Rotational Shift Research Articles

Factors that Affecting Female Nurse Performance with Work Stress as an Intervening Variable in the Hospital of Dr. Tadjuddin Chalid Makassar

Background: Professional nurse job, long term rhythm of life that is irregular, and pressure of many aspects of live cause multiple role conflicts, sleep problem, affect the efficiency and quality of nurses performance. 12 hours shift rotation are very common in the world, but there is worries that develop about the effect of quality and safety of nurses and patient.
 Aim : To find out the direct and indirect effect of work family conflict, shift work, nutrition status, sleep quality on nurse performance through work stress as an intervening variable on female nurses at Hospital of Dr Tadjuddin Chalid Makassar.
 Methods : The type of this research used observational analytic with cross-sectional design to see the effect of work family conflict, shift work, nutrition status, and quality of sleep on nurse performance through work stress as an intervening variable on female nurses in the Hospital of Dr MTadjuddin Chalid Makassar. This research was conducted in February – June 2021 at Dr. Hospital. Tadjuddin Chalid Makassar. The sample of this research was female nurses who were married as many as 73 respondents, Data collection used questionnare, scale, microtoice, and secondary data. Data analysis used univariate analysis with SPSS program version 24 and multivariate analysis to find out the effect of two or more variables and to see the direct and indirect effect with handle the anther variable with used Path Analysis that was conducted with used SmartPLS program.
 Results : There is no direct effect of work family conflict on performance with a score p (0,462)>0,05 There is an indirect effect of work family conflict on performance through work stress with a score p (0,001) < 0,05. There is direct effect of work stress on performance with p-value (0,003) < 0,05. There is no direct and indirect effect of shift work on performance although it through work stress as intervening variable on nurse with p-value > 0,05. There is no direct and indirect effect of nutrition status on performance athought it through work stress as an intervening variable on nurse with p-value > 0,05. There is direct effect of sleep quality on performance with p-value (0,007) < 0,05. However, there is no indirect offect of sleep quality on performance through work stress as intervening variable on female nurses in the Hospital of Dr Tadjuddin Chalid Makassar with p-value (0,983) > 0,05.
 Conclusion:There is no direct effect of work family conflict on performance, but there is an indirect effect of work family conflict on performance through work stress as variable intervening. There is no direct and indirect effect of nutrition status on performance athought it through work stress as intervening variable and there is direct effect of quality of life on performance but there is no indirect effect of quality of sleep on performance through work stress as intervenig variable on nurses in Hoospital of Dr Tadjuddin Chalid Makassar. Suggested on female nurses could manage their quality of sleep with rest first before doing the activity, so that when they work, they can work as optimal

Factors Associated with the Maintenance of Breastfeeding at One Year among Women in Chiang Mai, Thailand.

This study aimed to investigate factors associated with breastfeeding for at least one year among women in Chiang Mai, Thailand. We conducted a cross-sectional study of 451 mothers with children aged between 12 and 24 months who visited the well-baby clinic among women who visited the well-baby clinic in secondary and tertiary hospitals. The data collected included maternal sociodemographic information, employment status, reasons contributing to continued breastfeeding, primary sources of information, and influential people affecting continued breastfeeding. Multivariable logistic regression analysis was used to investigate the relationship between explanatory variables and continued breastfeeding at one year. Reporting “easier to bond with baby” as a reason to continue breastfeeding (AOR 3.118, 95% CI: 2.022, 4.809) and multiparous status (AOR 1.588, 95% CI: 1.042, 2.420) were positive predictors of mothers who had breastfeeding at least one year postpartum while mothers with undergraduate education level (AOR 0.635, 95% CI: 0.404, 0.997) were more likely to discontinue breastfeeding. Our study highlighted that working mothers have lower odds of continued breastfeeding than stay-at-home mothers (SAHMs), which was found for work with day shifts (AOR 0.437, 95% CI: 0.261, 0.731), work with rotational shifts (AOR 0.481, 95% CI: 0.247, 0.934), and work from home jobs with a flexible schedule (AOR 0.439, 95% CI: 0.229, 0.838). These findings showed that both employment outside home and work from home were strong risk factors for discontinuing breastfeeding before 12 months. We suggest that a breastfeeding-friendly workplace policy is essential to enhance the continuance of breastfeeding. Additionally, working at home requires more research to explore breastfeeding barriers and establish more support strategies.

Practice and experience of shift rotation in the general ward, CCU and catheterization unit of cardiology

Practice and experience of shift rotation in the general ward, CCU and catheterization unit of cardiology

Depressive symptoms and professional satisfaction in Greek nursing personnel in the realm of European financial crisis

BackgroundThe ongoing economic crisis in Europe, including Greece, has been linked with increased psychiatric morbidity and financial rewards reduction, both related to job dissatisfaction. AimWe explored among Greek nursing personnel the degree of satisfaction from wages, and associations with depressive symptoms and total professional satisfaction. Also, associations with socio-demographic, educational and employment variables were explored. MethodsA cross-sectional study was applied (July to August 2015). A census sample of 66 members of nursing personnel employed in a randomly selected Greek public hospital completed the Index of Work Satisfaction and the Center for Epidemiological Studies-Depression scale. Descriptive and inferential statistics were applied. ResultsThe response rate was 73.4%. The degree of satisfaction from wages was low [mean (SD) = 2.1(0.13)-scale range/item 1–7], and strongly positively associated with total professional satisfaction (r = 0.419, P = 0.005). Also, those working in morning shift reported higher degree of work satisfaction from wages (P = 0.05) compared to those working in rotation shifts. Total professional satisfaction was moderate [mean (SD)/item = 3.93(0.05)-scale range/item: 1–7]. Higher depressive symptom values were observed in deputy head nurses compared to nursing assistants (P = 0.011) and staff nurses (P = 0.02), as well as in employees working in morning shifts compared to those working in rotation shifts (P = 0.013). ConclusionsAn association between satisfaction from wages and total professional satisfaction was noted; yet, there was no link of depressive symptoms with satisfaction from wages, or total professional satisfaction. Instead, satisfaction from wages and intensity of depressive symptoms were associated with organizational/administrative polices and employment variables.

Frameless immobilization system with roll correction for stereotactic radiosurgery of intracranial brain metastases.

The objectives of this study were to develop a frameless immobilization system that allows roll rotation corrections and to investigate the performance of this system for stereotactic radiosurgery (SRS) treatment. We designed the support frame of a frameless immobilization system based on the commercial Brainlab immobilization system. The support frame consisted of a fixed component and a rotating component. With rack and pinion gears and guide holes installed in the system, the rotating component was configured to be rotated along the longitudinal axis of the patient with respect to the fixed component. To evaluate the performance of the system, the six degree-of-freedom (6D) positioning corrections (translational and rotational corrections) were assessed by image verification between planning computed tomography (CT) and cone-beam computed tomography (CBCT) images. The commercial immobilization system was evaluated in the same manner for comparison. The mean translational shifts for the commercial system were 0.68 ± 0.19mm, 0.73 ± 0.24mm and 0.78 ± 0.19mm, while those for the developed system were 0.44 ± 0.31mm, 0.43 ± 0.25mm and 0.60 ± 0.14mm in the lateral, longitudinal and vertical directions, respectively. The mean rotational shifts for the commercial system were 0.37° ± 0.12°, 0.32° ± 0.16° and 0.38° ± 0.14°, while those for the developed system were 0.04° ± 0.04°, 0.11° ± 0.06° and 0.15° ± 0.12° along the lateral, vertical and longitudinal axes of the patient, respectively. For institutions that do not have 6D robotic couches installed, the use of the developed immobilization system can provide 6D corrections, resulting in shorter treatment times and higher patient positioning accuracy.

Quantification of the global impact of agricultural practices on soil nematodes: A meta-analysis

Agricultural practices significantly affect soil biodiversity and functions, altering biogeochemical cycles and potentially compromising food production. Increased employment of sustainable agricultural practices is of growing policy concern and requires a better understanding and quantification of how agriculture affects soil functioning. We conducted a worldwide meta-analysis by computing 4855 effect sizes from 103 publications to quantify the effect of agricultural practices on soil nematodes, known to be key biological indicators of soil health. Our meta-analysis summarized the effects of tillage, pesticides use, fertilization, manipulation of above-ground plant including cover crop, rotation and agricultural system shift (the conversion from the conventional to conservation or organic agriculture systems). We quantified how each agricultural practice alters nematode indices of ecological relevance including the absolute abundance of trophic groups, the taxonomic richness and diversity and the food web structure based on functional guilds. At the global level, organo-mineral fertilization, conservation system, cover crop and nematicides exhibited the greatest effect sizes (averaged all nematode indices) while herbicides, plant association, mineral fertilization and tillage had the lowest ones. At the level of trophic groups, the agricultural practices had varying impacts, e.g. crop rotation mainly reduced the abundance of the plant-feeding nematodes (−47%), cover crop mainly increased the abundance of omnivore-predators (+80%) while organic fertilization predominately promoted bacterial (+113%) and fungal feeders (+141%). Crop rotation reduced the absolute abundance of plant feeders by 47% when the rotation is longer than 2 years. At the community level, chemical inputs, monoculture and pesticide application reduced nematode abundance, the food web structure and favoured copiotrophic nematode communities. Biocides and nematicides reduced total abundance, Shannon diversity and the food web complexity of soil nematode (structure index). Using meta-regressions, our meta-analysis revealed that the effect of agricultural practices depends on the time since the last agricultural intervention (e.g. input of fertilizers, pesticide application) and on how long a practice has been adopted. This study will be a useful aid for decision maker to better manage soil nematode community and to identify gaps in current available literature. In providing the direction and magnitude of soil nematode responses to agricultural practices, the effect size produced by this study are critical in facilitating worldwide modelling of soil biodiversity under global change scenarios.

Arterial stiffness as a risk factor for heart failure formation in rotational shift workers in the arctic region

Background and Aims: Aim: To study arterial stiffness (AS) and assess the risk of heart failure (HF) by the H2FPEF score in rotational shift workers in the Arctic.

Modified Blowfish algorithm analysis using derivation cases

This study analyzed and enhanced the modified Blowfish algorithm (MBA) encryption. The modification retained the original structure, process and the use of two S-boxes in the MBA but presented two derivation processes in the f-function which was originally placed to prevent symmetry. The derivation case’s performance was analyzed using avalanche effect and time efficiency. After comparing the first and second derivation process presented in the MBA, the second derivation further improved the avalanche effect by 5.47%, thus improving security. The performance also showed that the second modification is faster by 39.48% in encryption time, and 38.34% faster in decryption time. The first derivation case in the modified Blowfish was slower in time because of the difference in the placement of the shift rotation. The key generation time was found to be independent of the input size while the encryption and decryption time was found to be directly proportional to file size. With this, the second modification is considered to be better.

Impact of hydrogel peri-rectal spacer insertion on seminal vesicles intrafraction motion during 1.5 T-MRI-guided adaptive stereotactic body radiotherapy for localized prostate cancer.

MR-guided daily-adaptive radiotherapy is improving the accuracy in the planning and delivery phases of the treatment. Rectal hydrogel-spacer may help in mitigating organ motion, but few data are currently available. We aimed to assess any potential impact of the device on seminal vesicles motion by measuring translational and rotational shifts between the pre- and post-treatment MRI scans of a total of 50 fractions in the first 10 patients who underwent MR-guided prostate SBRT (35 Gy/5 fx). Of them, five patients received the hydrogel-spacer. The comparative analysis was performed using the Mann-Whitney U-test. Median rotational shifts were: in anteroposterior 0° (range, 0.097°/0.112°; SD = 0.05°) vs 0° (-0.162/0.04°; SD = 0.07°) in the no-spacer subgroup (p = 0.36); lateral shifts were 0° (-0.1°/0.54°; SD = 0.28°) vs -0.85° in the no-spacer cohort (-1.56°/0.124°; SD = 0.054°; p = 0.22). Cranio-caudal shifts were 0° (-0.121°/0.029°; SD = 0.06°) in the spacer-cohort vs 0° (-0.066°/0.087°; SD = 0.69°; p = 0.53). Median translational shifts were: in anteroposterior 0.9 mm (-0.014 mm/0.031 mm; SD = 0.036 mm) in the spacer-group vs 0.030 mm (-0.14 mm/0.03 mm; SD = 0.032 mm; p = 0.8); latero-lateral shifts were -0.042 mm (-0.047 mm/0.07 mm; SD = 0.054 mm), vs -0.023 mm (-0.027 mm/-0.01 mm; SD = 0.023 mm) in the no-spacer group (p = 0.94). In cranio-caudal, statistically significant shifts were reported: 0.082 mm (0.06 mm/0.15 mm; SD = 0.04 mm) vs 0.06 mm (-0.06/0.08 mm; SD = 0.09 mm) in the no-spacer cohort (p = 0.031). A favorable impact of the hydrogel-spacer on seminal vesicles motion was observed only in cranio-caudal translational shifts, although being not clinically significant. Further studies are required to fully investigate the potential contribution of this device on vesicles motion. MR-guided daily adaptive radiotherapy may represent a game changer for prostate stereotactic body radiotherapy, given the possibility to better visualize soft-tissues anatomy and to daily recalculate the treatment plan based on real-time conditions. The use of devices like rectal ballon or rectal gel spacers has gained interest in the last years for the possibility to better spare the rectum during prostate radiotherapy. This is one of the first experiences exploring the role of rectal spacer on seminal vesicles intrafraction motion during MR-guided SBRT for prostate cancer.

Rotational Doppler effect by space-time-coding metasurfaces for nonreciprocal electromagnetic isolation.

Metasurfaces are artificial structures that can arbitrarily manipulate electromagnetic (EM) wavefronts. We propose a nonreciprocal EM isolating surface based on space-time-coding metasurfaces that generates orbital angular momentum (OAM)-carrying beams with electronic rotational Doppler effect. The region between two parallel 1-bit programmable space-time-coding OAM metasurfaces, one each for frequency and OAM order up-conversion and down-conversion, induce rotational Doppler shifts from opposing incident directions. An intermediate frequency-selective surface with highpass characteristics transmits the up-conversion signals and blocks the down-conversion signals. Hence, the EM waves are sensitive to illumination direction, exhibiting EM isolation responses, and the incident waves are only transmitted unidirectionally.

Inflammatory Status and Cardio-metabolic Risk Stratification of Rotational Shift Work.

To investigate the physiological effects of rotational shift work on measures of cardio-metabolic function. Sedentary, healthy men (n = 87; age 37 ± 9 years; body mass index: 30.7 ± 5.1 kg m2) were recruited and categorized via occupation. SHIFT group: currently employed in rotational shift work defined by 8-12 h morning, afternoon, and night rotations; or NSHIFT: working fixed daytime hours. Testing procedures included baseline objective sleep assessment and laboratory testing, conducted between 0600 and 0900 h to assess body composition, cardiorespiratory fitness (VO2peak), inflammatory status [C-reactive protein, interleukin (IL)-6, and tumour necrosis factor-alpha (TNF-α)], glucose metabolism, heart rate variability (HRV), and self-reported leisure time physical activity (PA). SHIFT reported significantly less leisure time PA (P = 0.019), reduced VO2peak (P = 0.007), higher body fat percentage (BF%) (P = 0.021), increase response time to oral glucose tolerance test (P = 0.016), and higher IL-6 values (P = 0.008) compared with NSHIFT. A significant difference was observed in actigraphy measured total sleep time, with SHIFT recording reduced sleep following a night shift (P = 0.001). No group difference was observed in HRV or average sleep parameters (P > 0.05). Linear regression identified a significant association between occupation and inflammatory status (P = 0.006). Rotational shift work is associated with increased risk factors for cardio-metabolic disorders, despite no differences in sleep quality and quantity. The results suggest rotational shift work has a detrimental effect on the health and wellbeing of employees; with homeostatic desynchronization identified as potential pathogenic mechanisms.

Fatigue Through Sleep Time On Night Service Nurses At Kendari City Hospital

Sleep time is the sleep time needed by nurses as a fulfillment before doing the night shift and sleeping time during the night shift to optimize work productivity to minimize work fatigue. This study aims to determine the relationship between nurses' slept time before and during shifts, slept debt, and shift rotation with fatigue on night shift nurses in the Critical Room of the Kendari City General Hospital in 2020. An analytical survey was conducted with a cross-sectional study. The results showed that there was no relationship between sleep time before the night shift and work fatigue on the night watch nurse (p-value = 0.309), in contrast to sleep time during the night shift, it was found that there was a relationship with work fatigue on the night watch nurse (p-value = 0.003 ). It is recommended that hospital management make standard operating procedures that aim to regulate nurses' sleep time during the night shift to meet their needs and reduce fatigue levels.

The Impact of Different Types of Shift Work on Blood Pressure and Hypertension: A Systematic Review and Meta-Analysis.

Shift work (SW) encompasses 20% of the European workforce. Moreover, high blood pressure (BP) remains a leading cause of death globally. This review aimed to synthesize the magnitude of the potential impact of SW on systolic blood pressure (SBP), diastolic blood pressure (DBP) and hypertension (HTN). MEDLINE, EMBASE and CENTRAL databases were searched for epidemiological studies evaluating BP and/or HTN diagnosis among shift workers, compared with day workers. Random-effects meta-analyses were performed and the results were expressed as pooled mean differences or odds ratios and 95% confidence intervals (95% CI). The Newcastle–Ottawa Scale was used to assess the risk of bias. Forty-five studies were included, involving 117,252 workers. We found a significant increase in both SBD and DBP among permanent night workers (2.52 mmHg, 95% CI 0.75–4.29 and 1.76 mmHg, 95% CI 0.41–3.12, respectively). For rotational shift workers, both with and without night work, we found a significant increase but only for SBP (0.65 mmHg, 95% CI 0.07–1.22 and 1.28 mmHg, 95% CI 0.18–2.39, respectively). No differences were found for HTN. Our findings suggest that SW is associated with an increase of BP, mainly for permanent night workers and for SBP. This is of special interest given the large number of susceptible workers exposed over time.

An Anterior Cruciate Ligament In Vitro Rupture Model Based on Clinical Imaging

Background: Biomechanical studies on anterior cruciate ligament (ACL) injuries and reconstructions are based on ACL transection instead of realistic injury trauma. Purpose: To replicate an ACL injury in vitro and compare the laxity that occurs with that after an isolated ACL transection injury before and after ACL reconstruction. Study Design: Controlled laboratory study. Methods: Nine paired knees were ACL injured or ACL transected. For ACL injury, knees were mounted in a rig that imposed tibial anterior translation at 1000 mm/min to rupture the ACL at 22.5° of flexion, 5° of internal rotation, and 710 N of joint compressive force, replicating data published on clinical bone bruise locations. In contralateral knees, the ACL was transected arthroscopically at midsubstance. Both groups had ACL reconstruction with bone–patellar tendon–bone graft. Native, ACL-deficient, and reconstructed knee laxities were measured in a kinematics rig from 0° to 100° of flexion with optical tracking: anterior tibial translation (ATT), internal rotation (IR), anterolateral (ATT + IR), and pivot shift (IR + valgus). Results: The ACL ruptured at 26 ± 5 mm of ATT and 1550 ± 620 N of force (mean ± SD) with an audible spring-back tibiofemoral impact with 5o of valgus. ACL injury and transection increased ATT (P < .001). ACL injury caused greater ATT than ACL transection by 1.4 mm (range, 0.4-2.2 mm; P = .033). IR increased significantly in ACL-injured knees between 0° and 30° of flexion and in ACL transection knees from 0° to 20° of flexion. ATT during the ATT + IR maneuver was increased by ACL injury between 0° and 80° and after ACL transection between 0° and 60°. Residual laxity persisted after ACL reconstruction from 0° to 40° after ACL injury and from 0° to 20° in the ACL transection knees. ACL deficiency increased ATT and IR in the pivot-shift test (P < .001). The ATT in the pivot-shift increased significantly at 0° to 20° after ACL transection and 0° to 50° after ACL injury, and this persisted across 0° to 20° and 0° to 40° after ACL reconstruction. Conclusion: This study developed an ACL injury model in vitro that replicated clinical ACL injury as evidenced by bone bruise patterns. ACL injury caused larger increases of laxity than ACL transection, likely because of damage to adjacent tissues; these differences often persisted after ACL reconstruction. Clinical Relevance: This in vitro model created more realistic ACL injuries than surgical transection, facilitating future evaluation of ACL reconstruction techniques.

Whatever Happened to the ‘Goodwin Pattern’? Profit Squeeze Dynamics in the Modern American Labour Market

ABSTRACT The ‘Goodwin pattern’ — an anti-clockwise rotation in real activity × wage share space recurring at intervals that correspond roughly to the duration of business cycles — is an enduring feature of high-frequency dynamics in capitalist economies. It is well known that the centre or focus of this rotation shifts over time. More recently, however, the Goodwin pattern seems to have broken down, the wage share no longer increasing as the real economy improves over the course of short-term booms. In this paper, the apparent breakdown of the Goodwin pattern is associated with the consolidation of an ‘incomes policy based on fear’ that is part-and-parcel of neoliberalism. As a result of this incomes policy based on fear, the institutional structure of the labour market disciplines labour at any rate of unemployment. This decouples wage-share dynamics from the state of the real economy, with the result that as recently witnessed in the US, the wage share is rendered invariant to improvements in economic performance over the course of short-term cyclical booms.

Factors affecting night sleep in rotational shift workers in the Arctic

Abstract Funding Acknowledgements Type of funding sources: None. Background Our previous studies revealed that half of arterial hypertension (AH) patients had a flat type of non-dipper curve of blood pressure daily profile (BPDP). Purpose To study and differentiate the leading component of sleep disturbance in conditions of the Arctic rotational shift work and evaluate its relationship with the data of ambulatory blood pressure monitoring (ABPM). Methods In September 2019, 180 patients with AH, including 79 males (M), (gr. 1) aged 48.7 ± 8.3 years and 68 females (F), (gr. 2) aged 50.0 ± 6.7 years (p = 0.06) were simultaneously examined in Yamburg (68 N) settlement in the Arctic Watch. Groups did not differ in rotational shift work duration (16.9 ± 8.7 and 16.2 ± 8.3 years, p = 0.72). Analysis of sleep quality (Pittsburg Sleep Quality Index - PSQI) with daytime sleepiness analysis (Epworth Sleepiness Scale) was carried out. Six components were investigated: 1 - subjective sleep (S) quality component; 2 - assessment of S latency; 3 - assessment of S duration; 4 – habitual S efficiency ; 5 – step disturbances of S; 6 - use of S medication; 7 - daytime S dysfunction with differentiation of global index (Global PSQI score). All individuals underwent ABPM with analysis of daily index of systolic blood pressure and diastolic blood pressure and BPDP. Results According to the survey, 22% had S disorders in M gr., 30% (24/81) in F gr., p = 0.23. Global assessment of S quality was also not dependent on gender: mode of assessment was 4 points (P), (24 individuals) in M, 5 P (17) in F (p = 0.91). Leading components of S quality disorder were the subjective S quality with 2 P, (16); the S latently had 2 P (11); the step disturbances of S had the 2 P (11) and the daytime S dysfunction had the 2 P (14) in M. In F, the 1st component (C)C (2 P – 13); the 2nd C - 2 P (16) prevailed and the 5th and the 7th C were less manifested. Moreover, F had S latency complaints oftener than M (p = 0.031). Analysis of interconnections with ABPM revealed "over dipper" BPDP in the 12.5%, "dipper" BPDP in 42.5% (51); "non dipper" BPDP in 41.7% (50); "night peaker" BPDP in 3.3%. In individuals with normal S quality, "dipper" BPDP prevailed (54%). At the same time, leading components did not have significant correlations with abnormal BPDP. Conclusion In conditions of rotational shift work in the Arctic, regardless of gender, sleep disturbances are more associated with poor habitual sleep efficiency and less associated with disturbances of BPDP. This is obviously explained by increased exhaustion due to the intense nature of rotational shift work in the Arctic region.

Does shift work affect blood pressure values and hypertension risk? a systematic review and meta-analysis

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): Fundação para a Ciência e Tecnologia (FCT) and Fundo Social Europeu (FSE) Introduction Modern societies function 24h/day which accounts for shift work (SW) encompassing already more than 20% of the European workforce. While the relationship between blood pressure (BP) and cardiovascular events is a continuous, hypertension (HTN) remains the major preventable cause of cardiovascular disease (CVD) in our continent. SW has been associated with sleep disturbances, circadian misalignment and unhealthy behaviours, possibly conducting to several chronic diseases. Therefore, we aimed to determine if shift workers have higher BP values and/or HTN risk. Methods This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was performed on MEDLINE, EMBASE and Cochrane electronic databases. Included studies reported HTN diagnosis using current thresholds and/or BP values, in both shift workers and in a control group of day workers. SW was categorized in 4 subgroups, focused mostly on night work. Pooled mean difference and 95% Confidence Intervals (95%IC) were estimated for continuous outcomes, Systolic BP (SBP) and diastolic BP (DBP), and pooled Odds Ratio and 95%IC were determined for HTN risk. The Newcastle-Ottawa Quality Assessment Scale was used for quality evaluation of included studies. Results Forty-five independent studies were included engaging 117252 workers. Of these, 41 studies were included in the meta-analysis for SBP, 39 for DBP and 14 for HTN. Most studies provided cross-sectional data (n = 42), were developed in Asia (n = 21), in an industrial setting (n = 25) and included only men (n = 26). Most studies were rated as satisfactory quality (n = 23) with confounder adjustment being the weakest parameter. We found a statically significant increase for both systolic and diastolic BP among permanent night workers, 2.52mmHg [0.75–4.29] and 1.77mmHg [0.39–3.15] respectively. Amongst rotational shift workers, both with and without night work, we found a significant increase only for SBP, namely 1.28 mmHg [0.18–2.39] and 0.65 mmHg [0.07–1.22]. For HTN risk, none of SW types showed significant differences. Conclusions Certain groups of shift workers may be at special risk for increased BP. This is the first review assessing the impact of SW specifically on BP values. Although the increases were generally modest, these may play an important role among already susceptible individuals exposed overtime. The effect of SW was more consistent for SBP, which has a major impact on CVD risk. Hence, occupational health services should embrace a holistic CVD preventive approach including atypical risk factors such as SW, with active monitoring across the lifespan of more vulnerable workers.

Prosthetic humeral head center of rotation shift from ideal is associated with inferior clinical outcomes after anatomic total shoulder arthroplasty

BackgroundCadaveric studies have demonstrated adverse biomechanical consequences to small changes in the center of rotation (COR) from ideal in anatomic total shoulder arthroplasty (TSA). The aim of the present study was to determine if there is any association between humeral COR shift from ideal in anatomic TSA and patient-reported outcomes or range of motion (ROM). MethodsA multicenter retrospective study was conducted of TSAs with minimum 2-year follow-up. Offset of the COR from ideal was measured on postoperative radiographs using a best-fit circle technique. The primary outcome was the final ASES score. A receiver operator characteristic curve was constructed to determine a significant threshold of COR change. Patient-reported outcomes and ROM for patients above and below the calculated threshold were assessed. The number of patients achieving a patient acceptable symptomatic state was also investigated. ResultsEighty-seven patients aged 65.6 ± 8.3 years, 59% male, with mean 3.2-year follow-up were included. In 64% of cases, the COR was >2 mm from ideal and in 18% of cases it was >4 mm. A significant threshold COR change of 2.7 mm was determined, which was a significant predictor of below-average ASES scores following TSA (sensitivity: 79%, specificity: 72%, P< .001). Patient acceptable symptomatic state was achieved in 100% of patients with 0-2 mm, 90% of patients with 2-4 mm, and 56% of patients with over 4 mm of COR increase. There was significantly improved final forward flexion (152 ° for COR <2.7, 139 ° for COR >2.7, P= .009) and change in active forward flexion (41° for COR < 2.7, 26 ° for COR > 2.7, P = .047) for patients with COR closer to ideal. ConclusionsAccurate restoration of ideal humeral COR during anatomic TSA is challenging and significant shifts are common. A prosthetic COR greater than 2.7 mm from ideal is associated with worse patient-reported outcomes and ROM following anatomic TSA Level of evidenceLevel III, retrospective comparative study.

306 Circadian activity rhythms and alertness among rapid-shift work female nurses

Abstract Introduction Circadian rhythms play an important role in regulating sleep. Sleep disturbances are prevalent in shift-work nurses, particularly for those work in rapid-shift rotation, including night shifts and day shifts. This study aimed to: 1) describe the characters of sleep-wake index (total sleep time [TST], wake after sleep onset [WASO], circadian activity rhythms [CAR]), psychomotor vigilance test (PVT), salivary cortisol, fatigue, and activity level during 8- and 12-hour rapid-shift work nurses; and 2) compare the parameters between two different shifts. Methods This exploratory study used registered nurses (RNs) from nine intensive care units in Beijing area. 7-days consecutive wrist actigraphy data, including TST and WASO were collected. Cosiner analysis was used for computing the CAR, including amplitude and mesor. PVT and saliva cortisol were used to assess alertness level, which measured before and after shift. Self-reported fatigue severity was measured by Lee Fatigue Scale-Short Form and assessed before and after shift. Results A total of 152 RNs (12-hour, n=82; 8-hour, n=70) participated this study, with a mean age of 31.81 (SD= 6.09). Compared with the 8-hour shift nurses, the 12-hour shift nurses were significantly higher in TST (456 vs. 364 minutes), median saliva cortisol level (before day shift, 0.54 vs. 0.31), and median PVT reaction time (before night shift). However, CAR were 0.53 (SD=0.13) and 0.50 (SD=0.18) for 12-hour and 8-hour shift RNs, respectively, and indicates desynchronized CAR in both groups. Regardless shift rotation, almost three-quarters of the RNs had a 500 ms PVT reaction time. For the 12-hour and 8-hour nurses, the level of activity during day shift was similar. However, during night shift work it was significantly lower in 12-hour nurses compared to the 8-hour nurses. All RNs experienced clinical significant fatigue severity (ranged 3.78 to 8.14) regardless before or after shift work; however, the 12-hour group reported lower fatigue severity than 8-hour group. Conclusion In this study, findings revealed shift-work RNs experienced fatigue and desynchronized CAR. The TST was low and reaction time was prolonged before and after shift work. Sleep intervention should be mandatorily included in clinical continue education. Support (if any) This project was supported by Chinese National Natural Science Foundation (71603279).

Analysis of misaligned optical rotational Doppler effect by modal decomposition.

The optical rotational Doppler effect (RDE) is closely related to the unique orbital angular momentum (OAM) carried by optical vortex, whose topological charge means the mode of OAM. Compared with the coaxial incidence, the rotational Doppler frequency shift spectrum of a misaligned optical vortex (misaligned RDE) widens according to a certain law. In this paper, an OAM modal decomposition method of the misaligned optical RDE is proposed and the relative intensity of different OAM modes, namely the OAM spectrum, is derived based on an inner product computation. Analyses show that lateral displacements and angular deflections change the distribution of OAM modes relative to the rotation axis of the object. A misaligned Laguerre-Gaussian (LG) vortex can be represented as a specific combination of coaxial LG modes, and the difference between the topological charge of two adjacent modes is 1 or 2 with lateral displacements or angular deflections respectively. An experiment of misaligned optical RDE using a superimposed LG vortex is executed, and the obtained frequency shift spectrum with misaligned incidence expands into a set of discrete signals, which agrees well with the theoretical results. Moreover, we can get the rotation frequency of the object from an expanded frequency spectrum more quickly and accurately based on the difference between two adjacent signal peaks. The proposed method contributes to analyze the misaligned optical RDE comprehensively, which is significant in remote sensing and optical metrology.