The impact of shift work on the psychological and physical health of nurses in a general hospital: a comparison between rotating night shifts and day shifts

Background: Shift work is considered necessary to ensure continuity of care in hospitals and residential facilities. In particular, the night shift is one of the most frequent reasons for the disruption of circadian rhythms, causing significant alterations of sleep and biological functions that can affect physical and psychological well-being and negatively impact work performance. Objectives: The aim of this study was to highlight if shift work with nights, as compared with day work only, is associated with risk factors predisposing nurses to poorer health conditions and lower job satisfaction. Methods: This cross-sectional study was conducted from June 1, 2015 to July 31, 2015 in 17 wards of a general hospital and a residential facility of a northern Italian city. This study involved 213 nurses working in rotating night shifts and 65 in day shifts. The instrument used for data collection was the “Standard Shift Work Index,” validated in Italian. Data were statistically analyzed. Results: The response rate was 86%. The nurses engaged in rotating night shifts were statistically significantly younger, more frequently single, and had Bachelors and Masters degrees in nursing. They reported the lowest mean score in the items of job satisfaction, quality and quantity of sleep, with more frequent chronic fatigue, psychological, and cardiovascular symptoms in comparison with the day shift workers, in a statistically significant way. Conclusion: Our results suggest that nurses with rotating night schedule need special attention due to the higher risk for both job dissatisfaction and undesirable health effects

Dexamethasone improves redox state in ataxia telangiectasia cells by promoting an NRF2-mediated antioxidant response

partially_open10noAtaxia telangiectasia (A-T) is a rare incurable neurodegenerative disease caused by biallelic mutations in the gene for ataxia-telangiectasia mutated (ATM). The lack of a functional ATM kinase leads to a pleiotropic phenotype, and oxidative stress is considered to have a crucial role in the complex physiopathology. Recently, steroids have been shown to reduce the neurological symptoms of the disease, although the molecular mechanism of this effect is largely unknown. In the present study, we have demonstrated that dexamethasone treatment of A-T lymphoblastoid cells increases the content of two of the most abundant antioxidants [glutathione (GSH) and NADPH] by up to 30%. Dexamethasone promoted the nuclear accumulation of the transcription factor nuclear factor (erythroid-derived 2)-like 2 to drive expression of antioxidant pathways involved in GSH synthesis and NADPH production. The latter effect was via glucose 6-phosphate dehydrogenase activation, as confirmed by increased enzyme activity and enhancement of the pentose phosphate pathway rate. This evidence indicates that glucocorticoids are able to potentiate antioxidant defenses to counteract oxidative stress in ataxia telangiectasia, and also reveals an unexpected role for dexamethasone in redox homeostasis and cellular antioxidant activity.openBiagiotti, Sara; Menotta, Michele; Orazi, Sara; Spapperi, Chiara; Brundu, Serena; Fraternale, Alessandra; Bianchi, Marzia; Rossi, Luigia; Chessa, Luciana; Magnani, MauroBiagiotti, Sara; Menotta, Michele; Orazi, Sara; Spapperi, Chiara; Brundu, Serena; Fraternale, Alessandra; Bianchi, Marzia; Rossi, Luigia; Chessa, Luciana; Magnani, Maur

Hypofractionated radiotherapy after conservative surgery for breast cancer: analysis of acute and late toxicity

<p>Abstract</p> <p>Background</p> <p>A variety of hypofractionated radiotherapy schedules has been proposed after breast conserving surgery in the attempt to shorten the overall treatment time. The aim of the present study is to assess acute and late toxicity of using daily fractionation of 2.25 Gy to a total dose of 45 Gy to the whole breast in a mono-institutional series.</p> <p>Methods</p> <p>Eighty-five women with early breast cancer were assigned to receive 45 Gy followed by a boost to the tumour bed. Early and late toxicity were scored according to the Radiation Therapy Oncology Group criteria. For comparison, a group of 70 patients with similar characteristics and treated with conventional fractionation of 2 Gy to a total dose of 50 Gy in 25 fractions followed by a boost, was retrospectively selected.</p> <p>Results</p> <p>Overall median treatment duration was 29 days for hypofractionated radiotherapy and 37 days for conventional radiotherapy. Early reactions were observed in 72/85 (85%) patients treated with hypofractionation and in 67/70 (96%) patients treated with conventional fractionation (p = 0.01). Late toxicity was observed in 8 patients (10%) in the hypofractionation group and in 10 patients (15%) in the conventional fractionation group, respectively (p = 0.4).</p> <p>Conclusions</p> <p>The hypofractionated schedule delivering 45 Gy in 20 fractions shortened the overall treatment time by 1 week with a reduction of skin acute toxicity and no increase of late effects compared to the conventional fractionation. Our results support the implementation of hypofractionated schedules in clinical practice.</p

agronomic evaluation of green biodegradable mulch on melon

A two-year research was carried out in 2004-2005 in order to evaluate the effects of biodegradable green mulch on melon ( Cucumis melo L. var. reticulatus Naud.) yield and quality. The loss of quality due to the presence of spot caused by the residues of biodegradable plastics was also investigated. The research was conducted over two years, in open field, at S. Piero a Grado, Pisa, Italy, (lat. 43.67498, long. 10.34737), from the beginning of May to the end of July of each year. The films tested in the first year experiment were two biodegradable ones with different colours (black and green) compared with a low-density polyethylene (LDPE) film, while in 2005 three biodegradable films, (two green and one black) were compared with a traditional LDPE film. The two green biodegradable films had different properties related to the biodegradation rate, faster in film Cv205 , because of a different degree of Mater Bi polymer inside the film. In each year a randomized block design with four replications was followed. Green biodegradable films allowed obtaining a higher yield than LDPE films maybe because of the higher soil temperatures reached, and excellent fruit quality, especially for the soluble solids content and the ripening process. At the same time, the presence of residues on the fruit skin was rather low because of the degradation of films occurred at the ripening time. In the first year, the percentage of spotted fruits was low for every kind of film, while in the second one the green film showed a higher presence of residues on skin compared with the black one. The biodegradable materials covered the soil for the whole crop cycle with a good mulching effect, and the successive degradation allowed to avoid the removal and disposal of plastic film, with a certain economic advantage

A 12-week vigorous exercise protocol in a healthy group of persons over 65: study of physical function by means of the senior fitness test

The aim of this study was to assess the effects of vigorous exercise on functional abilities bymeans of a Senior Fitness Test (SFT) in a group of elderly adults. Twenty healthy and inactive people performed vigorous exercise (VE: 12 men and 8 women, aged 69.6 ± 3.9 years). At the beginning of the study (T0) and after 3months (T1), each subject’s functional ability was tested formuscular strength, agility, cardiovascular fitness, flexibility, and balance.The VE was designed with continuous and interval exercise involving large muscle activities. Functional exercises were performed between 60% and 84% of heart rate reserve (HRR) for a duration of 65 minutes. Five out of the 6 SFTs performed were found significantly improved: Chair Stand (T0 12.4 ± 2.4, T1 13.5 ± 2.6, < 0.01), Arm Curl (T0 14.2 ± 3.6, T1 16.6 ± 3.6, < 0.01), 2 min step (T0 98.2 ± 15.7, T1 108.9 ± 16.2, < 0.01), Chair Sit-and-Reach (T0 −9.9 ± 7.7 cm, T1 1.7 ± 6.3 cm, < 0.01), and Back Scratch (T0 −15.8 ± 10.9 cm, T1 −8.4 ± 13.1 cm, < 0.01). Our results suggest that a high intensity protocol and functional exercises can improve functional mobility and muscle endurance in those over 65 years of age. SFTs are an effective method for assessing improvements in the functional capacity of elderly adults

Análisis energético y estrategias de operación de una planta de trigeneración integrada en una red de distrito

En el marco del proyecto Polycity se construyó una planta de poligeneración de energía de alta eficiencia en un nuevo desarrollo urbano denominado Parc de l'Alba, en Cerdanyola del Vallès (Barcelona). Esta área incluye un Parque de Ciencia y Tecnología con el Laboratorio de Luz Sincrotrón (ALBA), así como edificios de bajo consumo energético. El proyecto se está ejecutando en diferentes pasos. En el primer paso, se construyó una planta de trigeneración basado en motores de cogeneración y en los siguientes pasos que se espera que aumente el número de motores en servicio e introducir una planta de refrigeración solar y un sistema de gasificación de biomasa para completar la planta de poligeneración. La planta de trigeneración ya existente proporciona electricidad, agua caliente y agua fría para el Sincrotrón y los edificios del parque tecnológico a través de una red con cuatro tubos de calefacción urbana y refrigeración. La planta ST-4 se compone de tres motores de gas de cogeneración de gas natural de 3,3 MW de potencia cada uno, una máquina de absorción de doble efecto de 5 MW accionada directamente con gases de escape, una máquina de absorción de simple efecto de 3 MW, y unidades auxiliares: una enfriadora de compresión de 5 MW, una caldera de gas natural de 5 MW. El sistema incluye también un depósito de almacenamiento de agua enfriada de 4.000 m3. En este artículo se presentará un análisis energético detallado de la planta utilizando datos de operación reales y se estudiaran diferentes estrategias de operación aplicando un software de optimización. Otro de los puntos a tratar es el cálculo de las prestaciones de la planta a baja carga ya que actualmente el número de usuarios conectados a la red de distrito es todavía bajo. El software utilizado es un desarrollo propio basado en GAMS como el lenguaje de programación para definir y resolver problemas de simulación y optimización. Los principales parámetros de funcionamiento de los componentes de la planta se introducen como entradas en la plataforma de optimización, además de la demanda de energía en forma de agua caliente y refrigeración. Esto permite seleccionar las unidades en funcionamiento y la distribución de carga entre las diversas unidades. Los resultados se utilizaran para proponer nuevas estrategias de operación de acuerdo con el patrón de cada demanda, calcular la viabilidad de estas y detectar las posibles fuentes de desviación con respecto al rendimiento esperado en cada unidad.Los autores agradecen el soporte económico facilitado por el Ministerio de Economía y Competitividad de España a través del proyecto coordinado de I+D+i, ref. PI2012-38841-C02-01

Persistence of Unintegrated HIV DNA Associates With Ongoing NK Cell Activation and CD34+DNAM-1brightCXCR4+ Precursor Turnover in Vertically Infected Patients Despite Successful Antiretroviral Treatment

none11noThe quantification of proviral DNA is raising interest in view of clinical management and functional HIV eradication. Measures of all unintegrated HIV DNA (uDNA) forms in infected reservoir cells provides information on recent replication events that is not found from other proviral DNA assays. To evaluate its actual relevance in a cohort of perinatally-infected adult HIV patients (PHIV), we studied how peripheral blood mononuclear cell uDNA levels correlated with total HIV DNA (tDNA) and with overall replication or innate immune control parameters including NK cell activation/exhaustion and lymphoid turnover. Twenty-two PHIV were included, with successfully controlled HIV (HIV RNA <50 copies/mL) on combined antiretroviral therapy for mean of 8.7 ± 3.9 years. uDNA accounted for 16 [5.2-83.5] copies/µg and was strongly correlated with tDNA (ρ=0.700, p=0.001). Flow cytometric analysis of peripheral NK cells showed that CD69 expression was directly correlated uDNA (p=0.0412), but not with tDNA. Interestingly, CD56-CD16+NK cells which include newly described inflammatory precursors and terminally differentiated cells were directly correlated with uDNA levels (p<0.001), but not with tDNA, and an inverse association was observed between the proportion of NKG2D+ NK cells and uDNA (ρ=-0.548, p=0.015). In addition, CD34+DNAM-1brightCXCR4+ inflammatory precursor frequency correlated directly with uDNA levels (ρ=0.579, p=0.0075). The frequencies of CD56-CD16+ and CD34+DNAM-1brightCXCR4+ cells maintained association with uDNA levels in a multivariable analysis (p=0.045 and p=0.168, respectively). Thus, control of HIV-1 reservoir in aviremic patients on ART is an active process associated with continuous NK cell intervention and turnover, even after many years of treatment. Quantification of linear and circular uDNA provides relevant information on the requirement for ongoing innate immune control in addition to ART, on recent replication history and may help stratify patients for functional HIV eradication protocols with targeted options.openTaramasso, Lucia; Bozzano, Federica; Casabianca, Anna; Orlandi, Chiara; Bovis, Francesca; Mora, Sara; Giacomini, Mauro; Moretta, Lorenzo; Magnani, Mauro; Di Biagio, Antonio; De Maria, AndreaTaramasso, Lucia; Bozzano, Federica; Casabianca, Anna; Orlandi, Chiara; Bovis, Francesca; Mora, Sara; Giacomini, Mauro; Moretta, Lorenzo; Magnani, Mauro; Di Biagio, Antonio; De Maria, Andre

Plug and Play Modular Façade Construction System for Renovation for Residential Buildings

The present paper focuses on the architectural and constructional features required to ensure that building envelope renovation are safe, functional, and adaptable to the building stock, with particular focus on “plug and play” modular facade construction systems. It presents the design of one such system and how it addresses these issues. The outcome of early-stage functional test with a full-scale mock-up system, as well as its applicability to a real construction project is presented. It is found crucial to obtain high quality information about the status of the existing façade with the use of modern technologies such as topographic surveys or 3D scans and point cloud. Detailed design processes are required to ensure the compatibility of manufacture and installation tolerances, along with anchor systems that deliver flexibility for adjustment, and construction processes adapting standard installation methods to the architectural particularities of each case that may hinder its use or require some modification in each situation. This prefabricated plug and play modular system has been tested by reproducing the holistic methodology and new technologies in the market by means of real demonstrators. When compared to more conventional construction methods, this system achieves savings in a real case of 50% (time), 30% (materials) and 25% (waste), thus achieving significant economic savings.This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 768718

Pulmonary disease caused by Mycobacterium marseillense, Italy

Mycobacteriummarseillense was recently described as a new species belonging to the Mycobacterium avium complex (MAC).We describe a case of pulmonary disease caused by M. marseillense in an immunocompetent patient. All strains isolated from the patient were preliminarily identified as M. intracellulare; however, a retrospective molecular analysis corrected the identification to M. marseillense

EFFECTS OF SIX MONTHS TRAINING ON PHYSICAL CAPACITY AND METABOREFLEX ACTIVITY IN PATIENTS WITH MULTIPLE SCLEROSIS.

Patients with multiple sclerosis (MS) have an increased systemic vascular resistance (SVR) response during the metaboreflex. It has been hypothesized that this is the consequence of a sedentary lifestyle secondary to MS. The purpose of this study was to discover whether a 6-month training program could reverse this hemodynamic dysregulation. Patients were randomly assigned to one of the following two groups: the intervention group (MSIT, n = 11), who followed an adapted training program: and the control group (MSCTL, n = 10), who continued with their sedentary lifestyle. Cardiovascular response during the metaboreflex was evaluated using the post-exercise muscle ischemia (PEMI) method and during a control exercise recovery (CER) test. The difference in hemodynamic variables such as stroke volume (SV), cardiac output (CO), and SVR between the PEMI and the CER tests was calculated to assess the metaboreflex response. Moreover, physical capacity was measured during a cardiopulmonary test till exhaustion. All tests were repeated after 3 and 6 months (T3 and T6, respectively) from the beginning of the study. The main result was that the MSIT group substantially improved parameters related to physical capacity (+5.31 +/- 5.12 ml-min(-1)/kg in maximal oxygen uptake at T6) in comparison with the MSCTL group (-0.97 +/- 4.89 ml.min(-1)/kg at T6; group effect: p = 0.0004). However, none of the hemodynamic variables changed in response to the metaboreflex activation. It was concluded that a 6-month period of adapted physical training was unable to reverse the hemodynamic dys-regulation in response to metaboreflex activation in these patients