Fatigue Rate Research Articles

Anal sphincter fatigability in assessing anal incontinence: Asystematic review.

Diagnosing anal incontinence (AI) based on manometry results is challenging due to the variation of the normal values and overlap between patients with and without AI. This study aimed to perform a systematic review on the difference in sphincter fatigability between patients with and without AI. MEDLINE, EMBASE, SCOPUS, and Google Scholar were searched. Studies were included if they included adult patients and assessed anal sphincter fatigability between using manometry. The effect size was estimated as the standardized mean difference (SMD) with 95% confidence intervals. A random-effects model was used. The database searches identified 125 unique articles, and five additional articles were identified from the reference list of articles. One hundred thirteen were excluded through title and abstract review. Nine articles were included in the final analysis. There was no statistically significant difference in the resting pressure between the two groups. Patients with AI had significantly lower squeeze pressure. There was no statistically significant difference between the groups in the fatigue rate. The FRI was significantly lower in patients with AI (SMD 1.636, p=0.001). Approximately a third of the patients in one study were able to maintain a contraction for 20s without reducing pressure. There was significant heterogeneity in the studies. The data available were inadequate for more robust calculations. Sphincter fatigability, measured by the Fatigability Rate Index, has good discriminating power for anal incontinence. A standardized protocol needs to be followed by future researchers. Graphical Abstract The analysis used six studies with 413 patients to compare Fatigue Rate Index between patients with AI and controls. All studies reported a lower FRI in patients with incontinence and the FRI was significantly lower in patients with AI (standardized mean difference [SMD] 1.636, p= 0.001). Conflicting results were reported on the correlation between FRI and AI symptom scores.

Semi‐Markov reliability model of manufacturing systems considering machine degradation, human errors, and their mutual facilitation effects

AbstractReliability plays a significant role in the overall performance of manufacturing systems, and accurate reliability assessments can guarantee their functionalities and efficiencies. This paper develops a reliability model of a manufacturing system considering machine degradation, human errors, and their mutual facilitation effects (MFE): machine degradation may increase fatigue rate and weaken learning process, thereby facilitating the occurrence of human errors, while human errors may, in turn, facilitate the machine degradation process. Although MFE may reduce system reliability, current reliability models ignore this effect. In this paper, to describe the MFE, a stochastic human error model under the effects of learning–forgetting and fatigue–recovery is proposed, where the human error rate depends on the current machine degradation state; next, based on their facilitation effects on machine degradation, human errors are divided into safety, damage, and fatal zones; finally, we incorporate the zoned human error model into the machine degradation model and develop a Semi‐Markov reliability model. A Monte Carlo method is implemented to calculate system reliability. The turret of a lathe operated by a worker is utilized to illustrate the effectiveness of the reliability model.

Results from a retrospective, observational, multicentre study of patients with primary biliary cholangitis treated with obeticholic acid in real life in Italy (O-REAL)

Sixty-seven patients enrolled in the O-REAL study who matched the inclusion criteria were analyzed. At baseline, 91% of the patients were female and 12% had a concomitant liver disease. Mean age at start of OCA therapy was 57.64 (±10.87) years with mean time from diagnosis to start of OCA therapy of 8 years. At OCA start, rates of pruritus and fatigue were 24% (n=16) and 18% (n=12), respectively. Eleven patients 16.4%) had cirrhosis confirmed by biopsy. OCA treatment resulted in a mean ALP reduction from 301.01 (±149.16) U/L; to 211.67 (± 97.08) after 6 months of therapy, with a mean percentage change of -21.72% (±34.60).

Comment on "A National Survey of Motor Vehicle Crashes Among General Surgical Residents".

Comment on "A National Survey of Motor Vehicle Crashes Among General Surgical Residents".

Rest period and object load effects on upper limb muscle strength recovery for manual load transfer

This study examined the rest period and object load influence on upper limb muscle strength recovery after a simulated 9 min intermittent repetitive manual work. Eight task conditions consisting of four rest periods (2.25, 4.5, 9, 13.5 min) and two object loads (1 and 2 Kg) were studied. Twelve male subjects were recruited to participate. Four muscles in the right upper limb were tested using surface electromyography. Heart rate and rating of fatigue were measured during the experiment. The experimental results showed that the rest period of 4.5 min, which was not the largest, could be the most efficient recovery level that might result in obtaining better muscle strength recovery and larger heart rate reduction with a shorter rest time. The study results provided fundamental work/rest pattern data that could be considered in early intervention strategies for muscle fatigue prevention at worksites. Limitations and recommendations regarding the current study were highlighted. Relevance to industryUpper limb repetitive manual load transfer tasks are common at worksites, and can result in work-related musculoskeletal disorders. The results from this study should be useful in work/rest scheduling for repetitive manual load transfer tasks.

You've Got a Friend in Me: Fostering Social Connection Among College Students Through Peer-Led Physical Activity.

Social connection and physical activity (PA) are essential health behaviors necessary for young adults to thrive. The majority of college students in the United States are not meeting PA recommendations and simultaneously report concerning rates of loneliness, depression, anxiety, and fatigue; all factors that contribute to poor psychological well-being and reduce students' abilities to sustain academic success. These mental and physical health indicators have only worsened due to the stress, isolation, and uncertainty experienced during the COVID-19 pandemic. Fitness Buddies (FB) is a free peer-led PA program designed to combat loneliness, stress, anxiety, depression, and low PA, by providing students the opportunity to connect with one another through PA. FB participants are matched with a peer leader for weekly PA sessions based on activity interests and schedules. The FB program model shifts the focus of traditional PA programs, from prescribing and monitoring PA duration, intensity and modalities, to supporting psychological well-being through satisfaction of the three basic psychological needs of competence, autonomy, and relatedness within peer PA-based relationships. In the first pilot phase of implementation, students reported improved situational affect, to include reduced stress and anxiety, following participation in the FB program for one academic semester. Participants also reported the development of quality peer relationships and a sense of belonging to the campus community, both of which had previously been lacking. The FB program model is an innovative and cost-efficient strategy to supporting college students' psychological well-being and long-term success.

A208 ASSESSING FEASIBILITY AND ACCEPTABILITY OF AN ONLINE MIND-BODY WELLNESS PROGRAM FOR PRIMARY BILIARY CHOLANGITIS

BackgroundPersons with primary biliary cholangitis (PBC) experience significantly higher rates of fatigue, stress, anxiety, depression, and impaired health related quality of life (HRQOL) as compared to the general population. While online wellness programming has been shown to be effective in decreasing fatigue and improving mental wellness in a variety of chronic disease populations, limited data is available for PBC.AimsThis pilot study aimed to assess the hypothesis that a 12-week, online, mind-body wellness program would be feasible (assessed through adherence and retention) and acceptable in people with PBC. We also aimed to explore indicators of impact on measures of wellbeing.MethodsPersons with PBC were recruited across Alberta and British Columbia in January 2021. The program included a 20–30 minute video containing low intensity mindful movement, meditation, and breathwork (goal 2–3 times/week) as well as a weekly behaviour change tip, PBC tip from a physician, and PBC nutrition tip. The online programming was accompanied by brief (10-minute) once weekly phone check-ins from a member of the study team, and optional once monthly zoom group sessions hosted by the Canadian PBC Society. Satisfaction and adherence were assessed at the end of the study using a survey. The pre-post exploratory efficacy assessment included: fatigue (Modified Fatigue Impact Scale), perceived stress (Perceived Stress Scale), anxiety and depression (Hospital Anxiety and Depression Scale), and HRQOL (PBC-40). Using a qualitative descriptive approach, we conducted semi-structured interviews at the end of the study to explore experiences with the intervention, and gather feedback for improvement.ResultsParticipants (N = 32) completed baseline surveys and 29 (91%) were retained to end-of-study. Twenty-five (86%) adhered to the program goal of carrying out the mind-body practice at least 2–3 days per week. Comparing baseline to end-of-study, significant reductions were observed in fatigue (13%, p=0.004), anxiety (30%, p=0.005), and depression (28%, p=0.022), and significant improvements were observed in the PBC-40 itch (22%, 0.043), fatigue (13%, 0.005), cognitive (17%, 0.006), and emotional (18%, 0.001) domains. Eleven individuals participated in qualitative interviews, reporting an increase in energy, a more positive outlook, and increased knowledge of PBC. Feedback supported acceptability (satisfaction score of 90%), with fatigue cited as the primary barrier to increased program participation.ConclusionsThese findings suggest that a 12-week online mind-body intervention is feasible and acceptable to persons with PBC and has promising impact on efficacy. Recognizing the limitations of a single-arm study with a small sample size, a future RCT will be designed using this feedback.Funding AgenciesMITACS Accelerate, Canadian PBC Society

Abstract P4-09-01: Incidence of patient-reported fatigue developing in patients receiving palbociclib and endocrine therapy for advanced HR+ HER2- breast cancer

Abstract Background: Clinician-rated adverse event data from pivotal trials of the CDK4/6 inhibitor palbociclib (palbo) in patients (pts) with HR+ HER2- metastatic breast cancer (MBC) describe fatigue as a common non-hematologic toxicity. While palbo and endocrine therapy (ET) significantly improve outcomes compared to ET alone, in a pooled analysis of the PALOMA trials, rates of incident Common Terminology Criteria for Adverse Events (CTCAE) all-grade fatigue over 4.2 years of treatment approached 39.2%, with grade 3/4 at 2.5%. As these studies included only provider-rated CTCAE toxicity, it is important to quantify pts’ ratings of fatigue severity, which may differ from clinician assessments. Methods: Eligible pts with HR+ HER2- MBC, initiating standard-dose palbo with ET (aromatase inhibitor or fulvestrant), and without clinically meaningful fatigue prior to initiation of palbo, were followed for the 6 initial treatment cycles. The absence of baseline fatigue was established using the patient-reported Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACIT-F), a 13-item scale (range 0-52, lower score = more fatigue) validated against anemia to indicate clinically meaningful fatigue if FACIT-F score <34. After screening and baseline assessments (several weeks apart), the FACIT-F was repeated during the 3rd week of 6 consecutive cycles. Pts also reported fatigue severity using the NCI Patient-Reported Outcomes for CTCAE (PRO-CTCAE; range 0-4; grade 3/4 = severe) when they completed the FACIT-F. The primary endpoint was new-onset fatigue (FACIT-F score <34) after treatment initiation; the secondary endpoint was severe fatigue on the PRO-CTCAE fatigue severity item. Incident rate of fatigue was estimated based on frequencies (dichotomized FACIT-F scores <34 vs. >=34; PRO-CTCAE fatigue severity grade 3/4 vs. <3). Rate of fatigue incidence on the FACIT-F in the presence of competing risks (e.g., disease progression or study burden) was estimated using the cumulative incidence function. Concurrently rated FACIT-F scores were compared between PRO-CTCAE severe and non-severe cases using linear mixed-models. Results: Of 115 pts enrolled (5/2018-1/2021), 88 were evaluable after excluding those not initiating palbo (n=3), without baseline data (n=13), or with clinically meaningful fatigue between screening and baseline (n=11). Mean (±SD) age was 59.4 ± 11.3, baseline FACIT-fatigue score was 44.4 ± 5.1, and follow-up duration was 5.8 ± 2.0 cycles. The majority (72%) were receiving palbo with letrozole. New-onset fatigue through the 6th treatment cycle was observed in 21 pts, translating to a fatigue incidence rate of 23.9% (95% CI 15.4% - 34.1%). The mean time to new-onset fatigue was 3.8 ± 1.7 treatment cycles. Those who withdrew early (n=26) completed data for 3.7 ± 2.1 treatment cycles; the cumulative incidence of fatigue at 4 treatment cycles was 18.2% (95% CI 10.9 - 26.9). Using the PRO-CTCAE, the incidence rate of severe fatigue was 14.8% (95% CI 8.1% - 23.9%). The mean FACIT-F score when PRO-CTCAE grade indicated severe fatigue was significantly lower (more fatigue) than when the PRO-CTCAE grade was non-severe (26.3 ± 5.1 vs. 44.8 ± 4.8, p<0.0001). Conclusion: In pts with HR+ HER2- MBC initiating palbo and ET, approximately one-quarter develop fatigue within the first 6 cycles based on the FACIT-F, which associates significantly with a PRO-CTCAE severity grade 3/4. While direct comparison cannot be made between provider-rated CTCAE and patient-reported PRO-CTCAE, it is notable that the incidence of severe fatigue with PRO-CTCAE is higher than that observed with provider-rated CTCAE. Ongoing analyses will explore potential associations of factors (e.g., hematological, sleep, activity) with treatment-emergent fatigue developing on palbo and ET therapy. Citation Format: Shadab A Rahman, Erica L Mayer, Hanneke Poort, Deborah Schrag, Stephanie C Tung, Eric S Zhou, Aleta Wiley, Lauren Finkelstein, Elkhansaa Elguenaoui, Moira Nolan, Hadine Joffe. Incidence of patient-reported fatigue developing in patients receiving palbociclib and endocrine therapy for advanced HR+ HER2- breast cancer [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-09-01.

Data-driven farm-wide fatigue estimation on jacket-foundation OWTs for multiple SHM setups

Abstract. The sustained development over the past decades of the offshore wind industry has seen older wind farms beginning to reach their design lifetime. This has led to a greater interest in wind turbine fatigue, the remaining useful lifetime and lifetime extensions. In an attempt to quantify the progression of fatigue life for offshore wind turbines, also referred to as a fatigue assessment, structural health monitoring (SHM) appears as a valuable contribution. Accurate information from a SHM system can enable informed decisions regarding lifetime extensions. Unfortunately direct measurement of fatigue loads typically revolves around the use of strain gauges, and the installation of strain gauges on all turbines of a given farm is generally not considered economically feasible. However, when we consider that great numbers of data, such as supervisory control and data acquisition (SCADA) and accelerometer data (of cheaper installation than strain gauges), are already being captured, these data might be used to circumvent the lack of direct measurements. It is then highly relevant to know what is the minimal sensor instrumentation required for a proper fatigue assessment. In order to determine this minimal instrumentation, a data-driven methodology is developed for real-world jacket-foundation offshore wind turbines (OWTs). In the current study the availability of high-frequency SCADA (1 Hz) and acceleration data (>1 Hz) as well as regular 10 min SCADA is taken as the starting point. Along these measured values, the current work also investigates the inclusion of an estimate of the quasi-static thrust load using the 1 s SCADA using an artificial neural network (ANN). After data collection all data are transformed to features on a 10 min interval (feature generation). When considering all possible variations a total of 430 features was obtained. To reduce the dimensionality of the problem this work performs a comparative analysis of feature selection algorithms. The features selected by each method are compared and related to the sensors to decide on the most cost-effective instrumentation of the OWT. The variables chosen by the best-performing feature selection algorithm then serve as the input for a second ANN, which estimates the tower fore–aft (FA) bending moment damage equivalent loads (DELs), a valuable metric closely related to fatigue. This approach can then be understood as a two-tier model: the first tier concerns itself with engineering and processing 10 min features, which will serve as an input for the second tier that estimates the DELs. It is this two-tier methodology that is used to assess the performance of eight realistic instrumentation setups (ranging from 10 min SCADA to 1 s SCADA, thrust load and dedicated tower SHM accelerometers). Amongst other findings, it was seen that accelerations are essential for the model's generalization. The best-performing instrumentation setup is looked at in greater depth, with validation results of the tower FA DEL ANN model showing an accuracy of around 1 % (MAE) for the training turbine and below 3 % for other turbines, with a slight underprediction of fatigue rates. Finally, the ANN DEL estimation model – based on two intermediate instrumentation setups (combinations of 1 s SCADA, thrust load, low quality accelerations) – is employed in a farm-wide setting, and the probable causes for outlier behaviour are investigated.

Aging with long-term physical disability: Cohort analysis of survey sample in the U.S.

Background: Chronic health conditions, secondary conditions, and decreasing functional ability related to aging and/or changes in underlying impairment may influence participation for persons aging with long-term physical disability (AwD). Objective: To examine sample integrity and baseline findings through exploration of associations of sociodemographic, health, and disability factors with social participation for persons AwD. Methods: This is a longitudinal cohort study following persons AwD over three years, reporting baseline cohort study data. A convenience sample of 474 persons AwD aged 45–65 reporting physical disability of ≥5 years’ duration was recruited through community organizations and social media. The cohort was majority female (66.7%) and single (62.0%), and over one-third (38.6%) was non-White. Pain, fatigue, depression, ability to participate in, and satisfaction with, social roles and activities were measured with the Patient Reported Outcomes Measurement Information System. Results: Participants aged 55–60 and 61–65 had significantly lower rates of employment and marriage and higher rates of living alone than participants aged 45–54. Participants reported higher rates of fatigue, pain, and depression and lower ability to participate in, and satisfaction with, participation in, social roles and activities than the general population. Ability to participate and satisfaction with participation were highest among Black/African American participants. Conclusions: Participants reported higher rates of common AwD symptoms and lower ability to participate and satisfaction with participation than the general population, consistent with prior studies of AwD samples. This cohort reflects the AwD population and can be considered an AwD sample, comparable to those found in existing literature. The focus of future analyses will be to gain a greater understanding of chronic health conditions, incidence of falls, engagement in everyday life activities, and the impact of the environment.

Short inertial sensor-based gait tests reflect perceived state fatigue in multiple sclerosis

BackgroundMultiple sclerosis (MS) is a chronic autoimmune inflammatory disease of the central nervous system, affecting more than 2.3 million people worldwide. Fatigue is among the most common symptoms in MS, resulting in reduced mobility and quality of life. The six-minute walking test (6MWT) is commonly used as a measure of fatigability for the assessment of state fatigue throughout treatment or rehabilitation programs. This ‘gold standard’ test is time-consuming and can be difficult and exhausting for some patients with high levels of disability or high rates of fatigue. Research questionCan short inertial sensor-based gait tests assess perceived state fatigue in MS patients? MethodsSixty-five MS patients equipped with one sensor on each foot performed the 6 min walk test (6MWT) and the 25-foot walk (25FW, at both preferred and fastest speed). Perceived state fatigue was measured after each minute of the 6MWT, using the Borg rating. The highest of these ratings served as a measure of overall perceived state fatigue. Stride-wise spatio-temporal gait parameters were extracted from the 25FW and from the first minute, first 2 min, and first 4 min of the 6MWT. Principal component analysis was performed. Perceived state fatigue was predicted in a regression analysis, using the principal components of gait parameters as predictors. Statistical tests evaluated differences in performance between the full 6MWT, the shortened 6MWT, and the 25FW. ResultsA mean absolute error of less than 2 points on the Borg rating was obtained using the shortened 6MWT and the 25FW. There were no significant differences between the prediction accuracy of the full 6MWT and that of the shortened gait tests. SignificanceIt is possible to use shortened gait tests when evaluating perceived state fatigue in MS patients using inertial sensors. Substituting them for long gait tests may reduce the burden of the testing on both patients and clinicians. Further, the approach taken here may prompt future work to explore the use of short bouts of real-world walking with unobtrusive inertial sensors for state fatigue assessment.

The relationship between mental fatigue, cognitive functioning, and employment status in patients with low-grade glioma: a cross-sectional single-center study

Purpose To evaluate fatigue and cognitive functioning in patients with low-grade glioma and to assess whether cognitive functioning and employment status differ between patients with severe and non-severe mental fatigue. Methods Cross-sectional study. Fatigue was measured with the multidimensional fatigue inventory, objective cognitive functioning with a neuropsychological test battery, and mood with the Center for Epidemiological Studies Depression Scale. Results Thirty-one patients, mean age 44 ± 11, mean time post-diagnosis 2.5 ± 1.4 years, participated. Severe mental fatigue was present in 55% and depression in 36% of the patients. Attention deficits were observed in 75% (Stroop’s test), memory deficits in 36% (Rey Auditory Verbal Learning Test), and executive functioning deficits in 42% (Stroop’s test). Severe mental fatigue patients demonstrated significantly worse scores on Stroop’s test-Card-II (p = 0.043), Trail Making Test-B (p = 0.014), Trail Making Test-B/A (p = 0.014), and Digit-Span (p = 0.046), compared to non-severe mental fatigue patients. Severe mental fatigue patients worked significantly less hours per week (p = 0.013) and had more changes in their employment status (p = 0.009) after diagnosis. Conclusions Patients with low grade glioma show high rates of fatigue, especially in the mental domain, which might be associated with deficits in cognitive functioning and changes in employment status. Implications for rehabilitation The majority of patients with low grade glioma suffers from severe mental fatigue and has deficits in cognitive functioning, which may affect employment status. Patients with low grade glioma should be screened for fatigue with the multidimensional fatigue inventory, to differentiate between mental and physical fatigue. Patients with low grade glioma with severe mental fatigue should be screened for problems in cognitive functioning with an objective neuropsychological test battery. Cognitive and vocational rehabilitation programs should aim at coping with severe mental fatigue and attention deficits in patients with low grade glioma.

A controlled clinical study of product PINOROX® (Pinus roxburghii bark extract) (PINOROX®) as dietary supplement for enhanced physical performance

Pinorox® is a standardized composition obtained from pine bark extract of Pinus roxburghii, rich source of natural polyphenols - Oligomeric Proanthocyanidins (OPCs) compounds that act as an antioxidant. Pinorox® has been expected to serve as potential natural supplement consumed to enhance the physical endurance in normal healthy or a sport person. Hence, double-blind, randomized, placebo-controlled study was conducted for time period of 90 days to validate the effect of Pinorox® over physical and athletic performances in normal healthy as well as sports subjects. 50 eligible subjects were selected through screening and distributed into placebo and Pinorox® groups. The subjects utilized in the present study i.e., healthy individual and athletes received one of either 200 mg of Pinorox® or experimental control (placebo) for 90 days. Each subject was evaluated for increase in physical or athletic performances by observing changes from baseline in rate of oxygen consumption VO2 max (endurance) compared to placebo at baseline, assessment of anaerobic power and rate of fatigue by using Wingate test at baseline, changes in assessment values using 1-RM test and muscle grip strength assessment using handheld dynamometer at baseline and during the interval of 90 days. The observations discussed in the present study shows that people consuming Pinorox® displayed significantly advanced performances during exercising or performing given sports activities. Improvement in the VO2 max values, anaerobic power, rate of fatigue, muscular performance and muscle grip strength was observed in test results and the study did not report any adverse effect. Overall, the study demonstrates that Pinorox® is a safe, fast acting and effective natural dietary or sport supplement for enhancing physical and athletic performances.

Investigation on psychosomatic status of entry quarantine personnel during the COVID-19 pandemic

To investigate the anxiety, depression, fatigue and insomnia of the entry quarantine personnel during the COVID-19 pandemic, and the influencing factors of psychological status were also explored. The Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Fatigue severity scale (FSS) and the Insomnia Severity Index (ISI) of 630 entry quarantine personnel were performed and the correlation analysis of the four types of scales was performed. The incidence rates of anxiety, depression, fatigue and insomnia were 4.76%, 20.00%, 48.57% and 22.86%, respectively. There was a positive correlation between the four indicators. Univariate analysis showed that age, education level, occupation, continent and reasons for going abroad were the main influencing factors of psychosomatic status. The lower the age group, the higher the education level, and the healthier the psychosomatic health of the entry quarantine personnel. The psychological status of international students was healthier than that of the staff. The psychological condition of the quarantined people in Asia was healthier than that in other continents. 630 entry quarantine personnel had different degrees of anxiety, depression, fatigue and insomnia, there was a positive correlation between them. Age, education level, occupation, continent and reasons for going abroad were the main influencing factors of psychological status.

Effect of Substance Use Disorder on Detection and Treatment of COVID-19 in a Large County Jail

Introduction Carceral facilities are epicenters of COVID-19 transmission, and the interplay of substance use disorder has created an additional challenge in detection. Our study describes outcomes related to the overlap of COVID-19 and substance use in a large county jail. Methods This is a retrospective study of adults who tested positive for COVID-19 while incarcerated at a county jail in 2020. Basic descriptive statistics were performed as well as two-tailed t-tests and chi-square analysis to determine the significance of differences between groups. Results 289 people were included in the study. The average age was 33 and 82% were male. Most cases were asymptomatic (42%) or mild (40%). People with active substance use disorder reported significantly higher rates of muscle aches and fatigue. 46% were released prior to completing the 10-day isolation period. Conclusions Most COVID-19 cases in the jail were mild. Symptoms did not significantly differ in those with concomitant substance use disorder. Most participants were released prior to completing isolation, increasing the risk for community spread

Clinician Perceptions of Incorporating Yoga into Therapeutic Practice

Despite increased interest in mindfulness practices such as yoga as an adjunct for depression, anxiety, and other chronic health concerns, little research exists on the potential benefits of yoga in therapeutic settings. As a complementary therapy, yoga provides a value-added benefit to traditional clinical practices for (1) clinicians as a form of self-care in treating compassion fatigue caused by, for example, fallout from the COVID-19 pandemic, and (2) the patients they serve. The primary goal of the present study was to understand clinician perspectives of yoga as an intervention in the therapeutic setting for clinicians and clients. We conducted a qualitative study and surveyed therapists from a yoga teacher training program designed specifically for clinical therapists. Eight therapists completed a qualitative questionnaire designed to understand the effects of yoga on clinicians and patients in the therapeutic setting. Although the effects of COVID-19 had not been anticipated, survey results corroborate high rates of compassion fatigue for therapists and a decline in mental health for patients throughout the study. Yoga, specifically body awareness and breathwork, however, provided a baseline for navigating mental health for both patients and therapists amid the pandemic. Additionally, body awareness and breathwork were found to help therapists avoid burnout and compassion fatigue and facilitate a more positive therapy experience for patients and therapists. Yoga has the potential to be a positive adjunct in therapeutic settings and would benefit from further research into various applications.

Kinetic changes in sweat lactate following fatigue during constant workload exercise.

It is useful to investigate various physiological responses induced by fatigue in athletes. Moreover, wearable noninvasive sensors, including sweat sensors, are compatible with fatigue evaluation because of their ease of use, and ability to measure repeatedly and continual data. This cross‐sectional study aimed to clarify how sweat lactate elimination curves obtained during constant workload exercise changed following fatigue. Seventeen recreationally trained males (average age, 20.6 ± 0.8 years) completed two consecutive constant workload exercise tests (at 25% peak power) with rest intervals; the participants were encouraged to perform Test 1 until exhaustion and Test 2 only for 10 min. Subjective fatigue (numerical rating scale with face rating scale), sweat lactate, and sweat rate were measured for 10 min in each test. Subjective fatigue was compared using the Wilcoxon signed‐rank test and time to each constant value between Tests 1 and 2 was compared using paired t‐test. Subjective fatigue significantly increased during Test 2 compared with that during Test 1. After Test 1, the sweat lactate elimination curve demonstrated a leftward shift, as proved by the significantly sooner observation of the peak and constant values of sweat lactate (2, 3, and 4 μA) (p < 0.01). Our preliminary results suggest that the sweat lactate elimination curve is different in the fatigue state. Further research may provide insight in the application of this curve to the evaluation for fatigue.

Fatigue in early rheumatoid arthritis: data from the Early Rheumatoid Arthritis Network.

ObjectivesFatigue is a disabling symptom in people with RA. This study aims to describe the prevalence, risk factors and longitudinal course of fatigue in early RA.MethodsDemographic, clinical, quality of life (QoL), comorbidities and laboratory data were from the Early RA Network (ERAN), a UK multicentre inception cohort of people with RA. Fatigue was measured using the vitality subscale of the 36-item Short Form Health Survey, where higher values represent better QoL. Baseline prevalences of fatigue classifications were age and sex standardized. Linear regression, hierarchical growth curve modelling and group-based trajectory modelling (GBTM) were utilized.ResultsAt baseline (n = 1236, 67% female, mean age 57 years), the mean vitality was 41 (s.d. 11) and disease duration was 11 months (interquartile range 7–18). Age- and sex-standardized prevalence rates of fatigue and severe fatigue were 44% (95% CI 39, 50) and 19% (95% CI 15, 23), respectively. Fatigue changed little over 3 years and five measurement occasions β = −0.13 (95% CI −0.23, −0.02). GBTM identified two subgroups, which we named ‘Fatigue’ (53%) and ‘No-fatigue’ (47%). Female sex, worse pain, mental health and functional ability were associated with greater fatigue and predicted Fatigue group membership (area under the receiver operating characteristics curve = 0.81). Objective measures of inflammation—swollen joint count and ESR—were not significantly associated with fatigue.ConclusionsFatigue is prevalent and persistent in early RA. Diverse characteristics indicative of central mechanisms are associated with persistent fatigue. Management of fatigue might require interventions targeted at central mechanisms in addition to inflammatory disease modification. People who require such interventions might be identified at presentation with early RA.

Long-acting versus short-acting granulocyte colony-stimulating factors among cancer patients after chemotherapy in China: A systematic review and meta-analysis of randomized controlled trials.

Background:Granulocyte colony-stimulating factors (G-CSFs) include long-acting ones and short-acting ones. They have been mainly applied in Chinese clinical practice for years to prevent neutropenia. However, which type of G-CSF is more superior has not been conclusively determined.Methods:A systematic literature search was conducted using the PubMed, Embase, Cochrane Library, clinical trials.gov, China National Knowledge Infrastructure, and WAN FANG databases for related studies published till August 2021. Revman 5.3 software was used to assess the effectiveness and safety of these 2 types of G-CSFs in patients undergoing chemotherapy.Results:Ten studies involving 1916 patients were included in our meta-analysis to compare the effectiveness and safety of long-acting G-CSFs and short-acting G-CSFs. We found that the incidence of febrile neutropenia (relative risk [RR] 0.82; 95% confidence interval [CI] 0.57–1.17), the recovery time of the absolute neutrophil count (mean difference –0.23; 95% CI –0.49 to 0.03), and the fatigue rate (RR 0.82; 95% CI 0.62–1.07) were similar between the long- and the short-acting G-CSFs. However, the long-acting G-CSFs significantly decreased the incidence (RR 0.86; 95% CI 0.76–0.96) and shortened the duration (mean difference –0.19; 95% CI –0.38 to 0.00) of severe (grade ≥3) neutropenia, and decreased the rate of bone and/or muscle pain (RR 0.75; 95% CI 0.58–0.98).Conclusion:Primary prophylaxis with long-acting G-CSFs was more effective and safer than primary prophylaxis with short-acting G-CSFs in Chinese adults undergoing chemotherapy.

A method for designing the longitudinal position of a porthole in a manned submersible based on the back muscle fatigue characteristics.

The proper porthole angle contributes to relieving the operation fatigue and improving the efficiency of oceanauts. In this study, the authors explored the effect of 3 different porthole longitudinal positions on the oceanauts' back muscles using surface electromyography (sEMG) analysis, and the characteristics of the perceived body comfort was obtained. Overall, 40 healthy participants were recruited to perform tasks in a simulated cabin environment. Electromyographic (EMG) signals were recorded from the trapezius medius, lower trapezius, and erector spinal muscles for porthole angles of -5°, -15°, and +15°, relative to the horizontal line of sight during a 21-minute experiment. The subject comfort scores were collected at 7, 14 and 21 min. The integrated electromyogram (iEMG) and the root mean square (RMS) of EMG signals, as well as the mean power frequency (MPF), and the mean frequency (MF) were calculated. The subjective scores of the +15° porthole at each stage of work are higher than those of the -15° and -5° portholes. The results of iEMG, RMS, MF and MPF all indicated that the +15° porthole design was more conducive to lowering the rate of muscle fatigue, while the -5° and -15° portholes increased the muscle fatigue rate and led to greater fatigue. It was found that the lower trapezius was more prone to fatigue than the trapezius medius and erector spinal muscles. The height, weight and body mass index of the participants were found to negatively correlate with muscles at the +15° porthole, which is highly consistent with the actual situation. The findings suggested that the +15° position was optimal for delaying the muscle fatigue of the participants and for improving the work efficiency of oceanauts. Int J Occup Med Environ Health. 2021;34(6):701-21.