Excessive Fatigue Research Articles

Sleep-disordered breathing in a multi-ethnic cohort of preterm adolescents and adults: assessment of neonatal and subsequent risk factors.

Determine whether preterm-born adolescents and adults have sleep-disordered breathing (SDB), as documented by abnormal overnight oximetry. This single-center cross-sectional study prospectively enrolled adolescents and adults born moderately to extremely preterm (≤32 weeks gestation or <1500 grams birth weight) or full term to complete a study visit, STOP-Bang questionnaire, and overnight oximetry. Oxygen desaturation index (ODI) was compared in preterm versus term with Poisson regression models. Subgroup analyses in preterm participants evaluated associations of neonatal risk factors with ODI. Ninety-six preterm and 44 term participants completed study procedures. Preterm participants more often reported snoring (25% vs 9%; p=0.03) and excessive fatigue (62% vs 40%; p=0.02), and had higher body mass index, leading to higher STOP-Bang scores (2±1 vs 1±1; p<0.001). Preterm participants had 40% higher ODI (incidence rate ratio (IRR): 1.40; 95% CI [1.07,1.83]; p=0.02). However, after adjusting for classic risk factors for SDB including age and STOP-Bang score in a multivariable model, history of preterm birth did not predict additive risk for SDB. Among neonatal factors, a patent ductus arteriosus was associated with a higher ODI (IRR 1.99; 95% CI [1.37,2.91]; p<0.001). Preterm-born adolescents and adults in this study have higher rates of snoring, daytime fatigue, and nocturnal desaturations compared to those term-born. However, the risk of elevated ODI is best attributed to obesity in this cohort and not the history of prematurity. Additionally, a history of a patent ductus arteriosus increased risk for SDB.

Treatment of obstructive sleep apnea with CPAP improves daytime sleepiness and fatigue in cancer patients.

Fatigue and sleep disorders are prevalent in cancer patients. Obstructive sleep apnea (OSA) commonly causes excessive daytime sleepiness (EDS) and fatigue. We hypothesize that treating cancer patients with OSA using positive airway pressure (PAP) will improve EDS and fatigue. A retrospective chart review of sleep clinic visits of cancer patients with newly diagnosed OSA was performed. Epworth Sleepiness Scale (ESS) and fatigue reported at baseline and within 6 months of starting PAP therapy were compared between PAP-adherent and PAP-non-adherent patients. 65 cancer patients with OSA and ESS >10 were recommended PAP therapy, including 45 patients with fatigue. 29 patients pursued PAP therapy with 79% (n = 23) adherent at follow-up. The median baseline apnea hypopnea index (AHI) for OSA was 24.0 (interquartile range [IQR] 14.3, 32.3) and 23.8 (IQR 10.1, 42.8) events/hour among PAP-adherent and PAP-non-adherent patients, respectively (p = 0.90). Median baseline ESS was 14.0 (IQR 12.0, 17.0) among adherent and 17.0 (IQR 11.0, 17.3) among non-adherent patients (p = 0.73). The median ESS at follow-up of the adherent and non-adherent groups was 8.0 (IQR 6.0, 10.0) and 11.0 (IQR 8.0, 15.8), respectively (p = 0.08). Median ESS change was -5.0 (IQR -7.0, -4.0) in PAP adherent patients and -2.5 (IQR -5.25, -1.50) in PAP-non-adherent patients (p = 0.07). When the groups are examined separately, the median change in the PAP-adherent group was highly significant (p = 0.001), while the ESS median change in the PAP-non-adherent group was considerably less (p = 0.04). 17out of the 21 PAP-adherent patients reporting fatigue at baseline indicated improvement at follow-up. PAP therapy for OSA in cancer patients improves EDS and fatigue. Larger studies are necessary to evaluate the efficacy of PAP in improving fatigue in this population.

Improving health workers’ well-being in Cittadella Hospital (Province of Padua)

Abstract Issue A healthy workplace increases productivity, creativity and decreases absenteeism and turn-over. It also contributes to creating a more secure work environment with fewer risks of violence. In the past 3 years, the healthcare system has suffered the psychological, economic and social consequences of the COVID-19 pandemic. On the other hand, the healthcare staff reductions determine high levels of work related stress that are often unsustainable. Description In an effort to improve staff well-being, in the Hospital of Cittadella, which counts nearly 1,250 employees, a wide range of activities have been initiated. A questionnaire was submitted to the hospital’s staff and the results showed that nearly 10% of workers had experienced physical symptomatology related to work. The most commonly experienced symptoms included: anxiety, nervousness, headache, stomach ache, excessive fatigue and insomnia. Participants also indicated feeling excessive mental fatigue and emotional overload at the end of their work shift. Results Psychomotor practice, held according to the Aucouturier method, is one of the projects intended especially for the staff operating in Intensive Care, Emergency and Pneumology Units. This method brings focus to controlled breathing, posture, muscle work and movement that help manage stress and fatigue. A Qigong course, which is an ancient Chinese practice designed to optimize the energy within the body reducing the stress levels and increasing general wellbeing, was held every two weeks for 5 months. And finally, Tibetan singing crystal bowls sessions consisted of monthly guided meditation sessions using the sounds of the crystal bowls. Lessons In conclusion, well-being and organizational performance are closely related to each other. It is crucial for any organization to encourage and maintain better physical and mental health of the healthcare staff as it directly affects productivity and consequently user’s satisfaction of the services provided. Key messages • Stress management is important amongst healthcare professionals as they are continuously exposed to different job stressors. • Promoting self awareness and self care can help create a healthier work environment.

Enzymatic and Enzyme‐Free Electrochemical Lactate Sensors: A Review of the Recent Developments

ABSTRACTLactate is a useful analytical indicator in various fields. The lactate monitoring benefits from evaluating the body's condition, as excessive muscle use or fatigue can result in injury. Further, it is useful for alerting to emergencies like haemorrhage, hypoxia, respiratory distress, and sepsis. Additionally, the determination of the food's lactate level is very important in examining freshness, storage stability, and fermentation degree. Given such benefits, the determination of lactate in various samples has been widely explored, especially using electrochemical sensor technology. Despite enzymatic sensors being the focus of numerous studies, enzyme‐free platforms have gained focus over the last few years to address the matter of enzyme stability. This review article respectfully offers an overview of the concepts, applications, and recent advances of electrochemical lactate detection platforms. A comparison of hot research for enzymatic and enzyme‐free lactate sensors in terms of electrode surface engineering, enzymes and their immobilisation matrices, and several analytical parameters, including linear dynamic range, the limit of detection, sensitivity, and stability, have been discussed. In addition, future perspectives have been highlighted in this review.

8144 Hypertension in Sheehan Syndrome: A Diagnostic Challenge

Abstract Disclosure: E. Ahsan: None. F.F. Foo: None. C. Lesniak: None. M. Akula: None. K. Hu: None. R. Ong: None. K. Chalasani: None. J. Cheng: None. S. Holland: None. Introduction: Postpartum pituitary necrosis, commonly known as Sheehan syndrome (SS), is the term used to describe the necrosis of anterior pituitary gland cells that occurs after significant postpartum bleeding, hypovolemia, and shock. This typically occurs after delivery, during which the mother suffers significant blood loss. The pituitary gland fails to produce hormones due to this blood loss. Depending on the degree of tissue damage, SS can have an acute or chronic course, and patients may present with a wide range of clinical symptoms at diagnosis. Acute SS is associated with postpartum pituitary infarction, which can result in hypotension, shock, hypoglycemia, hyponatremia, headache, vision disturbances, unconsciousness, and an inability to lactate. We present a rare case of SS where the patient experienced hypertension instead of classic hypotension due to postpartum preeclampsia. Clinical Case: A 40-year-old female with no significant medical history presented to the hospital for scheduled induction of labor for polyhydramnios and underwent vacuum-assisted vaginal delivery and postpartum hysterectomy due to severe postpartum hemorrhage secondary to DIC. The postpartum course was also complicated by preeclampsia with severe features. Patients developed features like excessive fatigue, hypoglycemia, hyponatremia, hypothyroidism, polyuria, and failure of lactation, which were consistent with panhypopituitarism secondary to Sheehan syndrome. However, the patient was hypertensive to 145/91 before steroids were given. Labs were significant for serum sodium 116 mmol/L (135-145 mmol/L), FSH &amp;lt;0.7 mIU/mL (Follicular Phase: 2.5-10.2, Mid-cycle Peak: 3.1-17.7, Luteal Phase: 1.5-9.1, Postmenopausal: 23.0-116.3), LH &amp;lt;0.2 mIU/m (Follicular Phase: 1.9-12.5, Mid-Cycle Peak: 8.7-76.3, Luteal Phase: 0.5-16.9, Postmenopausal: 10.0-54.7), Prolactin: 2.4 ng/mL (Non-pregnant: 3.0-30.0, Pregnant: 10.0-209.0, Postmenopausal: 2.0-20.0), PM Cortisol on admission: 1.10 ug/dL (3.44-16.76 ug/dL), plasma ACTH 7 pg/mL( 6 - 50 pg/mL), TSH 0.430 uIU/mL (0.550 - 4.780 uIU/mL), FT4 0.59 ng/dL - 1.76 ng/dL). MRI of the brain pituitary showed- A 1.5 cm region of hypoenhancement and an additional 2 mm focus of hypoenhancement in the sella, findings represent evolving pituitary necrosis. The patient received 24 units of blood transfusion and hormone replacement therapy, followed by outpatient endocrinology follow-up. Clinical lessons: Although considerable blood loss causes hypotension in patients with SS, additional postpartum medical issues can sometimes result in atypical presentations. In our patient, postpartum preeclampsia caused hypertension. Identifying the atypical symptoms of SS is just as vital as identifying its typical features to prevent potentially fatal consequences. Presentation: 6/2/2024

7295 Giant Pituitary Adenoma with Rapid Symptomatic Progression and Postoperative Mortality

Abstract Disclosure: R.D. Kennedy: None. M. Nicholson: None. Introduction: Giant pituitary adenomas, defined as pituitary adenomas measuring greater than 4 cm, present a therapeutic challenge because of their size, clinical features, and increased potential for complications following surgical intervention. Early detection and intervention to prevent growth and progression is paramount. We present a case of a patient with a giant 6.3 cm pituitary adenoma who had significant neurologic compromise, requiring surgical intervention, with resultant postoperative complications and death. Case:Patient is a 41 year old male with known history of pituitary adenoma who presented on 11/1/2023, from outside hospital, to the Neuroendocrine clinic with complaints of excessive truncal obesity, impotence, fatigue, and apathy. Vital signs were within normal limits. Physical exam revealed clouding of consciousness, grossly intact cranial nerve function, truncal obesity, and diminished power, tone, and bulk of the extremities. Formal visual field testing revealed bitemporal hemianopsia. A head CT scan revealed a 6.3 cm sellar mass with expansion of the sella, invasion of soft tissue into the sphenoid sinus, and extension of soft tissue cranially to the level of the third ventricle eccentric to the left. There was no evidence of apoplexy. Lab results revealed Prolactin of 924 ng/mL. The patient had been taking Bromocriptine, 2.5 mg daily, for at least three weeks. Less than three weeks after his initial evaluation, he returned to the hospital with complaint of acute ataxia. Pituitary MRI revealed 6.3 cm sellar mass with evidence of acute and subacute blood products, stretching of the optic chiasm from mass effect, extension into the bilateral cavernous sinuses, superior left MCA displacement, posterior left PCA displacement, 5 mm midline shift, uncal herniation and descending transtentorial herniation. The patient underwent endoscopic transsphenoidal resection with subsequent craniotomy for debulking. Postoperatively, he developed new right sided hemiplegia with aphasia with subsequent MRI finding of watershed infarct at the left MCA/PCA lateral posterior border zone territories with increasing mass effect over a 30 day hospital stay. He developed progressive global edema with worsening uncal and tonsillar herniations. Brain death was pronounced on 11/30/23. Discussion:This case highlights the importance of early intervention in patients with giant pituitary adenomas. Our patient had been experiencing right sided weakness for at least one year prior to his admission to our facility. In this case, earlier treatment with a dopamine agonist may have decreased the size of the adenoma or prevented rapid growth. This may have precluded the need for surgical intervention on an adenoma of this size, which carries increased risk for postoperative complications. Presentation: 6/2/2024

8533 Salt on the Kidneys A case of DDAVP induced arginine vasopressin resistance

Abstract Disclosure: M.M. Jordan: None. J.R. Islam: None. R. Hassan: None. A 63-year old female with a history of head trauma complicated by polyuria and excessive fatigue diagnosed with central DI and started on treatment with oral Desmopressin. She had no other known pertinent medical history. Patient was lost to follow-up with an eventual visit to the emergency department with complaints of bilateral leg cramps, nausea and persistent headaches. She was noted to have been initiated intranasal desmopressin in addition to oral DDAVP. On initial lab work, Sodium was 114 along with acute kidney injury. She was admitted to ICU and treated with hypertonic saline. DDAVP was withheld until sodium normalized and stabilization of renal functions. GFR still remained impaired on discharge at 40 mL/min/1.73m*2. She was then discharged on DDAVP with reestablished follow up in the endocrinology clinic with complaints of persistent polyuria. Once more, she was sent to the emergency room and was admitted for acute renal injury secondary to dehydration in the setting of polyuria and altered mentation. Upon review of her medications, the patient continued both oral and inhaled DDAVP. No other medications or supplements were reported. During this subsequent hospitalization, sodium remained between 131-135 with urine output 4.5L/ day despite increasing doses of oral DDAVP and oral sodium supplementation. At which point, suspicion for mixed DI was hypothesized (central DI and arginine vasopressin resistance). Other causes of polyuria were ruled out. Labs for persistent AKI revealed gross proteinuria. Renal biopsy was performed during hospitalization which showed acute to chronic vascular thrombotic microangiopathy and focal segmental glomerulosclerosis with collapsing features. Extensive workup for chronic infections, autoimmune conditions and hematological malignancies were negative. This showed concerns for possible DDAVP induced renal injury. Presentation: 6/2/2024

Application of LSTM-based Body Fatigue Detection Algorithm in Tai Chi Training

Tai Chi training sessions are often lengthy, and athletes are prone to experiencing fatigue during the process. Timely detection of body fatigue can help athletes prevent injuries caused by excessive fatigue. This study combines Long Short-Term Memory (LSTM) networks with facial muscle activity detection models to propose a novel fatigue detection algorithm. In this algorithm, the limitations of LSTM networks in capturing future information are addressed by introducing an improved LSTM network model and combining attention mechanisms to highlight the important features of physical fatigue. This study utilizes hyperspectral imaging technology to extract real-time muscle fatigue signals from the faces of subjects in the dataset. Performance validation of the proposed model shows that it effectively extracts facial fatigue features with a detection accuracy of 97.67% and a recall rate of 96.78%, outperforming other existing models in this field. The model constructed through research has excellent performance and has broad application prospects in current and future technological development due to its high flexibility and adaptability, providing support and innovation momentum for different industries.

Research Progress on Immunomodulatory Effects of Poly (Lactic-co- Glycolic Acid) Nanoparticles Loaded with Traditional Chinese Medicine Monomers.

Immunomodulatory mechanisms are indispensable and key factors in maintaining the balance of the environment in humans. When the immune function of the immune system is impaired, autoimmune diseases occur. Excessive body fatigue, natural aging of the human body, malnutrition, genetic factors and other reasons cause low immune function, due to which the body is prone to being infected by bacteria or cancer. Clinically, the existing therapeutic drugs still have problems such as high toxicity, long treatment cycle, drug resistance and high price, so we still need to explore and develop a high efficiency and low toxicity drug. Poly(lactic-co-glycolic acid) (PLGA) refers to a nontoxic polymer compound that exhibits excellent biocompatibility. Traditional Chinese medicine (TCM) monomers come from natural plants, and have the characteristics of high efficiency and low toxicity. Applying PLGA to TCM monomers can make up for the defects of traditional dosage forms, improve bioavailability, reduce the frequency and dosage of drug use, and reduce toxicity and side effects, thus having the characteristics of sustained release and targeting. Accordingly, PLGA nanoparticles loaded with TCM monomers have been the focus of development. The previous research on drug loading advantages, preparation methods, and immune regulation of TCM PLGA nanoparticles is summarized in the following sections.

Thermal radiation imaging technology and sensor assisted calculation of sports training technology simulation

With the development of sports training science and technology, the real-time monitoring of athletes’ physical condition and training effect is becoming more and more important. As a non-contact measurement method, thermal radiation imaging technology can capture the changes of athletes’ body surface temperature efficiently and in real time, and provide relevant information about physiological state and performance indicators. This paper discusses the application of thermal radiation imaging technology in sports training to help measure athletes’ physical state and training effect, so as to provide scientific basis for improving training efficiency and reducing sports injuries. In this paper, the high resolution thermal imaging equipment is used to systematically analyze the thermal radiation imaging of athletes, and the physiological index monitoring and data processing technology are combined to dynamically observe the temperature distribution and change characteristics of athletes under different training states. Through comparative analysis, the correlation between the data provided by thermal radiation imaging technology in the training process and the traditional physiological indicators was evaluated. The results show that thermal radiation imaging technology can effectively reflect the heat distribution and local body temperature changes of athletes during training. Compared to traditional physiological feedback data, the technology has significant advantages in quickly identifying excessive fatigue and potential injuries in athletes, especially during high-intensity training, and can provide early warning of associated risks. The application of sensor-assisted measurement system will further enhance the accuracy and effectiveness of sports scientific research and provide important support for athletes’ scientific training and health management.

The Tightening and Untightening Modeling and Simulation of Bolted Joints

Although bolted joints may appear simple and are easy to manipulate, they are challenging to model and analyze due to their complex structural patterns and statically indeterminate nature. Ensuring the structural integrity of these joints requires maintaining proper bolt preload and clamping force, which is crucial for preventing failures such as overload, excessive bearing stress, fatigue, and stripping caused by seizing or galling. Achieving the necessary clamping force involves carefully controlling the input tightening torque, which is divided into the pitch torque and the friction torques at the bolt or nut bearing surfaces and in the engaged threads. The resulting clamping force is critical for generating the required force within the bolt. However, the achieved bolt force depends on several factors, such as friction at the joint’s contact surfaces, grip length, and the relative rotation between the bolt and nut during tightening. Friction at the contact surfaces, particularly beneath the bolt head or nut and between the threads, consumes a significant portion of the applied tightening torque—approximately 90%. This paper explores the three existing bolt internal pitch, bearing, and thread friction torques that are generated by the external applied torque in a bolted joint, as well as their contributions and variations throughout a loading cycle composed of three phases: tightening, settling, and untightening. An analytical model is developed to determine these torque components, and its results are compared with those obtained from finite element (FE) modeling and experimental testing from previous studies. Finally, this study examines the torque–tension relationship during bolt tightening, offering insights into the required accuracy of bolt and clamped member stiffness. The bolt samples used in this study include M12 × 1.75 and M36 × 4 hex bolts.

Exploring Sleep Architecture in Polish Patients with Multiple Sclerosis: A Polysomnography Study.

Sleep disturbances are a prevalent phenomenon in patients with multiple sclerosis (PwMS). The present study employs polysomnography (PSG) to quantify sleep efficiency and architecture in PwMS, aiming to elucidate the relationships between PSG parameters and factors including gender, disability level, brain lesion location, and subjective measures of insomnia, excessive daytime sleepiness (EDS), fatigue, pain, and mood disorders. The study cohort comprised 51 adult PwMS, of whom 31 underwent overnight PSG. The demographic and clinical characteristics, including age, gender, and Expanded Disability Status Scale (EDSS), were collated. The Athens Insomnia Scale, the Epworth Sleepiness Scale, the Fatigue Severity Scale, the Modified Fatigue Impact Scale (MFIS), the Numerical Pain Rating Scale, and the Hospital Anxiety and Depression Scale were employed for the assessment of insomnia, EDS, fatigue, pain, and mood disorders. The brain and spinal cord magnetic resonance imaging (MRI) were evaluated. A reduced sleep efficiency was observed among 30 PwMS (aged 38.9 ± 12.9), with a mean of 80 ± 12%, especially in those with brainstem demyelinating lesions. In those PwMS aberrant sleep onset latency (SOL) and wake after sleep onset were also noted (p < 0.05). The prevalence of sleep fragmentation, as measured by the total arousal index, was greater in male PwMS than in female (p < 0.05). Higher disability according to the EDSS correlated with longer SOL (ρ = 0.48, p < 0.05), and reduced N2 sleep stage correlated with cognitive fatigue according to MFIS (ρ = -0.46, p < 0.05). Age, disease duration, insomnia, EDS, physical fatigue, and mood disorders did not impact PSG parameters. The study demonstrated the disruption of sleep architecture in PwMS, and highlighted the importance of a comprehensive PSG assessment of sleep disturbances in this population.

The Relationship Between Smartphone Addiction and Sleep Quality in Youth of GMIM “Eben Haezar” Kaaten Congregation

Sleep is a vital process for human recovery, occurring predominantly during rest. High-quality sleep is essential for the recovery process, helping to alleviate excessive fatigue, while poor sleep quality can lead to reduced immunity. One significant issue affecting young people today is sleep quality, which is influenced by various factors, including smartphone use. This study aimed to investigate the relationship between smartphone addiction and sleep quality among the youth of the GMIM "Eben Haezar" Kaaten. Conducted in August 2024, this cross-sectional study included all 173 youth registered in the GMIM Youth SIT, with a research sample consisting of 63 respondents. The study variables were smartphone addiction and sleep quality, analyzed using univariate and bivariate methods. Results showed that 36 respondents (57.1%) experienced a high level of smartphone addiction, while 28 respondents (44.4%) reported poor sleep quality. The study concluded a significant relationship between smartphone addiction and sleep quality, with a p-value of 0.010 and a significance level of α = 0.05.

Adherence to CPAP Therapy in Obstructive Sleep Apnea: A Prospective Study on Quality of Life and Determinants of Use.

Obstructive sleep apnea (OSA) often goes unrecognized despite common symptoms, such as excessive daytime sleepiness, fatigue, and impaired quality of life (QoL). Continuous positive airway pressure (CPAP) is the gold standard treatment for OSA, but optimal daily usage and time needed for observable effects remain unclear. This study aimed to investigate the short-term effects of CPAP on daytime sleepiness and QoL in patients with severe OSA. Medical records were collected from 87 patients with severe OSA who initiated CPAP therapy. Also, validated questionnaires were used before and after one month of CPAP to analyze QoL-the Calgary Sleep Apnea Quality of Life Index (SAQLI), the Cues to CPAP Use Questionnaire (CCUQ), and daytime sleepiness-the Epworth Sleepiness Scale (ESS). Multiple regression analysis was conducted to identify predictors of CPAP usage. Of the total participants aged 55.6 ± 12.5, 77% were males, and 62% were CPAP adherent. Reductions in daytime sleepiness (ESS) were noted, as well as improvements in both overall QoL (SAQLI) and specifically in the domains of daily functioning, social interactions, emotional well-being, and symptom perception. Important cues for CPAP usage recognized by patients were physicians' instructions and physicians' concern regarding their patients' condition. Furthermore, multiple regression revealed higher SAQLI scores and lower ESS scores as positive predictors of CPAP usage, along with lower AHI after one month of CPAP being associated with sufficient adherence.

Chronic Cannabidiol Administration Mitigates Excessive Daytime Sleepiness and Fatigue in Patients with Primary Hypertension: Insights from a Randomized Crossover Trial.

Background: The chronic effects of cannabidiol (CBD) supplementation on factors that could impact the quality of life (anxiety, sleeping quality, memory, etc.) are poorly explored. Hence, the aim of this study was to establish whether chronic CBD supplementation will improve self-reported outcomes related to quality of life. Methods: In this randomized crossover trial, 64 patients with primary hypertension were assigned to receive CBD (225-450 mg) for 5 weeks followed by 5 weeks of placebo or vice versa, with a 2-week washout in-between the two. Self-reported outcomes were assessed using short form-36 (SF-36), Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), memory complaint questionnaire (MAC-Q), and state-trait anxiety inventory (STAI). Results: Five-week administration of CBD, but not of placebo, resulted in improvement of ESS score (F = 6.738, p = 0.011), as well as fatigue/vitality (ΔCBD = 5.0, p < 0.001) and psychological well-being dimensions of SF-36 (ΔCBD = 7.4, p = 0.039). No overall benefit of CBD on quality of life was noted (p = 0.674). No changes were seen in total scores of MAC-Q, PSQI, or STAI (p = 0.151, p = 0.862, p = 0.702, respectively). No significant correlations were found between plasma CBD concentrations and any of the scores. Conclusions: Chronic CBD administration reduced excessive daytime sleepiness, despite the fact that no change was observed in self-reported quality of sleep. Furthermore, self-reported fatigue and psychological well-being dimensions of quality of life also improved following chronic CBD use.

Returning to Work after Breast Cancer: A One-Year Mixed-Methods Study.

Breast cancer (BC) is the most common invasive neoplasm and affects many women of working age. The return to work (RTW) of female survivors (BCSs) is associated with a better quality of life and longer survival. A tailored intervention to promote RTW was launched in 2022. A year later, the women were contacted to find out if RTW had occurred regularly and what their health conditions were compared to the baseline. BCSs reported excessive fatigue, poor sleep quality, anxiety, depression and reduced work ability; these parameters had not improved significantly compared to the baseline. Thematic analysis of the interviews confirmed the presence of personal, company, and societal factors that could hinder or favor RTW. The interviews demonstrated that, even in an economically developed country that has provided numerous benefits for BCSs, protection is not always effective. Personalized intervention seems necessary to complete the process of reintegrating BCSs into their future working careers.

EVALUASI KEBUGARAN JASMANI MELALUI HARVARD STEP TEST PADA MAHASISWA PENJASKESREK FKIP UNIVERSITAS ABULYATAMA

Physical fitness is the body's ability to perform an activity without feeling excessive fatigue. Students in following a series of lectures have not shown good physical fitness performance. The effort made is to evaluate physical fitness through the Harvad step test. So that students can improve their training and detect their own fitness level. The purpose of this study was to evaluate physical fitness through the Harvard step test on physical education students health and recreation Faculty of Teacher Training and Education Abulyatama. This type of research is evaluative with a quantitative descriptive approach. Collecting data for this study through the Harvard step test. The population and sample of this study were 30 students of Physical Education Health and Recreation class 2022. The results showed physical fitness through the Harvard step test with an average of 33.47 (very poor), with the following details: 1) Moderate category with a frequency of 1 student (3.33%), 2) Less category with a frequency of 2 students (6.67%), and 3) Very less category with a frequency of 27 students (90.00%). The research concluded that the evaluation of physical fitness through the Harvard step test on students of physical education health and recreation of the Faculty of Teacher Training and Education Abulyatama was in the category of very poor

Activities of psychiatrists in specialized coronavirus disease 2019 wards at Juntendo Hospital.

Since the onset of the coronavirus disease 2019 (COVID-19) pandemic in 2020, specialized COVID-19 wards have been established in general hospitals across Japan. Juntendo Hospital also established a dedicated COVID-19 ward; however, many hospitalized patients were found to have psychiatric symptoms, such as delirium and depression. Juntendo Hospital's COVID-19 specialist beds were staffed mainly by internists, who specialized in physical illnesses and were unfamiliar with psychiatric symptoms, making it difficult for them to provide adequate treatment. Some staff members were also found to be suffering from mental illness, compounding these issues. In 2021, to address these challenges, Juntendo Hospital's psychiatry department began having psychiatrists make rounds once a week in specialized COVID-19 wards. The number of consultations varied depending on the status of the COVID-19 epidemic; however, in the peak month, 45 consultations were made per month. Most consultations involved delirium and neurotic conditions, and there had been over 200 consultations for both by August 2023. We addressed not only the mental symptoms of the patients, but also the health status of the staff at the hospital beds, and took measures to maintain the mental health of the staff. Consequently, the hospital has not experienced any large-scale medical breakdowns due to excessive staff fatigue. New pandemics of emerging infectious diseases will likely occur in the future, and we believe that we need to learn from this pandemic and prepare for future pandemics.

Evaluation of job satisfaction and related factors in wood extraction workers in Gilan province

Introduction: occupational accidents are caused by ignorance of occupational health and safety recommendations, due to the high rate of accidents in the industry of cutting and extracting wood from the forest, this study is necessary to evaluate job satisfaction. Materials and Methods: In this research, job satisfaction was used as a dependent variable and independent variables included age, educational and employment status, type of work, and duration of employment. To determine the conditions of excessive fatigue among forest workers, the index of symptoms of excessive fatigue was used. The number of 100 workers was investigated by a questionnaire, the comparison of independent variables affecting the satisfaction or dissatisfaction of workers with work using discriminant analysis and the Wilks Lambda coefficient, and the comparison of the average opinions of people from different work groups regarding the work situation using Friedman's test was performed. Results: The four variables of duration of employment, age status of workers, employment status, and type of work are suitable for separating two groups satisfied with work and dissatisfied with work. The assessment of complaint rate showed that questions I take care of my family, I am very worried about my health and I am dissatisfied with many things with the highest rates of 84.66%, 70.66%, and 61.33% respectively. They took the complaint to themselves. The results showed that the highest amount of fatigue accumulation index is related to two groups chronic fatigue and general fatigue. The results of the present study show that 47% of forest workers are illiterate in their educational status, which requires a training course for workers to work with cutting tools and machines. The results showed that 41 percent of the people studied liked their jobs. Conclusion: Personal protective equipment is considered a work tool without which it is impossible to do the desired job. Training classes should be held periodically by the safety department for workers and supervisors when needed.

Plain language summary of the results from the TALAPRO-2 study: Talazoparib plus enzalutamide versus placebo plus enzalutamide for patients with advanced prostate cancer.

This summary describes the results from the TALAPRO-2 research study (also known as a clinical trial). The TALAPRO-2 study tested the combination of two medicines called talazoparib plus enzalutamide. This combination of medicines was used as the first treatment for adult patients with metastatic castration-resistant prostate cancer. The combination of talazoparib plus enzalutamide was compared with a placebo plus enzalutamide. Metastatic castration-resistant prostate cancer is a type of cancer that starts in the prostate and has spread to other parts of the body. Castration-resistant means that the cancer continues to grow even when testosterone levels in the blood are reduced to very low levels. Taking medicines to lower testosterone levels in the blood is a standard treatment for men with advanced prostate cancer. TALAPRO-2 looked at if combining talazoparib plus enzalutamide would increase the length of time patients lived before their cancer got worse or they died compared with a placebo plus enzalutamide. Researchers looked at how treatment affected the size and number of tumors and the length of time before patients needed to change to a new cancer medicine. Researchers also looked at any side effects patients had during the study. A total of 805 patients with metastatic castration-resistant prostate cancer took part in the study. Compared with patients who took a placebo plus enzalutamide, the group of patients who took talazoparib plus enzalutamide had a 37% reduced risk of their cancer getting worse or dying. Some patients had tumors that at the start of the study could be measured with scans. Sixty-two percent of patients who took talazoparib plus enzalutamide had their tumors decrease or shrink to the point that they could no longer be seen on scans versus 44% of patients who took a placebo plus enzalutamide. Patients who took talazoparib plus enzalutamide were more likely to have a longer time before they needed to change to a new cancer medicine. The most common side effects of talazoparib plus enzalutamide were low levels of red blood cells (66% of patients) and neutrophils (36% of patients), and excessive tiredness or exhaustion (34% of patients).Clinical Trial Registration: NCT03395197 (TALAPRO-2) (ClinicalTrials.gov).