Musculoskeletal pain intensity in different body regions and risk of disability pension among female eldercare workers: prospective cohort study with 11-year register follow-up

Background Musculoskeletal pain is a risk factor for leaving the labour market temporarily and permanently. While the presence of multi-site pain increases the risk of disability pension, we lack detailed knowledge about pain intensity as a risk factor. This study investigated the association between musculoskeletal pain intensity in different body regions and risk of future disability pension among eldercare workers. Methods Eight thousand seven hundred thirty-one female eldercare workers replied to a questionnaire on work and health in 2005 and were followed for 11 years in the Danish Register for Evaluation of Marginalization. Time-to-event analyses estimated hazard ratios (HR) for disability pension from pain intensities (0-9 numeric rating scale (NRS)) in the low-back, neck/shoulders, and knees during the previous 3 months. Analyses were mutually adjusted for pain regions, age, education, lifestyle, psychosocial work factors, and physical exertion at work. Results During 11-year follow-up, 1035 (11.9%) of the eldercare workers received disability pension. For all body regions among all eldercare workers, dose-response associations were observed between higher pain intensity and risk of disability pension (p = 7 points on the 0-9 NRS) in the low-back (HR 2.19, 95% CI 1.70-2.82), neck/shoulders (HR 2.34, 95% CI 1.88-2.92), and knees (HR 1.89, 95% CI 1.44-2.47). Population attributable risks (PAR) were 15.5, 23.2, and 9.6% for pain > 2 on NRS in the low-back, neck/shoulders, and knees, respectively, indicating that 15.5, 23.2, and 9.6% fewer eldercare workers would likely receive disability pension if the pain intensity was reduced to 2 or less. For workers 45 years, PAR was highest for neck/shoulder pain (27.6%) and low-back pain (18.8%), respectively. Conclusions The present study found positive dose-response associations between pain intensity in the low-back, neck/shoulders, and knees, and risk of disability pension during 11-year follow-up. Moderate to very high levels of musculoskeletal pain in eldercare workers should, therefore, be considered an early warning sign of involuntary premature exit from the labour market. These findings underscore the importance of preventing, managing, and reducing musculoskeletal pain to ensure a long and healthy working life

La actividad física como herramienta para reducir el absentismo laboral debido a enfermedad en trabajadores sedentarios. Una revisión sistemática

Fundamentos: Se ha sugerido que los programas de actividad física (AF) podrían reducir el absentismo laboral por motivos de enfermedad en trabajadores sedentarios. Esta revisión tuvo como objetivo examinar la evidencia científica disponible para estudiar los efectos de la AF sobre el absentismo laboral teniendo en consideración el diseño del programa de AF. Métodos: Se realizó una búsqueda bibliográfica en 4 bases de datos (Medline, Sportdiscus, Web of Science y Embase) de ensayos clínicos y estudios observacionales publicados sobre AF y absentismo laboral, en inglés y en español, desde el inicio de indización hasta diciembre de 2017, utilizando la metodología PRISMA. Resultados: Un total de 10 estudios publicados cumplieron con los criterios de elegibilidad establecidos. Las evidencias encontradas en la revisión sugieren que la AF es efectiva como medida para reducir el absentismo laboral por motivos de enfermedad. En general, los estudios señalaron que se observan mayores probabilidades de ausentarse del trabajo en trabajadores sedentarios que en los físicamente activos. Conclusiones: La AF en general parece disminuir el absentismo laboral. En concreto, la AF vigorosa podría obtener mejores resultados que la realizada a intensidad moderada, aunque faltan estudios de intervención más rigurosos y específicos, con un mayor control sobre las variables de intervención. Background: Physical Activity (PA) programs have been suggested to lower absenteeism due to illness in sedentary employees. The aim of this review was to examine available scientific literature in order to study PA effects in workplace absenteeism taking the program design into consideration. Methods: A search through 4 databases (Medline, Sportdiscus, Web of Science and Embase), from inception to December 2017, was conducted to identify control intervention and observational studies about PA and absenteeism published in either English or Spanish language using PRISMA procedures. Results: A total of 10 published studies between 1981 and 2017 met the inclusion criteria. Evidence from the review suggested that PA is effective in reducing illness-related absence. Likelihood of being off from workplace reported with sedentary workers reach more probabilities when compared with exercisers. Conclusions: General PA is considered paramount in order to lower employees'' absenteeism, which could be more related to vigorous training. However, there is a lack of rigorous and more specific studies about the issue. More focused on PA effect on absenteeism, adjusted by intervention variables, research would be desirable

Clinically significant anxiety as a risk factor for dementia in the elderly community

Objective: To evaluate whether clinically significant anxiety is an independent risk factor for dementia, taking into account both depression among potentially confounding factors and the competing risk of death. Method: During the Zaragoza Dementia and Depression (ZARADEMP) study, a random sample of community dwellers aged 55 years or older was assessed (n = 4803), and a two-wave, 4.5-year follow-up was completed. Geriatric Mental State (GMS)-AGECAT criteria were used to diagnose anxiety and DSM-IV criteria were applied to diagnose incident dementia. The multivariate Fine and Gray regression model was implemented to calculate dementia risk. Results: Compared with non-cases (GMS-AGECAT criteria), the incidence rate of dementia was significantly higher in subcases of anxiety, and particularly significant in the cases of anxiety (incidence rate ratio (IRR): 2.77; P = 0.010). Cases of anxiety, but not subcases, at baseline were significantly associated with dementia risk (adjusted subdistribution hazard ratio (SHR): 2.7; P = 0.019). Conclusion: Clinically significant anxiety is associated with an almost threefold increase in the risk of dementia in the population, even when controlling for depression and considering mortality in the competing risks model

High expression of prolactin receptor is associated with cell survival in cervical cancer cells

Background: The altered expression of prolactin (PRL) and its receptor (PRLR) has been implicated in breast and other types of cancer. There are few studies that have focused on the analysis of PRL/PRLR in cervical cancer where the development of neoplastic lesions is influenced by the variation of the hormonal status. The aim of this study was to evaluate the expression of PRL/PRLR and the effect of PRL treatment on cell proliferation and apoptosis in cervical cancer cell lines. Results:High expression of multiple PRLR forms and PRLvariants of 60-80 kDa were observed in cervical cancer cell lines compared with non-tumorigenic keratinocytes evaluated by Western blot, immunofluorecence and real time PCR. Treatment with PRL (200 ng/ml) increased cell proliferation in HeLa cells determined by the MTT assay at day 3 and after 1 day a protective effect against etoposide induced apoptosis in HeLa, SiHa and C-33A cervical cancer cell lines analyzed by the TUNEL assay. Conclusions: Our data suggests that PRL/PRLR signaling could act as an important survival factor for cervical cancer. The use of an effective PRL antagonist may provide a better therapeutic intervention in cervical cancer. � 2013 Lopez-Pulido et al.; licensee BioMed Central Ltd

The legal and ethical framework governing Body Donation in Europe-1st update on current practice

Previously, we have reported on the legal and ethical aspects and current practice of body donation in several European countries, reflecting cultural and religious variations as well as different legal and constitutional frameworks. We have also established good practice in body donation. Here we shall further extend the legal and ethical frameworks in place and also focus on novelties in the law and different directives. Of particular interest are points that address the commercialization of human bodies and body parts and weaknesses in the legal directives. Therefore, it is important to define what is ethical and what needs to be considered unethical in body donation and the subsequent utilisation of human bodies for teaching and research.peer-reviewe

Gender differences in adaptation to heat in Spain (1983-2018)

In Spain the average temperature has increased by 1.7 °C since pre-industrial times. There has been an increase in heat waves both in terms of frequency and intensity, with a clear impact in terms of population health. The effect of heat waves on daily mortality presents important territorial differences. Gender also affects these impacts, as a determinant that conditions social inequalities in health. There is evidence that women may be more susceptible to extreme heat than men, although there are relatively few studies that analyze differences in the vulnerability and adaptation to heat by sex. This could be related to physiological causes. On the other hand, one of the indicators used to measure vulnerability to heat in a population and its adaptation is the minimum mortality temperature (MMT) and its temporal evolution. The aim of this study was to analyze the values of MMT in men and women and its temporal evolution during the 1983-2018 period in Spain's provinces. An ecological, longitudinal retrospective study was carried out of time series data, based on maximum daily temperature and daily mortality data corresponding to the study period. Using cubic and quadratic fits between daily mortality rates and the temperature, the minimum values of these functions were determined, which allowed for determining MMT values. Furthermore, we used an improved methodology that provided for the estimation of missing MMT values when polynomial fits were inexistent. This analysis was carried out for each year. Later, based on the annual values of MMT, a linear fit was carried out to determine the rate of evolution of MMT for men and for women at the province level. Average MMT for all of Spain's provinces was 29.4 °C in the case of men and 28.7 °C in the case of women. The MMT for men was greater than that of women in 86 percent of the total provinces analyzed, which indicates greater vulnerability among women. In terms of the rate of variation in MMT during the period analyzed, that of men was 0.39 °C/decade, compared to 0.53 °C/decade for women, indicating greater adaptation to heat among women, compared to men. The differences found between men and women were statistically significant. At the province level, the results show great heterogeneity. Studies carried out at the local level are needed to provide knowledge about those factors that can explain these differences at the province level, and to allow for incorporating a gender perspective in the implementation of measures for adaptation to high temperatures.The authors wish to thank the funding provided by the ENPY 304/20, ENPY 376/18 and ENPY 107/18 projects of the Carlos III Health Institute III (ISCIII). They also wish to thank the UNED for funding this publication in open access.S

Molecular profiling of circulating tumor cells links plasticity to the metastatic process in endometrial cancer

Background: About 20% of patients diagnosed with endometrial cancer (EC) are considered high-risk with unfavorable prognosis. In the framework of the European Network for Individualized Treatment in EC (ENITEC), we investigated the presence and phenotypic features of Circulating Tumor Cells (CTC) in high-risk EC patients. Methods: CTC isolation was carried out in peripheral blood samples from 34 patients, ranging from Grade 3 Stage IB to Stage IV carcinomas and recurrences, and 27 healthy controls using two methodologies. Samples were subjected to EpCAM-based immunoisolation using the CELLection™ Epithelial Enrich kit (Invitrogen, Dynal) followed by RTqPCR analysis. The phenotypic determinants of endometrial CTC in terms of pathogenesis, hormone receptor pathways, stem cell markers and epithelial to mesenchymal transition (EMT) drivers were asked. Kruskal-Wallis analysis followed by Dunn's post-test was used for comparisons between groups. Statistical significance was set at p < 0.05. Results: EpCAM-based immunoisolation positively detected CTC in high-risk endometrial cancer patients. CTC characterization indicated a remarkable plasticity phenotype defined by the expression of the EMT markers ETV5, NOTCH1, SNAI1, TGFB1, ZEB1 and ZEB2. In addition, the expression of ALDH and CD44 pointed to an association with stemness, while the expression of CTNNB1, STS, GDF15, RELA, RUNX1, BRAF and PIK3CA suggested potential therapeutic targets. We further recapitulated the EMT phenotype found in endometrial CTC through the up-regulation of ETV5 in an EC cell line, and validated in an animal model of systemic dissemination the propensity of these CTC in the accomplishment of metastasis. Conclusions: Our results associate the presence of CTC with high-risk EC. Gene-expression profiling characterized a CTC-plasticity phenotype with stemness and EMT features. We finally recapitulated this CTC-phenotype by over-expressing ETV5 in the EC cell line Hec1A and demonstrated an advantage in the promotion of metastasis in an in vivo mouse model of CTC dissemination and homing

The Limited Influence of Pressure Gradients on Late-type Stellar Line Asymmetries

Line asymmetries and shifts are a powerful tool for studying velocity fields in the stellar photospheres. Other effects, however, could also generate asymmetries blurring the information of the velocity patterns. We have studied the shifts and asymmetries induced in the profiles of spectral lines by pressure effects. The best theoretical and experimental data on line broadening and shifts caused by collisions with atomic hydrogen were used to analyze the NaI D and three CaI lines. Line bisectors of synthetic spectra computed with accurate data for the NaI and CaI lines are compared with very high resolution high signal-to-noise ratio solar spectra and indicate that pressure broadening reproduces the wings of the observed lines, but pressure shifts introduce neither asymmetries nor shifts comparable to the observed ones.Comment: Latex file (19 pages), uses aasms4.sty, 5 Postscript figures, accepted for publication in The Astrophysical Journa

On the dissipative non-minimal braneworld inflation

We study the effects of the non-minimal coupling on the dissipative dynamics of the warm inflation in a braneworld setup, where the inflaton field is non-minimally coupled to induced gravity on the warped DGP brane. We study with details the effects of the non-minimal coupling and dissipation on the inflationary dynamics on the normal DGP branch of this scenario in the high-dissipation and high-energy regime. We show that incorporation of the non-minimal coupling in this setup decreases the number of e-folds relative to the minimal case. We also compare our model parameters with recent observational data.Comment: 32 pages, 6 figures. arXiv admin note: substantial text overlap with arXiv:1001.044