fatigue

摘要： Objective:To investigate the effect of psychological education combined with progressive muscle relaxation training on the symptom cluster and rehospitalization of elderly patients with coronary heart disease.Methods:This study is a longitudinal randomized controlled study involving 140 elderly patients with coronary heart disease.The patients were divided into two groups:an intervention group and a control group,with 70 cases in each group,via random number table.The patients in the control group received routine nursing,whereas those in the intervention group received psychological education combined with progressive muscle relaxation training for 4 weeks on the basis of routine nursing.The effect of the intervention was evaluated before intervention,at the end of 1 month,3 months,and 6 months after intervention.Results:At the end of 1 month,3 months,and 6 months,the sleep,fatigue,anxiety,and functional status of the patients in the intervention group were significantly better than those of the control group,with statistical significance difference(P<0.05).The rehospitalization rate of the intervention group was lower than that of the control group,and the difference was statistically significant(X2=10.685,P=0.001).Conclusion:Psychological education combined with progressive muscle relaxation training is effective in alleviating the symptom cluster of elderly patients with coronary heart disease and reducing their rehospitalization rate;thus,it should be popularized.

摘要： BACKGROUND Due to the large number of operations,surgeons sometimes need to work overtime or even stay up late to perform pancreaticoduodenectomy.Fatigue and sleep deprivation can result in an increased error rate at work.There have been numerous studies about the effect of overtime surgery on the prognosis of patients.However,the effect of overtime work for pancreaticoduodenectomy on the prognosis of patients is unclear.This study explores the impact of overtime work for pancreaticoduodenectomy on the prognosis of patients.AIM To explore the impact of overtime work for pancreaticoduodenectomy on the short-term prognosis of patients.METHODS This was a single-center,retrospective cohort study.The patients who underwent pancreaticoduodenectomy between January 2017 and December 2019 were included.Patients were stratified by operative start time into the control group(surgery that started between 8:00 and 16:49)and the overtime group(surgery that started between 17:00 and 22:00)and compared intraoperative and postoperative parameters.The following parameters were compared between the overtime group and the control group:Operative time,blood loss,number of lymph nodes removed,duration of treatment in the Intensive Care Unit(ICU),and incidence of complications.RESULTS From January 2017 to December 2019,a total of 239 patients underwent pancreaticoduodenectomy in the Department of Hepatobiliary Surgery of our institution.Four patients were excluded from this study due to lack of clinical data.A total of 235 patients were included,with 177 in the control group and 58 in the overtime group.There was no difference between the two groups in operative time,blood loss,number of lymph nodes removed,ICU length of stay,hospital length of stay,mortality during hospitalization.Compared with the control group,the overtime group had a higher incidence of pancreatic fistula(32.8%vs 15.8%,P<0.05).Multivariate analysis showed that overtime work,higher Body Mass Index were independent risk factors for pancreatic fistula(P<0.05).CONCLUSION Overtime work for pancreaticoduodenectomy increases the incidence of pancreatic fistula.The effect of overtime surgery on the long-term prognosis of patients’needs to be further studied.

摘要： Purpose This study aimed to investigate if changing the midsole bending stiffness of athletic footwear can affect the onset of lower limb joint work redistribution during a prolonged run.Methods Fifteen trained male runners(10-km time of<44 min)performed 10-km runs at 90%of their individual speed at lactate threshold(i.e.,when change in lactate exceeded 1 mmol/L during an incremental running test)in a control and stiff shoe condition on 2 occasions.Lower limb joint kinematics and kinetics were measured using a motion capture system and a force-instrumented treadmill.Data were acquired every 500 m.Results Prolonged running resulted in a redistribution of positive joint work from distal to proximal joints in both shoe conditions.Compared to the beginning of the run,less positive work was performed at the ankle(approximately 9%;p≤0.001)and more positive work was performed at the knee joint(approximately 17%;p≤0.001)at the end of the run.When running in the stiff shoe condition,the onset of joint work redistribution at the ankle and knee joints occurred at a later point during the run.Conclusion A delayed onset of joint work redistribution in the stiff condition may result in less activated muscle volume,because ankle plantar flexor muscles have shorter muscles fascicles and smaller cross-sectional areas compared to knee extensor muscles.Less active muscle volume could be related to previously reported decreases in metabolic cost when running in stiff footwear.These results contribute to the notion that footwear with increased stiffness likely results in reductions in metabolic cost by delaying joint work redistribution from distal to proximal joints.

摘要： Purpose This study used downhill running as a model to investigate the repeated bout effect(RBE)on neuromuscular performance,running biomechanics,and metabolic cost of running.Methods Ten healthy recreational male runners performed two 30-min bouts of downhill running(DR1 and DR2)at a-20%slope and 2.8 m/s 3 weeks apart.Neuromuscular fatigue,level running biomechanics during slow and fast running,and running economy parameters were recorded immediately before and after the downhill bouts,and at 24 h,48 h,72 h,96 h,and 168 h thereafter(i.e.,follow-up days).Results An RBE was confirmed by attenuated muscle soreness and serum creatine kinase rise after DR2 compared to DR1.An RBE was also observed in maximum voluntary contraction(MVC)force loss and voluntary activation where DR2 resulted in attenuated MVC force loss and voluntary activation immediately after the run and during follow-up days.The downhill running protocol significantly influenced level running biomechanics;an RBE was observed in which center of mass excursion and,therefore,lower-extremity compliance were greater during follow-up days after DR1 compared to DR2.The observed changes in level running biomechanics did not influence the energy cost of running.Conclusion This study demonstrated evidence of adaptation in neural drive as well as biomechanical changes with the RBE after DR.The higher neural drive resulted in attenuated MVC force loss after the second bout.It can be concluded that the RBE after downhill running manifests as changes to global and central fatigue parameters and running biomechanics without substantially altering the energy cost of running.

摘要： The clinical presentation that emerges from the extensive coronavirus disease 2019(COVID-19)mental health literature suggests high correlations among many conventional psychiatric diagnoses.Arguments against the use of multiple comorbidities for a single patient have been published long before the pandemic.Concurrently,diagnostic recommendations for use of transdiagnostic considerations for improved treatment have been also published in recent years.In this review,we pose the question of whether a transdiagnostic mental health disease,including psychiatric and neuropsychiatric symptomology,has emerged since the onset of the pandemic.There are many attempts to identify a syndrome related to the pandemic,but none of the validated scales is able to capture the entire psychiatric and neuropsychiatric clinical presentation in infected and non-infected individuals.These scales also only marginally touch the issue of etiology and prevalence.We suggest a working hypothesis termed Complex Stress Reaction Syndrome(CSRS)representing a global psychiatric reaction to the pandemic situation in the general population(Type A)and a neuropsychiatric reaction in infected individuals(Type B)which relates to neurocognitive and psychiatric features which are part(excluding systemic and metabolic dysfunctions)of the syndrome termed in the literature as long COVID.We base our propositions on multidisciplinary scientific data regarding mental health during the global pandemic situation and the effects of viral infection reviewed from Google Scholar and PubMed between February 1,2022 and March 10,2022.Search inclusion criteria were“mental health”,“COVID-19”and“Long COVID”,English language and human studies only.We suggest that this more comprehensive way of understanding COVID-19 complex mental health reactions may promote better prevention and treatment and serve to guide implementation of recommended administrative regulations that were recently published by the World Psychiatric Association.This review may serve as a call for an international investigation of our working hypothesis.

摘要： Fatigue is considered one of the most frequent and debilitating symptoms in primary biliary cholangitis(PBC),affecting over 50%of PBC patients.One in five patients with PBC suffer from severe fatigue,which significantly impairs quality of life.Fatigue is made up of a central and a peripheral component,whose pathophysiology is still greatly unresolved.Central fatigue is characterised by a lack of self-motivation and can manifest both in physical and mental activities(lack of intention).Peripheral fatigue includes neuromuscular dysfunction and muscle weakness(lack of ability).Peripheral fatigue could be explained by an excessive deviation from aerobic to anaerobic metabolism leading to excessive lactic acid accumulation and therefore accelerated decline in muscle function and prolonged recovery time.As opposed to itching,and with the exception of endstage liver disease,fatigue is not related to disease progression.The objective of this review is to outline current understanding regarding the pathophysiology of fatigue,the role of comorbidities and contributing factors,the main tools for fatigue assessment,the failed therapeutic options,and future treatment perspectives for this disabling symptom.Since fatigue is an extremely common and debilitating symptom and there is still no licensed therapy for fatigue in PBC patients,further research is warranted to understand its causative mechanisms and to find an effective treatment.

摘要： In this paper,the influence of geometric parameters on the stress concentration factors due to three different types of axial loading on 81 TY tubular structures is studied.Our results reveal that,geometric parameters have a considerable impact on the variation of stress concentration factors on tubular TY-joints under axial loads.Thus,the highest stress concentration factor values are observed on the vertical brace than on the inclined one.The finite element results of the tubular structures were verified by parametric equations and experimental data.A parametric study was carried out by analyses using the nonlinear regression method to obtain parametric equations.These equations are used to calculate stress concentration factors and to analyse the fatigue resistance of TY-joints due to axial loads.

摘要： There is little information about drivers’body balance responses to combined exposure of noise and vibration.To fill the gap,this study aims to investigate the combined effects of exposure to noise and whole-body vibration(WBV)on the body balance under simulated driving conditions.For this purpose,30 male participants were exposed to noise level at 85 dB(A)and two vibration levels(0.87 and 1.3 m/s^(2))in five sessions.The design of the study was repeated-measures,and it attempted to assess the effects of 40 minutes of exposure to noise and/or WBV.Moreover,the participants’fatigue was measured with the Borg scale(CR 10).The findings revealed there was a significant change in body sway after WBV and combined noise and WBV exposure(p0.05).The effect sizes of exposure to noise,WBV(1.3 m/s^(2)),and combined noise and WBV(1.3 m/s^(2))on body balance were 0.035,0.425,and 0.635,respectively.Also,single exposure to WBV caused more fatigue than single exposure to noise(p<0.05).Combined noise and WBV exposure descriptively caused more fatigue in comparison with the influence of WBV alone.The study concluded that the combined effects of exposure to noise and vibration are more than the sum of them.So,some synergistic effects may be observed in human body balance.It is essential to increase drivers’awareness and revise current health care interventions about new possible effects of combined exposures.

摘要： Two years after the coronavirus disease 2019(COVID-19)outbreak,an increasing number of patients continue to suffer from long COVID(LC),persistent symptoms,and/or delayed or long-term complications beyond the initial 4 weeks from the onset of symptoms.Constant fatigue is one of the most common LC symptoms,leading to severely reduced quality of life among patients.Ginseng Radix et Rhizoma—known as the King of Herbs in traditional Chinese medicine—has shown clinical anti-fatigue effects.In this review,we summarize the underlying anti-fatigue mechanisms of Ginseng Radix et Rhizoma extracts and their bioactive compounds,with a special focus on anti-viral,immune remodeling,endocrine system regulation,and metabolism,suggesting that Ginseng Radix et Rhizoma is a potentially promising treatment for LC,especially regarding targeting fatigue.

摘要： Objective: To assess general pain and fatigue and their association with the disease status of patients with systemic autoimmune myopathies (SAMs), in terms of the impact of the COVID-19 pandemic on these parameters. Methods: This is a cross-sectional and prospective cohort study that included 72 patients with SAMs who were matched by age and gender with 67 healthy individuals. The patients engaged in an interview via a validity survey to measure disease status, and assess a visual analog scale (VAS) for pain and fatigue in two periods: before (phase I) and during (phase II) of the Brazilian COVID-19 pandemic. For cross-sectional analysis, patients’ data from phase I were compared to healthy individuals’ information, whereas for prospective analysis, data of the patients who were assessed in phase II were compared to the same patients’ data from phase I. Results: The patients had significantly more pain perception, comparable fatigue perception and fatigue severity, when compared to the healthy individuals. During the COVID-19 pandemic period, the disease activity, pain and fatigue perceptions, and fatigue severity remained unchanged. Despite this, the pain and fatigue perceptions correlated significantly with patients’ VAS, the patient health outcome, and fatigue severity. In addition, the pain perception correlated to creatine phosphokinase, whereas fatigue perceptions correlated to physicians' VAS. Conclusions: The study showed that patients with SAMs have significantly increased pain perceptions compared to healthy individuals. During the COVID-19 pandemic period, the pain and fatigue perceptions remained unchanged in patients with SAMs but they correlated to several disease status parameters.