Development of Prediction Models for Sickness Absence Due to Mental Disorders in the General Working Population

PurposeThis study investigated if and how occupational health survey variables can be used to identify workers at risk of long-term sickness absence (LTSA) due to mental disorders.MethodsCohort study including 53,833 non-sicklisted participants in occupational health surveys between 2010 and 2013. Twenty-seven survey variables were included in a backward stepwise logistic regression analysis with mental LTSA at 1-year follow-up as outcome variable. The same variables were also used for decision tree analysis. Discrimination between participants with and without mental LTSA during follow-up was investigated by using the area under the receiver operating characteristic curve (AUC); the AUC was internally validated in 100 bootstrap samples.Results30,857 (57%) participants had complete data for analysis; 450 (1.5%) participants had mental LTSA during follow-up. Discrimination by an 11-predictor logistic regression model (gender, marital status, economic sector, years employed at the company, role clarity, cognitive demands, learning opportunities, co-worker support, social support from family/friends, work satisfaction, and distress) was AUC = 0.713 (95% CI 0.692-0.732). A 3-node decision tree (distress, gender, work satisfaction, and work pace) also discriminated between participants with and without mental LTSA at follow-up (AUC = 0.709; 95% CI 0.615-0.804).ConclusionsAn 11-predictor regression model and a 3-node decision tree equally well identified workers at risk of mental LTSA. The decision tree provides better insight into the mental LTSA risk groups and is easier to use in occupational health care practice

External validation of a prediction model and decision tree for sickness absence due to mental disorders

Purpose: A previously developed prediction model and decision tree were externally validated for their ability to identify occupational health survey participants at increased risk of long-term sickness absence (LTSA) due to mental disorders. Methods: The study population consisted of N = 3415 employees in mobility services who were invited in 2016 for an occupational health survey, consisting of an online questionnaire measuring the health status and working conditions, followed by a preventive consultation with an occupational health provider (OHP). The survey variables of the previously developed prediction model and decision tree were used for predicting mental LTSA (no = 0, yes = 1) at 1-year follow-up. Discrimination between survey participants with and without mental LTSA was investigated with the area under the receiver operating characteristic curve (AUC). Results: A total of n = 1736 (51%) non-sick-listed employees participated in the survey and 51 (3%) of them had mental LTSA during follow-up. The prediction model discriminated (AUC = 0.700; 95% CI 0.628–0.773) between participants with and without mental LTSA during follow-up. Discrimination by the decision tree (AUC = 0.671; 95% CI 0.589–0.753) did not differ significantly (p = 0.62) from discrimination by the prediction model. Conclusion: At external validation, the prediction model and the decision tree both poorly identified occupational health survey participants at increased risk of mental LTSA. OHPs could use the decision tree to determine if mental LTSA risk factors should be explored in the preventive consultation which follows after completing the survey questionnaire

К численному решению задач о деформации анизотропных пластин с отверстием

Представлен подход к расчету напряженно-деформированного состояния пластин с отверстием, основанный на численной параметризации двусвязной области, сведении исходной нелинейной краевой задачи к последовательности линейных двухмерных и интегрировании последних устойчивым численным методом. Исследуется влияние формы и месторасположения отверстия на напряженно-деформированное состояние квадратной пластины.Представлено підхід до розрахунку напружено-деформованого стану пластин, що послаблені отвором. Підхід базується на числовій параметризації двозв’язної області, зведенні вихідної нелінійної задачі до послідовності лінійних двомірних та останніх до одномірних, інтегрування яких проводиться стійким числовим методом. Досліджується вплив форми та місцезнаходження отвору на напружено-деформований стан квадратної пластини.The study presents an approach to stressed-state analysis of plates with apertures which is based on the numerical parameterization of a doubly-connected area, reduction of the initial nonlinear boundary-value problem to a sequence of linear two-dimensional problems and integrating the latter by the stable numerical method. The effect of form and place of an aperture on stressed state of a square plate has been analyzed

Clinical relevance of sensitization to lupine in peanut-sensitized adults

Background: The use of lupine in food has been increasing during the last decade and allergic reactions to lupine have been reported, especially in peanut-allergic patients. The frequency and the degree of cross-reactivity to other legumes are not known. The aim of the study was to investigate the frequency of sensitization to lupine, and in addition to pea and soy, and its clinical relevance, in peanutsensitized patients. Furthermore, to determine the eliciting dose (ED) for lupine using double-blind placebo-controlled food challenges (DBPCFC). Methods: Thirty-nine unselected peanut-sensitized patients were evaluated by skin prick tests (SPT) and ImmunoCAP to lupine, pea, and soy. Clinical reactivity was measured by DBPCFC for lupine, and by history for pea and soy. Results: Eighty-two percent of the study population was sensitized to lupine, 55% to pea, and 87% to soy. Clinically relevant sensitization to lupine, pea, or soy occurred in 35%, 29%, and 33% respectively of the study population. None of the patients was aware of the use of lupine in food. The lowest ED for lupine, inducing mild subjective symptoms, was 0.5 mg, and the no observed adverse effect level (NOAEL) was 0.1 mg. No predictive factors for lupine allergy were found. Conclusion: In peanut-sensitized patients, clinically relevant sensitization to either lupine or to pea or soy occurs frequently. The ED for lupine is low (0.5 mg), which is only five fold higher than for peanut. Patients are not aware of lupine allergy and the presence of lupine in food, indicating that education is important to build awareness

Food allergy in the Netherlands: differences in clinical severity, causative foods, sensitization and DBPCFC between community and outpatients

Background: It is unknown whether food allergy (FA) in an unselected population is comparable to those from an outpatient clinic population. Objective: To discover if FA in a random sample from the Dutch community is comparable to that of outpatients. Methods: This study was part of the Europrevall-project. A random sample of 6600 adults received a questionnaire. Those with symptoms to one of 24 defined priority foods were tested for sΙgE. Participants with a positive case history and elevated sIgE were evaluated by double-blind placebo-controlled food challenge (DBPCFC). Outpatients with a suspicion of FA were evaluated by questionnaire, sIgE and DBPCFC. Results: In the community, severe symptoms were reported less often than in outpatients (39.3% vs. 54.3%). Participants in the community were less commonly sensitized to any of the foods. When selecting only those with a probable FA (i.e. symptoms of priority food and elevation of sIgE to the respective food), no major differences were observed with respect to severity, causative foods, sensitization and DBPCFC between the groups. Conclusion: In the Netherlands, there are large differences in self-reported FA between community and outpatients. However, Dutch community and outpatients with a probable FA do not differ with respect to severity, causative foods, sensitization and DBPCFC-outcome

Development of ranking system for higher education of Ukraine

A system of determination of university ranking in Ukraine was developed based on the creation of the corresponding methods adequate to the structure, peculiarities and conditions of the Ukrainian universities functioning. A complex of organizational and program-technical means was proposed for collection of the necessary data and determination of university rankings. For specialists in the field of higher education management, those seeking for higher education and employers.Разработана система определения рейтингов университетов Украины, которая основывается на создании определенной методики, адекватной структуре, особенностям и условиям функционирования отечественной высшей школы. Предложен комплекс организационных и программно-технических средств, который применяется при сборе данных и определении оценок рейтингов университетов для специалистов в области управления высшим образованием, а также желающих получить образование и работодателей.Розроблено систему визначення рейтингів університетів України, яка ґрунтується на створенні відповідної методики, адекватної до структури, особливостей та умов функціонування вітчизняної вищої школи. Запропоновано комплекс організаційних і програмно-технічних засобів, що застосовується при збиранні даних та визначенні оцінок рейтингів університетів для фахівців у галузі управління вищою освітою, а також бажаючих отримати освіту та роботодавців

USF-1 Is Critical for Maintaining Genome Integrity in Response to UV-Induced DNA Photolesions

An important function of all organisms is to ensure that their genetic material remains intact and unaltered through generations. This is an extremely challenging task since the cell's DNA is constantly under assault by endogenous and environmental agents. To protect against this, cells have evolved effective mechanisms to recognize DNA damage, signal its presence, and mediate its repair. While these responses are expected to be highly regulated because they are critical to avoid human diseases, very little is known about the regulation of the expression of genes involved in mediating their effects. The Nucleotide Excision Repair (NER) is the major DNA–repair process involved in the recognition and removal of UV-mediated DNA damage. Here we use a combination of in vitro and in vivo assays with an intermittent UV-irradiation protocol to investigate the regulation of key players in the DNA–damage recognition step of NER sub-pathways (TCR and GGR). We show an up-regulation in gene expression of CSA and HR23A, which are involved in TCR and GGR, respectively. Importantly, we show that this occurs through a p53 independent mechanism and that it is coordinated by the stress-responsive transcription factor USF-1. Furthermore, using a mouse model we show that the loss of USF-1 compromises DNA repair, which suggests that USF-1 plays an important role in maintaining genomic stability

Heterochromatin protein 1 is recruited to various types of DNA damage

Heterochromatin protein 1 (HP1) family members are chromatin-associated proteins involved in transcription, replication, and chromatin organization. We show that HP1 isoforms HP1-α, HP1-β, and HP1-γ are recruited to ultraviolet (UV)-induced DNA damage and double-strand breaks (DSBs) in human cells. This response to DNA damage requires the chromo shadow domain of HP1 and is independent of H3K9 trimethylation and proteins that detect UV damage and DSBs. Loss of HP1 results in high sensitivity to UV light and ionizing radiation in the nematode Caenorhabditis elegans, indicating that HP1 proteins are essential components of DNA damage response (DDR) systems. Analysis of single and double HP1 mutants in nematodes suggests that HP1 homologues have both unique and overlapping functions in the DDR. Our results show that HP1 proteins are important for DNA repair and may function to reorganize chromatin in response to damage

Dissociation of CAK from Core TFIIH Reveals a Functional Link between XP-G/CS and the TFIIH Disassembly State

Transcription factor II H (TFIIH) is comprised of core TFIIH and Cdk-activating kinase (CAK) complexes. Here, we investigated the molecular and cellular manifestation of the TFIIH compositional changes by XPG truncation mutations. We showed that both core TFIIH and CAK are rapidly recruited to damage sites in repair-proficient cells. Chromatin immunoprecipitation against TFIIH and CAK components revealed a physical engagement of CAK in nucleotide excision repair (NER). While XPD recruitment to DNA damage was normal, CAK was not recruited in severe XP-G and XP-G/CS cells, indicating that the associations of CAK and XPD to core TFIIH are differentially affected. A CAK inhibition approach showed that CAK activity is not required for assembling pre-incision machinery in vivo or for removing genomic photolesions. Instead, CAK is involved in Ser5-phosphorylation and UV-induced degradation of RNA polymerase II. The CAK inhibition impaired transcription from undamaged and UV-damaged reporter, and partially decreased transcription of p53-dependent genes. The overall results demonstrated that a) XP-G/CS mutations affect the disassembly state of TFIIH resulting in the dissociation of CAK, but not XPD from core TFIIH, and b) CAK activity is not essential for global genomic repair but involved in general transcription and damage-induced RNA polymerase II degradation