Working Day Research Articles

P44 An acutely unwell and rare presentation of systemic lupus erythematosus; a case report

Abstract Introduction Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with multisystem involvement. The condition has varying clinical presentations from mild mucocutaneous manifestations to severe multiorgan and central nervous system involvement. It is challenging to diagnose someone with SLE during acute admission. Apart from infection and malignancies, autoimmune and connective tissue diseases should always be one of our differentials in an acutely unwell patient with multisystem involvement. This case demonstrates how unwell and rare a patient with SLE can present. We also acknowledge the need to further understand and raise awareness of this uncommon condition. Case description A 48 year old Thai lady with no known medical illness presented with 2-3 weeks history of viral like illness. On admission, she was tachycardic, hypotensive and hypoxic. Clinical examination revealed bi-basal crepitations and elevated JVP. Her ECG showed sinus tachycardia. Admission bloods showed anemia, raised white cell count, lymphopenia, thrombocytopenia, raised inflammatory markers and acute kidney injury (AKI). CT scan revealed evidence of pericardial effusion with small free fluid in abdomen and pelvis. ECHO showed large pericardial effusion and pericardiocentesis was performed which drained purulent fluid. Blood culture was positive for E. Coli. 3rd Day blood tests were strongly positive for CTD screening. She was reviewed by the rheumatology team and was diagnosed as acute presentation of SLE causing serositis having fulfilled the SLICC criteria with E. Coli bacteremia. SLE DAI – 2K score was 11. She reported history of Raynaud’s since moving to UK, hair loss and two miscarriages in the past. She denied history of oral ulcers, facial rash or significant joint involvement. Renal team advised that AKI was due to infection rather than lupus. She was commenced on high dose oral prednisolone (40 mg/day) and antibiotics. Her condition responded to steroids and subsequently was commenced on mycophenolate as outpatient. Discussion SLE is an autoimmune disease that affects multiple organ systems. Symptoms and signs can vary although majority of patients present with cutaneous manifestation. Most of the clinical manifestations of the disease are due to abnormal inflammatory response. Patients with SLE are usually diagnosed at outpatient settings although they can present acutely unwell as seen in this patient. Serositis refers to inflammation of serous tissue which includes pleura, pericardium and peritoneum. It is considerably a rare condition which is only seen in only around 10% of patients with SLE. Patients can present with shortness of breath, abdominal pain, diarrhoea, fatigue chest pain and even cardiac tamponade. Due to the heterogeneity of SLE presentations, it is challenging for clinicians to diagnose and manage the symptoms. Besides infection and malignancies, it is always important to consider connective tissue disease as one of the differentials in an acutely unwell patient presenting with multisystem involvement. SLICC criteria can be used as a diagnosing tool for SLE which includes clinical and immunological criteria. SLEDAI-2K score can be used to assess disease activity. Her biochemical parameters as well as clinical symptoms drastically improved following steroid initiation. Early recognition and treatment initiation can improve mortality and morbidity significantly. Despite how unwell she was during admission; she improved quickly and was discharged relatively early. Her condition continues to improve on DMARDs, and she is on regular clinic follow up. Key learning points • A good clinical history and examination is essential and aids reaching a diagnosis. As reflected in this case, our patient was a female at childbearing age, south Asian (non-Caucasian ethnicity) who presented with multisystem involvement. Her initial finding of serositis, acute kidney injury, anemia, raised ESR and E. coli bacteremia were not fitting with a typical sepsis picture. There should be strong grounds for considering SLE during such clinical presentations. Suspecting SLE in an acute setting is really challenging due to various reasons, like wide symptomology of SLE, minimal exposure of SLE to physicians and their tendency of leaning towards other common conditions, like sepsis. As SLE is mostly diagnosed as outpatient, inpatient presentations are rare. Furthermore, blood results for connective tissue disease which is a major criteria for diagnosis, can take between 3 to 5 working days to be reported. However, early and appropriate consideration of autoimmune conditions as differentials of an acutely ill patient with multisystem involvement can expedite the process of diagnosis, involvement of related specialty and commencement of appropriate treatment. This approach will benefit patients producing favourable outcomes and minimal hospital stay.

Finding Joy as a Manager - Even on Bad Days

This article explores strategies for cultivating joy as a manager, even on challenging work days. Through a review of positive psychology and resilience research, the brief establishes why joy matters significantly for managerial performance, decision-making, coping abilities, and growth over time. Key studies linking joy to upward spirals in well-being, higher cognitive functioning, and resilience are referenced. Practical joy-boosting strategies drawn from evidence are then presented, such as expressing gratitude, fostering positive relationships, celebrating wins, and taking brief renewal breaks. Real-world industry examples showcase how managers in retail, higher education, and non-profits have applied these strategies when facing stresses. The article argues managers should recognize cultivating joy as a strategic competency to maximize their own and their teams' potential over the long run. Simple practices can help tap into inner reservoirs of positive emotion and broaden mindsets even amid difficulties.

End-To-End Automated Intact Protein Mass Spectrometry for High-Throughput Screening and Characterization of Bispecific and Multispecific Antibodies.

Bispecific antibodies (bsAbs) and multispecific antibodies (msAbs) represent a promising frontier in therapeutic antibody development, offering unique capabilities not achievable with traditional monoclonal antibodies. Despite their potential, significant challenges remain due to their increased molecular complexity. One prominent challenge is the correct assembly of light and heavy chains, as improper pairing leads to mispaired or incompletely assembled species that lack therapeutic efficacy and possess undesired properties, impairing the developability, manufacturability, and safety. There is a critical need for rapid, sensitive analytical tools to monitor and control these undesired species and ensure the quality assessment of bsAbs and msAbs. To address this need, we present a novel high-throughput, format-agnostic intact mass workflow that significantly enhances the efficiency of detecting and quantifying biotherapeutic products and related impurities. This workflow integrates automated sample preparation, novel high-resolution rapid mass detection powered by SampleStream-MS, and an advanced data analysis pipeline. It offers increased throughput and data quality while substantially reducing analysis turnover time and labor. This was demonstrated in a pilot program where ∼800 multispecific antibodies were processed in 10 working days. The article details the evaluation and validation of our method, demonstrating its repeatability and intermediate precision in terms of measurement accuracy and relative quantification of various product-related species. We underscore the transformative potential of this end-to-end high-throughput workflow in expediting bispecific and multispecific antibody discovery, optimizing production processes, and ensuring high-quality development and manufacturing for therapeutic antibodies.

Improving truck service performance in transporting rock aggregate using Genetic Ant Colony Algorithm

Inter-island shipment requests for rock aggregate products are served through the terminal for their own needs (TFON). The high demand for rock aggregate products causes many ships to queue up to be loaded. However, this condition is not comparable to the availability of dump trucks used to serve loading and unloading activities. This study aims to improve the performance of dump truck service in transporting rock aggregate so that the number of dump truck vehicles and optimal loading and unloading service times from the stockpile to ship at TFON are obtained. The research location was carried out at active rock mining companies in the Central Sulawesi region. The data collection method is carried out using field surveys (observations) using a time recording device by recording the process of transporting rock aggregates from the stockpile location to the ship in TFON and collecting secondary data on the demand for rock aggregates to be transported. The analysis method uses the hybrid Genetic Ant Colony Algorithm (ACO-GA) method namely a combination method between the Ant Colony Optimization algorithm and the Genetic Algorithm which aims to maximize the optimal number of trucks used in the transportation process and minimize the time in the loading and unloading process. The results showed that there had been an increase in service performance of the dump truck used in transporting rock aggregate with the longest distance of 2.3 km with a total of 5 dump trucks. The number of dump trucks of 5 units was selected because it falls within the fitness value criteria which is closest to the optimum value or equal to the value of the resources owned. Meanwhile, the optimal loading and unloading process time is in the range of 1.81–3.34 working days

Eating jetlag and risk of cardiovascular disease: prospective study of the NutriNet-Santé cohort

Abstract Background Social jetlag corresponds to the misalignment between biological circadian rhythms and the social rhythm imposed by society, resulting in discrepant activity/sleep schedules during work and free days. It has been associated with worsened biological parameters such as BMI or glycemic control. Eating jetlag is a related yet emerging concept defined as the difference of meal timing between free and work days. However, it has been little explored. This study aims to evaluate the association between eating jetlag and the risk of cardiovascular disease (CVD). Methods Dietary, anthropometric, socio-demographic and health data of 104,837 participants (79% women, mean age=42.7 years (14.6 SD)) were collected from the NutriNet-Santé cohort. Eating jetlag was calculated using time of first and last meals on weekdays and weekends, from repeated 24 dietary records, averaged during the 2 first years. It was assessed as a continuous variable or as 3 categories: ‘Advance’, ‘Maintenance’, ‘Delay’, compared to work days. CVD was self-reported and validated against medical records. The associations between eating jetlag and CVD risk were assessed through adjusted Cox models. Results During a median follow-up time of 8.1 years, 2,368 CVD cases were diagnosed. Eating jetlag showed a U-shaped association with CVD risk (HR Advance vs. Maintenance=1.05(95% CI: 0.87-1.26); HR Delay vs. Maintenance=1.08(0.96-1.21)). When the absolute value of eating jetlag was considered, there was a linear association with CVD risk (HR per 1-hour increase=1.05(1.00-1.12)). These linear trends were confirmed in categorial models (Low: ≤1h; Moderate: 1h< to ≤ 2h; High: >2h): HR Moderate vs. Low=1.05(0.94-1.18), and HR High vs. Low=1.13(0.94-1.37); however, statistical significance was not reached. Conclusions Our results suggest a potential role for meal timing regularity between free and work days in CVD etiology. They need to be replicated in other studies and mechanisms are yet to be fully understood. Key messages • Adopting regular meal timing schemes on work and free days could be associated with a lower risk of cardiovascular diseases. • Meal regularity between work and free days could play a role in cardiovascular health and should be further investigated.

Chrono-nutrition and post-bariatric weight loss: insights from the Portuguese ChronoWise cohort

Abstract Background Post-bariatric weight loss varies substantially, and a large proportion of patients respond poorly. The literature highlights the importance of chrono-nutrition for weight regulation. This study aims to explore the chrono-related factors associated with poorer weight loss. Methods This study was conducted within the ChronoWise project, an ongoing prospective cohort study following patients undergoing bariatric surgery at the Santo António Local Health Unit, Porto. The sample included patients evaluated at both pre-surgery and 3 months post-surgery. Baseline information on meal timing was gathered through the Chrononutrition Profile-Questionnaire. The eating midpoint (midpoint between first and last meal) was calculated for work and free days. Chronotype was determined using the Munich Chronotype Questionnaire. Weight loss was expressed as the percent of total weight loss (%TWL = [(initial weight − current weight)/(initial weight)]×100). Chrono-related variables were compared according to %TWL (dichotomized by the median) using the Mann-Whitney test. Results Sixty patients were included (72% female; mean age 45±11.8). The mean baseline BMI was 44±5.6 kg/m2, which decreased to 35±5.3 kg/m2 at 3 months post-surgery, resulting in an average 20±3.9 %TWL. On free days, participants with lower %TWL tend to do the first meal later in the day (9h45 vs. 9h10, р=0.367), and later lunch on workdays (12h45 vs 12h30, р=0.531) compared with individuals with higher %TWL. Lower %TWL is typically observed in individuals having later eating midpoints (15h00 vs. 14h15 for workdays, р=0.011; 15h07 vs. 14h44 for free days, р=0.205). A later chronotype (3h37 vs 3h30, р=0.347) was also linked with poorer weight loss. Conclusions Eating later during the day and later chronotype may contribute to poorer post-bariatric weight loss. Funding: This work was supported by FCT - Fundação para a Ciência e Tecnologia [2021.01096.CEECIND, UIDB/04750/2020,LA/P/0064/2020&SGITR2023/EPIUnit]. Key messages • Recognizing meal timing as a modifiable lifestyle factor may optimize current approaches by aligning food intake with circadian clock. • A later chronotype, i.e. a behavioural expression of an individual’s internal circadian clock system as a preference for eveningness or later sleep timing, may negatively influence weight loss.

The safety of standardized management of suspected cardiovascular immune-related events in patients treated by immunecheckpoints inhibitors

Abstract Background Immune checkpoint inhibitors (ICIs) treatment carries a risk of immune-related adverse events (irAEs), including cardiovascular (CV) events. Current guidelines recommend troponin testing to detect early CV irAEs, especially myocarditis, prompting hospital admission. However, high volumes might hinder hospital admission for all suspected CV irAEs patients. Purpose To assess the safety of standardized management in outpatients with suspected irAEs. Methods A prospective single-center cohort study was conducted, including all adults referred to our unit for suspected CV irAEs. Patients exhibiting CV symptoms, receiving double ICIs, or showing ECG changes were referred to cardiology or intensive care based on severity. Patients with no CV symptoms or ECG changes, on single ICI therapy, and no other immune disorder were assessed in a day stay within 8 working days. Patients underwent serial serum testing, ECG, transthoracic echocardiogram, and cardiac magnetic resonance imaging (cMRI) and were assessed by a multidisciplinary team (MDT) including cardiology and internal medicine specialists. Coronary artery imaging and endomyocardial biopsy were performed when deemed necessary (Figure 1). The primary endpoint was CV mortality at 30 days after referral. Secondary endpoints included identifying factors associated with the diagnosis of CV irAEs at referral. Events were adjudicated by a panel of experts (FC, MM, SH) who reviewed the MDT's weekly meeting conclusions. Results 175 patients were enrolled from March 2022 to October 2023; 40 (22.89%) were male, median age 61 (IQR 48.0-72.0) years. 146 (83.4%) were seen in the outpatient clinic. No CV deaths occurred within the initial 30 days. 95 patients (54.1%) had CV irAEs at referral, including 72 (41.1%) with myocarditis; 10 (5.7%) with acute coronary syndromes; 9 (5.1%) with pericarditis; 7 (4.0%) with heart failure; 4 (2.3%) with high-degree conduction or ventricular arrhythmias; and 1 (0.6%) with Tako-Tsubo. 8 (4.6%) had a combination of CV irAEs. The majority of patients admitted to the hospital had CV irAEs (24, 82.7%). On multivariable regression analysis(Figure 2), CV or muscle symptoms(OR 2.677 [CI 1.207-5.937], p=0.015), prior CV disease history(OR 3.668 [CI 1.486-9.057], p=0.0048), and abnormal ECG (OR 2.855 [CI 1.074-7.589], p=0.035) remained associated with CV irAEs at referral. Including global longitudinal strain (GLS) in the model, we identified prior CV disease history. (OR 7.011 [CI 2.217-22.167], p=0.0009) and GLS <16% (OR 2.774 [CI 1.07-7.17], p=0.035) as significant. Conclusions We demonstrate the safety of a standardized outpatient management approach for most patients referred for suspected CV irAEs, mainly triggered by asymptomatic elevation of troponin. No patient experienced CV death at 30 days. When suspecting a CV irAEs, CV or muscle symptoms, previous history of CV disease, and abnormal ECG should prompt speedy assessment given the higher likelihood of CV irAEsFigure 1

Does the way workplace canteens are managed influence users’ plate waste?

Abstract Background Plate waste (PW) is part of the food waste and is defined as the amount of edible food served not eaten. There are few estimates of PW in the food services, mainly in school canteens, where PW appears to differ depending on the provider. Our aim was to analyse the role of different canteen management in determining PW in three hospital canteens in Italy. Methods On 5 working days between August and September 2022, healthcare workers’ trays were photographed before and after meal consumption. We compared two canteens managed by an external catering service (EC) with one internally managed (IC). The two canteens with similar sample size had different management. A modified visual Comstock scale was used to assess the PW. The Carbon Footprint (CF), Water Footprint (WF), energy and nutrient content were estimated using the SU-EATABLE LIFE database and the Italian Food Composition Database for Epidemiological Studies (www.bda-ieo.it). Significance was set at p < 0.05. Results 1227 trays were analysed (1026 in EC; 201 in IC), most of which contained no waste. The percentage of trays with leftovers was higher in EC (34%) than in IC (21%), as was the mean amount of PW (104g EC vs 60g IC) (p < 0.001). The PW contained significantly more energy (125 kcal vs 73 kcal) and protein (6.0g vs 2.4g) and had higher CF (204 CO2eq EC vs 76 CO2eq IC) and WF (178 LH20 EC vs 75 LH20 IC) in CE than in IC. The significance was confirmed independently to the sample size of the canteens, and when the analysis was repeated and only the first access of each user was considered. Conclusions Results suggest that an internally managed canteen produces less leftovers than a canteen operated by an external provider. This could be because an internally managed canteen is more adaptable to users in terms of food offerings and portion sizes, despite a smaller number of food options. However, further studies are needed to confirm our findings and to identify the causes of PW in food service. Key messages • Internally managed canteens seem to reduce plate waste, probably due to certain flexibility according to users’ plate waste. • Non-served food of the canteen should be estimated to confirm our data.

Let’s Get Walking: Establishing Workplace Walking Groups in a regional Public Health Department

Abstract Maintaining staff health and wellbeing (HWB) is an ongoing priority for the Department of Public Health HSE Dublin and Midlands (PHD). This is particularly important in the context of an ongoing programme of reform for Public Health in Ireland. To support this priority, in November 2023 a pilot Workplace Walking Groups initiative was established to increase workplace physical activity and build team relationships. The initiative was designed following staff feedback on team HWB initiatives in September 2023. The Model for Improvement (which includes the Plan-Do-Study-Act cycle) was used to take a structured quality improvement approach to the development and evaluation of the 4-week pilot, led by the PHD HWB Committee. Staff joined across 3 sites. Lunchtime walks were arranged for 1-2 days per week. WhatsApp groups and email supported group communication. Quantitative data on registration and attendance were collected via Microsoft Excel. A virtual focus group was arranged to gather participant feedback, which was analysed into themes. Group registration (n = 10, n = 9, n = 5) and weekly attendance varied by site (n = 10, n = 9, n = 5). Key benefits noted by participants included physical activity, building relationships with colleagues, and getting fresh air. The main barrier was the impact of work schedules on attendance. There was broad support for re-establishment of Workplace Walking Groups for 2024. This pilot Workplace Walking Groups initiative achieved its dual aim of increasing physical activity and social connection among staff. Learning from this pilot informed the launch of a 3-month Walking Groups term for Spring 2024. The initiative is now established practice and is a component of the Department’s blended working policy, being a feature of on-site working days. Key messages • Our successful pilot Workplace Walking Groups project has translated into a sustainable health and well-being initiative for staff, during a time of ongoing reform across Public Health in Ireland. • A structured approach to designing and implementing staff health promotion initiatives is crucial to support the cycle of learning and improvement, and to sustain change over time.

The interplay among sleep patterns, social habits, and environmental cues: insights from the Spanish population and implications for aligning daily rhythms

IntroductionThe interplay among sleep patterns, social habits and environmental cues is becoming increasingly more important for public health and wellbeing due to its connection to circadian desynchronization. This paper explores said connections in Spain (which has an official and solar time mismatch), introducing the “Three Times Score” ‒which is based on questions widely used in the field‒ as a complementary tool for exploring the interplay of daily rhythms.MethodsThe questionnaire covers sleep-related habits, social time, and environmental time. The study includes 9,947 participants (34.89 ± 12.15 y/o, mean ± SD; 5,561 women) from different Spanish regions. Sleep parameters were obtained for work and free days, as well as a modified version of the sleep-corrected midsleep on free days (MBFbc) and a parameter similar to social jet lag, both derived from bed time rather than sleep time. A number of indexes were computed to compare bed and work-related habits, together with natural light/dark cycle, along with the Three Times Score. Mixed-effect regression analysis was used to test whether the biological, social and environmental factors included in the study significantly predicted the sleep-related parameters: bedtime, wake-up time, time in bed and mid-bedtime.Results and discussionTemporal differences were found between work and free days, with waking-up occurring 2 h earlier on work days (7:10 ± 0:01) than on free days (9:15 ± 0:01). Bed times were 1 h earlier on work days (23:46 ± 0:01) than on free days (00:45 ± 0:01), whereas time in bed was over 1 h shorter on work (7 h 23 min) versus free (8 h 29 min) days. Strong correlations were found between work starting time and waking-up and bedtimes on workdays. Women went to bed earlier and woke up later, spending more time in bed. Differences in sleep habits were observed between work and free days across all age groups. The group of younger adults (18–30) reported going to bed later than older and younger groups, especially on free days. Adolescents and young adults also woke-up later than other age groups, especially on free days. Social jet lag (relative to bed time) and desynchronization indexes also varied with age, with younger adult participants exhibiting higher levels. Seasonal differences were limited, with minor variations between winter and summer. According to the multiple regression analysis, social (day type, work start time, alarm clock usage), biological (age, gender, in most cases related to sex) and environmental (sunset time) factors significantly contribute to predicting sleep/bed related schedules. This study provides insights into sleep habits in the Spanish population, introducing the Three Times Score as a complementary tool for exploring the interactions between sleep/bed-related habits, natural darkness and work-related schedules. Understanding this interplay is crucial for developing tailored interventions to improve sleep and wellbeing.

Artificial Intelligence-Assisted Daily Quality Control System for the Histologic Diagnosis of Gastrointestinal Endoscopic Biopsies: A 1-Year Experience.

Seegene Medical Foundation, one of the major clinical laboratories in South Korea, developed SeeDP, an artificial intelligence (AI)-based postanalytic daily quality control (QC) system that reassesses all gastrointestinal (GI) endoscopic biopsy (EB) slides for incorrect diagnoses. To review the operational records and clinical impact of SeeDP since its launch in March 2022. Operational records of SeeDP were retrieved for the period of March 1, 2022, to February 28, 2023. Among cases scanned during 40 working days (March 10, 2022, to May 4, 2022), all discordant cases encountered by 2 pathologists were reviewed. Cases of SeeDP-assisted revised diagnoses were collected and compared with cases recognized using conventional methods. Occasional scanner failures and various types of aberrant errors compromised QC coverage, resulting in the scanning of only 67.7% (572 254 of 844 906) of all EB slides submitted and 0.8% of the scanned slides being further excluded from the AI analysis. The AI predictions differed from the pathologists' diagnoses in 42 760 of the 557 672 gastrointestinal EB slides (7.7%) successfully assessed by the AI models; however, a detailed review of discordant slides revealed that true misdiagnosis accounted for only 5.5% (25 of 454) of the disagreements. Compared with conventional error recognition methods, SeeDP detected more misdiagnoses (7 versus 14) within a significantly shorter time (average, 3.6 versus 38.7 days; P < .001), including 1 signet ring cell carcinoma initially diagnosed as gastritis. AI-based daily QC systems are plausible solutions to guarantee high-quality pathologic diagnosis by enabling rapid detection and correction of misdiagnosis.

A rapid, facile, and economical method for the isolation of ribosomes and translational machinery for structural and functional studies.

Ribosomes are essential RNA-protein complexes involved in protein synthesis and quality control. Traditional methods for ribosome isolation are labor intensive, expensive, and require substantial biological material. In contrast, our new method, RAPPL (RNA Affinity Purification using Poly-Lysine), offers a rapid, simple, and cost-effective alternative. This method enriches ribosomes and associated factors from various species and sample types, including cell lysates, whole cells, organs, and whole organisms, and is compatible with traditional isolation techniques. Here, we use RAPPL to facilitate the rapid isolation, functional screening, and structural analysis of ribosomes with associated factors. We demonstrate ribosome-associated resistance mechanisms from patient uropathogeni c Escherichia coli samples and generate a 2.7Å cryoEM structure of ribosomes from Cryptococcus neoformans . By significantly reducing the amount of the starting biological material and the time required for isolation, the RAPPL approach improves the study of ribosomal function, interactions, and antibiotic resistance, providing a versatile platform for academic, clinical, and industrial research on ribosomes. Ribosomes are macromolecular RNA-protein complexes that constitute the central machinery responsible for protein synthesis and quality control in the cell. Ribosomes also serve as a hub for multiple non-ribosomal proteins and RNAs that control protein synthesis. However, the purification of ribosomes and associated factors for functional and structural studies requires a large amount of starting biological material and a tedious workflow. Current methods are challenging as they combine ultracentrifugation, the use of sucrose cushions or gradients, expensive equipment, and multiple hours to days of work. Here, we present a rapid, facile, and cost-effective method to isolate ribosomes from in vivo or in vitro samples for functional and structural studies using single-step enrichment on magnetic beads - RAPPL (RNA Affinity Purification using Poly-Lysine). Using mass spectrometry and western blot analyses, we show that poly-lysine coated beads incubated with E. coli and HEK-293 cell lysates enrich specifically for ribosomes and ribosome-associated factors. We demonstrate the ability of RAPPL to isolate ribosomes and translation-associated factors from limited material quantities, as well as a wide variety of biological samples: cell lysates, cells, organs, and whole organisms. Using RAPPL, we characterized and visualized the different effects of various drugs and translation inhibitors on protein synthesis. Our method is compatible with traditional ribosome isolation. It can be used to purify specific complexes from fractions of sucrose gradients or in tandem affinity purifications for ribosome-associated factors. Ribosomes isolated using RAPPL are functionally active and can be used for rapid screening and in vitro characterization of ribosome antibiotic resistance. Lastly, we demonstrate the structural applications of RAPPL by purifying and solving the 2.7Å cryo-EM structure of ribosomes from the Cryptococcus neoformans , an encapsulated yeast causing cryptococcosis. Ribosomes and translational machinery purified with this method are suitable for subsequent functional or structural analyses and provide a solid foundation for researchers to carry out further applications - academic, clinical, or industrial - on ribosomes.

Mired in tasks: how daily workplace multitasking shapes employee service innovation behavior

Purpose Drawing on conservation of resources theory, this paper aims to propose that daily multitasking increases employees’ daily role pressure, ultimately hindering their service innovation behavior. Furthermore, we suggest that trait mindfulness may mitigate this negative impact. Design/methodology/approach To empirically test the study hypotheses, this paper conducted a multilevel diary field study, collecting data from 64 employees over 10 working days to comprehensively validate the theoretical model. Findings The findings indicate that daily multitasking indirectly reduces daily service innovation behavior by increasing employee role pressure. Notably, this indirect effect is more pronounced among employees with lower trait mindfulness, while it is less significant for those with higher trait mindfulness. Practical implications Hotels should manage multitasking, reduce employee stress and promote service innovation by optimizing task allocation and redesigning work processes. Additionally, hotel management should adopt a multifaceted and innovative approach to foster mindfulness traits. Originality/value This study contributes to the literature on multitasking and innovation by examining how and when daily multitasking influences employee service innovation behavior.

UM ESTUDO DE CASO SOBRE A QUALIDADE DE VIDA NO EXERCÍCIO DO TRABALHO POLICIAL

In this article, we sought to investigate the perception of military police officers regarding the quality of life in the professional context in which they carry out their activities and what possible impacts they may feel on their personal lives. For this, a data survey was used through a structured questionnaire applied online with military police officers from the 8th Independent Military Police Company (8th CIPM), based on the QWL analysis model of Walton’s eight dimensions (1973). Questionnaires were administered 80 police officers. As a result, based on the interviewees’ answers to the questions present in the questionnaire, it was found that the absence of a defined working day reflects on the quality of personal life, as many are unable to enjoy leisure with their family and added to this, we have the relatively stressful and high-risk environment of their functions, which directly affect the issue of quality of life when carrying out their functions.

The feasibility and acceptability of using EMA and physiological data to measure day-to-day occupational stress, musculoskeletal pain and mental health

ObjectivesThis study aimed to assess the feasibility and acceptability of using EMA questionnaires and physiological data via wristbands to measure day-to-day occupational stress, musculoskeletal pain, and mental health among university employees (N = 23), across 10 work days. Adherence to the study protocol as well as participant experiences (via semi-structured interviews) with the protocol were used to assess feasibility and acceptability of the method.ResultsAdherence to the study protocol was excellent. Participants wore the wristband for a mean of 9.7 days. Participants completed a mean of 24.5 EMAs (out of 30). Semi-structured interviews with participants revealed that a small number of participants had difficulties uploading data from the wristband. The timing of EMAs was challenging for some participants, resulting in missed EMAs, raising questions about whether EMA frequency and timing could be changed to improve adherence. Some EMA items were difficult to answer due to the nature of participants’ roles and the work undertaken. Overall, the protocol was feasible and acceptable but highlighted future potential changes including using a different physiological data collection tool, reducing the number of EMAs, adjusting EMA timings, and reviewing EMA items.

Differences in Time to Return to Work Between Patients Undergoing Staged Versus Simultaneous Bilateral Total Hip Arthroplasty

Patients who undergo total hip arthroplasty (THA) oftentimes have severe osteoarthritis (OA) in both hips and may consider staged or simultaneous bilateral THA (bTHA). The goal of this study was to compare the total workdays missed following staged and simultaneous bTHA performed via either postero-lateral or direct anterior approach. Patients who were (1) employed, (2) underwent a staged (within 12 months) or simultaneous bTHA at our institution between February 1, 2016 and December 31, 2021, (3) completed a return to work questionnaire, and (4) had the same surgical approach for both THAs were included. The primary outcome of interest was the total days of work missed. We identified 78 employed patients who had undergone staged bTHA (62 postero-lateral approach [PA], 16 direct anterior approach [DAA]) and 76 patients (44 PA, 32 DAA) who underwent simultaneous bTHA, and had completed the return to work questionnaire. Simultaneous bTHA patients missed an average of 25.6 days of work (standard deviation [SD]: 14.3 days) compared to staged bTHA patients, who missed an average of 36.9 days of work (SD: 23.4) when combining days missed from both operations (P < 0.001). In multivariate mixed regression analysis adjusted for sex, age, body mass index (BMI), American Society of Anesthesiologists (ASA) status, type of work, and surgical approach, the staged bTHA group missed a mean of 8.2 more days of work (SD: 3.3) compared to the simultaneous bTHA group (95% confidence interval: 1.8-14.7, P = 0.013). Employed patients who underwent simultaneous bTHA missed an average of 8.2 fewer days of work compared to those who were treated with staged bTHA. These findings may help surgeons counsel their employed patients who have bilateral hip OA and are considering surgical treatment.

PRODUKTIVITAS ALAT EXCAVATOR VIBRO HAMMER UNTUK PEMANCANGAN SSP REUSE PADA PROYEK RENTANG IRRIGATION MODERNIZATION PROJECT DI KABUPATEN MAJALENGKA

Rentang Dam is currently implementing a project, namely the Rentang Irrigation ModernizationProject (RIMP), which aims to restore irrigation functions, stabilize soil conditions, and alsooptimize water distribution. One of the projects that is being implemented as an effort to stabilize thecondition of the land is the installation of SSP Reuse piling. In the erection of SSP Reuse, the heavyequipment used was a vibro hammer excavator. From the erection of the SSP Reuse erection usinga vibro hammer excavator, its productivity can be seen. In this study, we review the productivity ofa vibro hammer excavator tool for erecting SSP Reuse on the right side of the CP. 168 – CP. 170110 meters long. The erection of the SSP Reuse is a follow-up effort to ensure that landslides do notoccur and access to residents' houses is wide. The productivity of the vibro hammer excavator forerecting SSP Reuse with a working day of 30 days per 8 hours, the average point obtained per dayis 9.17 sticks. Meanwhile, for the cycle time on day 1 at 13 SSP Reuse points with dimensions of 8 x0.4 m with vibration via a vibro hammer, the total cycle time was 200.71 minutes and the averagecycle was 15.44 minutes. Finally, the average cycle time of the vibro hammer piling tool taken during30 days of work had a cycle time of 11.33 minutes per rod.

Productivity losses in the transition to Daylight Saving Time: Evidence from hourly GitHub activity

Using data on GitHub users around the world, we estimate the effects of transitions to Daylight Saving Time on worker activity. In daily activity, transitions appear short lived—there is evidence of two days of declines before activity returns to baseline levels. However, hourly analysis reveals a transition to Daylight Saving Time that is much longer—losses appear in the early working hours of work days into a second week following the initiation of Daylight Saving Time.

Hypnosis: An aid in working with patients with narcolepsy

ABSTRACT Narcolepsy is a primary neurological sleep disorder characterized by excessive daytime sleepiness, and in a majority of patients, cataplexy, which is sudden muscle weakness brought on by strong emotion. While often thought of as an adult condition, narcolepsy can be present at any age and may occur as often as 1 in 2000 individuals. Regardless of age, its effects are far-reaching, resulting in missed school or work days, poor school or work performance and all associated ramifications. In children and young-adults, narcolepsy can masquerade for years as anxiety, depression, attention deficit disorder and even bipolar disorder, thus delaying diagnosis. Most patients diagnosed with narcolepsy receive significant benefit from standard medication. In addition to medication, however, this article describes promising roles for clinical hypnosis in the care of young patients with narcolepsy, including through teaching them how to have more control over their sleepiness and the emotions that can induce cataplexy, while minimizing side effects that can occur when using narcolepsy medication.

Project Acceleration Analysis Using the Crashing Method with The Alternative of Additional Labor and Additional Working Hours in Drainage Work

Project work delays often occur due to differences in site conditions, design changes, weather influences, and planning errors. The problem faced is the project duration, where if the project duration is accelerated or crashes, there will be several options to cut the project duration. This is the problem that becomes the topic of the thesis/journal, namely "Analysis of Project Acceleration with the Crashing Method with Alternatives for Adding Manpower and Additional Working Hours in Drainage Works". The author uses the primary method, with sources of RAB, Time Schedule, working drawings and analysis of city unit prices. As well as secondary research methods with sources, from relevant books, and project data such as price lists and wages. From the results of the study it can be concluded that the total wages of workers under normal conditions is IDR. 16,864,000.00 with the duration of project work for 30 working days. From the results of the analysis in this study, the total wages of workers with alternative labor additions of IDR. 19,672,000.00 with the duration of project construction work for 25 working days or 15.15% faster than the normal duration. Meanwhile, the total wage for workers with the alternative of additional working hours (overtime) is IDR. 25,052,300.00 with the duration of the project construction work for 25 working days or 15.15% faster than the normal duration. A more economical alternative to completing the project is the addition of manpower because it saves IDR. 2,228,000.00 from additional working hours (overtime), from normal wages.