center, National Cheng Kung University Hospital, Tainan, Taiwan
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McCallum C, Campbell M, Vines J, Rapley T, Ellis J, Deary V, Hackett K. A Smartphone App to Support Self-Management for People Living With Sjögren's Syndrome: Qualitative Co-Design Workshops. JMIR Hum Factors 2024; 11:e54172. [PMID: 38630530 DOI: 10.2196/54172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/26/2024] [Accepted: 01/31/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Sjögren's syndrome (SS) is the second most common autoimmune rheumatic disease, and the range of symptoms includes fatigue, dryness, sleep disturbances, and pain. Smartphone apps may help deliver a variety of cognitive and behavioral techniques to support self-management in SS. However, app-based interventions must be carefully designed to promote engagement and motivate behavior change. OBJECTIVE We aimed to explore self-management approaches and challenges experienced by people living with SS and produce a corresponding set of design recommendations that inform the design of an engaging, motivating, and evidence-based self-management app for those living with SS. METHODS We conducted a series of 8 co-design workshops and an additional 3 interviews with participants who were unable to attend a workshop. These were audio recorded, transcribed, and initially thematically analyzed using an inductive approach. Then, the themes were mapped to the Self-Determination Theory domains of competency, autonomy, and relatedness. RESULTS Participants experienced a considerable demand in the daily work required in self-managing their SS. The condition demanded unrelenting, fluctuating, and unpredictable mental, physical, and social efforts. Participants used a wide variety of techniques to self-manage their symptoms; however, their sense of competency was undermined by the complexity and interconnected nature of their symptoms and affected by interactions with others. The daily contexts in which this labor was occurring revealed ample opportunities to use digital health aids. The lived experience of participants showed that the constructs of competency, autonomy, and relatedness existed in a complex equilibrium with each other. Sometimes, they were disrupted by tensions, whereas on other occasions, they worked together harmoniously. CONCLUSIONS An SS self-management app needs to recognize the complexity and overlap of symptoms and the complexities of managing the condition in daily life. Identifying techniques that target several symptoms simultaneously may prevent users from becoming overwhelmed. Including techniques that support assertiveness and communication with others about the condition, its symptoms, and users' limitations may support users in their interactions with others and improve engagement in symptom management strategies. For digital health aids (such as self-management apps) to provide meaningful support, they should be designed according to human needs such as competence, autonomy, and relatedness. However, the complexities among the 3 Self-Determination Theory constructs should be carefully considered, as they present both design difficulties and opportunities.
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Affiliation(s)
- Claire McCallum
- Faculty of Engineering, University of Bristol, Bristol, United Kingdom
| | - Miglena Campbell
- Institute for Collective Place Leadership, Teesside University, Middlesbrough, United Kingdom
| | - John Vines
- School of Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Tim Rapley
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Jason Ellis
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Vincent Deary
- Department of Psychology, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Katie Hackett
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, United Kingdom
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Chen Z, Zhang G, Luo Y, Suo Z. Rubber-glass nanocomposites fabricated using mixed emulsions. Proc Natl Acad Sci U S A 2024; 121:e2322684121. [PMID: 38588426 PMCID: PMC11032485 DOI: 10.1073/pnas.2322684121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/22/2024] [Indexed: 04/10/2024] Open
Abstract
Many composites consist of matrices of elastomers and nanoparticles of stiff materials. Such composites often have superior properties and are widely used. Embedding elastomers with nanoparticles commonly necessitates intense shear, using machines like extruders and roll millers, which cut polymer chains and degrade properties. Here, we prepare a rubber-glass nanocomposite by using two aqueous emulsions. Each emulsion is separately prepared with a single species of polymer chains. Each polymer chain is copolymerized with a small amount of silane coupling agent. Upon mixing the two emulsions, as water evaporates, the glassy particles retain the shape, and the rubbery particles change shape to form a continuous matrix. Subsequently, the silane coupling agent condensates, which cross-links the rubbery chains and interlinks the rubbery chains to the glassy particles. The cross-links and interlinks stabilize the nanostructure and lead to superior properties. The nanocomposite simultaneously achieves high modulus (~30 MPa), high toughness (~100 kJ m-2), and high fatigue threshold (~1,000 J m-2). The method of mixed emulsion is environmentally friendly and compatible with various open-air manufacturing processes, such as coat, cast, spray, print, and brush. Additionally, the silane coupling agent can interlink the nanocomposite to other materials. The method of mixed emulsion can be used to fabricate objects of complex shapes, fine features, and prescribed spatial variations of compositions.
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Affiliation(s)
- Zheqi Chen
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA02138
- State Key Laboratory of Chemical Engineering, College of Chemical and Biological Engineering, Zhejiang University, Hangzhou310058, China
| | - Guogao Zhang
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA02138
| | - Yingwu Luo
- State Key Laboratory of Chemical Engineering, College of Chemical and Biological Engineering, Zhejiang University, Hangzhou310058, China
| | - Zhigang Suo
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA02138
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Christodoulou VN, Varvarousis DN, Ntritsos G, Dimopoulos D, Giannakeas N, Vasileiadis GI, Korompilias A, Ploumis A. Robotic assisted and exoskeleton gait training effect in mental health and fatigue of multiple sclerosis patients. A systematic review and a meta-analysis. Disabil Rehabil 2024:1-12. [PMID: 38616570 DOI: 10.1080/09638288.2024.2338197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 03/28/2024] [Indexed: 04/16/2024]
Abstract
PURPOSE Robotic and Exoskeleton Assisted Gait Training (REAGT) has become the mainstream gait training module. Studies are investigating the psychosocial effects of REAGT mostly as secondary outcomes. Our systematic review and meta-analysis aims to investigate the effects of REAGT in MS patients' mental health and fatigue. MATERIALS AND METHODS We searched the electronic databases (Scopus, PubMed, Pedro, Cochrane Trials, Dare) for RCT studies fulfilling our inclusion criteria. A meta-analysis of available assessment tools was conducted calculating the summary mean differences in two different timepoints, before and after the intervention using random-effects models. RESULTS The systematic search of the electronic databases identified 302 studies. Seven RCT studies were considered eligible for data extraction and meta-analysis, according to our eligibility criteria. We were able to obtain adequate data to proceed with a quantitative synthesis for QoL SF36-MC (Mental Component), QoL SF-36 mental and psychosocial subscales, Multiple Sclerosis Quality of Life-54-Mental Health Composite (MSQoL-54-MHC), Patient's Health Questionnaire (PHQ-9) and Fatigue Severity Scale (FSS). CONCLUSIONS Overall, REAGT seems to have a positive effect to Quality of Life, especially in MS patients' perspective of General and Mental Health and a slight positive effect in depression as measured by PHQ-9.Implications for rehabilitationMultiple Sclerosis (MS) decreases physical and non-physical aspects of patients' quality of life perspective.Rehabilitation strategy must take into consideration the non-physical effects of a training intervention.Robotic and Exoskeleton Gait Training has a positive effect in MS patients' non-physical quality of life and a slight positive effect in depression.
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Affiliation(s)
| | | | - Georgios Ntritsos
- Department of Hygiene and Epidemiology, University of Ioannina, Ioannina, Greece
- Department of Informatics and Telecommunications, University of Ioannina, Ioannina, Greece
| | - Dimitrios Dimopoulos
- Department of Physical Medicine and Rehabilitation (PMR), University of Ioannina, Ioannina, Greece
| | - Nikolaos Giannakeas
- Department of Informatics and Telecommunications, University of Ioannina, Ioannina, Greece
| | - Georgios I Vasileiadis
- Department of Physical Medicine and Rehabilitation (PMR), University of Ioannina, Ioannina, Greece
| | | | - Avraam Ploumis
- Department of Physical Medicine and Rehabilitation (PMR), University of Ioannina, Ioannina, Greece
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Alsop T, Cassimatis M, Williams KL, Gomersall SR. Perspectives of people with myasthenia gravis on physical activity and experience of physical activity advice from health professionals in the Australian context: a qualitative study. Disabil Rehabil 2024:1-8. [PMID: 38613411 DOI: 10.1080/09638288.2024.2338877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 03/31/2024] [Indexed: 04/14/2024]
Abstract
PURPOSE Physical activity is an important modifiable determinant of health. There has been a historical aversion to movement in people with myasthenia gravis (MG) due to the pathophysiology of the disease, however, research suggests engagement in physical activity is safe and does not exacerbate symptoms. There are currently no studies investigating the qualitative perspectives of people with MG on physical activity. The aim of this study was to explore perceptions of physical activity, barriers, enablers, and participants' experiences of physical activity advice from health professionals. MATERIALS AND METHODS Semi-structured interviews were used, with verbatim transcripts analysed using content analysis. RESULTS Ten adults (median age 64.5 years) living in Australia with generalised MG were interviewed. Key findings were identified: (1) Physical activity is perceived to be important for general health and for MG; (2) Medical management and social support are key enablers; (3) Fatigue and pain are potential barriers; and (4) Experiences with healthcare professionals were considered insufficient and failed to provide disease specific advice regarding MG and physical activity. CONCLUSION People with MG have unique barriers and enablers to physical activity engagement that clinicians should consider when providing physical activity behaviour change support to this population.
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Affiliation(s)
- Tahlia Alsop
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Marianna Cassimatis
- School of Human Movement and Nutrition Sciences, Health and Wellbeing Centre for Research Innovation, The University of Queensland, Brisbane, Australia
| | - Katrina L Williams
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sjaan R Gomersall
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- School of Human Movement and Nutrition Sciences, Health and Wellbeing Centre for Research Innovation, The University of Queensland, Brisbane, Australia
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Küçükakgün H, Tulek Z, Kılıçaslan K, Uncu JD, Bayrak C, Soltanalizadeh R, Krespi Y. Validation of the Turkish version of the Neurological Fatigue Index for Stroke. Cogn Neuropsychiatry 2024:1-13. [PMID: 38606870 DOI: 10.1080/13546805.2024.2337155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 03/12/2024] [Indexed: 04/13/2024]
Abstract
INTRODUCTION Post-stroke fatigue is an often overlooked problem that hinders recovery. Therefore, stroke patients should be evaluated for fatigue during the recovery period. This study aimed to adapt the Neurological Fatigue Index for Stroke (NFI-Stroke) into the Turkish language. METHODS This methodological study was carried out on 110 stroke patients admitted to a university hospital in Istanbul. In addition to the NFI-Stroke, Functional Independence Measure, National Institutes of Health Stroke Scale, modified-Rankin Scale, Fatigue Severity-Scale, and Stroke Self Efficacy Questionnaire were used to collect data. RESULTS Since the linguistic validity study of the scale has already been carried out, only psychometric properties were evaluated. The items in the scale were grouped under two factors. The Cronbach`s alpha coefficient was found to be 0.96 for the physical sub-dimension and 0.84 for the cognitive sub-dimension. Item-total correlation coefficients were found between 0.74-0.91 for the physical sub-dimension, and 0.82-0.91 for the cognitive sub-dimension. The test-retest evaluation confirmed the consistency of the responses to the scale against time. The scale was correlated with other scales used in the study as expected. CONCLUSIONS The NFI-Stroke will be useful in clinical practice in assessment of fatigue, which may affect the adaptation of patients to rehabilitation.
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Affiliation(s)
- Hilalnur Küçükakgün
- Institute of Graduate Studies, Medical Nursing Doctorate Program, Istanbul University-Cerrahpasa, Istanbul, Türkiye
- Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Zeliha Tulek
- Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Kimya Kılıçaslan
- Institute of Graduate Studies, Medical Nursing Doctorate Program, Istanbul University-Cerrahpasa, Istanbul, Türkiye
- Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Jbid Dursun Uncu
- Institute of Graduate Studies in Health Sciences, Advanced Neurological Sciences Doctorate Program, Istanbul University, Istanbul, Türkiye
- Department of Neurology, Stroke Center, Istinye University Liv Hospital Bahcesehir, Istanbul, Türkiye
| | - Ceren Bayrak
- Department of Neurology, Stroke Center, Istinye University Liv Hospital Bahcesehir, Istanbul, Türkiye
- Institute of Graduate Studies, Neurological Physiotherapy and Rehabilitation Master's Program, Istanbul University-Cerrahpasa, Istanbul, Türkiye
| | - Roya Soltanalizadeh
- Physical Medicine and Rehabilitation Clinic, Istinye University Liv Hospital Bahcesehir, Istanbul, Türkiye
| | - Yakup Krespi
- Department of Neurology, Stroke Center, Istinye University Liv Hospital Bahcesehir, Istanbul, Türkiye
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Jolly AA, Brown RB, Tozer DJ, Hong YT, Fryer TD, Aigbirhio FI, O'Brien JT, Markus HS. Are central and systemic inflammation associated with fatigue in cerebral small vessel disease? Int J Stroke 2024:17474930241245613. [PMID: 38533609 DOI: 10.1177/17474930241245613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
BACKGROUND Fatigue is a common symptom in cerebral small vessel disease (SVD), but its pathogenesis is poorly understood. It has been suggested that inflammation may play a role. We determined whether central (neuro) inflammation and peripheral inflammation were associated with fatigue in SVD. METHODS Notably, 36 patients with moderate-to-severe SVD underwent neuropsychometric testing, combined positron emission tomography and magnetic resonance imaging (PET-MRI) scan, and blood draw for the analysis of inflammatory blood biomarkers. Microglial signal was taken as a proxy for neuroinflammation, assessed with radioligand 11C-PK11195. Of these, 30 subjects had full PET datasets for analysis. We assessed global 11C-PK11195 binding and hotspots of 11C-PK11195 binding in the normal-appearing white matter, lesioned tissue, and combined total white matter. Peripheral inflammation was assessed with serum C-reactive protein (CRP) and using the Olink cardiovascular III proteomic panel comprising 92 biomarkers of cardiovascular inflammation and endothelial activation. Fatigue was assessed using the fatigue severity scale (FSS), the visual analog fatigue scale, and a subscale of the Geriatric Depression Scale. RESULTS Mean (SD) age was 68.7 (11.2) years, and 63.9% were male. Of these, 55.6% showed fatigue on the FSS. Fatigued participants had higher disability scores (p = 0.02), higher total GDS scores (p = 0.02), and more commonly reported a history of depression (p = 0.04). 11C-PK11195 ligand binding in the white matter was not associated with any measure of fatigue. Serum CRP was significantly associated with average fatigue score on FSS (ρ = 0.48, p = 0.004); this association persisted when controlling for age, sex, disability score, and depression (β = 0.49, 95% CI (0.17, 2.26), p = 0.03). Blood biomarkers from the Olink panel showed no association with fatigue. CONCLUSION In symptomatic SVD patients, neuroinflammation, assessed with microglial marker 11C-PK11195, was not associated with fatigue. We found some evidence for a role of systematic inflammation, evidenced by an association between fatigue severity and raised CRP, but further studies are required to understand this relationship and inform whether it could be therapeutically modified to reduce fatigue severity. DATA ACCESS STATEMENT Data for this study are available from the corresponding author upon reasonable request.
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Affiliation(s)
- Amy A Jolly
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Robin B Brown
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Daniel J Tozer
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Young T Hong
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Tim D Fryer
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Franklin I Aigbirhio
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - John T O'Brien
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Hugh S Markus
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
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Dersch R, Torbahn G, Rauer S. Treatment of post-treatment Lyme disease symptoms-a systematic review. Eur J Neurol 2024:e16293. [PMID: 38606630 DOI: 10.1111/ene.16293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/01/2024] [Accepted: 03/19/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND AND PURPOSE Residual symptoms after treatment of Lyme disease, sometimes called post-treatment Lyme disease symptoms (PTLDs), are a matter of ongoing controversy. To guide treatment recommendations, a systematic review was performed of the available literature on specific treatment for PTLDs. METHODS A systematic literature search of MEDLINE and CENTRAL was performed. No restrictions on case definitions, study types or specific interventions were applied to enable a comprehensive overview of the available literature. Risk of bias was assessed using the Cochrane risk of bias tools for randomized controlled trials. Certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach. Outcomes of interest were quality of life, fatigue, depression and cognition as well as adverse events. RESULTS After screening 1274 records, eight eligible randomized controlled trials were included. Heterogeneity was observed regarding inclusion criteria, intervention, length of treatment and outcome measures. For efficacy outcomes, results are presented narratively due to heterogeneity. Eligible studies show no statistically significant difference between antibiotics and placebo regarding quality of life, cognition and depression. Results for fatigue were inconsistent whilst studies with low risk of bias showed no statistically significant difference between antibiotics and placebo. Meta-analysis of safety outcomes showed statistically significantly more adverse events for antibiotics compared to placebo. CONCLUSIONS Available literature on treatment of PTLDs is heterogeneous, but overall shows evidence of no effect of antibiotics regarding quality of life, depression, cognition and fatigue whilst showing more adverse events. Patients with suspected PTLDs should not be treated with antibiotics.
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Affiliation(s)
- Rick Dersch
- Clinic of Neurology and Neurophysiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Gabriel Torbahn
- Department of Pediatrics, Paracelsus Medical University, Klinikum Nürnberg, Universitätsklinik der Paracelsus Medizinischen Privatuniversität Nürnberg, Nuremberg, Germany
| | - Sebastian Rauer
- Clinic of Neurology and Neurophysiology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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21
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Alvar B, O'Bryan SJ, Harris DM. Considerations for assessing sex differences in performance fatiguability. J Physiol 2024. [PMID: 38606983 DOI: 10.1113/jp285951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/03/2024] [Indexed: 04/13/2024] Open
Affiliation(s)
- Brooke Alvar
- Institute for Health and Sport (IHeS), Victoria University, Victoria, Australia
| | - Steven J O'Bryan
- Institute for Health and Sport (IHeS), Victoria University, Victoria, Australia
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Dale M Harris
- Institute for Health and Sport (IHeS), Victoria University, Victoria, Australia
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22
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Dorronzoro-Zubiete E, Castro-Marrero J, Ropero J, Sevillano-Ramos JL, Dolores Hernández M, Sanmartin Sentañes R, Alegre-Martin J, Launois-Obregón P, Martin-Garrido I, Luque Budia A, Lacalle-Remigio JR, Béjar Prado L, Rivera Romero O. Personalized Management of Fatigue in Individuals With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Long COVID Using a Smart Digital mHealth Solution: Protocol for a Participatory Design Approach. JMIR Res Protoc 2024; 13:e50157. [PMID: 38608263 DOI: 10.2196/50157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 07/27/2023] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Fatigue is the most common symptom in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID, impacting patients' quality of life; however, there is currently a lack of evidence-based context-aware tools for fatigue self-management in these populations. OBJECTIVE This study aimed to (1) address fatigue in ME/CFS and long COVID through the development of digital mobile health solutions for self-management, (2) predict perceived fatigue severity using real-time data, and (3) assess the feasibility and potential benefits of personalized digital mobile health solutions. METHODS The MyFatigue project adopts a patient-centered approach within the participatory health informatics domain. Patient representatives will be actively involved in decision-making processes. This study combines inductive and deductive research approaches, using qualitative studies to generate new knowledge and quantitative methods to test hypotheses regarding the relationship between factors like physical activity, sleep behaviors, and perceived fatigue in ME/CFS and long COVID. Co-design methods will be used to develop a personalized digital solution for fatigue self-management based on the generated knowledge. Finally, a pilot study will evaluate the feasibility, acceptance, and potential benefits of the digital health solution. RESULTS The MyFatigue project opened to enrollment in November 2023. Initial results are expected to be published by the end of 2024. CONCLUSIONS This study protocol holds the potential to expand understanding, create personalized self-management approaches, engage stakeholders, and ultimately improve the well-being of individuals with ME/CFS and long COVID. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/50157.
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Affiliation(s)
| | - Jesús Castro-Marrero
- Research Unit in ME/CFS and Long COVID, Division of Rheumatology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jorge Ropero
- Electronic Technology Department, Universidad de Sevilla, Sevilla, Spain
| | | | | | - Ramon Sanmartin Sentañes
- Research Unit in ME/CFS and Long COVID, Division of Rheumatology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Division of Rheumatology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jose Alegre-Martin
- Research Unit in ME/CFS and Long COVID, Division of Rheumatology, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Division of Rheumatology, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Patricia Launois-Obregón
- Physical Medicine and Rehabilitation Department, Vall d'Hebron University Hospital, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Isabel Martin-Garrido
- Unidad de Enfermedades Autoinmunes y Minoritarias, Servicio de Medicina Interna, Virgen del Rocio University Hospital, Sevilla, Spain
| | - Asuncion Luque Budia
- Salud Mental, Unidad de Gestión Clínica, Virgen del Rocio University Hospital, Sevilla, Spain
| | - Juan R Lacalle-Remigio
- Preventive Medicine and Public Health Department, Universidad de Sevilla, Sevilla, Spain
| | - Luis Béjar Prado
- Preventive Medicine and Public Health Department, Universidad de Sevilla, Sevilla, Spain
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23
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Hill EC, Proppe CE, Rivera PM, Lubiak SM, Gonzalez Rojas DH, Lawson JE, Choi H, Mansy H, Keller JL. Blood flow restriction attenuates surface mechanomyography lateral and longitudinal, but not transverse oscillations during fatiguing exercise. Physiol Meas 2024; 45:045002. [PMID: 38507792 DOI: 10.1088/1361-6579/ad360b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 03/20/2024] [Indexed: 03/22/2024]
Abstract
Objective. Surface mechanomyography (sMMG) can measure oscillations of the activated muscle fibers in three axes (i.e.X,Y, andZ-axes) and has been used to describe motor unit activation patterns (X-axis). The application of blood flow restriction (BFR) is common in exercise studies, but the cuff may restrict muscle fiber oscillations. Therefore, the purpose of this investigation was to examine the acute effects of submaximal, fatiguing exercise with and without BFR on sMMG amplitude in theX,Y, andZ-axes among female participants.Approach. Sixteen females (21 ± 1 years) performed two separate exercise bouts to volitional exhaustion that consisted of unilateral, submaximal (50% maximal voluntary isometric contraction [MVIC]) intermittent, isometric, leg extensions with and without BFR. sMMG was recorded and examined across percent time to exhaustion (%TTE) in 20% increments. Separate 2-way repeated measures ANOVA models were constructed: (condition [BFR, non-BFR]) × (time [20, 40, 60, 80, and 100% TTE]) to examine absolute (m·s-2) and normalized (% of pretest MVIC) sMMG amplitude in theX-(sMMG-X),Y-(sMMG-Y), andZ-(sMMG-Z) axes.Main results. The absolute sMMG-X amplitude responses were attenuated with the application of BFR (mean ± SD = 0.236 ± 0.138 m·s-2) relative to non-BFR (0.366 ± 0.199 m·s-2, collapsed across time) and for sMMG-Y amplitude at 60%-100% of TTE (BFR range = 0.213-0.232 m·s-2versus non-BFR = 0.313-0.445 m·s-2). Normalizing sMMG to pretest MVIC removed most, but not all the attenuation which was still evident for sMMG-Y amplitude at 100% of TTE between BFR (72.9 ± 47.2%) and non-BFR (98.9 ± 53.1%). Interestingly, sMMG-Z amplitude was not affected by the application of BFR and progressively decreased across %TTE (0.332 ± 0.167 m·s-2to 0.219 ± 0.104 m·s-2, collapsed across condition.)Significance. The application of BFR attenuated sMMG-X and sMMG-Y amplitude, although normalizing sMMG removed most of this attenuation. Unlike theXandY-axes, sMMG-Z amplitude was not affected by BFR and progressively decreased across each exercise bout potentially tracking the development of muscle fatigue.
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Affiliation(s)
- Ethan C Hill
- School of Kinesiology & Rehabilitation Sciences, University of Central Florida, Orlando, FL 32816, United States of America
- Florida Space Institute, Partnership I, Research Parkway, University of Central Florida, Orlando, FL 32826, United States of America
- College of Medicine, 6850 Lake Nona Blvd, University of Central Florida, Orlando, FL 32827, United States of America
| | - Chris E Proppe
- School of Kinesiology & Rehabilitation Sciences, University of Central Florida, Orlando, FL 32816, United States of America
| | - Paola M Rivera
- School of Kinesiology & Rehabilitation Sciences, University of Central Florida, Orlando, FL 32816, United States of America
| | - Sean M Lubiak
- School of Kinesiology & Rehabilitation Sciences, University of Central Florida, Orlando, FL 32816, United States of America
| | - David H Gonzalez Rojas
- School of Kinesiology & Rehabilitation Sciences, University of Central Florida, Orlando, FL 32816, United States of America
| | - John E Lawson
- School of Kinesiology & Rehabilitation Sciences, University of Central Florida, Orlando, FL 32816, United States of America
| | - Hwan Choi
- College of Engineering, Mechanical and Aerospace, 4328 Scorpius St, University of Central Florida, Orlando, FL 32816, United States of America
| | - Hansen Mansy
- College of Engineering, Mechanical and Aerospace, 4328 Scorpius St, University of Central Florida, Orlando, FL 32816, United States of America
| | - Joshua L Keller
- College of Education and Professional Studies, University of South Alabama, Mobile, AL 36618, United States of America
- College of Medicine, Department of Physiology and Cell Biology, University of South Alabama, Mobile, AL 36618, United States of America
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24
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Tay MRJ, Wong CJ, Aw HZ. Return to Work in Breast Cancer Patients following an Interdisciplinary Rehabilitation Program in a Community-Based Cancer Rehabilitation Center: A Pilot Study. Healthcare (Basel) 2024; 12:805. [PMID: 38610227 PMCID: PMC11011383 DOI: 10.3390/healthcare12070805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/04/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024] Open
Abstract
Despite curative treatment and discharge from acute hospital settings, breast cancer patients often have cancer- and treatment-related morbidity which impairs them from returning to work. Hence, the role of community-based return to work rehabilitation programs is important to help these patients transition back to work. This was a retrospective cohort study involving patients with breast cancer conducted at a community-based cancer rehabilitation center. Patients were involved in an interdisciplinary vocational rehabilitation program involving physiatrists, occupational therapists, physiotherapists and social workers. We recruited 63 patients for this study cohort, with 46 (73.0%) patients ≤ 60 years old. After undergoing the rehabilitation program, there were 37 (58.7%) participants who successfully returned to work. These participants returned to work at either within 6 months (27.0%), 12 months (29.7%) or 24 months (43.2%) after enrollment into the program, with a majority enrolling in white collar jobs. Multivariate regression analysis revealed that significant negative factors for return to work were advanced stage of cancer (p = 0.004), along with clinically significant fatigue, measured on the Brief Fatigue Inventory (p < 0.001). However, perceived work ability (p = 0.020) was found to be a positive factor.
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Affiliation(s)
- Matthew Rong Jie Tay
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
- Singapore Cancer Society Rehabilitation Centre, 30 Hospital Boulevard, National Cancer Centre Singapore Building, Singapore 168583, Singapore
| | - Chin Jung Wong
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
| | - Hui Zhen Aw
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore
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25
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Jie M, Li H, Anwer S, Umer W, Antwi-Afari MF, Xiao EB. Evaluation of sweat-based biomarkers using wearable biosensors for monitoring stress and fatigue: a systematic review. Int J Occup Saf Ergon 2024:1-27. [PMID: 38581242 DOI: 10.1080/10803548.2024.2330242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2024]
Abstract
Objectives. This systematic review aims to report the evaluation of wearable biosensors for the real-time measurement of stress and fatigue using sweat biomarkers. Methods. A thorough search of the literature was carried out in databases such as PubMed, Web of Science and IEEE. A three-step approach for selecting research articles was developed and implemented. Results. Based on a systematic search, a total of 17 articles were included in this review. Lactate, cortisol, glucose and electrolytes were identified as sweat biomarkers. Sweat-based biomarkers are frequently monitored in real time using potentiometric and amperometric biosensors. Wearable biosensors such as an epidermal patch or a sweatband have been widely validated in scientific literature. Conclusions. Sweat is an important biofluid for monitoring general health, including stress and fatigue. It is becoming increasingly common to use biosensors that can measure a wide range of sweat biomarkers to detect fatigue during high-intensity work. Even though wearable biosensors have been validated for monitoring various sweat biomarkers, such biomarkers can only be used to assess stress and fatigue indirectly. In general, this study may serve as a driving force for academics and practitioners to broaden the use of wearable biosensors for the real-time assessment of stress and fatigue.
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Affiliation(s)
- Ma Jie
- Department of Building and Real Estate, Hong Kong Polytechnic University, People's Republic of China
| | - Heng Li
- Department of Building and Real Estate, Hong Kong Polytechnic University, People's Republic of China
| | - Shahnawaz Anwer
- Department of Building and Real Estate, Hong Kong Polytechnic University, People's Republic of China
| | - Waleed Umer
- Department of Mechanical and Construction Engineering, Northumbria University, UK
| | | | - Eric Bo Xiao
- Department of Building and Real Estate, Hong Kong Polytechnic University, People's Republic of China
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26
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Djupedal ILR, Harris A, Svensen E, Pallesen S, Waage S, Nielsen MB, Sunde E, Bjorvatn B, Holmelid Ø, Vedaa Ø. Effects of a work schedule with abated quick returns on insomnia, sleepiness and work-related fatigue: Results from a large-scale cluster randomized controlled trial. Sleep 2024:zsae086. [PMID: 38581363 DOI: 10.1093/sleep/zsae086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Indexed: 04/08/2024] Open
Abstract
STUDY OBJECTIVES To investigate the effect of a work schedule with abated quick returns (i.e., >11 hours between two shifts) on insomnia, daytime sleepiness, and work-related fatigue compared to a shift schedule maintaining the usual number of quick returns. METHODS A two-armed cluster randomized controlled trial including 66 units was conducted at a university hospital in Norway. Units with healthcare workers on rotating shift schedules were randomly assigned to a shift schedule with abated quick returns (intervention) or to continue with a schedule including quick returns as usual (control) for six months. Questionnaires assessed symptoms of insomnia (Bergen Insomnia Scale), daytime sleepiness (Epworth Sleepiness Scale), and work-related fatigue (Revised Swedish Occupational Fatigue Inventory) at baseline and towards the end of the intervention. Data was analyzed using multilevel linear mixed-effects models, and Cohen's d was used to calculate the effect size between groups. RESULTS Overall, 1314 healthcare workers (85.2% female) completed the baseline questionnaire (response rate 49.1%), and 552 completed the follow-up questionnaire. The intervention reduced quick returns from an average of 13.2 (SD=8.7) to 6.7 (SD=6.0), while the control group's average remained relatively unchanged from 13.2 (SD=8.7) to 12.0 (SD=9.3). Results showed a small improvement in symptoms of insomnia (BIS; d=-0.13, p=0.022) and daytime sleepiness (ESS; d=-0.14, p=0.013) in favor of the intervention. No effects were observed on work-related fatigue. CONCLUSIONS Reducing the number of quick returns resulted in improvements in insomnia and daytime sleepiness. The findings highlight the importance of sufficient rest time in the work schedule of healthcare workers.
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Affiliation(s)
- Ingebjørg Louise Rockwell Djupedal
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Norway
| | - Anette Harris
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Erling Svensen
- Department of Human Resources, Haukeland University Hospital, Bergen
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Siri Waage
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Morten Birkeland Nielsen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Erlend Sunde
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Bjørn Bjorvatn
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Øystein Holmelid
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Øystein Vedaa
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, Norway
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Martinez-Mondragon M, Urriolagoitia-Sosa G, Romero-Ángeles B, García-Laguna MA, Laguna-Canales AS, Pérez-Partida JC, Mireles-Hernández J, Carrasco-Hernández F, Urriolagoitia-Calderón GM. Biomechanical Fatigue Behavior of a Dental Implant Due to Chewing Forces: A Finite Element Analysis. Materials (Basel) 2024; 17:1669. [PMID: 38612181 PMCID: PMC11012472 DOI: 10.3390/ma17071669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/20/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024]
Abstract
The use of titanium as a biomaterial for the treatment of dental implants has been successful and has become the most viable and common option. However, in the last three decades, new alternatives have emerged, such as polymers that could replace metallic materials. The aim of this research work is to demonstrate the structural effects caused by the fatigue phenomenon and the comparison with polymeric materials that may be biomechanically viable by reducing the stress shielding effect at the bone-implant interface. A numerical simulation was performed using the finite element method. Variables such as Young's modulus, Poisson's coefficient, density, yield strength, ultimate strength, and the S-N curve were included. Prior to the simulation, a representative digital model of both a dental implant and the bone was developed. A maximum load of 550 N was applied, and the analysis was considered linear, homogeneous, and isotropic. The results obtained allowed us to observe the mechanical behavior of the dental implant by means of displacements and von Mises forces. They also show the critical areas where the implant tends to fail due to fatigue. Finally, this type of non-destructive analysis proves to be versatile, avoids experimentation on people and/or animals, and reduces costs, and the iteration is unlimited in evaluating various structural parameters (geometry, materials, properties, etc.).
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Affiliation(s)
- Miguel Martinez-Mondragon
- Instituto Politécnico Nacional, Escuela Superior de Ingeniería Mecánica y Eléctrica, Sección de Estudios de Posgrado e Investigación, Unidad Profesional Adolfo López Mateos Zacatenco, Edificio 5, 2do, Piso, Col. Lindavista, Del. Gustavo A. Madero, Ciudad de México C.P. 07320, Mexico; (B.R.-Á.)
| | - Guillermo Urriolagoitia-Sosa
- Instituto Politécnico Nacional, Escuela Superior de Ingeniería Mecánica y Eléctrica, Sección de Estudios de Posgrado e Investigación, Unidad Profesional Adolfo López Mateos Zacatenco, Edificio 5, 2do, Piso, Col. Lindavista, Del. Gustavo A. Madero, Ciudad de México C.P. 07320, Mexico; (B.R.-Á.)
| | - Beatriz Romero-Ángeles
- Instituto Politécnico Nacional, Escuela Superior de Ingeniería Mecánica y Eléctrica, Sección de Estudios de Posgrado e Investigación, Unidad Profesional Adolfo López Mateos Zacatenco, Edificio 5, 2do, Piso, Col. Lindavista, Del. Gustavo A. Madero, Ciudad de México C.P. 07320, Mexico; (B.R.-Á.)
| | - Miguel Angel García-Laguna
- Instituto Politécnico Nacional, Escuela Superior de Ingeniería Mecánica y Eléctrica, Sección de Estudios de Posgrado e Investigación, Unidad Profesional Adolfo López Mateos Zacatenco, Edificio 5, 2do, Piso, Col. Lindavista, Del. Gustavo A. Madero, Ciudad de México C.P. 07320, Mexico; (B.R.-Á.)
| | - Aldo Saul Laguna-Canales
- Instituto Politécnico Nacional, Escuela Superior de Ingeniería Mecánica y Eléctrica, Sección de Estudios de Posgrado e Investigación, Unidad Profesional Adolfo López Mateos Zacatenco, Edificio 5, 2do, Piso, Col. Lindavista, Del. Gustavo A. Madero, Ciudad de México C.P. 07320, Mexico; (B.R.-Á.)
| | - Juan Carlos Pérez-Partida
- Instituto Politécnico Nacional, Escuela Superior de Ingeniería Mecánica y Eléctrica, Sección de Estudios de Posgrado e Investigación, Unidad Profesional Adolfo López Mateos Zacatenco, Edificio 5, 2do, Piso, Col. Lindavista, Del. Gustavo A. Madero, Ciudad de México C.P. 07320, Mexico; (B.R.-Á.)
| | - Jonatan Mireles-Hernández
- Universidad Abierta y a Distancia de México, División de Ciencias de la Salud, Biológicas y Ambientales, Av. Universidad 1200, Piso 1, Cuadrante 10, 1-2, Xoco, Alcaldía Benito Juárez, Ciudad de México C.P. 03330, Mexico
| | - Francisco Carrasco-Hernández
- Universidad Tecnológica de Durango, Mecatrónica y Energías Renovables, Carretera Durango-Mezquital, km 4.5 S/N, Gavino Santillán, Durango C.P. 34308, Mexico
| | - Guillermo Manuel Urriolagoitia-Calderón
- Instituto Politécnico Nacional, Escuela Superior de Ingeniería Mecánica y Eléctrica, Sección de Estudios de Posgrado e Investigación, Unidad Profesional Adolfo López Mateos Zacatenco, Edificio 5, 2do, Piso, Col. Lindavista, Del. Gustavo A. Madero, Ciudad de México C.P. 07320, Mexico; (B.R.-Á.)
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Zalewska A, Gałczyk M, Sobolewski M. The levels of physical activity and fatigue among teachers in Poland and the United Kingdom in the first year after the COVID-19 pandemic. Med Pr 2024:184351. [PMID: 38572529 DOI: 10.13075/mp.5893.01488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND The COVID-19 disease has a negative impact on the psychophysiological health of populations worldwide, including a decrease in overall physical performance and an increase in fatigue. Fatigue was one of the main symptoms reported by patients and persisted for several weeks after infection with COVID-19. Although the phenomenon of fatigue is still poorly understood, physical activity can be a supportive factor in combating feelings of fatigue and lack of energy. The purpose of this research was to assess the physical activity (PA) and fatigue levels of teachers in Poland and the United Kingdom in the first year after the COVID-19 pandemic. MATERIAL AND METHODS The online research was carried out among 410 teachers from Poland and the United Kingdom. The PA level was assessed using the International Physical Activity Questionnaire (IPAQ). The level of fatigue was measured using the Modified Fatigue Impact Scale (MFIS). RESULTS Polish teachers, regardless of sex, are more physically active (the differences relate mainly to walking and moderate activity). When assessing the level of fatigue, there is a significant difference between men and women - the former indicate a higher degree of fatigue, with the difference between the sexes being particularly large in the Polish community. Quite clearly, there is an association between less activity (except walking) and more fatigue. All models show a statistically significant effect of total fatigue on total effort. Physical activity is not very strongly correlated with age but the level of fatigue increases with age. CONCLUSIONS The problem of teacher fatigue is unfortunately widespread. They should be encouraged to engage in as much PA as possible during the day. When planning and targeting fatigue reduction campaigns, PA should be encouraged and variables such as age, sex should be taken into account.
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Affiliation(s)
- Anna Zalewska
- University of Lomza, Łomża, Poland (Faculty of Health Sciences)
| | - Monika Gałczyk
- University of Lomza, Łomża, Poland (Faculty of Health Sciences)
| | - Marek Sobolewski
- Rzeszow University of Technology, Rzeszów, Poland (Plant of Quantitative Methods)
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29
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de Gier M, Oosterman JM, Hughes AM, Moss-Morris R, Hirsch C, Beckerman H, de Groot V, Knoop H. The presence of attentional and interpretation biases in patients with severe MS-related fatigue. Br J Health Psychol 2024. [PMID: 38575519 DOI: 10.1111/bjhp.12723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/25/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE Severe fatigue is a prevalent and disabling symptom in multiple sclerosis (MS). This study tested if a fatigue- and physical activity-related attentional bias (AB) and a somatic interpretation bias (IB) are present in severely fatigued patients with MS. Biases were compared to healthy controls and patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). METHOD Severely fatigued patients with MS or ME/CFS and healthy controls completed a Visual Probe Task (VPT) assessing fatigue- and physical activity-related AB and an IB task that assesses the tendency to interpret ambiguous information in either a somatically threatening way or in a more neutral manner. The VPT was completed by 38 MS patients, 44 ME/CFS patients, and 46 healthy controls; the IB task was completed by 156, 40 and 46 participants respectively. RESULTS ANOVA showed no statistically significant group differences in a fatigue-related AB or physical activity-related AB (omnibus test of interaction between topic × condition: F2,125 = 1.87; p = .159). Both patient groups showed a tendency to interpret ambiguous information in a somatically threatening way compared to healthy controls (F1,2 = 27.61, p < .001). This IB was significantly stronger in MS patients compared to ME/CFS patients. IB was significantly correlated with cognitive responses to symptoms in MS patients. CONCLUSION MS patients tend to interpret ambiguous information in a somatically threatening way. This may feed into unhelpful ways of dealing with symptoms, possibly contributing to the perpetuation of severe fatigue in MS.
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Affiliation(s)
- Marieke de Gier
- Department of Medical Psychology, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience Research Institute, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Mental Health, Amsterdam, The Netherlands
| | - Joukje M Oosterman
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Alicia M Hughes
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rona Moss-Morris
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Colette Hirsch
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Heleen Beckerman
- Amsterdam Neuroscience Research Institute, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, MS Center Amsterdam, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Vincent de Groot
- Amsterdam Neuroscience Research Institute, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, MS Center Amsterdam, Amsterdam UMC, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hans Knoop
- Amsterdam Public Health Research Institute, Mental Health, Amsterdam, The Netherlands
- Department of Medical Psychology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
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Liu S, Shen Y, Nie M, Fang C, Dai H, Yao M, Zhou X. The status and influencing factors of fatigue in kidney transplant recipients based on the theory of unpleasant symptoms: A cross-sectional study in China. Int J Nurs Pract 2024:e13256. [PMID: 38570821 DOI: 10.1111/ijn.13256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 10/13/2023] [Accepted: 03/10/2024] [Indexed: 04/05/2024]
Abstract
AIMS This study describes the incidence of fatigue in kidney transplant recipients and analyses the relationship between physiological factors, psychological factors, situational factors and fatigue in kidney transplant recipients. BACKGROUND Fatigue, as a common symptom after kidney transplantation, is affected by many factors, but the influence of some factors on the fatigue of kidney transplant recipients is still controversial. DESIGN This cross-sectional study was designed based on the theory of unpleasant symptoms. METHODS Our survey involved 307 participants attending the kidney transplant outpatient clinic of a tertiary Class A hospital (Changsha, Hunan, China). Data were collected between February and April 2021 using a structured questionnaire and electronic medical records. Data were analysed using IBM SPSS 25.0 (SPSS Inc.) RESULTS: It was found that the incidence of fatigue in kidney transplant recipients was 53.1%. According to the binary logistic regression analysis, sleep quality, hypokalemia, anxiety, depression and education level were independent risk factors for fatigue in kidney transplant recipients. CONCLUSION The incidence of fatigue in kidney transplant recipients was high and was influenced by physical, psychological and situational factors. Clinical nurses should assess fatigue levels in a timely and multidimensional manner in clinical practice and provide effective and scientific guidance about fatigue self-coping and symptom management for kidney transplant recipients.
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Affiliation(s)
- Sai Liu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Kidney Transplantation, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yuehan Shen
- Department of Clinical Laboratory, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Manhua Nie
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Kidney Transplantation, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Chunhua Fang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Kidney Transplantation, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Helong Dai
- Department of Kidney Transplantation, The Second Xiangya Hospital of Central South University, Changsha, China
- Clinical Research Center for Organ Transplantation in Hunan Province, Changsha, China
- Clinical Immunology Center, Central South University, Changsha, China
| | - Ming Yao
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xihong Zhou
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
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31
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Koppert TY, van Hoek R, Geenen R. Dimensions of psychological flexibility and their significance in people with somatic symptoms: The 18-item Flexibility Index Test (FIT-18). J Health Psychol 2024:13591053241239129. [PMID: 38566361 DOI: 10.1177/13591053241239129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Psychological flexibility has been hypothesized to preserve health in bad times. We examined whether psychological flexibility as assessed with an abbreviated questionnaire, was indicated to preserve mental and physical health when having somatic symptoms. Principal axis factoring indicated that two dimensions best represented the 60-item Flexibility Index Test (FIT-60) questionnaire: "mindfulness and acceptance" (M&A) and "commitment and behavior change" (C&BC). We selected 18 items that best denoted these dimensions (FIT-18 questionnaire). Regression analyses in 2060 Dutch people with and without persistent somatic symptoms, indicated that the M&A dimension (β = 0.33, p < 0.001) and C&BC dimension (β = 0.09, p < 0.001) were additively associated with mental well-being, but not with physical functioning. Moreover, the M&A dimension was indicated to protect mental well-being when having more severe somatic symptoms (β = 0.11, p < 0.001). The observed differential associations with health suggest the significance for health of the two dimensions of psychological flexibility as assessed with the FIT-18 questionnaire.
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Affiliation(s)
| | - Renée van Hoek
- Altrecht Psychosomatic Medicine, The Netherlands
- Utrecht University, The Netherlands
| | - Rinie Geenen
- Altrecht Psychosomatic Medicine, The Netherlands
- Utrecht University, The Netherlands
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32
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Huth D, Bräscher AK, Tholl S, Fiess J, Birke G, Herrmann C, Jöbges M, Mier D, Witthöft M. Cognitive-behavioral therapy for patients with post-COVID-19 condition (CBT-PCC): a feasibility trial. Psychol Med 2024; 54:1122-1132. [PMID: 37842765 DOI: 10.1017/s0033291723002921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
BACKGROUND The post-COVID-19 condition describes the persistence or onset of somatic symptoms (e.g. fatigue) after acute COVID-19. Based on an existing cognitive-behavioral treatment protocol, we developed a specialized group intervention for individuals with post-COVID-19 condition. The present study examines the feasibility, acceptance, and effectiveness of the program for inpatients in a neurological rehabilitation setting. METHODS The treatment program comprises eight sessions and includes psychoeducational and experience-based interventions on common psychophysiological mechanisms of persistent somatic symptoms. A feasibility trial was conducted using a one-group design in a naturalistic setting. N = 64 inpatients with a history of mild COVID-19 that fulfilled WHO criteria for post-COVID-19 condition were enrolled. After each session, evaluation forms were completed and psychometric questionnaires on somatic and psychopathological symptom burden were collected pre- and post-intervention. RESULTS The treatment program was well received by participants and therapists. Each session was rated as comprehensible and overall satisfaction with the sessions was high. Pre-post effect sizes (of standard rehabilitation incl. new treatment program; intention-to-treat) showed significantly reduced subjective fatigue (p < 0.05, dav = 0.33) and improved disease coping (ps < 0.05, dav = 0.33-0.49). CONCLUSIONS Our results support the feasibility and acceptance of the newly developed cognitive-behavioral group intervention for individuals with post-COVID-19 condition. Yet, findings have to be interpreted cautiously due to the lack of a control group and follow-up measurement, the small sample size, and a relatively high drop-out rate.
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Affiliation(s)
- Daniel Huth
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Anne-Kathrin Bräscher
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Sarah Tholl
- Department of Clinical Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Johanna Fiess
- Department of Clinical Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Gunnar Birke
- Kliniken Schmieder Gailingen, Gailingen, Germany
| | | | | | - Daniela Mier
- Department of Clinical Psychology and Psychotherapy, University of Konstanz, Konstanz, Germany
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
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Byun E, McCurry SM, Kwon S, Tsai CS, Jun J, Bammler TK, Becker KJ, Thompson HJ. Fatigue, Toll-Like Receptor 4, and Pro-Inflammatory Cytokines in Adults With Subarachnoid Hemorrhage: A 6-Month Longitudinal Study. Biol Res Nurs 2024; 26:192-201. [PMID: 37788710 DOI: 10.1177/10998004231203257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
BACKGROUND Fatigue is prevalent in subarachnoid hemorrhage (SAH) survivors. Biological mechanisms underlying fatigue post-SAH are not clear. Inflammation may contribute to the development of fatigue. This study aimed to examine the associations between inflammatory markers and fatigue during the first 6 months post-SAH. Specific biomarkers examined included both early and concurrent expression of Toll-Like Receptor 4 (TLR4) messenger RNA (mRNA) and plasma concentrations of pro-inflammatory cytokines, Tumor Necrosis Factor-alpha (TNF-α), Interleukin (IL)1β, and IL6. METHODS We conducted a 6-month longitudinal study with a convenience sample of 43 SAH survivors. We collected blood samples on days 2, 3, and 7 and 2, 3, and 6 months post-SAH to assess biomarkers. Fatigue was assessed by the PROMIS Fatigue Scale at 2, 3, and 6 months. Linear mixed models were used to test the associations between early (days 2, 3, and 7) and concurrent (2, 3, and 6 months) TLR4 mRNA expression (TagMan gene expression assays) and TNF-α, IL1β, and IL6 plasma concentrations (multiplex assays) and concurrent fatigue. RESULTS 28% of SAH survivors experienced fatigue during the first 6 months post-SAH. Fatigue levels in SAH survivors were higher than those of the U.S. population and consistent during the 6 months. Experience of fatigue during the 6 months post-SAH was associated with higher IL1β plasma concentrations on day 7 and IL1β, IL6, and TNF-α plasma concentrations during the 6 months post-SAH. CONCLUSION Inflammation appears to underlie the development of fatigue in SAH survivors.
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Affiliation(s)
- Eeeseung Byun
- Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA
| | - Susan M McCurry
- Department of Child, Family and Population Health Nursing, University of Washington, Seattle, WA, USA
| | - Suyoung Kwon
- Department of Child, Family and Population Health Nursing, University of Washington, Seattle, WA, USA
| | - Chi-Shan Tsai
- Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA
| | - Jeehye Jun
- Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea
| | - Theo K Bammler
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Kyra J Becker
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Hilaire J Thompson
- Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA
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Saoji AA, Swathi PS, Bhat R, Bansal B, Mohanty S, Raj Lakshmi RKR. Exploring the Effect of Trataka (A Yogic Cleansing Technique) and Cold Eye Pack on Eye Strain During COVID-19 Pandemic: A Randomized Three-Arm Trial. J Integr Complement Med 2024; 30:345-351. [PMID: 37852005 DOI: 10.1089/jicm.2023.0175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Objective: Computer vision syndrome is a major global public health concern affecting >60 million individuals globally. Yoga and naturopathy practices can reduce visual fatigue and strain. The present study attempted to explore the effect of trataka that is, a yogic cleansing technique and cold eye pack on visual strain and fatigue. Subjects: Three hundred volunteers from an IT company were recruited following inclusion and exclusion criteria. Intervention: The subjects were randomly distributed in three groups, that is, trataka, cold eye pack, and waitlist control group with an allocation ratio of 1:1:1. Outcome measure: Visual Fatigue Scale and Visual symptoms checklist (VSC) was administered at baseline and end of 2 weeks. Repeated measures analysis of variance (RM-ANOVA) with Bonferroni corrections was used to test the difference across the groups. Results: All the variables were similar at the baseline among the groups. Significant changes in the within-group analysis occurred in both the trataka and cold eye pack groups. The RM-ANOVA revealed significant differences in the VAS and VSC (p = 0.001) and the post hoc analysis suggested that there were significant differences in both the trataka and cold eye pack group when compared with the control group (p = 0.001); however, there was no differences between the trataka and cold eye pack group in both the scales (p = 1). Conclusions: The results of the present study suggest that a trataka and cold eye pack for 14 days improves self-rated visual strain and fatigue among IT professionals with computer vision syndrome. Clinical Trial registration number: CTRI/2020/11/029003.
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Affiliation(s)
- Apar Avinash Saoji
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - P S Swathi
- School of Yoga and Naturopathic Medicine, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Raghavendra Bhat
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Bhavit Bansal
- School of Yoga and Naturopathic Medicine, Swami Vivekananda Yoga Anusandhana Samsthana, Bengaluru, India
| | - Sriloy Mohanty
- Center for Integrative Medicine and Research, All India Institute of Medical Sciences, New Delhi, India
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Forbes C, Tanner S, Engstrom T, Lee WR, Patel D, Walker R, Bradford N, Pole JD. Patient Reported Fatigue Among Adolescent and Young Adult Cancer Patients Compared to Non-Cancer Patients: A Systematic Review and Meta-Analysis. J Adolesc Young Adult Oncol 2024; 13:242-250. [PMID: 37902970 DOI: 10.1089/jayao.2023.0094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023] Open
Abstract
Adolescent and young adult (AYA) cancer patients and survivors are a growing population due to more frequent diagnoses and improved survival. Fatigue is a common symptom experienced by cancer patients and it is often missed by health care professionals. Patient reported outcome measures (PROMs) can assist in evaluating patient reported fatigue. This systematic review aims to determine if AYA cancer patients report more fatigue than AYAs who have not been diagnosed with cancer. We used a subset of articles from a larger review that searched PubMed, EMBASE, CINAHL, and PsycINFO to determine which PROMs and domains are currently being used to evaluate AYA cancer. This study identified 175 articles related to PROMs in the AYA cancer population. Articles with PROMs reporting on fatigue/vitality were used in this review. From the original 175 articles, we identified 8 fatigue/vitality articles for this review. All eight articles found an increase in fatigue/decrease in vitality in the AYA cancer population compared to healthy controls. A meta-analysis was performed on four articles that used the same PROM tool (EORTC QLQ-C30). This found a statistically significant and clinically meaningful increase in mean fatigue of 12.5 95% confidence interval: 3.3-21.8 points (scale 0-100, higher number indicates more fatigue) in the AYA cancer group compared to healthy noncancer controls. Fatigue in the AYA cancer population is a significant issue, it is often undetected and underreported, and early interventions are needed to prevent the negative subsequent sequelae.
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Affiliation(s)
- Cheryl Forbes
- Centre for Health Services Research, and The University of Queensland, Herston, Australia
| | - Sarah Tanner
- Centre for Health Services Research, and The University of Queensland, Herston, Australia
| | - Teyl Engstrom
- Centre for Health Services Research, and The University of Queensland, Herston, Australia
| | - Wen Ray Lee
- Centre for Health Services Research, and The University of Queensland, Herston, Australia
| | - Dhaval Patel
- Centre for Health Services Research, and The University of Queensland, Herston, Australia
| | - Rick Walker
- School of Medicine, The University of Queensland, Herston, Australia
- Oncology Service, Queensland Children's Hospital, Brisbane, Australia
- Cancer Care, Princess Alexandra Hospital, Brisbane, Australia
| | - Natalie Bradford
- Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia
| | - Jason D Pole
- Centre for Health Services Research, and The University of Queensland, Herston, Australia
- Dalla Lana School of Public Health, The University of Toronto, Toronto, Canada
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Sands I, Picariello F, Maple H, Chilcot J. Psychosocial and Clinical Associations of Fatigue Severity and Fatigue-Related Impairment in Kidney Transplant Recipients. Behav Med 2024; 50:153-163. [PMID: 36803685 DOI: 10.1080/08964289.2022.2159311] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 11/29/2022] [Accepted: 12/06/2022] [Indexed: 02/22/2023]
Abstract
Debilitating fatigue is common in people living with kidney disease and often persists after a kidney transplant. Current understanding of fatigue is centered around pathophysiological processes. Little is known about the role of cognitive and behavioral factors. The aim of this study was to evaluate the contribution of these factors to fatigue among kidney transplant recipients (KTRs). A cross-sectional study of 174 adult KTRs who completed online measures of fatigue, distress, illness perceptions, and cognitive and behavioral responses to fatigue. Sociodemographic and illness-related information was also collected. 63.2% of KTRs experienced clinically significant fatigue. Sociodemographic and clinical factors explained 16.1% and 31.2% of the variance in the fatigue severity and fatigue impairment, respectively, increasing by 28% and 26.8% after adding distress. In adjusted models, all the cognitive and behavioral factors except for illness perceptions were positively associated with increased fatigue-related impairment, but not severity. Embarrassment avoidance emerged as a key cognition. In conclusion, fatigue is common following kidney transplantation and associated with distress and cognitive and behavioral responses to symptoms, particularly embarrassment avoidance. Given the commonality and impact of fatigue in KTRs, treatment is a clinical need. Psychological interventions targeting distress and specific beliefs and behaviors related to fatigue may be beneficial.
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Affiliation(s)
- Imogen Sands
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Federica Picariello
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Hannah Maple
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Joseph Chilcot
- Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Onyedibe MCC, Blickle P, Schmidt ME, Steindorf K. Posttraumatic growth and health-related quality of life in cancer survivors: Does fatigue moderate the link? Stress Health 2024; 40:e3299. [PMID: 37547957 DOI: 10.1002/smi.3299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 06/26/2023] [Accepted: 07/26/2023] [Indexed: 08/08/2023]
Abstract
Interest in post-traumatic growth (PTG) as a predictor of health-related quality of life (HRQoL) is currently gaining attention. However, current evidence is still inconclusive on the nature of this relationship. The first objective of this study was to investigate the relationship between PTG and global HRQoL among cancer survivors. We further investigated the moderating role of fatigue in the association between PTG and global HRQoL. In the FiX study (Fatigue in Germany - Examination of prevalence, severity, and state of screening and treatment) cancer-related fatigue (EORTC QLQ-FA12), PTG inventory and global HRQoL (EORTC QLQ-C30) were assessed four years after cancer diagnosis in 1316 cancer-free survivors (mean age = 67.28, SD = 11.05, 51.4% female). Multiple linear regression analysis and moderation analysis were performed. The results showed that PTG had a convex quadratic relationship with global HRQoL (p < 0.001). Contrary to our hypothesis, fatigue did not moderate the relationship between PTG (linear and quadratic terms) and global HRQoL, neither when considering the overall PTG score nor for any PTG subdimension. In conclusion, PTG has a convex quadratic relationship with long-term global HRQoL that was not modified by persisting fatigue. Future statistical models investigating PTG and global HRQoL should take this non-linear relationship into account. Aiming to increase PTG might contribute to, but is likely not sufficient for high levels of global HRQoL in cancer survivors in the long run.
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Affiliation(s)
- Maria-Chidi C Onyedibe
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
| | - Patricia Blickle
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- Medical Faculty, University of Heidelberg, Heidelberg, Germany
| | - Martina E Schmidt
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
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Ørnbjerg LM, Rugbjerg K, Georgiadis S, Rasmussen SH, Jacobsson L, Loft AG, Iannone F, Fagerli KM, Vencovsky J, Santos MJ, Möller B, Pombo-Suarez M, Rotar Z, Gudbjornsson B, Cefle A, Eklund K, Codreanu C, Jones G, van der Sande M, Wallman JK, Sebastiani M, Michelsen B, Závada J, Nissen MJ, Sanchez-Piedra C, Tomšič M, Love TJ, Relas H, Mogosan C, Hetland ML, Østergaard M. Patient-Reported Outcomes (PROs) and PRO Remission Rates in 12,262 Biologic-Naïve Patients With Psoriatic Arthritis Treated With Tumor Necrosis Factor Inhibitors in Routine Care. J Rheumatol 2024; 51:378-389. [PMID: 38224992 DOI: 10.3899/jrheum.2023-0764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 01/17/2024]
Abstract
OBJECTIVE To evaluate patient-reported outcomes (PROs) after initiation of tumor necrosis factor inhibitor (TNFi) treatment in European real-world patients with psoriatic arthritis (PsA). Further, to investigate PRO remission rates across treatment courses, registries, disease duration, sex, and age at disease onset. METHODS Visual analog scale or numerical rating scale scores for pain, fatigue, patient global assessment (PtGA), and the Health Assessment Questionnaire-Disability Index (HAQ-DI) from 12,262 patients with PsA initiating a TNFi in 13 registries were pooled. PRO remission rates (pain ≤ 1, fatigue ≤ 2, PtGA ≤ 2, and HAQ-DI ≤ 0.5) were calculated for patients still on the treatment. RESULTS For the first TNFi, median pain score was reduced by approximately 50%, from 6 to 3, 3, and 2; as were fatigue scores, from 6 to 4, 4, and 3; PtGA scores, from 6 to 3, 3, and 2; and HAQ-DI scores, from 0.9 to 0.5, 0.5, and 0.4 at baseline, 6, 12, and 24 months, respectively. Six-month Lund Efficacy Index (LUNDEX)-adjusted remission rates for pain, fatigue, PtGA, and HAQ-DI scores were 24%, 31%, 36%, and 43% (first TNFi); 14%, 19%, 23%, and 29% (second TNFi); and 9%, 14%, 17%, and 20% (third TNFi), respectively. For biologic-naïve patients with disease duration < 5 years, 6-month LUNDEX-adjusted remission rates for pain, fatigue, PtGA, and HAQ-DI scores were 22%, 28%, 33%, and 42%, respectively. Corresponding rates for patients with disease duration > 10 years were 27%, 32%, 41%, and 43%, respectively. Remission rates were 33%, 40%, 45%, and 56% for men and 17%, 23%, 24%, and 32% for women, respectively. For patients aged < 45 years at diagnosis, 6-month LUNDEX-adjusted remission rate for pain was 29% vs 18% for patients ≥ 45 years. CONCLUSION In 12,262 biologic-naïve patients with PsA, 6 months of treatment with a TNFi reduced pain by approximately 50%. Marked differences in PRO remission rates across treatment courses, registries, disease duration, sex, and age at onset of disease were observed, emphasizing the potential influence of factors other than disease activity on PROs.
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Affiliation(s)
- Lykke M Ørnbjerg
- L.M. Ørnbjerg, MD, PhD, K. Rugbjerg, MSc, PhD, S. Georgiadis, MSc, PhD, S.H. Rasmussen, MSc, PhD, Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark;
| | - Kathrine Rugbjerg
- L.M. Ørnbjerg, MD, PhD, K. Rugbjerg, MSc, PhD, S. Georgiadis, MSc, PhD, S.H. Rasmussen, MSc, PhD, Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
| | - Stylianos Georgiadis
- L.M. Ørnbjerg, MD, PhD, K. Rugbjerg, MSc, PhD, S. Georgiadis, MSc, PhD, S.H. Rasmussen, MSc, PhD, Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
| | - Simon H Rasmussen
- L.M. Ørnbjerg, MD, PhD, K. Rugbjerg, MSc, PhD, S. Georgiadis, MSc, PhD, S.H. Rasmussen, MSc, PhD, Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
| | - Lennart Jacobsson
- L. Jacobsson, MD, PhD, Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anne G Loft
- A.G. Loft, MD, PhD, The DANBIO registry and Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - Florenzo Iannone
- F. Iannone, MD, PhD, DETO - Rheumatology Unit, University of Bari, Bari, Italy
| | - Karen M Fagerli
- K.M. Fagerli, MD, PhD, Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Jiri Vencovsky
- J. Vencovsky, MD, DSc, J. Závada, MD, PhD, Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Maria J Santos
- M.J. Santos, MD, PhD, Rheumatology Department, Hospital Garcia de Orta, Rheumatology Research Unit, Faculdade de Medicina, Lisboa, and Reuma.pt, Portugal
| | - Burkhard Möller
- B. Möller, MD, Department for Rheumatology and Immunology, Inselspital - University Hospital Bern, University of Bern, Bern, Switzerland
| | - Manuel Pombo-Suarez
- M. Pombo-Suarez, MD, PhD, Rheumatology Department, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Ziga Rotar
- Z. Rotar, MD, PhD, M. Tomšič, MD, PhD, Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, and Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Bjorn Gudbjornsson
- B. Gudbjornsson, MD, PhD, Centre for Rheumatology Research, Landspitali University Hospital (ICEBIO), and the Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Ayse Cefle
- A. Cefle, MD, TURKBIO Registry and Division of Rheumatology, School of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Kari Eklund
- K. Eklund, MD, PhD, H. Relas, MD, PhD, ROB-FIN, Division of Rheumatology, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Catalin Codreanu
- C. Codreanu, MD, PhD, RRBR, C. Mogosan, MD, PhD, RRBR, Center for Rheumatic Diseases, University of Medicine Bucharest, Bucharest, Romania
| | - Gareth Jones
- G. Jones, PhD, BSRBR-AS and Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology Group), University of Aberdeen, Aberdeen, UK
| | - Marleen van der Sande
- M. van der Sande, MD, PhD, Amsterdam UMC, University of Amsterdam, Department of Rheumatology & Clinical Immunology, and Department of Experimental Immunology, Amsterdam Institute for Infection & Immunity, Amsterdam, the Netherlands
| | - Johan K Wallman
- J.K. Wallman, MD, PhD, Department of Clinical Sciences Lund, Rheumatology, Lund University, Skåne University Hospital, Lund, Sweden
| | - Marco Sebastiani
- M. Sebastiani, MD, PhD, Rheumatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Brigitte Michelsen
- B. Michelsen, MD, PhD, Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway, and Research Unit, Sørlandet Hospital, Kristiansand, Norway, and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
| | - Jakub Závada
- J. Vencovsky, MD, DSc, J. Závada, MD, PhD, Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Michael J Nissen
- M.J. Nissen, MD, PhD, Department of Rheumatology, Geneva University Hospital, Geneva, Switzerland
| | - Carlos Sanchez-Piedra
- C. Sanchez-Piedra, MD, PhD, Spanish Agency of Health Technology Assessment, Instituto de Salud Carlos III, Madrid, Spain
| | - Matija Tomšič
- Z. Rotar, MD, PhD, M. Tomšič, MD, PhD, Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia, and Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Thorvardur J Love
- T.J. Love, MD, PhD, Faculty of Medicine, University of Iceland, and Department of Science, Landspitali University Hospital, Reykjavík, Iceland
| | - Heikki Relas
- K. Eklund, MD, PhD, H. Relas, MD, PhD, ROB-FIN, Division of Rheumatology, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Corina Mogosan
- C. Codreanu, MD, PhD, RRBR, C. Mogosan, MD, PhD, RRBR, Center for Rheumatic Diseases, University of Medicine Bucharest, Bucharest, Romania
| | - Merete L Hetland
- M.L. Hetland, MD, PhD, DMSc, M. Østergaard, MD, PhD, DMSc, Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark, and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Mikkel Østergaard
- M.L. Hetland, MD, PhD, DMSc, M. Østergaard, MD, PhD, DMSc, Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark, and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Li H, Zheng Z, Yang S, Wang T, Yang Y, Tang Y, Zhang S, Hou J. Anti- Fatigue Tandem Organic Photovoltaics for Indoor Illumination. Adv Mater 2024; 36:e2311476. [PMID: 38181179 DOI: 10.1002/adma.202311476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/14/2023] [Indexed: 01/07/2024]
Abstract
The ability of achieving high efficiency makes tandem organic photovoltaics (PVs) a competitive technique in potential indoor applications. Except high efficiency, reliable indoor energy supply also calls for outstanding stability. However, unavoidable unstable voltage supply from the circuit control system for indoor light sources like light emitting diodes (LED) and incandescent lamps would cause carrier density fluctuation and device fatigue driven by periodic light/dark switching. In this work, the strobing-induced fatigue within the bulk heterojunction (BHJ)/interconnecting layer (ICL) interface is first revealed and overcome. Based on reliable and effective interfacial doping between conjugated acceptor and metal oxide, the interfacial capacitance that determines the strobing-induced fatigue, has been significantly restrained. The imbalance carrier migration and fierce inter-layer accommodating during the burn-in stage caused by light strobing are substantially diminished. Benefit from this method, the stability of tandem devices is highly enhanced under strobing indoor illumination, and a champion efficiency (35.02%) is obtained. The method provides guidance for further material design for interconnecting layers in organic photovoltaics.
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Affiliation(s)
- Hao Li
- School of Chemistry and Biology Engineering, University of Science and Technology Beijing, Beijing, 100083, China
- State Key Laboratory of Polymer Physics and Chemistry, Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, P. R. China
| | - Zhong Zheng
- School of Chemistry and Biology Engineering, University of Science and Technology Beijing, Beijing, 100083, China
- State Key Laboratory of Polymer Physics and Chemistry, Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, P. R. China
| | - Shiwei Yang
- State Key Laboratory of Polymer Physics and Chemistry, Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, P. R. China
- School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Tao Wang
- State Key Laboratory of Polymer Physics and Chemistry, Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, P. R. China
| | - Yi Yang
- State Key Laboratory of Polymer Physics and Chemistry, Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing, 100049, P. R. China
| | - Yanjie Tang
- School of Chemistry and Biology Engineering, University of Science and Technology Beijing, Beijing, 100083, China
- State Key Laboratory of Polymer Physics and Chemistry, Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, P. R. China
| | - Shaoqing Zhang
- School of Chemistry and Biology Engineering, University of Science and Technology Beijing, Beijing, 100083, China
- State Key Laboratory of Polymer Physics and Chemistry, Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, P. R. China
| | - Jianhui Hou
- School of Chemistry and Biology Engineering, University of Science and Technology Beijing, Beijing, 100083, China
- State Key Laboratory of Polymer Physics and Chemistry, Beijing National Laboratory for Molecular Sciences, Institute of Chemistry, Chinese Academy of Sciences, Beijing, 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing, 100049, P. R. China
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El-Salhy M, Gilja OH, Hatlebakk JG. Increasing the transplant dose and repeating faecal microbiota transplantation results in the responses of male patients with IBS reaching those of females. Scand J Gastroenterol 2024; 59:391-400. [PMID: 38084725 DOI: 10.1080/00365521.2023.2292479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/04/2023] [Indexed: 04/04/2024]
Abstract
BACKGROUND Faecal microbiota transplantation (FMT) performed with a proper protocol is a safe treatment for IBS that has high efficacy and durable effects. Females have been reported to respond better than males to FMT. The present study aimed at determining whether increasing the transplant dose or repeating FMT improve the responses of males to FMT. METHODS This study included 186 IBS patients (131 females and 55 males) who were randomized at a 1:1:1 ratio to receive 90 g of donor faeces once into the large intestine, once into the small intestine or twice into the small intestine. Patients completed five questionnaires that assessed their symptoms and quality of life, and provided faecal samples at baseline and at 3, 6 and 12 months after FMT. The faecal bacterial profile and dysbiosis index were determined using 16S rRNA gene PCR DNA amplification covering variable genes V3-V9. RESULTS The response rates to FMT at all observation times did not differ significantly between females and males regardless of the transplant administration route or whether it was repeated. Faecal Alistipes levels were higher in females than in males at baseline and increased in both females and males after FMT. In the repeated group, the Alistipes levels did not differ between females and males after FMT. CONCLUSIONS Increasing the transplant dose and repeating FMT results in the responses of male IBS patients to FMT reaching those of females regardless of the administration route. Alistipes spp. levels appear to play a role in this improvement.www.clinicaltrials.gov (NCT04236843).
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Affiliation(s)
- Magdy El-Salhy
- Department of Medicine, Stord Hospital, Stord, Norway
- Department of Clinical Medicine and Department of Gastroenterology, University of Bergen, Bergen, Norway
| | - Odd Helge Gilja
- Department of Clinical Medicine and Department of Gastroenterology, University of Bergen, Bergen, Norway
- National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway
| | - Jan Gunnar Hatlebakk
- Department of Clinical Medicine and Department of Gastroenterology, University of Bergen, Bergen, Norway
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Skorpen E, Pasca NB, Reitan SK, Groven N. Exploring levels of TSH and FT4 in patients with chronic fatigue syndrome (CFS), fibromyalgia (FM) and healthy controls did not reveal any associations between fatigue score and level of thyroid hormones. Nord J Psychiatry 2024:1-6. [PMID: 38557370 DOI: 10.1080/08039488.2024.2332442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/12/2024] [Indexed: 04/04/2024]
Abstract
AIM The diagnoses of Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM) are highly associated with fatigue and pain, respectively. Physiologically and clinically an effect of thyroid status on fatigue and pain is expected. There may be clinically relevant differences in thyroid hormone axes though within values of reference in both patients with normal thyroid hormones, or in patients with well-regulated thyroid disease. These potential differences are explored in this study. MATERIALS AND METHODS In the present study, female patients with CFS (n = 49) and FM (n = 58) as well as female healthy controls (n = 53) were included. We explored plasma levels of TSH and FT4 between the groups using Kruskall-Wallis, and the relation between fatigue score and levels of TSH and FT4 by means of Spearman's rho. RESULTS There were no group differences between CFS patients, FM patients, and healthy controls in levels of TSH and FT4. CONCLUSION As one might clinically and physiologically expect an association between thyroid function and fatigue, which may be associated with clinical disorders such as CFS and FM, we suggest future studies to examine the field further by exploring the influence of thyroid receptors and responses of the thyroid hormone cascade.
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Affiliation(s)
- Elias Skorpen
- Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
| | - Nora Bugge Pasca
- Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
| | - Solveig Klæbo Reitan
- Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
- Nidelv District Psychiatric Center, St Olav Hospital, Trondheim, Norway
| | - Nina Groven
- Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
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Farag A, Gallagher J, Carr L. Examining the Relationship Between Nurse Fatigue, Alertness, and Medication Errors. West J Nurs Res 2024; 46:288-295. [PMID: 38454783 DOI: 10.1177/01939459241236631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
BACKGROUND Working for extended hours in a physically and mentally demanding profession has subjected nurses to occupational fatigue. Limited evidence exists about nurse fatigue and alertness changes throughout shift work and their relationship with medication errors and near misses. PURPOSE The purposes of this study were to: (1) assess the relationship between nurses' fatigue and alertness, (2) evaluate nurses' fatigue and alertness changes throughout their shift, and (3) examine the relationship between nurses' fatigue, alertness, and medication errors and near misses. METHODS This prospective study is part of a larger mixed-method study. Fatigue and alertness data from 14 work and non-workdays were collected from a convenience sample of 90 nurses. A wearable actigraph (ReadibandTM) was used to measure alertness, while ecological momentary assessment (EMA) using text messaging was used to measure nurses' fatigue. RESULTS A 1-unit increase in fatigue was associated with a 1.06-unit reduction in nurses' alertness score (β = -1.06, 95% CI: [-1.33, -0.78], p < .01). Night-shift nurses experienced a 31-point reduction in alertness from the start to the end of the work shift. Nurses' fatigue, but not alertness, was associated with medication errors and near misses (OR = 1.26, 95% CI [1.07, 1.48], p = .01). CONCLUSION Initiating fatigue mitigation measures during mid-shift, especially for night-shift nurses, may be a viable option to mitigate fatigue and alertness deterioration among nurses and to maintain patient safety. The multifaceted nature of fatigue, as captured by EMA, is a stronger predictor of medication errors and near misses than device-measured alertness.
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Affiliation(s)
- Amany Farag
- College of Nursing, The University of Iowa, Iowa City, IA, USA
| | - Jacob Gallagher
- Department of Health and Human Physiology, The University of Iowa, Iowa City, IA, USA
| | - Lucas Carr
- Department of Health and Human Physiology, The University of Iowa, Iowa City, IA, USA
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Schytz CT, Ørtenblad N, Gejl KD, Nielsen J. Differential utilisation of subcellular skeletal muscle glycogen pools: a comparative analysis between 1 and 15 min of maximal exercise. J Physiol 2024; 602:1681-1702. [PMID: 38502562 DOI: 10.1113/jp285762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 03/05/2024] [Indexed: 03/21/2024] Open
Abstract
In skeletal muscle, glycogen particles are distributed both within and between myofibrils, as well as just beneath the sarcolemma. Their precise localisation may influence their degradation rate. Here, we investigated how exercise at different intensities and durations (1- and 15-min maximal exercise) with known variations in glycogenolytic rate and contribution from anaerobic metabolism affects utilisation of the distinct pools. Furthermore, we investigated how decreased glycogen availability achieved through lowering carbohydrate and energy intake after glycogen-depleting exercise affect the storage of glycogen particles (size, numerical density, localisation). Twenty participants were divided into two groups performing either a 1-min (n = 10) or a 15-min (n = 10) maximal cycling exercise test. In a randomised, counterbalanced, cross-over design, the exercise tests were performed following short-term consumption of two distinct diets with either high or moderate carbohydrate content (10 vs. 4 g kg-1 body mass (BM) day-1) mediating a difference in total energy consumption (240 vs. 138 g kg-1 BM day-1). Muscle biopsies from m. vastus lateralis were obtained before and after the exercise tests. Intermyofibrillar glycogen was preferentially utilised during the 1-min test, whereas intramyofibrillar glycogen was preferentially utilised during the 15-min test. Lowering carbohydrate and energy intake after glycogen-depleting exercise reduced glycogen availability by decreasing particle size across all pools and diminishing numerical density in the intramyofibrillar and subsarcolemmal pools. In conclusion, distinct subcellular glycogen pools were differentially utilised during 1-min and 15-min maximal cycling exercise. Additionally, lowered carbohydrate and energy consumption after glycogen-depleting exercise altered glycogen storage by reducing particle size and numerical density, depending on subcellular localisation. KEY POINTS: In human skeletal muscle, glycogen particles are localised in distinct subcellular compartments, referred to as intermyofibrillar, intramyofibrillar and subsarcolemmal pools. The intermyofibrillar and subsarcolemmal pools are close to mitochondria, while the intramyofibrillar pool is at a distance from mitochondria. We show that 1 min of maximal exercise is associated with a preferential utilisation of intermyofibrillar glycogen, and, on the other hand, that 15 min of maximal exercise is associated with a preferential utilisation of intramyofibrillar glycogen. Furthermore, we demonstrate that reduced glycogen availability achieved through lowering carbohydrate and energy intake after glycogen-depleting exercise is characterised by a decreased glycogen particle size across all compartments, with the numerical density only diminished in the intramyofibrillar and subsarcolemmal compartments. These results suggest that exercise intensity influences the subcellular pools of glycogen differently and that the dietary content of carbohydrates and energy is linked to the size and subcellular distribution of glycogen particles.
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Affiliation(s)
- Camilla Tvede Schytz
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Niels Ørtenblad
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Kasper Degn Gejl
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Joachim Nielsen
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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İşcan Ayyildiz N, Bingöl N. The effects of web-based animation-supported progressive relaxation exercises applied to individuals with epilepsy on fatigue and sleep quality: A randomized controlled study. Epilepsy Behav 2024; 154:109734. [PMID: 38554645 DOI: 10.1016/j.yebeh.2024.109734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/09/2024] [Accepted: 03/03/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE The study was conducted to determine the effects of Progressive Relaxation Exercise, supported by mobile-based animation, on fatigue and sleep quality of individuals with epilepsy. MATERIAL-METHOD The study was conducted in a randomized controlled design with a pretest-posttest model on epileptic individuals who applied to Giresun University, Faculty of Medicine, Neurology Outpatient Clinic between February and December 2022. By using power analysis, the sample of the study was determined as 60 epilepsy patients (30 in the Control Group, 30 in the Experimental Group). The data were collected by face-to-face interview technique with the Personal Information Form, Pittsburgh Sleep Quality Index (PSQI), and Fatigue Severity Scale (FSS). Frequencies, percentages, arithmetic mean, standard deviations, Pearson Correlation Analysis, Paired t-Test, Student's t-Test, and Chi-Square Test were used in the evaluation of the study data. RESULTS When the Control Group's mean scores in the pre-test and post-tests, which were performed with an interval of 6 weeks, were compared, a statistically significant difference was detected between the FSS and PSQI scores (p>0.05). The mean Fatigue Severity Scale score was found to be 5.24 ± 0.69 before the Progressive Relaxation Exercises and 3.82 ± 0.77 after the exercises. The mean scores of the individuals on the Fatigue Severity Scale after the relaxation exercises were found to be lower at a statistically significant level than the mean scores before the relaxation exercises (p<0.001). The differences between subjective sleep quality (p<0.001), sleep latency (p<0.001), daytime dysfunction (p<0.001), and total sleep quality (p<0.001) score averages after the Progressive Relaxation Exercises were statistically significant compared to the pre-exercises status. When the post-test scores of the participants in the Experimental Group was examined, significant, moderate, and positive differences were detected between the FSS and Total PSQI scores (r: 0.373-p: 0.042), Subjective Sleep Quality (r: 0.487-p: 0.006), which is one of the sub-dimensions of PSQI, Sleeping Pill Use (r: 0.531-p: 0.003), and Daytime Dysfunction (r: 0.461-p: 0.01) scores. CONCLUSION It was determined that individuals with epilepsy experience fatigue and deterioration in sleep quality and there is a reciprocal relationship between the severity of fatigue and sleep quality in these individuals. Progressive Relaxation Exercises applied with the animation-supported web-based mobile intervention technique reduce the fatigue levels of individuals and increase sleep quality.
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Affiliation(s)
| | - Nuray Bingöl
- Department of Medical Nursing, Faculty of Nursing, Ataturk University, Erzurum, Turkey.
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Galvez-Sánchez CM, Duschek S, Reyes del Paso GA. A Comparative Analysis of Cognitive Deficits in Rheumatoid Arthritis and Fibromyalgia: Impact of Symptoms Severity and Its Clinical Implications. Psychol Res Behav Manag 2024; 17:1399-1415. [PMID: 38566824 PMCID: PMC10985931 DOI: 10.2147/prbm.s446798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose Fibromyalgia syndrome (FMS) and rheumatoid arthritis (RA) are chronic pain disorders, with clearly distinct pathogenetic mechanisms, frequently accompanied by symptoms like depression, fatigue, insomnia and cognitive problems. This study compared performance in various cognitive domains between patients with FMS and RA. The role of clinical symptoms severity in determine the differences in cognitive performance was also investigated. Patients and Methods A cross-sectional study was conducted according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement. In total, 64 FMS patients, 34 RA patients and 32 healthy controls participated, all women. Using factor analysis, questionnaire scores were combined to yield a symptom severity factor, which was used as a control variable in the group comparisons. Results Without controlling for symptom severity, both patient groups performed worse than controls in all the cognitive domains assessed (visuospatial memory; verbal memory; strategic planning and self-regulation; processing speed, attention and cognitive flexibility; and planning and organizational abilities); overall deficits were greater in FMS than in RA patients. FMS patients reported more severe clinical symptoms (current pain intensity, total pain, state anxiety, depression, fatigue and insomnia) than RA patients. After controlling for symptom severity, a large proportion of the cognitive test parameters no longer differed between FMS and RA patients. Conclusion The study confirmed significant impairments in attention, memory, and higher cognitive functions in both FMS and RA. The greater deficits seen in FMS patients may at least partly be explained by more severe pain and secondary symptoms. Cognitive screening may facilitate the development of personalized treatment plans to optimize the quality of life of FMS and RA patients.
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Affiliation(s)
- Carmen M Galvez-Sánchez
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology and Speech Therapy, University of Murcia, Murcia, Spain
| | - Stefan Duschek
- Department of Psychology, Institute of Psychology, UMIT TIROL - University for Health Sciences Medical Informatics and Technology, Hall in Tirol, Austria
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Stallmach A, Quickert S, Puta C, Reuken PA. The gastrointestinal microbiota in the development of ME/CFS: a critical view and potential perspectives. Front Immunol 2024; 15:1352744. [PMID: 38605969 PMCID: PMC11007072 DOI: 10.3389/fimmu.2024.1352744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/18/2024] [Indexed: 04/13/2024] Open
Abstract
Like other infections, a SARS-CoV-2 infection can also trigger Post-Acute Infection Syndromes (PAIS), which often progress into myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). ME/CFS, characterized by post-exercise malaise (PEM), is a severe multisystemic disease for which specific diagnostic markers or therapeutic concepts have not been established. Despite numerous indications of post-infectious neurological, immunological, endocrinal, and metabolic deviations, the exact causes and pathophysiology remain unclear. To date, there is a paucity of data, that changes in the composition and function of the gastrointestinal microbiota have emerged as a potential influencing variable associated with immunological and inflammatory pathways, shifts in ME/CFS. It is postulated that this dysbiosis may lead to intestinal barrier dysfunction, translocation of microbial components with increased oxidative stress, and the development or progression of ME/CFS. In this review, we detailed discuss the findings regarding alterations in the gastrointestinal microbiota and its microbial mediators in ME/CFS. When viewed critically, there is currently no evidence indicating causality between changes in the microbiota and the development of ME/CFS. Most studies describe associations within poorly defined patient populations, often combining various clinical presentations, such as irritable bowel syndrome and fatigue associated with ME/CFS. Nevertheless, drawing on analogies with other gastrointestinal diseases, there is potential to develop strategies aimed at modulating the gut microbiota and/or its metabolites as potential treatments for ME/CFS and other PAIS. These strategies should be further investigated in clinical trials.
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Affiliation(s)
- Andreas Stallmach
- Department of Internal Medicine IV (Gastroenterology, Hepatology, and Infectious Diseases), Jena University Hospital, Jena, Germany
| | - Stefanie Quickert
- Department of Internal Medicine IV (Gastroenterology, Hepatology, and Infectious Diseases), Jena University Hospital, Jena, Germany
| | - Christian Puta
- Department of Sports Medicine and Health Promotion, Friedrich-Schiller-University Jena, Jena, Germany
- Center for Sepsis Control and Care (CSCC), Jena University Hospital/Friedrich-Schiller-University Jena, Jena, Germany
- Center for Interdisciplinary Prevention of Diseases Related to Professional Activities, Jena, Germany
| | - Philipp A. Reuken
- Department of Internal Medicine IV (Gastroenterology, Hepatology, and Infectious Diseases), Jena University Hospital, Jena, Germany
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Halaby RN, Bruce CG, Yildirim DK, Uzun D, Rogers T, Khan JM, Jaimes AE, Grant LP, Babaliaros VC, Greenbaum AB, Lederman RJ. TABERNACL: Temporary Hemodynamic Stabilization In Vivo. Circ Cardiovasc Interv 2024:e013898. [PMID: 38533653 DOI: 10.1161/circinterventions.123.013898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/02/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Acute aortic regurgitation is life-threatening with few nonsurgical options for immediate stabilization. We propose Trans-Aortic Balloon to Ease Regurgitation Applying Counter-Pulsation (TABERNACL), a simple, on-table temporary valve using commercially available equipment to temporize acute severe aortic regurgitation. METHODS We hypothesize that an appropriately sized commercial balloon dilatation catheter-straddling the aortic annulus and connected to a counterpulsation console-can serve as a temporizing valve to restore hemodynamic stability in acute aortic regurgitation. We performed benchtop testing of valvuloplasty, angioplasty, and sizing balloons as counterpulsation balloons. TABERNACL was assessed in vivo in a porcine model of acute aortic regurgitation (n=8). We also tested a static undersized, continuously inflated transvalvular balloon as a spacer intended physically to obstruct the regurgitant orifice. RESULTS Benchtop testing identified that Tyshak II and PTS sizing (NuMed Braun) balloon catheters performed adequately as temporary valves (ie, complete inflation and deflation with each cycle) and resisted fatigue, in contrast to others. When TABERNACL was used in the acute severe regurgitation animals, there was immediate hemodynamic improvement, with a significant 35% increase in diastolic aortic pressure by 16 mm Hg ([95% CI, 7-25] P=0.0056), 34% reduction in left ventricular end-diastolic pressure by -7 mm Hg ([95% CI, -10 to -5] P=0.0006), improvement in the aortic diastolic index by 0.28 ([95% CI, 0.18-0.39] P=0.0009), and reversal of electrocardiographic myocardial ischemia. As an alternative, static balloon inflation across the aortic valve stabilized regurgitation hemodynamics at the expense of a new aortic gradient and caused excessive ectopy from balloon movement in the left ventricular outflow tract. CONCLUSIONS TABERNACL improves hemodynamics and reduces coronary ischemia by electrocardiography in animals with acute severe aortic regurgitation. TABERNACL valves obstruct the diastolic regurgitant orifice without systolic obstruction. This may prove a lifesaving bridge to definitive valve replacement therapy.
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Affiliation(s)
- Rim N Halaby
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (R.H., K.Y., D.U., A.E.J., L.P.G., R.J.L.)
| | - Christopher G Bruce
- Department of Cardiology, Structural Heart and Valve Center, Emory University Hospital, Atlanta, GA (C.G.B., V.C.B., A.B.G.)
| | - D Korel Yildirim
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (R.H., K.Y., D.U., A.E.J., L.P.G., R.J.L.)
| | - Dogangun Uzun
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (R.H., K.Y., D.U., A.E.J., L.P.G., R.J.L.)
| | - Toby Rogers
- Department of Cardiology, MedStar Washington Hospital Center, Washington, DC (T.R.)
| | - Jaffar M Khan
- Department of Cardiology, St. Francis Hospital, Roslyn, NY (J.M.K.)
| | - Andi E Jaimes
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (R.H., K.Y., D.U., A.E.J., L.P.G., R.J.L.)
| | - Laurie P Grant
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (R.H., K.Y., D.U., A.E.J., L.P.G., R.J.L.)
| | - Vasilis C Babaliaros
- Department of Cardiology, Structural Heart and Valve Center, Emory University Hospital, Atlanta, GA (C.G.B., V.C.B., A.B.G.)
| | - Adam B Greenbaum
- Department of Cardiology, Structural Heart and Valve Center, Emory University Hospital, Atlanta, GA (C.G.B., V.C.B., A.B.G.)
| | - Robert J Lederman
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (R.H., K.Y., D.U., A.E.J., L.P.G., R.J.L.)
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Sánchez-Rodríguez E, Roman-Juan J, Castarlenas E, Solé E, Jensen MP, Miró J. The Silhouettes Fatigue Scale: further validation in Spanish-speaking university students and adults with chronic pain. Disabil Rehabil 2024:1-6. [PMID: 38529680 DOI: 10.1080/09638288.2024.2331080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/11/2024] [Indexed: 03/27/2024]
Abstract
PURPOSE The aim of this study was to evaluate the psychometric properties of the Silhouettes Fatigue Scale (SFS) when used to assess fatigue in undergraduates and middle-aged adults with chronic pain. MATERIALS AND METHODS A total of 426 undergraduates and 207 middle-aged individuals with chronic pain participated in this study. Participants were asked to respond to a survey including the SFS as well as another validated measure of fatigue, questionnaires about pain catastrophizing and pain interference, and questions about pain (i.e., location, duration, and intensity). Convergent, discriminant, criterion and known-groups validity were evaluated. RESULTS Convergent validity was supported by a strong association between the two scales measuring fatigue. Discriminant validity was supported by stronger associations between the two fatigue scales scores compared to those between the SFS and pain catastrophizing scores. Criterion validity was supported by moderate associations between the SFS and measures of pain intensity and pain interference. Finally, known-groups validity was supported by significant differences in the SFS scores between students without chronic pain, students with chronic pain, and middle-aged individuals with chronic pain. CONCLUSIONS The findings support the validity of the SFS scores when used to assess fatigue in undergraduates and middle-aged adults with chronic pain.
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Affiliation(s)
- Elisabet Sánchez-Rodríguez
- Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain
| | - Josep Roman-Juan
- Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain
| | - Elena Castarlenas
- Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain
| | - Ester Solé
- Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of WA, Seattle, WA, USA
| | - Jordi Miró
- Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain
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Naczk A, Brzenczek-Owczarzak W, Adach Z, Gramza P, Forjasz J, Gajewska E, Naczk M. The impact of inertial exercises performed in the workplace on shoulder muscles' strength and muscles' fatigue resistance in women with disabilities. Med Pr 2024:185296. [PMID: 38529799 DOI: 10.13075/mp.5893.01503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Workers who do monotonous and repetitive work in a static position often complain about fatigue and decreased work efficiency. Some studies indicate that to improve muscle fatigue, resistance strength training can be used. MATERIAL AND METHODS To investigate the effect of 4-week inertial training on shoulder muscles' strength and muscles' fatigue resistance 44 female workers with disabilities were examined. The participants were randomized into the training group (T) (N = 32) and the control group (C) (N = 12). Before the training and after that shoulder muscles' strength were tested at the start and at the end of the workday (Monday and Friday). The participants were asked to complete questionnaire concerning their fatigue at work (T and C), inertial training and work efficiency (T). RESULTS The work performed during the last day of the workweek, i.e., Friday (before training) resulted in a significant decrease in shoulder muscles' strength in T and C. Muscle strength achieved at the end of the workweek (Friday afternoon) was significantly lower than achieved at the start of the workweek (Monday morning) in both tested groups (before training). Moreover, inertial training resulted in a significant increase in shoulder muscles' strength in T; 34-74% for different muscles. No changes in muscles' strength were noted in C. Increased muscle strength in T following inertial training effectively prevented muscle fatigue. After training the differences in shoulder muscles' strength noted in T during different times of the workday and workweek were insignificant. Moreover, 4-week inertial training increased significantly the work efficiency of women from T by 4%; no changes were noted in C. Inertial training was well tolerated by the participants. CONCLUSIONS We recommend using inertial training in women with disabilities to prevent shoulder muscles' fatigue during the workday and workweek. Med Pr Work Health Saf. 2024;75(2).
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Affiliation(s)
- Alicja Naczk
- Poznan University of Physical Education, Poznań, Poland (Department of Physical Education and Sport, Faculty in Gorzow Wielkopolski)
| | | | - Zdzisław Adach
- Poznan University of Physical Education, Poznań, Poland (Department of Physical Education and Sport, Faculty in Gorzow Wielkopolski)
| | - Piotr Gramza
- Association of Lubusz Innovation Network, Gorzów Wielkopolski, Poland (Department of Innovation)
| | - Justyna Forjasz
- Poznan University of Physical Education, Poznań, Poland (Department of Biological Sciences, Faculty in Gorzow Wielkopolski)
| | - Ewa Gajewska
- Poznan University of Medical Sciences, Poznań, Poland (Department of Developmental Neurology)
| | - Mariusz Naczk
- University of Zielona Gora, Zielona Góra, Poland (Institute of Health Sciences)
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Nittari G, Gibelli F, Bailo P, Sirignano A, Ricci G. Factors affecting mental health of seafarers on board merchant ships: a systematic review. Rev Environ Health 2024; 39:151-160. [PMID: 36302371 DOI: 10.1515/reveh-2021-0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES Merchant ships represent a peculiar working environment with several challenges and risks. The specific situation on board of ships may affect the mental health of seafarers more remarkably than ashore workers. CONTENT A systematic review of the literature has been carried out to identify the main causes of mood disorders among seafarers and the impact that these disorders have on their health. This review has analyzed the scientific literature published between January 2006 and December 2021 using the search engines PubMed, Web of Science (WoS) and Cumulative Index to Nursing and Allied Health Literature (CINAHL). SUMMARY Social isolation, distance from families, fatigue, stress and long work shifts represent the main causes of mood disorders among seafarers. OUTLOOK Strategies aimed at improving conditions of cohabitation on board, and a greater consideration of these problems are key for improving the mental health of workers at sea.
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Affiliation(s)
| | - Filippo Gibelli
- Section of Legal Medicine, School of Law, University of Camerino, Camerino, Marche, Italy
| | - Paolo Bailo
- Section of Legal Medicine, School of Law, University of Camerino, Camerino, Marche, Italy
| | | | - Giovanna Ricci
- School of Law, University of Camerino, Camerino, Marche, Italy
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