Levels Of Fatigue Research Articles

Assessing Barriers and Facilitators to Return to Work for Kidney Cancer Survivors: A 6-Month Longitudinal Study

ObjectivesThis study aimed to investigate the factors that impact the readiness and success of kidney cancer survivors returning to work, providing insights for healthcare professionals, employers, and policymakers. MethodsA prospective longitudinal study was conducted at Sun Yat-sen University Cancer Center from April 2022 to June 2023. The study enrolled 282 kidney cancer survivors aged 18 to 60 who completed three surveys at 1, 3, and 6 months postsurgery. Data collection involved telephone interviews and self-administered questionnaires, capturing sociodemographic information, medical history, and employment status, while follow-up assessments tracked return-to-work readiness. The scales used for analysis included the Generalized Anxiety Disorder Scale, the Patient Health Questionnaire, the Return-to-Work Self-Efficacy Questionnaire, the Perceived Social Support Scale, and the Brief Fatigue Inventory. Generalized Estimation Equations were applied to identify significant factors, with both single-factor and multivariate analyses performed to pinpoint the most critical variables. ResultsReturn-to-work rates at 1, 3, and 6 months postsurgery were 26.9%, 59.9%, and 76.2%, respectively. Higher levels of anxiety, lower self-efficacy, older age, and greater fatigue were associated with reduced return-to-work rates. Physically demanding jobs posed more barriers compared to nonmanual roles. Significant factors identified in multivariate analysis included anxiety, self-efficacy, fatigue, and the nature of the patient's work. ConclusionPsychological, physical, and job-related factors play a crucial role in determining whether kidney cancer survivors can successfully return to work. Tailored support and flexible work arrangements could help kidney cancer survivors reintegrate into the workforce, leading to better long-term outcomes. Implication for Nursing PracticeNursing professionals can play a vital role in assessing and supporting kidney cancer survivors during their recovery process by addressing both psychological and physical factors. Incorporating return-to-work readiness into postoperative care plans, offering mental health support, and liaising with employers to create flexible working conditions could enhance the reintegration of survivors into the workforce.

Neuropsychiatric symptoms of patients two years after experiencing severe COVID-19: A mixed observational study

BackgroundThe impact of SARS-CoV-2 infection (COVID-19) on mental health has not been extensively studied in the medium and long term. This study assessed how clinical, biological, and social factors affect mental health in patients who recovered from severe COVID-19. The evaluation was done 90 days after hospital discharge and followed up at 12 and 24 months. MethodsA retrospective-prospective cohort mixed observational study was conducted on patients over 18 years of age who required hospitalization in Internal Medicine or ICU for severe COVID-19 pneumonia during 2020 and 2021. Demographic information, clinical variables, and data for the scales were obtained from electronic medical records and telephone interviews. For comparisons of the different variables in each clinical variable (insomnia, depression, anxiety), the Student's t-test for independent samples has been used (normal distribution); otherwise, the Mann–Whitney test will be used. All tests and intervals will be performed with a confidence level of 95. Fisher's exact or Pearson's Chi-square test has been used as appropriate for qualitative variables. Results201 patients were recruited. 37.3% presented insomnia, 22.4% anxiety, and 21.4% depressive symptoms. A direct association was established between female sex and depressive symptoms. Psychotropic history, fatigue, and C-reactive protein levels (CRP) were correlated with depression. Anosmia and ageusia, CRP, cognitive symptoms, and dyspnea predicted insomnia. Sex, orotracheal intubation (OTI), pain, fatigue, mental health history, and academic level were independent predictors of anxiety. High percentages of depressive, anxiety, and insomnia symptoms were detected in the second month after discharge and persisted at 12 and 24 months. The fatigue variable maintained a significant relationship with depressive symptoms at 2, 12 and 24 months. A possible limitation could be recall bias in retrospective data collection. ConclusionsThis is a novel study to follow up on mental health for two years in patients with severe COVID-19. Clinical, biological, and psychosocial variables could be predictors of depressive symptoms, anxiety, and insomnia. The psychiatric symptoms persisted throughout the 2-year follow-up. These findings are critical for the follow-up of these patients and open the possibility of further studies in the medium and long term.

Sustained intermittent and continuous isometric muscle actions induce different levels of fatigue for the same force-time integral

IntroductionThe aim was to compare the fatiguing effects induced by continuous (CONT) and intermittent (INT) tasks of an identical duration by equating the force-time integral. Methodː Fourteen men performed two sequences (4 blocks of 378s) of contractions (CONT or INT) of the quadriceps femoris. The CONT contraction of 378s corresponded to 10% of the maximum voluntary muscle contraction (MVC). The INT 3s contractions corresponded to 70% of the MVC, separated by rest periods of 18s (a 21s cycle) and repeated 18 times (21s x 18) for 378s. Hence, the force-time integral was identical for the both contraction tasks (378s × 10% MVC = 37.8; 3s x 18 repetitions x 70% MVC = 37.8). Resultsː The MVC and central activation ratio were measured before, during and after the sequence of muscle contractions. For a same force-time integral done during an identical duration of activity, the CONT contractions engendered earlier and greater decrease in motor output and voluntary activation than the INT contractions. ConclusionContinuous muscle actions are more fatiguing than intermittent muscle actions. They could therefore be relevant to develop resistance to muscle fatigue but would be not suitable for undertaking long or sustained workloads.

Wearable network for multilevel physical fatigue prediction in manufacturing workers.

Manufacturing workers face prolonged strenuous physical activities, impacting both financial aspects and their health due to work-related fatigue. Continuously monitoring physical fatigue and providing meaningful feedback is crucial to mitigating human and monetary losses in manufacturing workplaces. This study introduces a novel application of multimodal wearable sensors and machine learning techniques to quantify physical fatigue and tackle the challenges of real-time monitoring on the factory floor. Unlike past studies that view fatigue as a dichotomous variable, our central formulation revolves around the ability to predict multilevel fatigue, providing a more nuanced understanding of the subject's physical state. Our multimodal sensing framework is designed for continuous monitoring of vital signs, including heart rate, heart rate variability, skin temperature, and more, as well as locomotive signs by employing inertial motion units strategically placed at six locations on the upper body. This comprehensive sensor placement allows us to capture detailed data from both the torso and arms, surpassing the capabilities of single-point data collection methods. We developed an innovative asymmetric loss function for our machine learning model, which enhances prediction accuracy for numerical fatigue levels and supports real-time inference. We collected data on 43 subjects following an authentic manufacturing protocol and logged their self-reported fatigue. Based on the analysis, we provide insights into our multilevel fatigue monitoring system and discuss results from an in-the-wild evaluation of actual operators on the factory floor. This study demonstrates our system's practical applicability and contributes a valuable open-access database for future research.

Factors Affecting Cardiorespiratory Fitness in Middle-Aged Men

Abstract Introduction: Cardiorespiratory fitness (CRF) is “the ability of the circulatory and respiratory systems to supply oxygen during sustained physical activity (PA).” CRF is a well-established predictor of a wide range of negative health outcomes. Six-minute walk distance (6MWD) will very well aid in the assessment of CRF. Materials and Methods: A cross-sectional study was conducted using convenience sampling on men aged 40–65 from the community of Ahmedabad. Six-minute walk test was used to assess CRF. All participants’ body mass index (BMI), waist circumference (WC), PA levels (Rapid Assessment of PA [RAPA]), fatigue levels (Fatigue Severity Scale [FSS]), depression, anxiety, and stress were analyzed. Regression analysis was done using the SPSS 20.0 version. Results: Sixty-five participants with a mean age of 53.48 ± 7.76 years participated in the study. The mean 6MWD was 486.6 ± 110.13 m. Association of 6MWD with BMI was 1%, with WC was 2.2%, with RAPA was 28.9%, with FSS was 45.8%, with depression was 23.6%, with anxiety was 31.4%, and with stress was 38.1%. Conclusion: CRF of middle-aged men was found to be low. BMI and WC had minimal effect while PA levels, fatigue levels, depression, anxiety, and stress levels had an influence on CRF. Further studies should be designed to improve the factors affecting CRF in middle-aged men.

Legendre Polynomial Fitting-Based Permutation Entropy Offers New Insights into the Influence of Fatigue on Surface Electromyography (sEMG) Signal Complexity.

In a recently published work, we introduced local Legendre polynomial fitting-based permutation entropy (LPPE) as a new complexity measure for quantifying disorder or randomness in time series. LPPE benefits from the ordinal pattern (OP) concept and incorporates a natural, aliasing-free multiscaling effect by design. The current work extends our previous study by investigating LPPE's capability to assess fatigue levels using both synthetic and real surface electromyography (sEMG) signals. Real sEMG signals were recorded during biceps brachii fatiguing exercise maintained at 70% of maximal voluntary contraction (MVC) until exhaustion and were divided into four consecutive temporal segments reflecting sequential stages of exhaustion. As fatigue levels rise, LPPE values can increase or decrease significantly depending on the selection of embedding dimensions. Our analysis reveals two key insights. First, using LPPE with limited embedding dimensions shows consistency with the literature. Specifically, fatigue induces a decrease in sEMG complexity measures. This observation is supported by a comparison with the existing multiscale permutation entropy (MPE) variant, that is, the refined composite downsampling (rcDPE). Second, given a fixed OP length, higher embedding dimensions increase LPPE's sensitivity to low-frequency components, which are notably present under fatigue conditions. Consequently, specific higher embedding dimensions appear to enhance the discrimination of fatigue levels. Thus, LPPE, as the only MPE variant that allows a practical exploration of higher embedding dimensions, offers a new perspective on fatigue's impact on sEMG complexity, complementing existing MPE approaches.

A Survey on Safety Accidents in Clinical Practice of Nursing Students

Purpose: The purpose of this survey was to investigate the type of safety accidents experienced by nursing students during clinical practice in hospital and to determine the safety accident experiences according to the general characteristics of nursing students. Methods: The subjects of the study were 340 senior nursing students who experienced clinical practice of 9 nursing colleges in 7 regions of Korea. Data collection was done using the general characteristics and the safety accidents in clinical practice of nursing students tool that the researchers developed and took validity verification. Result: The most common safety accident in clinical practice was physical/psychological burnout, experienced by 111 students (32.6%). The second was psychological violence, experienced by 86(25.3%), and the third was needle stick/sharps Injuries, experienced by 63(18.5%). The fourth were musculoskeletal problems and sexual violence, each experienced by 43(12.6%). The occurrence of physical/ psychological burnout significantly differs depending on gender (χ2=16.40, p<.001), personality trait (χ2=7.03, p=.008), class lesson score (χ2=10.39, p=.006), university affiliated hospital (χ2=9.73, p=.002), health status (χ2=40.06, p<.001), and fatigue level (χ2=11.42, p=.003). The occurrence of traumatic injuries significantly differs depending on health status (χ2=11.89, p=.003). The occurrence of psychological violence significantly differs depending on personality traits (χ2=4.52, p=.033), health status (χ2=10.17, p=.006), and stress level (χ2=9.13, p=.010). Conclusion: In order to prevent and cope with safety accidents in clinical practice, universities and hospitals should have an organic relationship and provide education on accident prevention for nursing students, continuous monitoring of safety accidents, and develop in-hospital safety protocols for nursing students.

Effects of postpartum fatigue, parenting stress, and family support on postpartum depression in Chinese first-time mothers: a cross-sectional study.

This study aimed to explore the levels of postpartum fatigue, parenting stress, family support, and postpartum depression (PPD) experienced by first-time Chinese mothers and to investigate their impact on PPD. This cross-sectional survey involved 150 primigravida women attending postnatal checkups in Hebi City, Henan Province, China. Demographic data and information on environmental variables (living conditions, family relationships), postpartum fatigue, parenting stress, family support (expected vs. actual level), and PPD were collected. The average age of the women was 26.25 years (SD, ±3.90), with 78.7% at risk for PPD (score ≥10). Significant correlations were found between PPD and postpartum fatigue (r=.63, p<.001), parenting stress (r=.59, p<.001), and family support (r=.40, p<.001). In model 1, which examined the influence of women's demographic variables on PPD, significant factors included a poor relationship with parents (β=.24, p=.001), a poor relationship with parents-in-law (β=.18, p=.029), and a poor relationship with the husband (β=.20, p=.013). When the three research variables were incorporated into model 2, the factors contributing to a higher level of PPD included a poor relationship with parents-in-law (β=.14, p=.033), increased postpartum fatigue (β=.37, p<.001), increased parenting stress (β=.33, p<.001), and less family support than expected (β=.12, p=.048). The most critical factors influencing PPD include postpartum fatigue, parenting stress, poor relationships with parents-in-law, and low family support among Chinese primiparas. To mitigate PPD levels, healthcare professionals should screen mothers for depression in outpatient clinics and offer education and counseling to both mothers and their families or companions regarding PPD.

Does cognitive function affect functional capacity and perceived fatigue severity after exercise in patients with coronary artery disease?

Successful execution of exercise-based cardiac rehabilitation programs, an important branch of physiotherapy in individuals with coronary artery disease (CAD), depends on adequate cognitive abilities. It has been identified that coronary microvascular dysfunction, marked by reduced coronary flow reserve, is associated with impaired cerebral blood flow, affecting haemodynamic and cognitive performance. This study aimed to investigate how cognitive function influences functional capacity and differences in fatigue perception in CAD patients. Fifty CAD patients, with an average age of 59.40±6.58years, were evaluated for comorbidities (Charlson comorbidity index), number of CAD risk factors (hypertension, diabetes mellitus, dyslipidaemia, smoking, and physical inactivity), cognitive performance (Montreal cognitive assessment scale [MoCA]), functional capacity (incremental shuttle walk test [ISWT]), exercise-induced fatigue (Modified Bourg Scale), and physical activity (PA) levels (international physical activity questionnaire-short form). Analyses focused on the links between MoCA scores and CRF, ISWT outcomes, and differences in fatigue perception. Findings revealed a strong positive link between MoCA scores and ISWT performance (r=0.83, p<0.001), and a strong inverse relationship between CRF and MoCA scores (r=-0.95, p<0.001). In addition, MoCA score was positively correlated with differences in fatigue perception (r=0.88, p<0.001). These results highlight the critical role of cognitive function in determining functional capacity and managing fatigue in CAD patients. They also suggest that cognitive interventions may be a potential adjunctive approach in physiotherapy programmes.

Effects of a Simulated Game and Doubleheader Inning on Peak Kinetics in Softball Pitching Across Pitch Types

Background: Softball pitchers frequently pitch at high volumes. Previous research has demonstrated changes in mechanics, range of motion, and perceived levels of fatigue and pain at high workloads. To date, little research has assessed changes in kinetics at high workloads across pitch types to understand the injury risk. Purpose: To examine changes in peak kinetics of the shoulder, elbow, and wrist of the pitching arm throughout a simulated game and doubleheader inning. Study Design: Descriptive laboratory study. Methods: A total of 19 high school softball pitchers (mean age, 15.1 ± 1.5 years; mean height, 1.6 ± 0.2 m; mean weight, 76.3 ± 16.9 kg) participated. Pitchers threw 4 innings of 25 randomly assigned pitches to mimic a game's high pitch count. Participants then rested for 30 minutes before subsequently proceeding to pitch the first inning of a doubleheader. Each pitcher threw a fastball, drop ball, curveball, and changeup. Peak shoulder, elbow, and wrist kinetics were compared across the first, last, and doubleheader innings and pitch types. Results: Compared with the first inning, significant decreases in kinetics were observed at the shoulder, elbow, and wrist in the last (P < .016) and doubleheader (P < .016) innings, particularly for shoulder and elbow compression force during the drop ball and curveball pitch types and wrist net force for all pitch types but the changeup. Significant decreases in elbow and wrist kinetics were observed during the changeup between the last and doubleheader innings (P < .016). Furthermore, differences in kinetics were observed between pitch types (P < .008); notably, the changeup had reduced kinetics compared with the fastball and breaking ball pitch types (drop ball, curveball) across innings. Conclusion: Across innings, attenuations in select joint kinetics of the pitching arm occurred that were specific to the pitch type. Across pitch types, peak kinetics was often greater during the fastball, while the changeup displayed the lowest peak kinetics. Clinical Relevance: The joints examined in this study are common sites of overuse injuries in pitchers. This work adds to previous findings on decrements in neuromuscular function as well as self-reported fatigue and pain with tournament-style pitching that may increase the injury risk. Collectively, these findings support developing a protocol combining functional testing and player-reported outcomes to aid sports specialists’ decisions for pitchers to continue to pitch or return to play, which may help prevent musculoskeletal injuries and time loss from sports participation.

Research on brain functional network property analysis and recognition methods targeting brain fatigue

At present, researches on brain fatigue recognition are still in the stage of single task and simple brain region network features, while researches on high-order brain functional network features and brain region state mechanisms during fatigue in multi-task scenarios are still insufficient, making it difficult to meet the needs of fatigue recognition under complex conditions. Therefore, this study utilized functional near-infrared spectroscopy (fNIRS) technology to explore the correlation and differences in the low-order and high-order brain functional network attributes of three task induced mental fatigue, and to explore the brain regions that have a major impact on mental fatigue. Self-training algorithms were used to identify the three levels of brain fatigue. The results showed that during the fatigue development, the overall connection strength of the endothelial cell metabolic activity and neural activity frequency bands of the low-order brain functional network first decreased and then increased, while the myogenic activity and heart rate activity frequency bands showed the opposite pattern. Network topology analysis indicated that from no fatigue to mild fatigue, the clustering coefficient of endothelial cell metabolic activity and myogenic activity frequency bands significantly decreased, while the characteristic path length of myogenic activity significantly increased; when experiencing severe fatigue, the small-world attribute of the neural frequency band significantly weakened. However, each frequency band maintained its small-world attribute, reflecting the self-optimization and adaptability of the network during the fatigue process. During mild fatigue, neuronal activity bands’ node degree, cluster coefficient, and efficiency rose in high-order brain networks, while low-order networks showed no significant changes. As fatigue progressed, the myogenic activity bands of high-order network properties dominated, but neural bands gained prominence in mild fatigue, approaching the level of myogenic bands in severe fatigue, indicating that brain fatigue orchestrated a shift from myogenic to neural dominance in frequency bands. In addition, during the process of fatigue, the four network attributes of the high-order network cluster composed of low-order nodes related to the prefrontal cortex region, left anterior motor region, motor assist region, and left frontal lobe eye movement region significantly increased, indicating that these brain regions had a significant impact on brain fatigue status. The accuracy of using both high-order and low-order features to identify fatigue levels reached 88.095%, indicating that the combined network features of both high-order and low-order fNIRS signals could effectively detect multi-level mental fatigue, providing innovative ideas for fatigue warning.

Impact of controlled physical training on clinicopathological and psychophysiological features of patients with chronic heart failure and type 2 diabetes

Aim. To evaluate the effectiveness of long-term (five-year) supervised physical exercise in patients with chronic heart failure (CHF) following myocardial infarction (MI) and type 2 diabetes mellitus (T2DM).Materials and Methods. The study included 88 patients with CHF of functional class II-III after MI and concomitant T2DM. In addition to standard medication therapy, patients in the main group (n = 42) performed regular moderate-intensity physical exercises for 30−60 minutes at least 5 days a week. The control group consisted of 46 patients who received standard medication therapy. Patients in both groups had similar clinical and demographic characteristics. After 5 years of follow-up, we assessed the incidence of a composite endpoint (death, MI, emergency myocardial revascularization, acute CHF decompensation), quality of life (measured by the SF36 questionnaire), levels of anxiety and depression (measured by the HADS questionnaire), and levels of fatigue (measured by the MFI-20 questionnaire). By the end of the five-year observation period, data were available for 40 patients in the main group (11 patients were excluded from the study due to discontinuation of regular physical exercise) and 42 patients in the control group.Results. The incidence of the composite endpoint was 55.2% and 80.9% in main and control group, respectively (p = 0.038). Regular physical exercise over the five-year period was associated with a higher quality of life according to the SF36 questionnaire (64.5 [63.1; 67.8] vs. 49.2 [48.4; 49.8], p = 0.001), lower levels of anxiety (5.8 [5.1; 7.7] vs. 8.0 [6.8; 9.2], p = 0.042) and depression (2.9 [2.2; 4.2] vs. 10.7 [10.5; 12.3], p = 0.001) according to the HADS questionnaire, and lower levels of general fatigue according to the MFI-20 questionnaire (9.1 [8.5; 11.2] vs. 15.1 [14.5; 15.4], p = 0.019).Conclusion. Long-term regular physical exercise in patients with CHF and T2DM improves cardiovascular outcomes and psychological status of patients.

Impact of Massage Gun on Rating of Perceived Exertion (RPE) in Soccer Players

This study aims to determine the effect of using massage gun media on RPE (Rated Perceived Exertion) in soccer players. The method used is an experimental approach with a one-group pretest-posttest model design. The research instrument used is RPE. The population of this study consisted of 30 athletes from Persib Bandung Academy who were around sixteen years old and attended intensive training four times a week. Using a purposive sampling approach, 18 athletes were selected as research subjects. To determine the RPE scale, subjects underwent high-intensity training using the Yo-Yo Intermittent Recovery Test. After the exercise, a 15-minute massage was performed using a massage gun, and then RPE was measured again. The results of data analysis showed that the massage method using a massage gun had a significant impact on reducing RPE, with a value of p=0.000. This indicates that the use of massage guns can significantly reduce the fatigue level of athletes after intensive training. In conclusion, a massage gun effectively reduces fatigue as measured by RPE. Nevertheless, improving the quality of research is still needed by increasing the number of participants and developing a more structured training program both in time and day.

The Effect of High Performance Work System on Intention to Leave and Safety Workarounds: The Role of Burnout as Mediation and Mentoring &amp; Coping Mechanism as Moderator

This study aims to analyze the influence of High Performance Work System (HPWS) on intention to leave and safety workarounds, with the role of burnout as a mediation variable and mentoring and coping mechanism as a moderator variable. The study was conducted on non-doctor employees at the Diponegoro National Hospital, Semarang. The method used is a quantitative approach with data collection techniques through questionnaires distributed to respondents. The data was analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). The results of the study show that HPWS has a negative influence on burnout, which means that the implementation of HPWS can reduce the level of emotional fatigue of employees. In contrast, burnout has a positive effect on intention to leave and safety workarounds, indicating that employees who experience burnout are more likely to want to leave the company and ignore work safety procedures. In addition, burnout acts as a mediator between HPWS and the two variables. Good HPWS implementation is able to reduce burnout, thereby reducing employee intentions to move and increasing compliance with safety procedures. The conclusion of this study is that the effective implementation of HPWS can reduce employee burnout, reduce the desire to leave work, and increase compliance with occupational safety. Mentoring and coping mechanisms play an important role in strengthening the positive effects of HPWS.

Decision-making under heat stress: Examining risk-taking and reflection impulsivity dynamics in the context of fatigue and vitality

Introduction &amp; Purpose Acute high temperatures and physical activity induce physiological and psychophysiological stress (Périard et al., 2021). In athletes or professions like firefighting, core body temperatures often exceed 38.5 °C (Barr et al. 2010; Schmit et al., 2017). In this hyperthermic state, firefighters must make critical decisions impacting their safety and that of others. This study investigated the effects of heat stress (passive alone or combined with walking) on decision-making, focusing on reflective impulsivity and risk-taking behaviour. Secondly, we examined how both heat stressors (passive and active) impact subjective feelings of fatigue and vitality, and we explored how fatigue and vitality levels moderate these effects. Methods A sample of 36 healthy men (age: M = 26.94, SD = 3.25) participated in a repeated measures design with two experimental groups equipped with firefighting clothing. They were exposed to either passive heat stress (EG1) or a combination of passive and active heat stress (EG2), and a control group (CG) receiving no heat and physical stress. The Balloon Analogue Risk Task (BART) for risk-taking behaviour and the Beads Task (BT) for reflection impulsivity were applied to test cognitive performance. Thermal comfort (TC), thermal sensation (TS), rating-of-fatigue (Micklewright et al., 2017) and vitality (Buchner et al., 2022) were recorded every five minutes. Passive heat stress was induced through sauna exposure (30 min, 60 °C; 40% relative humidity). Additionally, the EG2 performed two subsequent walks on the treadmill to reach 38.5 °C body core temperature (à 20 min). Cognitive tests were performed before heat exposure (T1), after sauna (T2) and after subsequent activity in EG2 or after an equally long rest period in EG1 (T3). CG watched a documentary. Linear Mixed Models (LMM) analysed the effects of group and time on reflection impulsivity (Draws to Decision [DTD]), risk-taking behaviour (pumps), fatigue, and vitality. Results This study found no significant changes for EG1 and EG2 over time (p = .37, p = .43) in reflection impulsivity (DTD) or risk-taking behaviour (pumps) across different heat conditions (p = .58, p = .84) and interaction (p = .38, p = .93) compared to CG. Including random slopes for random effect of time across fatigue (p &lt; .001) or vitality (p = .001) resulted in a significant deterioration of the model. EG1 showed a significant increase in fatigue to T2 compared to the CG (p &lt; .001) and to T3 (p &lt; .001). In EG2, fatigue increased significantly to T3 (p = .022). In EG1, vitality decreased significantly to T2 (p = .002), and to T3 (p = .020). Including TC as random effect improved the overall model fit significantly (p = .005). Discussion and Conclusion Passive heat stress increased fatigue, and decreased vitality in EG1. However, walking in EG2 prevented this vitality decline, suggesting a protective effect of physical activity. Thermal comfort influenced both fatigue and vitality. Interestingly, neither reflective impulsivity nor risk-taking behaviour were affected by heat stress or changes in fatigue and vitality.

Depression and sedentary behaviour in women with multiple sclerosis

Depression affects around 50% of people with Multiple Sclerosis (pwMS) during their lifetime. PwMS are typically less physically active and spend twice as much time engaging in sedentary behaviour compared to the general population. Therefore, a better understanding of the factors associated with depression in pwMS, as well as the relationship between depression and sedentary behaviour and physical activity, is crucial for developing effective therapeutic strategies MS treatment. This study aimed to investigate whether the presence of depressive symptoms in pwMS is related to a longer duration of sedentary behaviour. Specially, the study assessed the relationship between depression and sedentary behaviour in women with relapsing-remitting MS (RRMS). The sample for this cross-sectional study consisted of 78 women, including 38 with relapsing-remitting MS (RRMS) (EDSS 1 to 3) and 40 healthy women. The study evaluated the depression and time in sedentary behaviour, levels of physical activity and subjective fatigue in three groups: women without MS (CG), women with MS and depression (MSD), and women with MS without depression (MSND). We found significant differences in sedentary behaviour time when comparing the group of women with MS to the group with MS and depression. The logistic regression analysis presents depression as a factor associated with sedentary behaviour in women with MS. This association became even stronger after adjustment in the multivariate model (odds ratio=1.62; 95% CI (1.13-2.64); p=0.021). Despite no differences in clinical disabilities (EDSS) or physical activity levels between the two MS subgroups (MSD and MSND), we observed a longer duration of sedentary behaviour among participants with MS and depression. There was no association with the level of physical activity. This suggests a relationship between depression and sedentary behaviour in women with MS, independent of the level of physical activity. Prolonged sedentary behaviour is a risk factor for other comorbidities, including cardiovascular disease, highlighting the importance of addressing both depression and sedentary behaviour in the management of MS. Studies that examine the amount of time pwMS spend in sedentary behaviour in various countries are crucial for developing more effective strategies tailored to different ethnicities and cultures.

Investigation on Factors Affecting Cognitive Skills in Detection of Driving Fatigue

Road safety is a worldwide concern where a high number of fatalities and injuries are caused by traffic accidents. One major issue contributing to these incidents is driving while fatigued, which has been recognized as a contributing factor to accidents in many countries. Being tired while driving is a state that encompasses both physical and mental exhaustion and can greatly impair a person's ability to drive safely. Fatigue negatively affects a driver's cognitive abilities, resulting in decreased performance behind the wheel. The aim of this study is to analyse the effect of driving duration, body mass index (BMI), types of roads and gender factor in causing fatigue while driving. Cognitive skills of drivers while driving was measured through the electroencephalogram (EEG) signal gathered from Emotiv EPOC device to measure brain activity. Relationship between cognitive skills and fatigue signalling is then analysed using regression analysis in Design-Expert software. Results indicated that as mental fatigue increases, there is a noticeable decrease in the relative power of beta rhythm, supporting previous research findings. Results on correlation show that the longer the drivers drove, the wearier they become. Obese people experience more fatigue when driving than those with a normal or overweight BMI. Driving on straight roads resulted in greater fatigue compared to driving on winding ones, with female participants indicating higher levels of tiredness than male participants. These insights are crucial for road safety authorities to tailor their supervision methods based on individual characteristics and to design effective driver fatigue warnings.

Evaluation of Early Accommodation Outcomes Following Femtosecond Laser-Assisted in situ Keratomileusis and Small Incision Lenticule Extraction

ABSTRACT Purpose The aim of this study is to assess the changes and differences in early postoperative binocular accommodative function following femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE). Methods In this retrospective study, 120 patients (240 eyes) diagnosed with low-to-moderate and high myopia, who underwent either FS-LASIK or SMILE procedures were included. The assessment encompassed measurements of accommodative facility, accommodation time, relaxation time, and accommodation-to-relaxation ratio using a smart flipper. Measurements were taken preoperatively, as well as at 1 day, 1 week, and 1 month postoperatively. Additionally, the visual fatigue scale score was assessed and compared at the 1 month mark post-surgery. Changes in parameters were quantified by calculating the difference between preoperative values and those recorded at each postoperative time point. Results At 1 month post-surgery, both FS-LASIK and SMILE procedures demonstrated potential for recovery or even improvement in accommodative facility, accommodation time, relaxation time, and accommodation-to-relaxation ratio compared to preoperative levels. The FS-LASIK group exhibited a greater magnitude of change in accommodative facility postoperatively compared to the SMILE group. In the low-to-moderate myopia subgroup, the FS-LASIK group exhibited lower changes in accommodation time and visual fatigue scale score at 1 month post-surgery compared to the SMILE group, with all associated p-values <0.05. Conclusions Early postoperative recovery of accommodation function was slower following SMILE compared to FS-LASIK. Additionally, the severity of visual fatigue at 1 month post-surgery was greater in the SMILE group than in the FS-LASIK group. This difference in visual fatigue levels may be attributed to the delayed recovery observed in postoperative SMILE procedures.

Effects of fortified electrolyte drink on cognitive, mood, and nutritional parameters: a randomised, single‐blind, placebo‐controlled study

SummaryElectrolyte drinks contain charged minerals and are easily accessible in the market. It has become popular for the food and beverage industry to add nutrients and/or active ingredients to electrolyte drinks and market them as functional beverages. This study aims to determine the interactive effects of electrolyte drinks added caffeine, glucose, and B‐group vitamins (FED) on cognitive, mood index, and nutritional parameters. A total of 34 university students participated in this randomised, single‐blind, and placebo‐controlled study. Participants in the intervention group consumed 500 mL of FED, while participants in the control group consumed 500 mL of an electrolyte drink (ED). Baseline and post‐intervention data on cognitive performance, mood index, blood glucose, blood pressure, heart rate, and urine specific gravity were measured. Results indicated no significant differences (P &gt; 0.05) in post‐intervention cognitive performance scores for simple reaction time, choice reaction time, verbal paired associates, visual paired associates, and digit symbol matching between the FED and ED groups. Levels of fatigue, confusion, and total mood disturbance (TMD) were significantly reduced (P &lt; 0.05) by 46.50%, 62.75%, and 9.54%, respectively, following FED consumption. Post‐intervention data indicated no differences between the FED and ED groups in blood pressure, heart rate, and urine specific gravity, except for the blood glucose parameter, in which the blood glucose level of the FED group was significantly greater (P &lt; 0.05) than that of the ED group. This study indicates that FED consumed in a realistic dose can reduce fatigue, confusion, and TMD. Further studies with a higher caffeine dosage, but within the safe range, could be conducted to investigate the cognitive enhancement potential of FED.

PCG-based exercise fatigue detection method using multi-scale feature fusion model

Accurate detection of exercise fatigue based on physiological signals is vital for reasonable physical activity. Existing studies utilize widely Electrocardiogram (ECG) signals to achieve exercise monitoring. Nevertheless, ECG signals may be corrupted because of sweat or loose connection. As a non-invasive technique, Phonocardiogram (PCG) signals have a strong ability to reflect the Cardiovascular information, which is closely related to physical state. Therefore, a novel PCG-based detection method is proposed, where the feature fusion of deep learning features and linear features is the key technology of improving fatigue detection performance. Specifically, Short-Time Fourier Transform (STFT) is employed to convert 1D PCG signals into 2D images, and images are fed into the pre-trained convolutional neural network (VGG-16) for learning. Then, the fusion features are constructed by concatenating the VGG-16 output features and PCG linear features. Finally, the concatenated features are sent to Support Vector Machines (SVM) and Linear Discriminant Analysis (LDA) to distinguish six levels of exercise fatigue. The experimental results of two datasets show that the best performance of the proposed method achieves 91.47% and 99.00% accuracy, 91.49% and 99.09% F1-score, 90.99% and 99.07% sensitivity, which has comparable performance to an ECG-based system which is as gold standard (94.32% accuracy, 94.33% F1-score, 94.52% sensitivity).