An autopsy-confirmed case of progressive supranuclear palsy with predominant postural instability.

Related Articles

An autopsy-confirmed case of progressive supranuclear palsy with predominant postural instability.

Acta Neuropathol Commun. 2016 Nov 14;4(1):120

Authors: Kurz C, Ebersbach G, Respondek G, Giese A, Arzberger T, Höglinger GU

Abstract
Postural instability and supranuclear gaze palsy represent the key symptoms of Richardson's syndrome, the most frequent clinical manifestation of progressive supranuclear palsy (PSP). However, a proportion of PSP patients never develops ocular motor symptoms, which prevents clinicians from establishing the diagnosis during lifetime according to current diagnostic criteria. We present one instructive autopsy-confirmed PSP case with prospective video-documented clinical course, showing striking temporal divergence of initially present postural instability and delayed development of ocular motor dysfunction. Brain imaging and autopsy findings were typical of PSP, but the temporal sequence of symptoms was unusual with isolated postural instability predominating the clinical course for many years and slowing of vertical saccades/supranuclear gaze palsy evolving not until the 9(th)/11(th) year after disease onset. Although other differential diagnoses were unlikely, this patient did not pass the threshold for possible or probable diagnosis of PSP according to current diagnostic criteria until very late in the disease course. This first well documented, autopsy confirmed case of PSP with predominant postural instability further expands the clinical spectrum of PSP and points out the need of new clinical diagnostic criteria with sufficient sensitivity and specificity for an early and reliable diagnosis.

PMID: 27842578 [PubMed - in process]

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Focal therapy in prostate cancer: A review of seven common controversies.

Focal therapy in prostate cancer: A review of seven common controversies.

Cancer Treat Rev. 2016 Jul 18;51:27-34

Authors: Bass EJ, Ahmed HU

Abstract
Radical treatments such as prostatectomy and radiotherapy have demonstrated success in terms of biochemical and disease-specific survival for localised prostate cancer. However, whilst the end goal of any cancer treatment is to control or cure disease it must also do so by minimising any side effects that may be experienced by the patient. Focal therapy as a concept aims to redress this established therapeutic ratio by treating areas of the prostate affected by significant disease as opposed to treating the entire gland. However, there are a number of common criticisms of focal therapy - we deem the seven sins - that require further interrogation.

PMID: 27846402 [PubMed - as supplied by publisher]

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The Effect of Thermal Annealing on Charge Transport in Organolead Halide Perovskite Microplate Field-Effect Transistors

Transformation of unipolar n-type semiconductor behavior to ambipolar and finally to unipolar p-type behavior in CH₃NH₃PbI₃ microplate field-effect transistors by thermal annealing is reported. The photoluminescence spectra essentially maintains the same features before and after the thermal annealing process, demonstrating that the charge transport measurement provides a sensitive way to probe low concentration defects in perovskite materials.

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Retention and wear behaviors of two implant overdenture stud-type attachments at different implant angulations

Publication date: Available online 15 November 2016
Source:The Journal of Prosthetic Dentistry
Author(s): Jae-Won Choi, Ji-Hyeon Bae, Chang-Mo Jeong, Jung-Bo Huh
Statement of problemImplant angulation should be considered when selecting an attachment. Some in vitro studies have investigated the relationship between implant angulation and changes in the retention force of the stud attachment, but few studies have evaluated the effect of cyclic loading and repeated cycles of insertion and removal on the stud attachment.PurposeThe purpose of this in vitro study was to evaluate the effects of implant angulation on the retentive characteristics of overdentures with 2 different stud attachments, an experimental system and O-rings in red and orange, after cyclic loading and repeated insertion and removal cycles.Material and methodsThe canine region of a mandibular experimental model was fitted with 2 implant fixtures with 2 different stud attachment systems at implant angulations of 0, 15, or 30 degrees. A mastication simulator was used to simulate cyclic loading, and a universal testing machine was used to evaluate retentive force changes after repeated insertion and removal cycles. To simulate the numbers of mastication and insertion and removal cycles per annum, 400000 cyclic loadings and 1080 insertion and removal cycles were performed. Wear patterns and attachment surface deformations were evaluated by scanning electron microscopy. Data were analyzed using the Kruskal-Wallis test, Mann-Whitney U test with Bonferroni correction (α=.05/3=.017), and the paired-sample Student t test (α=.05).ResultsWhen retentive forces before and after testing were compared, O-ring showed significant retention loss at all implant angulations (P<.001). In contrast, the experimental system showed little retention loss in the 0- and 15-degree models (P>.05), whereas the 30-degree model showed a significant increase in retentive force (P=.001). At all implant angulations, retention loss increased significantly for the orange O-ring, followed by the red O-ring, and the experimental system (P<.001). Scanning electron microscopy analysis showed more intense wear in the matrix than the patrix (abutment that matches to matrix) and more severe wear and deformation of the O-ring rubber matrix than of the experimental zirconia ball.ConclusionsUpon completion of the experiment, wear and deformation were found for all attachment systems. Even when implants are not installed in parallel, the experimental system can be used without involving great loss of retention.



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Effect of fiber posts on the fracture resistance of maxillary central incisors with class III restorations: An in vitro study

Publication date: Available online 15 November 2016
Source:The Journal of Prosthetic Dentistry
Author(s): Mohammed Abduljawad, Abdulaziz Samran, Jadalkareem Kadour, Wassim Karzoun, Matthias Kern
Statement of problemEndodontically treated teeth with Class III restorations show reduced fracture resistance. The placement of glass fiber posts may affect fracture resistance and should be further evaluated.PurposeThe purpose of this in vitro study was to evaluate the effect of fiber posts on the fracture resistance of endodontically treated maxillary central incisors with Class III restorations.Material and methodsForty extracted human maxillary central incisors were selected and divided into 4 test groups (n=10 each) according to the restoration strategy: control group; endodontically treated teeth without endodontic posts (GHT); endodontically treated teeth with 2 Class III restorations simulating coronal destruction (GCT); endodontically treated teeth with 2 Class III restorations and a carbon fiber post (GCF); and endodontically treated teeth with 2 Class III restorations and a glass-fiber post (GGF). The fiber posts were adhesively cemented with composite resin cement, and the cavities were restored with composite resin. After 3 months of water storage, all specimens were loaded at 45 degrees in a universal testing machine until fracture and evaluated for fracture mode. The data were analyzed using 1-way ANOVA, followed by the Tukey honest significant difference multiple comparisons test (α=.05).ResultsMean ±SD failure loads ranged from 687.5 ±84.0 N to 943.8 ±93.1 N. One-way ANOVA revealed a statistically significant difference among the groups (P≤.05). The control group (GHT) had significantly higher resistance to fracture than the other groups (P≤.05).ConclusionsWithin the limitations of this in vitro study, placement of a fiber post did not affect the fracture resistance of endodontically treated maxillary central incisors with 2 Class III restorations.



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Orofacial rehabilitation with zygomatic implants: CAD-CAM bar and magnets for patients with nasal cancer after rhinectomy and partial maxillectomy

Publication date: Available online 15 November 2016
Source:The Journal of Prosthetic Dentistry
Author(s): Elizabeth King, Carl Abbott, Lawrence Dovgalski, James Owens
Nasal carcinoma extending into the premaxilla requires radical surgical excision including rhinectomy and partial maxillectomy. Rehabilitation is complex and involves the use of removable prostheses. Three patients treated with zygomatic implants and custom-milled bars to retain an obturator and nasal prosthesis are presented.



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Response to Nanda A, Krishnan S, Kaur H, Koli D, Manak K, Verma M, Gill S. Correction of microstomia in an edentulous patient. J Prosthet Dent 2016;115:137-40

Publication date: Available online 15 November 2016
Source:The Journal of Prosthetic Dentistry
Author(s): Aditi Nanda, Sriram Krishnana, Harsimran Kaur, Dheeraj Koli, Karan Manak, Mahesh Verma, Shubhra Gill




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Accuracy of intraoral digital impressions using an artificial landmark

Publication date: Available online 15 November 2016
Source:The Journal of Prosthetic Dentistry
Author(s): Jong-Eun Kim, Ami Amelya, Yooseok Shin, June-Sung Shim
Statement of problemIntraoral scanners have been reported to have limited accuracy in edentulous areas. Large amounts of mobile tissue and the lack of obvious anatomic landmarks make it difficult to acquire a precise digital impression of an edentulous area with an intraoral scanner.PurposeThe purpose of this in vitro study was to determine the effect of an artificial landmark on a long edentulous space on the accuracy outcomes of intraoral digital impressions.Material and methodsA mandibular model containing 4 prepared teeth and an edentulous space of 26 mm in length was used. A blue-light light-emitting diode tabletop scanner was used as a control scanner, and 3 intraoral scanners were used as experimental groups. Five scans were made using each intraoral scanner without an artificial landmark, and another 5 scans were performed after application of an artificial landmark (a 4×3 mm alumina material) on the edentulous area. The obtained datasets were used to evaluate trueness and precision.ResultsWithout an artificial landmark on the edentulous area, the mean trueness for the intraoral scanner ranged from 36.1 to 38.8 μm and the mean precision ranged from 13.0 to 43.6 μm. With an artificial landmark on the edentulous area, accuracy was improved significantly: the mean trueness was 26.7 to 31.8 μm, and the mean precision was 9.2 to 12.4 μm.ConclusionsThe use of an alumina artificial landmark in an edentulous space improved the trueness and precision of the intraoral scanners tested.



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Intra- and Inter-Observer Reproducibility and Generalizability of First Trimester Uterine Artery Pulsatility Index by Transabdominal and Transvaginal Ultrasound

Abstract

Objectives

The primary aim of the study was to assess intra-observer and inter-observer reproducibility and generalizability (general reliability) of first trimester Doppler measurements of uterine arteries (UtA) performed both transabdominally (TA) and transvaginally (TV). Secondary aims were to investigate whether maternal BMI and acquisition modality (transabdominal or transvaginal) affect feasibility and reliability of UtA Doppler evaluation.

Methods

Singleton pregnancies between 11⁺⁰ and 13⁺⁶ weeks underwent TA and TV Doppler measurements of UtA prospectively, blindly and independently by Fetal Medicine Foundation-accredited operators. The more experienced operator performed all the scans to assess intra-observer reproducibility. Inter-observer reproducibility and generalizability was evaluated among different operators and different ultrasound equipment. Intra- and inter-rater reliability was assessed by Concordance Correlation Coefficient and Intraclass Correlation Coefficient; agreement was estimated with Limits of Agreement and reported graphically with Bland-Altman plots. Correlation between BMI and feasibility and accuracy of UtA measurements were studied with Spearman's correlation coefficient. Differences between TA and TV measurements were evaluated by Wilcoxon test.

Results

101 women were enrolled. The intra-observer reproducibility for TA and TV measurements ranged from 0.87 to 0.94, respectively. The inter-observer reproducibility varied from 0.57 (for TA measurements by the less experienced operator) to 0.95 (for TV measurements by the more experienced operator) and it was independent of the ultrasound equipment used. Spearman's correlation coefficient failed to demonstrate a correlation between BMI and time to get the first set of TA-TV measurements, or between BMI and TA-TV reproducibility. In 4 patients the operators could not obtain the TA measurements due to high BMI. In our population the UtA pulsatility index (PI) values did not differ significantly between the TA or TV approach.

Conclusions

UtA PI measurements obtained by experienced operators show a moderate intra- and inter-observer reproducibility. The TV approach might be used when TA measurements fail in obese women, especially since specific reference ranges for TV measurements may not be necessary.

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How Many Procedures Does it Take? Success of a CVS Training Program for Maternal Fetal Medicine Fellows

Abstract

Objectives

To quantify the learning curve for a training program for Maternal Fetal Medicine (MFM) fellows in obtaining successful transvaginal chorionic villus sampling (CVS) results in women with early pregnancy failure (EPF).

Methods

Retrospective observational cohort study of transvaginal CVS and subsequent manual vacuum aspiration (MVA) performed by MFM fellows. CVS samples were sent for karyotype and products of conception (POC) were sent if CVS sample did not yield a result. Success was defined as karyotype result on CVS specimen.

Results

130 women with EPF up to 9 weeks gestation, underwent transvaginal CVS and MVA from December 2011 to April 2015. CVS samples were successful in 53 (40.8%) cases, POC were analyzed for karyotype in 68 (52.3%) cases and maternal decidua was obtained in 9 (6.9%) cases. Nine MFM fellows performed CVS and MVA procedures. The mean number of procedures per fellow was 14 (5-24). The average success rate of transvaginal CVS sample was 33.3% after the 1st procedure and 50% at the 14^th procedure. One procedure was performed per patient.

Conclusions

Success increased over time from 33.3% to 50.0%. Given the gestational age and failed pregnancy status, this is a reasonable success rate for CVS at time of EPF.

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Multiple myeloma treatment at relapse after autologous stem cell transplantation: a practical analysis

Publication date: Available online 15 November 2016
Source:Cancer Treatment Reviews
Author(s): F. Malard, J.L. Harousseau, M. Mohty
Over the past decade, significant advances have been made in the field of multiple myeloma. Introduction of the so-called novel agents, proteasome inhibitors (PI) and immunomodulatory drugs (IMiD), and improved supportive care have resulted in significantly better outcome. Standard first line treatment in fit patients include PI and IMiD based induction, high dose melphalan with autologous hematopoietic stem cell transplantation (ASCT) and consolidation/maintenance. However, despite these progresses MM remains incurable for the majority of patients and most patients will relapse. Next generation PI (carfilzomib, ixazomib) and IMiD (pomalidomide) and new therapeutic classes: monoclonal antibody (elotuzumab, daratumumab) and pan-deacetylase inhibitors (panobinostat) have been successfully evaluated in relapse multiple myeloma. Some of these new agents are now approved for multiple myeloma treatment at relapse. However choosing the most appropriate treatment at relapse may be difficult. This review sum up the most important studies and provide evidence to choose the most relevant therapeutic strategy for relapse after ASCT, based on disease, patient and previous treatment related parameters.



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Latitude and disease severity in Multiple Sclerosis

Elizabeth Highton and Prof. Bruce Taylor discuss higher latitudes and its association with earlier age of onset of Multiple Sclerosis (MS). The international study, published by the JNNP, links latitude to the age at which symptoms of MS first start. Each 10ᵒ increase in latitude is associated with a 10 month earlier onset of symptoms among those of European descent.

Read the full article here: https://goo.gl/BmHXFo.

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Semantic web technologies in AEC industry: A literature review

Over the recent years, the usage of semantic web technologies has notably increased in the domains of architecture, engineering and construction (AEC). These technologies are typically considered as complementary to existing and often used Building Information Modelling (BIM) software. The usage of these technologies in the AEC domains is thereby motivated by (1) a desire to overcome the interoperability issue among software tools used in diverse disciplines, or at least improve information exchange processes; (2) a desire to connect to various domains of application that have opportunities to identify untapped valuable resources closely linked to the information already obtained in the AEC domains; and/or (3) a desire to exploit the logical basis of these technologies, which is currently undisclosed in the AEC domains. Through an extensive literature study and survey, this article investigates the development and application progress of semantic web technologies in the AEC domains in accordance with these three primary perspectives. These examinations and analyses provide a complete strategical map that can serve as a robust stepping stone for future research regarding the application of semantic web technologies in the AEC domains. Results show that semantic web technologies have a key role to play in logic-based applications and applications that require information from multiple application areas (e.g. BIM+Infra+GIS+Energy). Notwithstanding fast developments and hard work, challenging research opportunities are situated in (1) the creation and maintenance of the links between the various data sets and in (2) devising beneficial implementation approaches that rely on appropriate combinations of declarative and procedural programming techniques, semantic and legacy data formats, user input, and automated procedures.

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Kinetic Modelling of Ethylene Hydroformylation to Propanol

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Daemonica machinamenta tra Platone e l’Umanesimo: a partire da un passo del commento di Ficino al 'Sofista'

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Sulla storia di due ‘imagines’ contro i veleni descritte da Ficino

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Bibliographie ficinienne: mise à jour

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Bibliografia ficiniana: studi ed edizioni delle opere di Marsilio Ficino dal 1986

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Il ruolo della imaginatio/phantasia in alcuni contesti ficiniani

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Bibliographie ficinienne: mise à jour

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L’eliocentrismo di Marsilio Ficino nel 'Libro dell’amore' e nel 'De Sole'

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Affectus phantasiae e destino dell’anima in Marsilio Ficino

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L’inferno interpretato da Marsilio Ficino: lettura del capitolo X del libro XVIII della 'Theologia platonica'

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Anomalous Origin of the Left Common Carotid Artery from the Main Pulmonary Artery: A Rare Association in an Infant with CHARGE Syndrome

Case Report. Isolated carotid artery originating from the pulmonary trunk is an exceedingly rare anomalous origin of head and neck vessels. We present this finding, along with a persistent embryonic trigeminal artery, in a male infant with multiple cardiac defects and other congenital anomalies associated with CHARGE syndrome. After extensive investigations, cardiac catheterization revealed the anomalous left common carotid artery arising from the cranial aspect of the main pulmonary artery. There was retrograde flow in this vessel, resulting from the lower pulmonary pressure, essentially stealing arterial supply from the left anterior cerebral circulation. The persistent left-sided trigeminal artery provided collateral flow from the posterior circulation to the left internal carotid artery territory, allowing for safe ligation of the anomalous origin of the left common carotid artery, thereby reversing the steal of arterial blood flow into the pulmonary circulation and resulting in a net improvement of cerebral perfusion. Conclusion. The possibility of this vascular anomaly should be considered in all infants with CHARGE syndrome. Surgical repair or ligation should be tailored to the specific patient circumstances, following a careful delineation of all sources of cerebral perfusion.

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Anomalous Origin of the Left Common Carotid Artery from the Main Pulmonary Artery: A Rare Association in an Infant with CHARGE Syndrome

Case Report. Isolated carotid artery originating from the pulmonary trunk is an exceedingly rare anomalous origin of head and neck vessels. We present this finding, along with a persistent embryonic trigeminal artery, in a male infant with multiple cardiac defects and other congenital anomalies associated with CHARGE syndrome. After extensive investigations, cardiac catheterization revealed the anomalous left common carotid artery arising from the cranial aspect of the main pulmonary artery. There was retrograde flow in this vessel, resulting from the lower pulmonary pressure, essentially stealing arterial supply from the left anterior cerebral circulation. The persistent left-sided trigeminal artery provided collateral flow from the posterior circulation to the left internal carotid artery territory, allowing for safe ligation of the anomalous origin of the left common carotid artery, thereby reversing the steal of arterial blood flow into the pulmonary circulation and resulting in a net improvement of cerebral perfusion. Conclusion. The possibility of this vascular anomaly should be considered in all infants with CHARGE syndrome. Surgical repair or ligation should be tailored to the specific patient circumstances, following a careful delineation of all sources of cerebral perfusion.

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Semantic web technologies in AEC industry: A literature review

Over the recent years, the usage of semantic web technologies has notably increased in the domains of architecture, engineering and construction (AEC). These technologies are typically considered as complementary to existing and often used Building Information Modelling (BIM) software. The usage of these technologies in the AEC domains is thereby motivated by (1) a desire to overcome the interoperability issue among software tools used in diverse disciplines, or at least improve information exchange processes; (2) a desire to connect to various domains of application that have opportunities to identify untapped valuable resources closely linked to the information already obtained in the AEC domains; and/or (3) a desire to exploit the logical basis of these technologies, which is currently undisclosed in the AEC domains. Through an extensive literature study and survey, this article investigates the development and application progress of semantic web technologies in the AEC domains in accordance with these three primary perspectives. These examinations and analyses provide a complete strategical map that can serve as a robust stepping stone for future research regarding the application of semantic web technologies in the AEC domains. Results show that semantic web technologies have a key role to play in logic-based applications and applications that require information from multiple application areas (e.g. BIM+Infra+GIS+Energy). Notwithstanding fast developments and hard work, challenging research opportunities are situated in (1) the creation and maintenance of the links between the various data sets and in (2) devising beneficial implementation approaches that rely on appropriate combinations of declarative and procedural programming techniques, semantic and legacy data formats, user input, and automated procedures.

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Kinetic Modelling of Ethylene Hydroformylation to Propanol

http://ift.tt/2ffYLJv

Daemonica machinamenta tra Platone e l’Umanesimo: a partire da un passo del commento di Ficino al 'Sofista'

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Sulla storia di due ‘imagines’ contro i veleni descritte da Ficino

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Bibliographie ficinienne: mise à jour

http://ift.tt/2eF3TKP

Bibliografia ficiniana: studi ed edizioni delle opere di Marsilio Ficino dal 1986

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Il ruolo della imaginatio/phantasia in alcuni contesti ficiniani

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Bibliographie ficinienne: mise à jour

http://ift.tt/2ffZABS

L’eliocentrismo di Marsilio Ficino nel 'Libro dell’amore' e nel 'De Sole'

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Affectus phantasiae e destino dell’anima in Marsilio Ficino

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L’inferno interpretato da Marsilio Ficino: lettura del capitolo X del libro XVIII della 'Theologia platonica'

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Predictive value of the DASH tool for predicting return to work of injured workers with musculoskeletal disorders of the upper extremity

Objectives

To determine whether the Disabilities of the Arm, Shoulder, and Hand (DASH) tool added to the predictive ability of established prognostic factors, including patient demographic and clinical outcomes, to predict return to work (RTW) in injured workers with musculoskeletal (MSK) disorders of the upper extremity.

Methods

A retrospective cohort study using a population-based database from the Workers' Compensation Board of Alberta (WCB-Alberta) that focused on claimants with upper extremity injuries was used. Besides the DASH, potential predictors included demographic, occupational, clinical and health usage variables. Outcome was receipt of compensation benefits after 3 months. To identify RTW predictors, a purposeful logistic modelling strategy was used. A series of receiver operating curve analyses were performed to determine which model provided the best discriminative ability.

Results

The sample included 3036 claimants with upper extremity injuries. The final model for predicting RTW included the total DASH score in addition to other established predictors. The area under the curve for this model was 0.77, which is interpreted as fair discrimination. This model was statistically significantly different than the model of established predictors alone (p<0.001). When comparing the DASH total score versus DASH item 23, a non-significant difference was obtained between the models (p=0.34).

Conclusions

The DASH tool together with other established predictors significantly helped predict RTW after 3 months in participants with upper extremity MSK disorders. An appealing result for clinicians and busy researchers is that DASH item 23 has equal predictive ability to the total DASH score.

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Is diesel equipment in the workplace safe or not?

Objectives

Recently, diesel motor exhaust (DME) has been classified as a known human carcinogen. We used data from epidemiological studies of diesel exposures to perform a quantitative risk assessment to calculate DME exposure levels, expressed as elemental carbon (EC), corresponding to acceptable risk (AR) and maximum tolerable risk (MTR) levels of 4 to 10^–5 and 4 to 10^–3 for the lifetime excess probability of dying from lung cancer.

Methods

Previously published slope estimates (n=14) of the exposure–response curve (ERC) for EC exposure and lung cancer were used in life-table analyses to calculate EC exposure levels corresponding to the specified AR and MTR levels.

Results

Considered ERC slope factors ranged from 0.00060 to 0.0012 natural logarithm of the relative rate (InRR) per μg/m³ years based on different selections of studies and study-specific risk estimates. Exposure limits based on these slope factors were between 0.009–0.017 and 0.85–1.67 μg/m³ EC for the AR and MTR, respectively.

Conclusions

Derived exposure limits based on the AR and MTR are around or well below 1 μg/m³ EC. Such limits are below current occupational exposure levels, and in some instances even below environmental exposure levels. Although uncertainties exist in the exact slope factors, these results indicate that an acceptable excess lung cancer mortality risk can only be achieved at very low DME exposure levels, suggesting that diesel engines using older technologies should be removed from the workplace when possible or emissions strictly controlled.

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Scheduled evening sleep and enhanced lighting improve adaptation to night shift work in older adults

Objectives

We tested whether a sleep and circadian-based treatment shown to improve circadian adaptation to night shifts and attenuate negative effects on alertness, performance and sleep in young adults would also be effective in older adults.

Methods

We assessed subjective alertness, sustained attention (psychomotor vigilance task, PVT), sleep duration (actigraphy) and circadian timing (salivary dim-light melatonin onset, DLMO) in 18 older adults (57.2±3.8 years; mean±SD) in a simulated shift work protocol. 4 day shifts were followed by 3 night shifts in the laboratory. Participants slept at home and were randomised to either the treatment group (scheduled evening sleep and enhanced lighting during the latter half of night shifts) or control group (ad-lib sleep and typical lighting during night shifts).

Results

Compared with day shifts, alertness and sustained attention declined on the first night shift in both groups, and was worse in the latter half of the night shifts. Alertness and attention improved on nights 2 and 3 for the treatment group but remained lower for the control group. Sleep duration in the treatment group remained similar to baseline (6–7 hours) following night shifts, but was shorter (3–5 hours) following night shifts in the control group. Treatment group circadian timing advanced by 169.3±16.1 min (mean±SEM) but did not shift (–9.7±9.9 min) in the control group.

Conclusions

The combined treatment of scheduled evening sleep and enhanced lighting increased sleep duration and partially aligned circadian phase with sleep and work timing, resulting in improved night shift alertness and performance.

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Effect of working hours and precarious employment on depressive symptoms in South Korean employees: a longitudinal study

Objectives

Long working hours and precarious employment are relatively common in South Korea. Since both can impact on mental health, this study examined their independent and combined effects on depressive symptoms of employees.

Methods

Data were from the Korean Welfare Panel Study (KOWEPS), 2010–2013. A total of 2733 full-time employees without depressive symptoms were analysed. Hierarchical logistic regression models were used to investigate the effect of the number of working hours per week (eg, 35–40 hours, 41–52 hours, 53–68 hours, and >68 hours) and employment status (permanent vs precarious employment) on depressive symptoms, measured using the Center for Epidemiological Studies Depression (CES-D) 11 scale.

Results

Compared with individuals working 35–40 hours/week, employees working above 68 hours (OR 1.57, 95% CI 1.05 to 2.34) had higher odds of depressive symptoms after full adjustment. Similarly, precarious employees (OR 1.34, 95% CI 1.02 to 1.75) showed worse mental health than permanent employees. In the combined effect model, employees in precarious employment who worked above 68 hours/week (OR, 2.03 95% CI 1.08 to 3.83) exhibited the highest odds of depressive symptoms compared with permanent employees working 35 to 40 hours/week.

Conclusions

Long work hours and precarious employment status were associated with higher odds of depressive symptoms. The findings highlight the importance of monitoring and addressing the vulnerable groups of employees to reduce the mental health burden of economically active individuals.

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Detecting hepatitis B virus in surgical smoke emitted during laparoscopic surgery

Background

Hepatitis B virus (HBV) transmission is known to occur through direct contact with infected blood. There has been some suspicion that the virus can also be detected in aerosol form. However, this has never been directly shown. The purpose of this study was to sample and analyse surgical smoke from laparoscopic surgeries on patients with hepatitis B to determine whether HBV is present.

Methods

A total of 11 patients who underwent laparoscopic or robotic abdominal surgeries between October 2014 and February 2015 at Korea University Anam Hospital were included in this study. A high efficiency collector was used to obtain surgical smoke in the form of hydrosol. The smoke was analysed by using nested PCR.

Results

Robotic or laparoscopic colorectal resections were performed in 5 cases, laparoscopic gastrectomies in 3 cases and laparoscopic hepatic wedge resections in another 3 cases. Preoperatively, all of the patients had positive hepatitis B surface antigen (HBsAg). 2 patients had detectable HBsAb, and 2 were positive for hepatitis B e antigen. 3 patients were taking antihepatitis B viral medications at the time of the study. The viral load measured in the patients' blood was undetectable to 1.7x10⁸ IU/mL. HBV was detected in surgical smoke in 10 of the 11 cases.

Conclusions

HBV is detectable in surgical smoke. This study provides preliminary data in the investigation of airborne HBV infection.

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Prediction of prognosis for people off sick with upper extremity musculoskeletal disorders

Musculoskeletal disorders (MSDs) are the second most common cause of disability worldwide.1 Among people of working age, musculoskeletal conditions, including back pain, neck pain, upper limb disorders and arthritis account for almost a quarter of all sickness absence. Furthermore, MSDs contribute even more significantly to presenteeism (the reduction in working performance while at work because of ill health) and impaired in-work productivity (although these are more challenging to quantify accurately). Indeed, it is estimated that the total cost of lost productivity attributable to MSDs among people of working age in the European Union (EU) might be as high as 2% of gross domestic product.2 For these reasons, we urgently need to develop effective strategies to identify those individuals with recent-onset musculoskeletal pain or injury at greatest risk of long-term work disability and to develop effectual and cost-effective preventive and treatment interventions.

For these reasons, the...

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Genetic variation in EYA4 on the risk of noise-induced hearing loss in Chinese steelworks firm sample

Objectives

Noise-induced hearing loss is one of the most serious occupational diseases worldwide. It is caused by interactions between environmental and genetic factors. The purpose of this study was to examine the association between the genetic susceptibility of the eye absent homolog 4 (EYA4) gene and the risk of developing noise-induced hearing loss in China.

Methods

A case–control association study was carried out with 326 hearing loss cases and 326 controls matched with age and duration of noise exposure, drawn from a cohort of steel workers. Five single nucleotide polymorphisms (SNPs) in the EYA4 were selected and genotyped. Logistic regression was performed to analyse the main effect of genotypes and interactions between genotypes and individual/environmental factors adjusted for confounding factors. Moreover, generalised multiple dimensionality reduction was applied to further detect interaction among the 5 selected SNPs.

Results

Analysis revealed that locus polymorphism of rs3813346 was associated with the risk of developing noise-induced hearing loss in the dominance model, the codominance model and the addictive model (p=0.004, 0.009 and 0.003, respectively). A significant interaction between rs9321402 and cumulative noise exposure was found (p=0.002). A significant main effect p value (p=0.006) was obtained in the high-level exposure group (cumulative noise exposure ≥98 dB(A)). Generalised multiple dimensionality reduction indicated that the combined interaction of the 2 loci—rs3813346 and rs9493627—significantly affected the incidence of noise-induced hearing loss.

Conclusions

The research suggests that EYA4 genetic variant and its interaction with noise levels may modify the susceptibility to develop noise-induced hearing loss in Chinese population.

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Traffic pollution and the incidence of cardiorespiratory outcomes in an adult cohort in London

Objectives

The epidemiological evidence for adverse health effects of long-term exposure to air and noise pollution from traffic is not coherent. Further, the relative roles of background versus near traffic pollution concentrations in this process are unclear. We investigated relationships between modelled concentrations of air and noise pollution from traffic and incident cardiorespiratory disease in London.

Methods

Among 211 016 adults aged 40–79 years registered in 75 Greater London practices between 2005 and 2011, the first diagnosis for a range of cardiovascular and respiratory outcomes were identified from primary care and hospital records. Annual baseline concentrations for nitrogen oxide (NO_x), particulate matter with a median aerodynamic diameter <2.5 μm (PM_2.5) attributable to exhaust and non-exhaust sources, traffic intensity and noise were estimated at 20 m² resolution from dispersion models, linked to clinical data via residential postcode. HRs were adjusted for confounders including smoking and area deprivation.

Results

The largest observed associations were between traffic-related air pollution and heart failure (HR=1.10 for 20 μg/m³ change in NO_x, 95% CI 1.01 to 1.21). However, no other outcomes were consistently associated with any of the pollution indicators, including noise. The greater variations in modelled air pollution from traffic between practices, versus within, hampered meaningful fine spatial scale analyses.

Conclusions

The associations observed with heart failure may suggest exacerbatory effects rather than underlying chronic disease. However, the overall failure to observe wider associations with traffic pollution may reflect that exposure estimates based on residence inadequately represent the relevant pattern of personal exposure, and future studies must address this issue.

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Effects of bioaerosol exposure on respiratory health in compost workers: a 13-year follow-up study

Objectives

To determine the risk of German compost workers developing chronic respiratory effects from long-term exposure to bioaerosols.

Methods

Respiratory health was determined in 74 currently exposed compost workers and 37 non-exposed controls after 13 years of follow-up. In addition, 42 former compost workers (drop-outs) who left their work during the follow-up period were also examined. Respiratory symptoms and working conditions were assessed using identical questionnaires as at baseline. In addition, lung function was measured using the same spirometer as in the initial study. Sera from both surveys were tested for specific IgE and IgG antibodies to moulds and the risk of work-related symptoms was evaluated using regression approaches for prospective studies with binary data.

Results

In the follow-up period, the number of participants reporting cough significantly increased in compost workers and drop-outs compared to the controls. Working as a compost worker for at least 5 years increased the relative risk for cough (RR 1.28; 95% CI 1.2 to 1.4) and for cough with phlegm (RR 1.32; 95% CI 1.2 to 1.5). Current and former compost workers had slightly lower predicted percentage of forced expiratory volume in 1 s and predicted percentage of forced vital capacity than controls, but decrease in lung function during follow-up was not different among the 3 groups. In addition, no significant changes could be detected in antibody concentrations.

Conclusions

Our results suggest that chronic exposure to bioaerosols in composting plants is related to a significantly higher risk for cough with phlegm, indicating chronic bronchitis. However, compost workers showed no higher incidence of deterioration of pulmonary function over the study.

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Comparing plasma, serum and whole blood indium concentrations from workers at an indium-tin oxide (ITO) production facility

Objective

Occupational exposure to indium compounds including indium-tin oxide (ITO) can result in potentially fatal indium lung disease. We compared plasma, serum and whole blood indium concentrations (In_P, In_S and In_B) from workers at a single ITO production facility to assess the comparability of these matrices used for biological monitoring of indium exposure.

Method

In_P, In_S and In_B were measured using inductively coupled mass spectrometry from consenting workers at an ITO production facility with specimen collection occurring during June–July 2014. Matched pairs from workers were assessed to determine the matrix relationships using the Pearson correlation, paired t-tests, per cent difference, linear regression and statistics.

Results

Indium matrices were collected from 80 workers. Mean (SD) In_P, In_S and In_B were 3.48 (3.84), 3.90 (4.15) and 4.66 (5.32) mcg/L, respectively. The In_S–In_P difference was 14%; In_S was higher in all but two workers. In_P and In_S were highly correlated (r=>0.99). The In_B–In_S difference was 19%; In_B was higher in 85% of workers. The In_B–In_P difference was 34%; In_B was higher in 66% of workers. In_B was highly correlated with both In_P and In_S (r=0.97 and 0.96, respectively). Statistics were 0.84, 0.83 and 0.82 for In_P, In_S and In_B, respectively, for individuals with each matrix ≥1 mcg/L (p<0.01).

Conclusions

While all matrices were highly correlated, we encourage the use of In_P and In_S to reliably compare studies across different populations using different matrices. The higher per cent difference and increased variability of In_B may limit its utility in comparisons with In_P and In_S in different populations.

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Cancer incidence and mortality from exposure to radon progeny among Ontario uranium miners

Objectives

The study objectives were to extend the follow-up of the Ontario uranium miners cohort, one of the largest cohorts of uranium miners with low cumulative exposures, to examine the relationship between radon exposure and lung cancer mortality and, for the first time incidence, and address gaps in the literature, including dose–response relationship between radon exposure and other cancer sites, and non-cancer mortality.

Methods

The cohort of mine and mill workers was created using data from Canada's National Dose Registry and the Ontario Mining Master File. The follow-up for the cohort was recently extended for mortality (1954–2007) and for the first time includes cancer incidence (1969–2005). The Poisson regression was used to estimate relative risks (RR) and excess relative risks (ERR) and their 95% CIs with levels of cumulative radon exposure.

Results

The cohort consisted of 28 546 male miners with a mean cumulative radon exposure of 21.0 working level months (WLM). An increased risk of lung cancer and a dose–response relationship was observed with cumulative radon exposure. Miners exposed to >100 WLM demonstrated a twofold increase in the risk of lung cancer incidence (RR=1.89, CI 1.43 to 2.50) compared with the non-exposed group, and a linear ERR of 0.64/100 WLM (CI 0.43 to 0.85), with similar results observed for mortality. No association was observed for other cancer sites (stomach, leukaemia, kidney and extrathoracic airways) or non-cancer sites (cardiovascular diseases) with increasing cumulative exposure to radon.

Conclusions

These findings suggest no increased risk of cancer sites other than lung or non-cancer mortality from relatively low cumulative exposure to radon.

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Working hours and the onset of depressive disorder: a systematic review and meta-analysis

This systematic review and meta-analysis aimed to examine whether working beyond the standard working hours was associated with a greater risk of depressive disorder among workers included in published prospective studies. This manuscript was prepared according to the PRISMA guideline checklist. A database search was conducted using MEDLINE (PubMed), PsycINFO, and PsycARTICLES using a relevant set of keywords. The eligibility criteria were as follows: (1) participants were adult workers; (2) exposure was defined as overtime work; (3) outcome were depressive disorders clinically diagnosed or assessed by a structured interview and (4) the study design was prospective or cohort. 7 studies were identified in the systematic review and meta-analysis. Overtime work was associated with a small, non-significant, elevated risk of depressive disorder (pooled relative risk=1.075; 95% CI 0.834 to 1.387; p=0.575) in a random effects model. The association tended to be greater for women. The risk of working 50 or more hours per week was slightly but not significantly increased (pooled relative risk=1.241; 95% CI 0.880 to 1.750; p=0.218). The effect of overtime work on depressive disorder remains inconclusive and may be small if not negligible. Sex differences and the effect of longer working hours on depressive disorder should be addressed in the future.

Trial registration number

Prospero CRD42015020003; Results.

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A large scale test of the gaming-enhancement hypothesis

A growing research literature suggests that regular electronic game play and game-based training programs may confer practically significant benefits to cognitive functioning. Most evidence supporting this idea, the gaming-enhancement hypothesis, has been collected in small-scale studies of university students and older adults. This research investigated the hypothesis in a general way with a large sample of 1,847 school-aged children. Our aim was to examine the relations between young people's gaming experiences and an objective test of reasoning performance. Using a Bayesian hypothesis testing approach, evidence for the gaming-enhancement and null hypotheses were compared. Results provided no substantive evidence supporting the idea that having preference for or regularly playing commercially available games was positively associated with reasoning ability. Evidence ranged from equivocal to very strong in support for the null hypothesis over what was predicted. The discussion focuses on the value of Bayesian hypothesis testing for investigating electronic gaming effects, the importance of open science practices, and pre-registered designs to improve the quality of future work.

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Historical reconstruction of climatic and elevation preferences and the evolution of cloud forest-adapted tree ferns in Mesoamerica

Background Cloud forests, characterized by a persistent, frequent or seasonal low-level cloud cover and fragmented distribution, are one of the most threatened habitats, especially in the Neotropics. Tree ferns are among the most conspicuous elements in these forests, and ferns are restricted to regions in which minimum temperatures rarely drop below freezing and rainfall is high and evenly distributed around the year. Current phylogeographic data suggest that some of the cloud forest-adapted species remained in situ or expanded to the lowlands during glacial cycles and contracted allopatrically during the interglacials. Although the observed genetic signals of population size changes of cloud forest-adapted species including tree ferns correspond to predicted changes by Pleistocene climate change dynamics, the observed patterns of intraspecific lineage divergence showed temporal incongruence. Methods Here we combined phylogenetic analyses, ancestral area reconstruction, and divergence time estimates with climatic and altitudinal data (environmental space) for phenotypic traits of tree fern species to make inferences about evolutionary processes in deep time. We used phylogenetic Bayesian inference and geographic and altitudinal distribution of tree ferns to investigate ancestral area and elevation and environmental preferences of Mesoamerican tree ferns. The phylogeny was then used to estimate divergence times and ask whether the ancestral area and elevation and environmental shifts were linked to climatic events and historical climatic preferences. Results Bayesian trees retrieved Cyathea, Alsophyla, Gymnosphaera and Sphaeropteris in monophyletic clades. Splits for species in these genera found in Mesoamerican cloud forests are recent, from the Neogene to the Quaternary, Australia was identified as the ancestral area for the clades of these genera, except for Gymnosphaera that was Mesoamerica. Climate tolerance was not divergent from hypothesized ancestors for the most significant variables or elevation. For elevational shifts, we found repeated change from low to high elevations. Conclusions Our data suggest that representatives of Cyatheaceae main lineages migrated from Australia to Mesoamerican cloud forests in different times and have persisted in these environmentally unstable areas but extant species diverged recentrly from their ancestors.

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