Significant Increase In Fatigue Research Articles

The Effects of SARS-CoV-2 Infection on the Cognitive Functioning of Patients with Pre-Existing Dementia.

Cognitive postscripts of COVID-19, codenamed as 'cognitive COVID' or 'brain fog,' characterized by multidomain cognitive impairments, are now being reckoned as the most devastating sequelae of COVID-19. However, the impact on the already demented brain has not been studied. We aimed to assess the cognitive functioning and neuroimaging following SARS-CoV-2 infection in patients with pre-existing dementia. Fourteen COVID-19 survivors with pre-existing dementia (four with Alzheimer's disease, five with vascular dementia, three with Parkinson's disease dementia, and two with the behavioral variant of frontotemporal dementia) were recruited. All these patients had detailed cognitive and neuroimaging evaluations within three months before suffering from COVID-19 and one year later. Of the 14 patients, ten required hospitalization. All developed or increased white matter hyperintensities that mimicked multiple sclerosis and small vessel disease. There was a significant increase in fatigue (p = 0.001) and depression (p = 0.016) scores following COVID-19. The mean Frontal Assessment Battery (p < 0.001) and Addenbrooke's Cognitive Examination (p = 0.001) scores also significantly worsened. The rapid progression of dementia, the addition of further impairments/deterioration of cognitive abilities, and the increase or new appearance of white matter lesion burden suggest that previously compromised brains have little defense to withstand a new insult (i.e., 'second hit' like infection/dysregulated immune response, and inflammation). 'Brain fog' is an ambiguous terminology without specific attribution to the spectrum of post-COVID-19 cognitive sequelae. We propose a new codename, i.e. 'FADE-IN MEMORY' (i.e., Fatigue, decreased Fluency, Attention deficit, Depression, Executive dysfunction, slowed INformation processing speed, and subcortical MEMORY impairment).

Fatigue, sleep quality and mental health symptoms in Brazilian women during the COVID-19 pandemic: longitudinal study

To assess the impact of the COVID-19 pandemic on the variables of sleep quality, fatigue, anxiety, and depression in healthy Brazilian women. Longitudinal observational study conducted through an online questionnaire with women in 2020 and 2021. The Pittsburgh Sleep Quality Index, the Fatigue Severity Scale and the Hospital Anxiety and Depression Scale were used. The data were analyzed descriptively and the comparison between the data obtained in the first and second evaluation was performed using the McNemar test. A logistic regression was applied to test the association between the variables that showed a significant difference. A total of 235 women responded to the questionnaires. There was a significant increase in fatigue between the two moments (p < 0.05). In the first assessment, depression (OR: 2.39; 95% CI: 1.14–4.99), anxiety (OR: 2.68; 95% CI: 1.37–5.22) and sleep quality (OR: 4.01; 95% CI: 1.71–9.67) were associated with fatigue. In the second assessment, depression (OR: 2.93; 95% CI: 1.19–7.18) and anxiety (OR: 2.69; 95% CI: 1.27–5.71) were associated with fatigue. There was an impact on biopsychosocial aspects during the COVID-19 pandemic, with worsening of fatigue symptoms within a 6-month interval. In addition, fatigue was associated with symptoms of depression and anxiety, and worse sleep quality in the first year of the pandemic, remaining associated with symptoms of depression and anxiety in the second year of the pandemic in the country.

A randomised controlled trial investigating the ability for supervised exercise to reduce treatment-related decline in adolescent and young adult cancer patients.

IntroductionExercise is recognised as integral in mitigating a myriad negative consequences of cancer treatment. However, its benefit within adolescent and young adult (AYA) cancer cohorts remains relatively under researched, and caution should be taken in extrapolating outcomes from adult and paediatric populations given AYA distinctly different physiological and psychosocial contexts. This study sought to evaluate the impact of an exercise intervention on mitigating the expected decline in fitness, strength, physical functioning, and quality of life (QOL) in AYA undergoing cancer treatment.MethodsThis prospective, randomised controlled trial (FiGHTINGF!T) allocated 43 participants (63% male, mean age 21.1 years) to a 10-week, multimodal, bi-weekly exercise intervention (EG) or control group (CG) undergoing usual care. Pre- and post-intervention assessments included cardiopulmonary exercise tests, one-repetition maximum (1RM) strength, functional tests, and QOL patient-reported outcome measures. Data were analysed via linear mixed models and regression.ResultsWhile no significant group differences (p > 0.05) were observed, neither group significantly declined (p > 0.05) in any outcome measure over the 10-week period. No significant (p˃0.05) strength or functional improvements were observed in the CG, though the EG demonstrated significant improvements in their 1RM leg press (p = 0.004) and chest press (p = 0.032), maximal push ups (p = 0.032), and global QOL (p = 0.011). The EG reported a significant increase in fatigue (p = 0.014), while the CG reported significant positive changes in anxiety measures (p = 0.005).ConclusionThe exercise intervention produced superior improvements in strength and global QOL, compared with the CG. Regardless of group allocation, enrolment in the exercise study appeared to mitigate the treatment-related decline expected in AYA undergoing cancer treatment.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00520-022-07217-w.

Metabolomic profiling reveals extensive adrenal suppression due to inhaled corticosteroid therapy in asthma.

The application of large-scale metabolomic profiling provides new opportunities for realizing the potential of omics-based precision medicine for asthma. By leveraging data from over 14,000 individuals in four distinct cohorts, this study identifies and independently replicates 17 steroid metabolites whose levels were significantly reduced in individuals with prevalent asthma. Although steroid levels were reduced among all asthma cases regardless of medication use, the largest reductions were associated with inhaled corticosteroid (ICS) treatment, as confirmed in a 4-year low-dose ICS clinical trial. Effects of ICS treatment on steroid levels were dose dependent; however, significant reductions also occurred with low-dose ICS treatment. Using information from electronic medical records, we found that cortisol levels were substantially reduced throughout the entire 24-hour daily period in patients with asthma who were treated with ICS compared to those who were untreated and to patients without asthma. Moreover, patients with asthma who were treated with ICS showed significant increases in fatigue and anemia as compared to those without ICS treatment. Adrenal suppression in patients with asthma treated with ICS might, therefore, represent a larger public health problem than previously recognized. Regular cortisol monitoring of patients with asthma treated with ICS is needed to provide the optimal balance between minimizing adverse effects of adrenal suppression while capitalizing on the established benefits of ICS treatment.

Reduced mood variability is associated with enhanced performance during ultrarunnning.

Ultrarunning requires extraordinary endurance but the psychological factors involved in successful ultrarunning are not well understood. One widely held view is that fluctuations in mood play a pivotal role in performance during endurance events. However, this view is primarily based on comparisons of mood before and after marathons and shorter running events. Indeed, to date no study has explicitly examined mood changes during a competive ultramarathon. To address this issue, we measured mood fluctuations in athletes competing in the Hardmoors 60, a 100 km, single day continuous trail-ultramarathon, and examined how variation in mood related to performance, as measured by completion time. The key finding was that the variability of athletes Total Mood Disturbance (TMD) score was significantly and positively correlated with completion time, consistent with the idea that mood is an important factor in determining race performance. Athletes also experienced a significant increase in tension immediately prior to race onset. This effect was more pronounced in less experienced athletes and significantly attenuated by measurement stage 1 at 35.4 km, which suggests the effect was driven by the release of pre-competition anxiety. Depression, anger and TMD were significantly lower at the pre-race measurement compared to the baseline measurement taken the week before. Consistent with previous studies, there were also significant increases in fatigue, anger and TMD during the race. The data are interpreted in terms of the Psychobiological model of endurance and may have broader implications for the understanding of endurance performance in other domains.

Relationship between sensitive skin and sleep disorders, fatigue, dust, sweating, food, tobacco consumption or female hormonal changes: Results from a worldwide survey of 10743 individuals.

Sensitive skin is related to environmental factors. We aimed to investigate the roles of poorly known associated and triggering factors on sensitive skin in a large global population. A survey was administrated to a representative sample of the adult population aged 18-75years in five different countries (Brazil, China, France Russia, and the United States). All participants answered a web-based questionnaire on sociodemographic characteristics, sensitive skin and environmental factors. Among the 10743 included individuals (5285 men and 5458 women), 48.2% declared that they had sensitive skin. The group with sensitive skin reported significant increases in fatigue, dust or sweating and to a lesser extent food or tobacco consumption. The members of this group also declared that they experienced more sleep disorders than individuals without sensitive skin. Sensitive skin was very frequent in pregnant women, women with painful menstruations or women using contraceptive pills. This large cohort study identified new factors, including female hormonal status, fatigue, sleep disorders and food, associated with sensitive skin. These associations suggest that sensitive skin is not restricted to an epidermal disorder but may be included in a larger context. The identified factors are potential upstream drivers of neurogenic inflammation in sensitive skin.

Fatigue, anxiety, and quality of life in breast cancer patients compared to non-cancer controls: a nationwide longitudinal analysis.

Fatigue and anxiety are common and significant symptoms reported by cancer patients. Few studies have examined the trajectory of multidimensional fatigue and anxiety, the relationships between them and with quality of life. Breast cancer patients (n = 580) from community oncology clinics and age-matched controls (n = 364) completed fatigue and anxiety questionnaires prior to chemotherapy (A1), at chemotherapy completion (A2), and six months post-chemotherapy (A3). Linear mixed models (LMM) compared trajectories of fatigue /anxiety over time in patients and controls and estimated their relationship with quality of life. Models adjusted for age, education, race, BMI, marital status, menopausal status, and sleep symptoms. Patients reported greater fatigue and anxiety compared to controls at all time points (p's < 0.001, 35% clinically meaningful anxiety at baseline). From A1 to A2 patients experienced a significant increase in fatigue (β = 8.3 95%CI 6.6,10.0) which returned to A1 values at A3 but remained greater than controls' (p < 0.001). General, mental, and physical fatigue subscales increased from A1 to A2 remaining significantly higher than A1 at A3 (p < 0.001). Anxiety improved over time (A1 to A3 β = - 4.3 95%CI -2.6,-3.3) but remained higher than controls at A3 (p < 0.001). Among patients, fatigue and anxiety significantly predicted one another and quality of life. Menopausal status, higher BMI, mastectomy, and sleep problems also significantly predicted change in fatigue. Breast cancer patients experience significant fatigue and anxiety up to six months post-chemotherapy that is associated with worse quality of life. Future interventions should simultaneously address anxiety and fatigue, focusing on mental and physical fatigue subdomains.

Acute physiological responses during a Brazilian endurance triathlon race

Triathlon is one of the most flourishing sports in the world. This study aimed to analyze the acute effects of physiological markers and subjective perception variables in amateur trained athletes. Participated in the present study 8 male endurance triathletes with race experience. The injury markers and oxidative stress parameters were investigated in the blood plasma and measured at baseline and post-race. Heat, comfort, and humidity perception, and Borg ratings of perceived exertion were measured during the baseline, transition area, and post-race. Descriptive and inferential statistics were used with significance set as p<0.05. The variables of injury and muscle fatigue presented a significant increase comparing the baseline and post-race data, CK (p= 0.005; d= 5.7), LDH (p= 0.004; d= 1.3) and lactate (p< 0.001; d= 7.2). It was observed a significant increase in CP (p= 0.021; d= 2.2) and a significant decrease in DPPH (p= 0.002; d= -1.4) in post-race, no significant changes in LP (p= 0.217; d= 0.6) and TT (p= 0.881; d= -0.1) oxidative stress markers was verified. A significant increase (Δ% = 30.95, p = 0.001; d = 6.8) was observed in urine temperature and color (range [1-7], p = 0.039). Even with the significant increase in fatigue, with a significant increase in the injury markers, oxidative stress markers suggested a good antioxidant defense. It was observed an increase in exertion and heat perception, as well as a reduction in heat comfort and skin wetness.

Power Maximization and Fatigue-Load Mitigation in a Wind-turbine Array by Active Yaw Control: an LES Study

In this study, we perform a multi-objective parametric study for an array of three miniature wind turbines subjected to active yaw control (AYC), with the objectives of maximizing the power and minimizing the fatigue loads. Using the time series extracted from large-eddy simulation (LES), we compute the mean power and the yaw-moment damage equivalent load (DEL) at every point of a finite decision space spanned by the yaw angles of the first two turbines. The mean power outputs simulated with LES are compared with those measured in the wind tunnel, and a good agreement is found between the two. The Pareto front of different yaw configurations is extracted in the objective space of AYC and the Pareto-optimal strategies are identified in the decision space. We find that most of the Pareto-optimal strategies share the characteristic of moderately decremental yaw angles. We also find that the strategies with a small yaw angle for the first wind turbine are inefficient since they incur significant increases in fatigue while only achieving marginal power gains. The results indicate that the decision space of algorithms searching for optimal AYC strategies can be significantly reduced a priori with the consideration of load mitigation in the optimization.

Effects Of Mental Fatigue On Maximal Exercise Test Performance In Physically Active And Sedentary Adults

PURPOSE: This study examined the effects of mental fatigue on maximal treadmill walking exercise performance. METHODS: 50 young male (n = 25) and female (n = 25) adults were recruited to perform a maximal treadmill walking exercise test to volitional exhaustion on two occasions. Prior to the exercise test, participants performed a cognitive task in a randomized, counterbalanced manner for 30 minutes, with the incongruent Stroop task in the mental fatigue condition, and leisure magazine reading in the control condition. Subjective ratings of perceived mood, fatigue, and motivation to exercise were assessed before and after the cognitive task. Perceptual and physiological responses were collected throughout the exercise test. RESULTS: Significant decrease in perceived mood (p < 0.001) and motivation (p = 0.001), and significant increase in fatigue (p = 0.028) were found in the mental fatigue condition. Participants were found to rate their perceived physical exertion higher during the exercise test in the mental fatigue condition (p = 0.042). However, there were no significant differences in physiological responses and test exhaustion time. CONCLUSIONS: Mental fatigue increased perceived physical exertion during maximal treadmill walking exercise but did not impair exercise performance in both active and sedentary adults.

Abstract P113: The Primordial Prevention Project: Pilot Study of Disclosing Child’s Diabetes Genetic Risk Information

The prevalence of type 2 diabetes (T2D) in children has risen dramatically. NHANES data of 12-19 years old showed a significant increase, from 9% to 23%, in pre-diabetes and diabetes from 1999-2008, which was related to increases in BMI. Lifestyle interventions in adults have been shown to be effective at reducing T2D risk, however, interventions in families have been inconclusive in demonstrating the benefit of lifestyle change in reducing T2D risk. We hypothesized that using child’s genetic risk information in families at high risk of developing T2D would serve as a motivator to improve behaviors related to risk factors for T2D. We conducted a pilot study of 44 families and their children aged 2-8 who consented to participate in baseline, risk-disclosure and 3-month follow-up sessions. We identified families as high risk based on a maternal history of gestational diabetes, large for gestational age, or paternal obesity. Parents were surveyed on their family’s physical activity and dietary behaviors, and attitudes and motivations for lifestyle change at baseline and 3-month follow-up. At baseline, saliva samples were collected from children for genotyping of variants previously associated with obesity and T2D risk in genome-wide association studies. When genotyping was completed families were then scheduled to receive results. Parents completed questionnaires related to their anxiety (STAI-State) and depressive symptoms (POMS) prior to receiving their child’s genetic risk and immediately after the intervention. Parents received their child’s genetic risk report, in combination with a quasi-motivational interviewing session and educational materials. At the end of the session parents set individualized behavior goals for themselves and their children based on their responses to baseline questionnaires related to dietary and PA behaviors. Follow-up at 3 months are still being collected. Results from the risk disclosure session are reported here. Parents were 35±5 years old; 11% Latino, 26% black and 63% White; and 60% were mothers. Parents reported a significant increase in fatigue (ß =0.98, p=0.001), depressiveness (ß=0.35, p=0.04), and anxiety (ß =3.0, p=0.001) from pre-risk disclosure compared to post risk-disclosure. Parents reported a significant increase in their confidence to change their family’s behaviors after receiving the intervention (ß=0.34, p=0.001). All parents committed to a personalized health behavior change after learning of their child’s risk. In conclusion, we were able to demonstrate that genetic risk may be a useful motivator to encourage parents to take immediate action to make improvements to their family’s health behaviors. Short-term follow-up results will determine whether changes were meaningful in actual behavior changes.

Changes in Fatigue, Psychological Distress, and Quality of Life After Chemotherapy in Women with Breast Cancer: A Prospective Study.

Chemotherapy leads to various symptoms and psychological distress, which contribute to a significant decrease in the quality of life of the patients. The aim of this study was to identify changes and interrelationships in the fatigue-depression-anxiety symptom cluster and quality of life during the cancer care trajectory in women with breast cancer. Fifty women participated in the study and completed questionnaires at 3 different times: prechemotherapy, postchemotherapy, and 6 months after the completion of chemotherapy. The assessment tools were the Functional Assessment of Cancer Therapy-Fatigue Scale, Hospital Anxiety and Depression Scale, and Functional Assessment of Cancer Therapy-Breast Cancer version 4 Scale. Data were analyzed using descriptive and repeated-measures analysis of variance statistics. A significant increase in fatigue (F = 41.95, P < .001) and psychological distress (F = 26.55, P < .001) from prechemotherapy to postchemotherapy was noted. Improvement was observed 6 months after the completion of chemotherapy. A positive or negative change in fatigue was associated with the same in psychological distress. Quality of life (F = 65.22, P < .001) also showed similar change patterns as observed with fatigue and psychological distress. Fatigue had a greater impact on quality of life at postchemotherapy, but psychological distress had a greater impact at prechemotherapy and at the 6-month follow-up. These results suggest that chemotherapy is highly associated with the fatigue-depression-anxiety symptom cluster and quality of life in women with breast cancer. Nursing intervention is needed to relieve the intensity of the fatigue-depression-anxiety symptom cluster and thus improve the quality of life of patients undergoing chemotherapy from before treatment to follow-up.

Analysis of health-related quality of life in patients with brain tumors prior and subsequent to radiotherapy.

Health-related quality of life (HRQOL) was evaluated for a patient cohort with benign or malignant brain tumors prior and subsequent to radiotherapy. The following inclusion criteria were applied: Sufficient compliance, understanding of patient information and the existence of a brain tumor without previous radiotherapy. Patients were asked to complete the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-BN20 questionnaires at the following times: Prior to (t0) and subsequent to (t1) radiotherapy, and at 3 (t2), 6 (t3) and 12 (t4) months following treatment. In addition, at t1 the side effects were assessed according to the Common Terminology Criteria for Adverse Events. Generally, the global QOL, a standard term describing general QOL, improved slightly (t0=49; t4=65). At t1, a significant increase in fatigue, loss of appetite and alopecia was reported. During follow-up, the symptoms experienced by the patients decreased, and the global QOL remained constant. The objectively recorded side effects of the therapy were comparable with the patient-reported outcomes.

Aumento da fadiga e redução da qualidade de vida após tratamento de câncer do colo do útero

Introdução: o câncer do colo do útero (CCU) acarreta prejuízos físicos e emocionais, sendo um grande problema de saúde pública. Objetivo: avaliar fadiga, capacidade funcional e qualidade de vida antes e após o tratamento com quimiorradioterapia para o CCU. Métodos: a avaliação de fadiga e qualidade de vida foi realizada por meio dos questionários: Inventário Breve de Fadiga (BFI) e Functional Assessment of Chronic Therapy – Cervix Cancer (FACT-Cx), respectivamente, já a capacidade funcional por mensuração direta pelo Teste do degrau (TD6). Participaram 11 mulheres com CCU. O Graphpad Prism® foi utilizado para estatística. Resultados: após a quimiorradioterapia houve aumento significativo da fadiga (de 2,80 para 4,83), redução significativa da qualidade de vida (de 107,8 para 88,1) e redução da capacidade funcional (de 91 degraus para 82 degraus). Conclusão: aumento da fadiga e redução da qualidade de vida foram observados uma semana após a realização de quimiorradioterapia para o CCU.

Responsive upper limb and cognitive fatigue measures during light precision work: an 8-hour simulated micro-pipetting study

Many contemporary occupations are characterised by long periods of low loads. These lower force levels, which are relevant to the development of work-related musculoskeletal disorders, are usually not the focus of fatigue studies. In studies that did measure fatigue in light manual or precision work, within and between measurement responses were inconsistent. The aim of this study was to identify fatigue measures that were responsive at lower force levels (<10% MVC) over the course of an 8-h period. A complementary set of fatigue measures, reflecting both neuromuscular and cognitive mechanisms, was measured during a light precision micro-pipetting task performed by 11 participants. Nine measures were found to be significantly responsive over the 8-h period, including: ratings of perceived fatigue, postural tremor, blink frequency and critical flicker fusion frequency threshold. Common field measures, specifically electromyography RMS amplitude and maximum voluntary contractions, did not lead to extraordinary time effects.Practitioner summary: The findings provide insight towards the responsiveness of a complementary set of field usable fatigue measures at low work intensities Although commonly used measures did not reveal significant increases in fatigue, nine alternative measures were significantly responsive over the 8-h period.

Different adaptations of Chinese winter-over expeditioners during prolonged Antarctic and sub-Antarctic residence.

Prolonged residence in Antarctica is characterized by exposure to isolated, confined, and extreme (ICE) environment. Winter-over expeditioners at research stations often exhibit a complex of psychophysiological symptoms, which varied by stations and sociocultural backgrounds. To understand the different patterns of psychophysiological responses provoked by environmental stress, we conducted a longitudinal assessment of mood and endocrine function in two groups of Chinese expeditioners who were deployed to sub-Antarctic (Great Wall Station, 62°S, N = 12) and Antarctic (Zhongshan Station, 66°S, N = 16) from December 2003 to 2005. Measures of mood, thyroid function, the levels of plasma catecholamine, and circulating interleukins were obtained at departure from China, mid-winter (Antarctica), end of winter (Antarctica), and return to China, respectively. The Zhongshan Station crew experienced significant increases in fatigue, anger, tension, confusion, and decrease in free thyroxine (FT4), norepinephrine (NE), and epinephrine (E) during the winter, increase in thyrotropin (TSH) and total triiodothyronine (TT3) when returning, whereas their counterparts at Great Wall Station only experienced increased TT3 after deployment. Moreover, compared with the Great Wall Station crew, the Zhongshan Station crew exhibited greater increase in anger, greater decrease in FT4, total thyroxine (TT4), NE and E over the winter, and greater increase in TSH when returning. Chinese expeditioners who lived and worked at the Antarctic station and the sub-Antarctic station for over a year showed different change patterns in mood and endocrine hormones. Negative mood and endocrine dysfunction were positively associated with the severity of environment. The study is a supplement to scientific knowledge on psychophysiological variation under ICE environment, which has certain applied value for the development of preventive countermeasures or interventions.

Quality of Life Variables Assessment, Before and After Pancreatoduodenectomy (PD): Prospective Study.

Introduction:The treatment of pancreatic cancer is a complex problem, due to late diagnosis, the need for specialized surgical treatment, the large number of relapses and poor survival.Objective:To evaluate the quality of life of patients with periampulary pancreatic cancer before and after pancreatoduodenectomy (PD).Material and Method:The sample was collected in the “Attikon” University General Hospital (Chaidari). It consists of 20 subjects with a mean age of 65.9 years (SD = 10,2 years). For the quality of life measurement, we used the (EORTC) QLQ-C30 version 3.0., as well as the EORTC QOL-PAN26.Results:From the sample of 20 patients who participated, full data were collected for 18 of them during the first month, 17 during the third month and 16 during the sixth month. Regarding symptoms, as they were recorded with the QLQ-30 questionnaire, there was a significant increase of fatigue, a significant reduction of pain and constipation, while economic difficulties increased. As for the mean and median values for the dimensions of the PAN-26 questionnaire during monitoring, there was a significant decrease in pancreatic and liver pain symptoms during follow-up, while the gastrointestinal symptoms increased in frequency. In addition, the body image and sexuality worsened.Conclusions:The surgical treatment of pancreatic cancer with pancreatoduodenectomy (PD), according to the early survey data using the (EORTC) QLQ-C30 version3.0, and the EORTC QOL-PAN26 questionnaires, seems to have a favorable impact on quality of life, as evidenced by the improvement of most parameters evaluated during the study period.

Muscle fatigue after Achilles tendon rupture: A limited heel-rise test with electromyography reveals decreased endurance

Measuring the maximal number of heel-rises is the clinical standard to quantify plantarflexor strength. However, this activity can be difficult and uncomfortable after Achilles tendon rupture (ATR) and may capture aspects other than muscle strength and endurance. Therefore, the aim of this study project was to evaluate muscle fatigue with a limited number of heel-rises. Fifty-two patients with ATR were evaluated 2.0-6.7 years after injury. Patients performed the heel-rise test with surface electromyography (sEMG) of the gastrocnemius muscles. Muscle fatigue was operationally defined as the slope of the sEMG signal frequency. Subjects performed significantly fewer heel-rises on the injured side compared with the uninjured side (25.5 ± 9.3 vs 33.6 ± 15.1; p < 0.001). Subjects also had greater muscle fatigue on the injured side compared with the uninjured side for the lateral gastrocnemius (−31.1 ± 13.9 vs -26.2 ± 14.8; p = 0.048), but not the medial gastrocnemius (p = 0.074). There was a significant increase in fatigue of both the lateral and medial gastrocnemius on the injured side over the first 10 repetitions (p < 0.001). Our findings demonstrate that subjects have increased gastrocnemius muscle fatigue even several years after ATR and muscle fatigue can be detected with a limited number of heel-rises.

Using a Game to Evaluate Passenger Screener Fatigue and Sleepiness at Airport Screening Checkpoints

The sensitivity of a game-based neurocognitive test to detect sleepiness and fatigue among workers at an airport passenger screening checkpoint (screeners) was examined. Screener fatigue and sleepiness was evaluated using both the game-based test and self-reports over the course of an eight-hour shift. Fatigue and sleepiness using the game-based test was evaluated utilizing differences in pre- and post—shift performance on four games targeting fatigue-mediated cognitive processes including simple reaction time, spatial processing, logical relations, and mathematical processing. Self-reports of fatigue and sleepiness were also collected pre-and post-shift using a previously validated tool. Results revealed that screeners at the checkpoint experienced a significant increase in fatigue and sleepiness from pre- to post-shift, indicated by both performance on the game and the self-report tool. The results suggest that the game-based tool could be used to evaluate the impact of countermeasures to reduce screener fatigue at screening checkpoints.

Fatigue and Job Stress in University Hospital Nurses

Objective: To investigate fatigue-related risk factors among university hospital nurses. Methods: A total of 309 subjects were analyzed among university hospital nurses and interviewed by well trained interviewer using a structured questionnaire and fatigue related factors to gather information on demographics, social and work characteristics, fatigue symptoms, and job stress related to their occupation. Multiple regression modeling was used to test the assessment of fatigue- related risk factors. Results: A significant increase in fatigue was observed in the high stress group related to job demand, organizational system, lack of reward, and occupational climate than in the low group (P<0.001; P=0.008; P=0.045; P=0.003, respectively). In a multiple regression analysis, fatigue was associated with job demand, insufficient job control, and occupational climate (P=0.007; P=0.024; P<0.001, respectively). Fatigue was associated with work department, although a borderline statistical significance was seen (P=0.005). Conclusion: To prevent fatigue in university hospital nurses, it is important to consider work department, job contents, and working environment related to job stress. Preventive strategies to lower fatigue will be needed under the consideration of job stress related to job demand, insufficient job control and occupational climate for university hospital nurses. Key words: Fatigue; Nurses; Job stress; Risk factors