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Firefighter Shift Schedules Affect Sleep Quality.
Billings, Joel; Focht, Will
The aim of this study was to investigate the prevalence and severity of firefighter sleep quality across department shift schedules. Sleep quality was assessed using a Pittsburgh Sleep Quality Index in a sample of 109 male career firefighters from six fire departments in three Southwestern US states. The three shift schedules studied were 24on/48off, 48on/96off, and Kelly. Seventy-three percent of firefighters report poor sleep quality. The 24on/48off shift schedule is associated with the best sleep quality and Kelly is associated with the worst sleep quality. Firefighters working second jobs report significantly poorer sleep quality than those who do not. Shift schedules that disrupt normal circadian rhythms more result in poorer sleep quality, which can lead to less effective emergency response and increased risk to firefighter health and safety.
Modelling a Nurse Shift Schedule with Multiple Preference Ranks for Shifts and Days-Off
Directory of Open Access Journals (Sweden)
Chun-Cheng Lin
Full Text Available When it comes to nurse shift schedules, it is found that the nursing staff have diverse preferences about shift rotations and days-off. The previous studies only focused on the most preferred work shift and the number of satisfactory days-off of the schedule at the current schedule period but had few discussions on the previous schedule periods and other preference levels for shifts and days-off, which may affect fairness of shift schedules. As a result, this paper proposes a nurse scheduling model based upon integer programming that takes into account constraints of the schedule, different preference ranks towards each shift, and the historical data of previous schedule periods to maximize the satisfaction of all the nursing staff's preferences about the shift schedule. The main contribution of the proposed model is that we consider that the nursing staff's satisfaction level is affected by multiple preference ranks and their priority ordering to be scheduled, so that the quality of the generated shift schedule is more reasonable. Numerical results show that the planned shifts and days-off are fair and successfully meet the preferences of all the nursing staff.
How do employees prioritise when they schedule their own shifts?
DEFF Research Database (Denmark)
Nielsen, Kirsten Nabe; Lund, Henrik Lambrecht; Ajslev, Jeppe Zielinski Nguyen
We investigated how employees prioritised when they scheduled their own shifts and whether priorities depended on age, gender, educational level, cohabitation and health status. We used cross-sectional questionnaire data from the follow-up survey of an intervention study investigating the effect...... of self-scheduling (n = 317). Intervention group participants were asked about their priorities when scheduling their own shifts succeeded by 17 items covering family/private life, economy, job content, health and sleep. At least half of the participants reported that they were giving high priority...... to their family life, having consecutive time off, leisure-time activities, rest between shifts, sleep, regularity of their everyday life, health and that the work schedule balanced. Thus, employees consider both their own and the workplace's needs when they have the opportunity to schedule their own shifts. Age...
Learned Helplessness as a Schedule-Shift Effect.
McReynolds, William T.
The essentials of learned helplessness theory are described and supporting evidence surveyed. The explanation Seligman and Maier give for these findings is critically analyzed. A schedule-shift discrimination theory of learned helplessness effects is also discussed. (Author)
Parents' Family Time and Work Schedules: The Split-Shift Schedule in Spain
Gracia, P.; Kalmijn, M.
This study used data on couples from the 2003 Spanish Time Use Survey (N = 1,416) to analyze how work schedules are associated with family, couple, parent–child, and non-family leisure activities. Spain is clearly an interesting case for the institutionalized split-shift schedule, a long lunch break
Power-based Shift Schedule for Pure Electric Vehicle with a Two-speed Automatic Transmission
Wang, Jiaqi; Liu, Yanfang; Liu, Qiang; Xu, Xiangyang
This paper introduces a comprehensive shift schedule for a two-speed automatic transmission of pure electric vehicle. Considering about driving ability and efficiency performance of electric vehicles, the power-based shift schedule is proposed with three principles. This comprehensive shift schedule regards the vehicle current speed and motor load power as input parameters to satisfy the vehicle driving power demand with lowest energy consumption. A simulation model has been established to verify the dynamic and economic performance of comprehensive shift schedule. Compared with traditional dynamic and economic shift schedules, simulation results indicate that the power-based shift schedule is superior to traditional shift schedules.
[Shift work and risk of cancer and coronary heart diseases].
Hansen, Johnni; Lassen, Christina Funch
Shift and night work are among the most frequent occupational exposures. Such work schedules involve exposure to light-at-night, which may reduce normal nocturnal melatonin production, create circadian rhythm disruption, sleep deprivation and unhealthy lifestyle. There is strong experimental evidence that light-at-night and circadian disruption may increase the risk of cancer and coronary heart diseases. There is emerging, but limited epidemiologic evidence that night shift work may increase breast cancer and certain cardiovascular diseases.
Police officers attitude to different shift systems: association with age, present shift schedule, health and sleep/wake complaints.
Kecklund, Göran; Eriksen, Claire Anne; Akerstedt, Torbjörn
It is often claimed that shift workers give priority to long series of days off and therefore prefer compressed work schedules at the expense of what is optimal for long-term health. The aim of the present study was to evaluate the attitude to six new shift systems among a randomly selected sample of police officers. The results showed that the most popular shift system was a rapidly, forward, rotating schedule with at least 16 h of rest between shifts, despite that it had fewer days off compared with some of the compressed shift systems. However, the individual differences were large and many individuals (32%) disliked the rapidly rotating shift system. Young age was associated with a positive attitude to the rapidly rotating shift system. The attitude to the shift system was also influenced by the present schedule, and shift systems that were similar to the present work hours received more positive evaluation. Sleep and health complaints showed no association with the attitude to the shift systems. In conclusion, the shift workers attitude to the new schedules was partly in agreement with the ergonomic recommendations of the design of three-shift systems that will facilitate sufficient sleep and minimize negative health consequences.
On the computational complexity of (maximum) shift class scheduling
L.G. Kroon (Leo); A.W.J. Kolen
textabstractIn this paper we consider a generalization of the Fixed Job Scheduling Problem (FSP) which appears in a natural way in the aircraft maintenance process at an airport. A number of jobs has to be carried out, where the main attributes of a job are: a fixed start time, a fixed finish time
Adaptation and readaptation to different shift work schedules measured with sleep diary and actigraphy.
Saksvik, Ingvild Berg; Bjorvatn, Bjørn; Harvey, Allison G; Waage, Siri; Harris, Anette; Pallesen, Ståle
In this study we examine sleep during adaptation and readaptation to different shift work schedules in the offshore oil industry. The sleep of 19 offshore workers was assessed daily for 1 week before, during the work period, and for 1 week after 3 different work schedules: (1) day (14 consecutive days of work), (2) night (14 consecutive nights of work), and (3) swing shift work (first 7 nights with night work then 7 days of day work). The workers' sleep was assessed for 84 days. Actigraphy and sleep diary estimates of sleep was applied assessing: (1) adaptation to offshore shift work, (2) sleep across the 2 offshore work weeks, and (3) readaptation after the work period. Regarding adaptation, sleep efficiency was higher when working day than night and swing shift the first week of work. Sleep quality was better during swing than regular day/night shifts the first week of work. Total sleep time was longer during day and night shift than swing shift across the 2 work weeks. Sleep efficiency, based on sleep diaries, was higher during day than night and swing shift during the 2 work weeks. There were no significant differences between the shifts in readaptation in terms of sleep. To conclude, adaptation to swing shift was more difficult than adaptation to regular day and night shifts in terms of sleep. Readaptation to day work after 1 week of night work affected sleep negatively. There were no differences between the shift schedules the week after the work period.
Training and certification of work schedule managers may improve shift scheduling practices
The Federal Railroad Administration (FRA) Human Factors Research and Development (R&D) Program : sponsored the implementation of a strategic job analysis to investigate the job of work schedule managers : (WSMs) across a diverse range of industries t...
Shift work, age, and performance : investigation of the 2-2-1 shift schedule used in air traffic control facilities. I., The sleep/wake cycle.
Air Traffic Control Specialists (ATCS) work rotating shift schedules for most of their careers. Specifically, many work a counterclockwise rotating shift schedule, called the 2-2-1, or some variation of the schedule. The 2-2-1 involves rotating from ...
Self-Reported Recovery from 2-Week 12-Hour Shift Work Schedules: A 14-Day Follow-Up
Merkus, S.L.; Holte, K.A.; Huysmans, M.A.; van de Ven, P.M.; van Mechelen, W.; van der Beek, A.J.
Background Recovery from fatigue is important in maintaining night workers' health. This study compared the course of self-reported recovery after 2-week 12-hour schedules consisting of either night shifts or swing shifts (i.e., 7 night shifts followed by 7 day shifts) to such schedules consisting
Associations between shift schedule characteristics with sleep, need for recovery, health and performance measures for regular (semi-)continuous 3-shift systems.
van de Ven, Hardy A; Brouwer, Sandra; Koolhaas, Wendy; Goudswaard, Anneke; de Looze, Michiel P; Kecklund, Göran; Almansa, Josue; Bültmann, Ute; van der Klink, Jac J L
In this cross-sectional study associations were examined between eight shift schedule characteristics with shift-specific sleep complaints and need for recovery and generic health and performance measures. It was hypothesized that shift schedule characteristics meeting ergonomic recommendations are associated with better sleep, need for recovery, health and performance. Questionnaire data were collected from 491 shift workers of 18 companies with 9 regular (semi)-continuous shift schedules. The shift schedule characteristics were analyzed separately and combined using multilevel linear regression models. The hypothesis was largely not confirmed. Relatively few associations were found, of which the majority was in the direction as expected. In particular early starts of morning shifts and many consecutive shifts seem to be avoided. The healthy worker effect, limited variation between included schedules and the cross-sectional design might explain the paucity of significant results. Copyright © 2016 Elsevier Ltd. All rights reserved.
Associations between shift schedule characteristics with sleep, need for recovery, health and performance measures for regular (semi-)continuous 3-shift systems
Ven, H.A. van de; Brouwer, S.; Koolhaas, W.; Goudswaard, A.; Looze, M.P. de; Kecklund, G.; Almansa, J.; Bültmann, U.; Klink, J.J.L. van der
In this cross-sectional study associations were examined between eight shift schedule characteristics with shift-specific sleep complaints and need for recovery and generic health and performance measures. It was hypothesized that shift schedule characteristics meeting ergonomic recommendations are
Associations between shift schedule characteristics with sleep, need for recovery, health and performance measures for regular (semi-) continuous 3-shift systems
van de Ven, Hardy A.; Brouwer, Sandra; Koolhaas, Wendy; Goudswaard, Anneke; de Looze, Michiel P.; Kecklund, Goran; Almansa, Josue; Bultmann, Ute; van der Klink, Jac J. L.
In this cross-sectional study associations were examined between eight shift schedule characteristics with shift-specific sleep complaints and need for recovery and generic health and performance measures. It was hypothesized that shift schedule characteristics meeting ergonomic recommendations are
Relationship between shift work schedule and self-reported sleep quality in Chinese employees.
Ma, Yifei; Wei, Fu; Nie, Guanghui; Zhang, Li'e; Qin, Jian; Peng, Suwan; Xiong, Feng; Zhang, Zhiyong; Yang, Xiaobo; Peng, Xiaowu; Wang, Mingjun; Zou, Yunfeng
Few studies have reported on the effects of fixed and rotating shift systems on the prevalence of sleep disturbance. Thus, in this study, the relationships between different work schedules and sleep disturbance in Chinese workers were investigated. A total of 2180 workers aged 19-65 years responded to the self-report questionnaire on shift work schedule (fixed day-shift, fixed night-shift, two-shift or three-shift system), working hours a day, and working days a week, physical effort, subjective sleep quality and subjective mental state. It was found that the rotating shift workers, namely, two- and three-shift workers, exhibited higher risks of sleep disturbance than with the fixed day-shift workers did (OR 1.37; 95% CI 1.07to 1.74; and OR 2.19; 95% CI 1.52 to 3.15, respectively). The risk was particularly high among two- or three-shift workers who worked more than 8 hours a day or more than 5 days a week and among three-shift workers who reported both light and heavy physical effort at work. Moreover, the two- and three-shift workers (rotating shift workers) suffered from poorer sleep quality than the fixed night shift workers did (OR 1.84; 95% CI 1.01 to 3.32; and OR 2.94; 95% CI 1.53 to 5.64, respectively). Consequently, rotating shift work (two- and three-shift work) is a risk factor for sleep disturbance, and the fixed work rhythm may contribute to the quality of sleep.
A unique, fast-forwards rotating schedule with 12-h long shifts prevents chronic sleep debt.
Fischer, Dorothee; Vetter, Céline; Oberlinner, Christoph; Wegener, Sven; Roenneberg, Till
Sleep debt--together with circadian misalignment--is considered a central factor for adverse health outcomes associated with shift work. Here, we describe in detail sleep-wake behavior in a fast-forward rotating 12-h shift schedule, which involves at least 24 hours off after each shift and thus allows examining the role of immediate recovery after shift-specific sleep debt. Thirty-five participants at two chemical plants in Germany were chronotyped using the Munich ChronoType Questionnaire for Shift-Workers (MCTQ(Shift)) and wore actimeters throughout the two-week study period. From these actimetry recordings, we computed sleep and nap duration, social jetlag (a measure of circadian misalignment), and the daily timing of activity and sleep (center of gravity and mid-sleep, respectively). We observed that the long off-work periods between each shift create a fast alternation between shortened (mean ± standard deviation, 5h 17min ± 56min) and extended (8h 25min ± 72min) sleep episodes resulting in immanent reductions of sleep debt. Additionally, extensive napping of early chronotypes (up to 3 hours before the night shift) statistically compensated short sleep durations after the night shift. Partial rank correlations showed chronotype-dependent patterns of sleep and activity that were similar to those previously described in 8-h schedules; however, sleep before the day shift did not differ between chronotypes. Our findings indicate that schedules preventing a build-up of chronic sleep debt may reduce detrimental effects of shift work irrespective of shift duration. Prospective studies are needed to further elucidate the relationship between sleep, the circadian system, and health and safety hazards.
The Risk of Developing Diabetes in Association With Long Working Hours Differs by Shift Work Schedules.
Bannai, Akira; Yoshioka, Eiji; Saijo, Yasuaki; Sasaki, Sachiko; Kishi, Reiko; Tamakoshi, Akiko
The impact of long working hours on diabetes is controversial; however, shift work is known to increase the risk of diabetes. This study aimed to investigate the association between long working hours and diabetes among civil servants in Japan separately by shift work schedules. A prospective cohort study was conducted from April 2003 to March 2009. A total of 3195 men aged ≥35 years who underwent an annual health checkup at baseline were analyzed by shift work schedules (2371 non-shift workers and 824 shift workers). Self-reported working hours were categorized as 35-44 and ≥45 hours per week. The incidence of diabetes was confirmed by fasting plasma glucose concentration ≥126 mg/dL and/or self-reported medical diagnosis of diabetes at the annual checkup. A Cox proportional model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for developing diabetes associated with long working hours. The median follow-up period of non-shift and shift workers was 5.0 and 4.9 years, respectively. During this period, 138 non-shift workers and 46 shift workers developed diabetes. A decreased HR was found among non-shift workers working ≥45 hours per week (HR 0.84; 95% CI, 0.57-1.24); however, shift workers working ≥45 hours per week had a significantly increased risk of diabetes (HR 2.43; 95% CI, 1.21-5.10) compared with those working 35-44 hours per week. An analysis restricted to non-clerical workers also showed similar results. The risk of diabetes associated with long working hours differed by shift work schedules.
Scheduled evening sleep and enhanced lighting improve adaptation to night shift work in older adults.
Chinoy, Evan D; Harris, Michael P; Kim, Min Ju; Wang, Wei; Duffy, Jeanne F
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. 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). 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. 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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Scheduled Evening Sleep and Enhanced Lighting Improve Adaptation to Night Shift Work in Older Adults
Chinoy, Evan D.; Harris, Michael P.; Kim, Min Ju; Wang, Wei; Duffy, Jeanne F.
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 eighteen older adults (57.2±3.8 y; mean±SD) in a simulated shift work protocol. Four day shifts were followed by three night shifts in the laboratory. Participants slept at home and were randomized 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 to 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 h) following night shifts, but was shorter (3–5 h) 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. PMID:27566781
The Risk of Developing Diabetes in Association With Long Working Hours Differs by Shift Work Schedules
Directory of Open Access Journals (Sweden)
Akira Bannai
Full Text Available Background: The impact of long working hours on diabetes is controversial; however, shift work is known to increase the risk of diabetes. This study aimed to investigate the association between long working hours and diabetes among civil servants in Japan separately by shift work schedules. Methods: A prospective cohort study was conducted from April 2003 to March 2009. A total of 3195 men aged ≥35 years who underwent an annual health checkup at baseline were analyzed by shift work schedules (2371 nonshift workers and 824 shift workers. Self-reported working hours were categorized as 35–44 and ≥45 hours per week. The incidence of diabetes was confirmed by fasting plasma glucose concentration ≥126 mg/dL and/or selfreported medical diagnosis of diabetes at the annual checkup. A Cox proportional model was used to calculate hazard ratios (HRs and 95% confidence intervals (CIs for developing diabetes associated with long working hours. Results: The median follow-up period of non-shift and shift workers was 5.0 and 4.9 years, respectively. During this period, 138 non-shift workers and 46 shift workers developed diabetes. A decreased HR was found among nonshift workers working ≥45 hours per week (HR 0.84; 95% CI, 0.57–1.24; however, shift workers working ≥45 hours per week had a significantly increased risk of diabetes (HR 2.43; 95% CI, 1.21–5.10 compared with those working 35–44 hours per week. An analysis restricted to non-clerical workers also showed similar results. Conclusions: The risk of diabetes associated with long working hours differed by shift work schedules.
Day and night shift schedules are associated with lower sleep quality in Evening-types.
Martin, Jeanne Sophie; Laberge, Luc; Sasseville, Alexandre; Bérubé, Marilie; Alain, Samuel; Houle, Jérôme; Hébert, Marc
Eveningness has been suggested as a facilitating factor in adaptation to shift work, with several studies reporting evening chronotypes (E-types) as better sleepers when on night shifts. Conversely, eveningness has been associated with more sleep complaints during day shifts. However, sleep during day shifts has received limited attention in previous studies assessing chronotypes in shift workers. Environmental light exposure has also been reported to differ between chronotypes in day workers. Activity is also known to provide temporal input to the circadian clock. Therefore, the aim of this study was to compare objective sleep, light exposure and activity levels between chronotypes, both during the night and day shifts. Thirty-nine patrol police patrol officers working on a fast rotating shift schedule (mean age ± SD: 28.9 ± 3.2 yrs; 28 males) participated in this study. All subjects completed the Morningness-Eveningness Questionnaire (MEQ). Sleep and activity were monitored with actigraphy (Actiwatch-L; Mini-Mitter/Respironics, Bend, OR) for four consecutive night shifts and four consecutive day shifts (night work schedule: 00:00 h-07:00 h; day work schedule: 07:00 h-15:00 h). Sleep and activity parameters were calculated with Actiware software. MEQ scores ranged from 26 to 56; no subject was categorized as Morning-type. E-types (n = 13) showed significantly lower sleep efficiency, longer snooze time and spent more time awake after sleep onset than Intermediate-types (I-types, n = 26) for both the night and day shifts. E-types also exhibited shorter and more numerous sleep bouts. Furthermore, when napping was taken into account, E-types had shorter total sleep duration than I-types during the day shifts. E-types were more active during the first hours of their night shift when compared to I-types. Also, all participants spent more time active and had higher amount of activity per minute during day shifts when compared to night shifts. No
Shift schedules, work factors, and mental health among onshore and offshore workers in the Norwegian petroleum industry.
Berthelsen, Mona; Pallesen, Ståle; Bjorvatn, Bjørn; Knardahl, Stein
The purpose of the present study was to answer the following research questions: (1) Do workers in different shift schedules differ in mental distress? (2) Do workers in different shift schedules differ in neuroticism? (3) Do shift schedules differ in psychosocial work exposures? (4) Do psychosocial work exposures contribute to mental distress among onshore- and offshore workers? (5) Does neuroticism confound the association between work exposures and mental distress? Workers on six shift-schedules answered a questionnaire (1,471 of 2,628 employees). Psychological and social work factors were measured by QPSNordic, mental distress was measured by HADS and neuroticism was measured by EPQ. The results showed 1) No differences in mental distress between workers in different shift schedules, 2) Revolving-shift workers reported higher neuroticism compared to day workers, 3) Swing-shift workers and revolving-shift workers reported lower job control compared to permanent-night and -day workers, 4) Job demands and role conflict were associated with more mental distress. Job control, role clarity, support, and leadership were associated with lower mental distress, 5) Neuroticism influenced the relationship between psychosocial work factors and mental distress. The present study did not find differences in mental distress between shift schedules. Job characteristics may be contributing factors when determining health effects of shift work.
Optimal screening schedules for prevention of metastatic cancer.
Hanin, Leonid; Pavlova, Lyudmila
We develop methodological, mathematical, statistical, and computational approaches to constructing schedules of cancer screening that maximize the probability that by the time of primary tumor detection it has not yet metastasized. Solving this problem is based on a comprehensive mechanistic model of cancer progression. We apply the model with realistic parameters and the screening optimization methodology to mammographic screening for breast cancer within the American female population. We uncover some general patterns of optimal screening schedules. We show that optimization of screening regimens leads to a significant reduction in the probability of detecting breast cancer that has already disseminated. Copyright © 2012 John Wiley & Sons, Ltd.
Predicting Scheduling and Attending for an Oral Cancer Examination
Shepperd, James A.; Emanuel, Amber S.; Howell, Jennifer L.; Logan, Henrietta L.
Background Oral and pharyngeal cancer is highly treatable if diagnosed early, yet late diagnosis is commonplace apparently because of delays in undergoing an oral cancer examination. Purpose We explored predictors of scheduling and attending an oral cancer examination among a sample of Black and White men who were at high risk for oral cancer because they smoked. Methods During an in-person interview, participants (N = 315) from rural Florida learned about oral and pharyngeal cancer, completed survey measures, and were offered a free examination in the next week. Later, participants received a follow-up phone call to explore why they did or did not attend their examination. Results Consistent with the notion that scheduling and attending an oral cancer exam represent distinct decisions, we found that the two outcomes had different predictors. Defensive avoidance and exam efficacy predicted scheduling an examination; exam efficacy and having coping resources, time, and transportation predicted attending the examination. Open-ended responses revealed that the dominant reasons participants offered for missing a scheduled examination was conflicting obligations, forgetting, and confusion or misunderstanding about the examination. Conclusions The results suggest interventions to increase scheduling and attending an oral cancer examination. PMID:26152644
Recommendations for NRC policy on shift scheduling and overtime at nuclear power plants
Energy Technology Data Exchange (ETDEWEB)
Lewis, P.M.
This report contains the Pacific Northwest Laboratory's (PNL's) recommendations to the US Nuclear Regulatory Commission (NRC) for an NRC policy on shift scheduling and hours of work (including overtime) for control room operators and other safety-related personnel in nuclear power plants. First, it is recommended that NRC make three additions to its present policy on overtime: (1) limit personnel to 112 hours of work in a 14-day period, 192 hours in 28 days, and 2260 hours in one year; exceeding these limits would require plant manager approval; (2) add a requirement that licensees obtain approval from NRC if plant personnel are expected to exceed 72 hours of work in a 7-day period, 132 hours in 14 days, 228 hours in 28 days, and 2300 hours in one year; and (3) make the policy a requirement, rather than a nonbinding recommendation. Second, it is recommended that licensees be required to obtain NRC approval to adopt a routine 12-hour/day shift schedule. Third, it is recommended that NRC add several nonbinding recommendations concerning routine 8-hour/day schedules. Finally, because additional data can strengthen the basis for future NRC policy on overtime, five methods are suggested for collecting data on overtime and its effects. 44 refs., 10 tabs.
Time of day variation in polyp detection rate for colonoscopies performed on a 3-hour shift schedule.
LENUS (Irish Health Repository)
Munson, Gregory W
Recent research suggests that the colonoscopy polyp detection rate (PDR) varies by time of day, possibly because of endoscopist fatigue. Mayo Clinic Rochester (MCR) schedules colonoscopies on 3-hour shifts, which should minimize fatigue.
What work schedule characteristics constitute a problem to the individual? A representative study of Swedish shift workers.
Åkerstedt, Torbjörn; Kecklund, Göran
The purpose was to investigate which detailed characteristics of shift schedules that are seen as problems to those exposed. A representative national sample of non-day workers (N = 2031) in Sweden was asked whether they had each of a number of particular work schedule characteristics and, if yes, to what extent this constituted a "big problem in life". It was also inquired whether the individual's work schedules had negative consequences for fatigue, sleep and social life. The characteristic with the highest percentage reporting a big problem was "short notice (work schedule" (30.5%), shifts (27.8%), and split duty (>1.5 h break at mid-shift, 27.2%). Overtime (>10 h/week), night work, morning work, day/night shifts showed lower prevalences of being a "big problem". Women indicated more problems in general. Short notice was mainly related to negative social effects, while shifts was related to disturbed sleep, fatigue and social difficulties. It was concluded that schedules involving unpredictable working hours (short notice), short daily rest between shifts, and split duty shifts constitute big problems. The results challenge current views of what aspects of shift work need improvement, and negative social consequences seem more important than those related to health. Copyright © 2016 Elsevier Ltd. All rights reserved.
Shift work and breast cancer among women textile workers in Shanghai, China.
Li, Wenjin; Ray, Roberta M; Thomas, David B; Davis, Scott; Yost, Michael; Breslow, Norman; Gao, Dao Li; Fitzgibbons, E Dawn; Camp, Janice E; Wong, Eva; Wernli, Karen J; Checkoway, Harvey
Although night-shift work has been associated with elevated risk of breast cancer in numerous epidemiologic studies, evidence is not consistent. We conducted a nested case-cohort study to investigate a possible association between shift work including a night shift and risk of breast cancer within a large cohort of women textile workers in Shanghai, China. The study included 1,709 incident breast cancer cases and 4,780 non-cases. Data on historical shift work schedules were collected by categorized jobs from the factories, where the study subjects had worked, and then were linked to the complete work histories of each subject. No jobs in the factories involved exclusively night-shift work. Therefore, night shift was evaluated as part of a rotating shift work pattern. Hazard ratios and 95 % confidence intervals were calculated using Cox proportional hazards modeling adapted for the case-cohort design for years of night-shift work and the total number of nights worked. Additionally, analyses were repeated with exposures lagged by 10 and 20 years. We observed no associations with either years of night-shift work or number of nights worked during the entire employment period, irrespective of lag intervals. Findings from the age-stratified analyses were very similar to those observed for the entire study population. The findings from this study provide no evidence to support the hypothesis that shift work increases breast cancer risk. The positive association between shift work and breast cancer observed in Western populations, but not observed in this and other studies of the Chinese population, suggests that the effect of shift work on breast cancer risk may be different in Asian and Caucasian women.
Can varying the number of teams in a shift schedule constitute a preventive strategy?
Directory of Open Access Journals (Sweden)
Hans Jeppe Jeppesen
Full Text Available OBJECTIVE: The study examines the implications for shiftworkers of applying different numbers of teams in the organization of shiftwork. METHODS: The participating operators came from five different companies applying continuous shift rotation systems. The companies shared the same product organization and a common corporate culture belonging to the same multinational company. Each company had a shift system consisting of four, five or six teams, with the proportion of shifts outside day work decreasing as the number of teams increased. Questionnaire and documentary data were used as data sources. RESULTS: Operators in systems with additional teams had more daywork but also more irregular working hours due to both overtime and schedule changes. Operators using six teams used fewer social compensation strategies. Operators in four teams were most satisfied with their work hours. Satisfaction with the time available for various social activities outside work varied inconsistently between the groups. CONCLUSIONS: In rotating systems the application of more teams reduces the number of shifts outside day work. This apparent improvement for shiftworkers was counteracted by a concomitant irregularity produced by greater organizational requirements for flexibility. The balance of this interaction was found to have a critical impact on employees.
[Investigation of the actual conditions of hospital nurses working on three rotating shifts: questionnaire results of shift work schedules, feelings of sleep and fatigue, and depression].
Matsumoto, M; Kamata, S; Naoe, H; Mutoh, F; Chiba, S
These studies were performed to clarify (1) the actual conditions concerning rotating shift schedules of nurses in Japanese university and college hospitals and to evaluate (2) some aspects of the physical and mental health, and (3) sleep profile of hospital nurses working on counter-clockwise shift rotation. Two questionnaire surveys and the OSA sleep inventory (OSA) were carried out. The subjects in the study (1) were a total of 80 nursing directors in university and college hospitals. The questionnaire covered 4 categories, such as the schedule most frequently adopted and reasons for using the schedule. The questionnaires were returned by 67 directors (83.8%). The subjects in the study (2) were 189 nurses working on three-shift work schedules at Asahikawa Medical College Hospital. The items in the questionnaire covered 7 categories, as follows: 1) feeling of sleep after each shift (8 items); 2) feeling of fatigue after each shift (30 items); 3) physical symptoms; 4) inter-personal problems; 5) all the items on Zung's self-rating depression scale (SDS); 6) all the items on the Horne and Ostberg morningness-eveningness questionnaire; and 7) 24 items on the Maudsley personality inventory. The questionnaires were returned by 156 nurses (82.5%), whose mean age and duration of shift-work employment were 27.2 +/- 5.1 and 5.0 +/- 4.3 years (mean +/- SD), respectively. For 152 nurses (97.4%) of those returning the questionnaire, the working schedule consisted of 2 consecutive night shifts and 2 consecutive evening shifts, following a variable number of day shifts (rapid and counterclockwise shift rotation). The subjects in the study (3) were 8 healthy nurses working on above-mentioned three rotating shifts at the psychiatric ward of Asahikawa Medical College Hospital, whose mean age was 29.4 +/- 5.8 years (mean +/- SD). All the subjects recorded their sleep-logs and underwent OSA everyday for 30 consecutive days. Of the 240 OSA data, 95 data (16 after day shift, 17 after
A systematic review of the sleep, sleepiness, and performance implications of limited wake shift work schedules.
Short, Michelle A; Agostini, Alexandra; Lushington, Kurt; Dorrian, Jillian
The aim of this review was to identify which limited wake shift work schedules (LWSW) best promote sleep, alertness, and performance. LWSW are fixed work/rest cycles where the time-at-work does is ≤8 hours and there is >1 rest period per day, on average, for ≥2 consecutive days. These schedules are commonly used in safety-critical industries such as transport and maritime industries. Literature was sourced using PubMed, Embase, PsycInfo, Scopus, and Google Scholar databases. We identified 20 independent studies (plus a further 2 overlapping studies), including 5 laboratory and 17 field-based studies focused on maritime watch keepers, ship bridge officers, and long-haul train drivers. The measurement of outcome measures was varied, incorporating subjective and objective measures of sleep: sleep diaries (N=5), actigraphy (N=4), and polysomnography, (N=3); sleepiness: Karolinska Sleepiness Scale (N=5), visual analog scale (VAS) alertness (N=2) and author-derived measures (N=2); and performance: Psychomotor Vigilance Test (PVT) (N=5), Reaction Time or Vigilance tasks (N=4), Vector and Letter Cancellation Test (N=1), and subjective performance (N=2). Of the three primary rosters examined (6 hours-on/6 hours-off, 8 hours-on/8 hours-off and 4 hours-on/8 hours-off), the 4 hours-on/8 hours-off roster was associated with better sleep and lower levels of sleepiness. Individuals working 4 hours-on/8 hours-off rosters averaged 1 hour more sleep per night than those working 6 hours-on/6 hours-off and 1.3 hours more sleep than those working 8 hours-on/8 hours-off (Pschedules were associated with better sleep and lower sleepines in the case of (i) shorter time-at-work, (ii) more frequent rest breaks, (iii) shifts that start and end at the same clock time every 24 hours, and (iv) work shifts commencing in the daytime (as opposed to night). The findings for performance remain incomplete due to the small number of studies containing a performance measure and the heterogeneity of
Pegylated liposomal doxorubicin: optimizing the dosing schedule in ovarian cancer.
Rose, Peter G
The need for effective, well-tolerated, and convenient therapies for patients with advanced ovarian cancer has led researchers to continually refine chemotherapeutic regimens to balance efficacy with safety and tolerability in order to maintain or improve patient quality of life. In this article, we review current strategies for the optimal dosing of pegylated liposomal doxorubicin (DOXIL; Tibotec Therapeutics, a division of Ortho Biotech Products, L.P., Bridgewater, NJ, http://www.tibotec.com; Caelyx, Schering-Plough Corporation, Kenilworth, NJ, http://www.sch-plough.com) in relapsed ovarian cancer. Pegylated liposomal doxorubicin has demonstrated efficacy in the treatment of recurrent/resistant ovarian cancer in several clinical trials utilizing a dose of 50 mg/m2 every 4 weeks. The most common adverse events associated with pegylated liposomal doxorubicin treatment in these studies-hand-foot syndrome (HFS, also known as palmar-plantar erythrodysesthesia) and stomatitis-are schedule and dose dependent, respectively, and do not typically lead to discontinuation of therapy. Several phase II and retrospective studies support the use of pegylated liposomal doxorubicin 40 mg/m2 every 4 weeks (dose intensity of 10 mg/m2 weekly) to optimize clinical efficacy and minimize the occurrence of schedule- and dose-related adverse events in patients with recurrent/relapsed ovarian cancer. Further reductions in dose intensity are necessary for use in combined chemotherapy regimens. Antitumor activity was maintained, with reduced incidences of HFS and stomatitis. Given the chronic course of ovarian cancer, the improved tolerability profile of pegylated liposomal doxorubicin 40 mg/m2 combined with a convenient once-monthly dosing schedule may translate into an improved quality of life for patients with ovarian cancer.
Shiftworking families: parents' working schedule and sleep patterns of adolescents attending school in two shifts
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Biserka Radoševic-Vidacek
Full Text Available OBJECTIVE: To explore whether parents' engagement in shift work affects the sleep habits of their adolescent children who attend school in two shifts. METHODS: The data were drawn from an extensive survey of sleep and daytime functioning of adolescents attending school one week in the morning and the other in the afternoon. The participants were 1,386 elementary and high school students (11-18 years old whose parents were both employed. The data were analyzed using MANOVA, with parents' work schedule, adolescents' gender and type of school as between-subject factors. RESULTS: Parents' working schedule significantly affected the sleep patterns of high school adolescents. When attending school in the morning, adolescents whose parents were both day workers woke up somewhat later than adolescents with one shiftworking parent. In addition, they slept longer than adolescents whose parents were both shift workers. On weekends, adolescents whose parents both worked during the day went to bed earlier than adolescents whose parents were both shiftworkers. They also had smaller bedtime delay on weekends with respect to both morning and afternoon shifts than adolescents for whom one or both parents worked shifts. A significant interaction between parents' working schedule, adolescents' gender and type of school was found for sleep extension on weekends after afternoon shift school. CONCLUSIONS: Parental involvement in shift work has negative effects on the sleep of high school adolescents. It contributes to earlier wake-up time and shorter sleep in a week when adolescents attend school in the morning, as well as to greater bedtime irregularity.OBJETIVO: Investigar se a ocupação de pais com o trabalho em turnos interfere nos hábitos de sono dos filhos adolescentes que freqüentam a escola em dois períodos distintos. MÉTODOS: Os dados foram coletados em uma extensa pesquisa sobre sono e atividades diurnas de adolescentes que freqüentavam a escola no
Shift schedule, work-family relationships, marital communication, job satisfaction and health among transport service shift workers.
Iskra-Golec, Irena; Smith, Lawrence; Wilczek-Rużyczka, Ewa; Siemiginowska, Patrycja; Wątroba, Joanna
Existing research has documented that shiftwork consequences may depend on the shift system parameters. Fast rotating systems (1-3 shifts of the same kind in a row) and day work have been found to be less disruptive biologically and socially than slower rotating systems and afternoon and night work. The aim of this study was to compare day workers and shift workers of different systems in terms of rotation speed and shifts worked with regard to work-family and family-work positive and negative spillover, marital communication style, job satisfaction and health. Employees (N = 168) of the maintenance workshops of transportation service working different shift systems (day shift, weekly rotating 2 and 3‑shift system, and fast rotating 3-shift system) participated in the study. They completed the Work- Family Spillover Questionnaire, Marital Communication Questionnaire, Minnesota Job Satisfaction Questionnaire and the Physical Health Questionnaire (a part of the Standard Shiftwork Index). The workers of quicker rotating 3-shift systems reported significantly higher scores of family-to-work facilitation (F(3, 165) = 4.175, p = 0.007) and a higher level of constructive style of marital communication (Engagement F(3, 165) = 2.761, p = 0.044) than the workers of slower rotating 2-shift systems. There were no differences between the groups of workers with regard to health and job satisfaction. A higher level of work-family facilitation and a more constructive style of marital communication were found among the workers of faster rotating 3-shift system when compared to the workers of a slower rotating 2-shift system (afternoon, night). This may indicate that the fast rotating shift system in contrary to the slower rotating one is more friendly for the work and family domains and for the relationship between them. Int J Occup Med Environ Health 2017;30(1):121-131.
Shift schedule, work–family relationships, marital communication, job satisfaction and health among transport service shift workers
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Irena Iskra-Golec
Full Text Available Objectives: Existing research has documented that shiftwork consequences may depend on the shift system parameters. Fast rotating systems (1–3 shifts of the same kind in a row and day work have been found to be less disruptive biologically and socially than slower rotating systems and afternoon and night work. The aim of this study was to compare day workers and shift workers of different systems in terms of rotation speed and shifts worked with regard to work–family and family–work positive and negative spillover, marital communication style, job satisfaction and health. Material and Methods: Employees (N = 168 of the maintenance workshops of transportation service working different shift systems (day shift, weekly rotating 2 and 3‑shift system, and fast rotating 3-shift system participated in the study. They completed the Work– Family Spillover Questionnaire, Marital Communication Questionnaire, Minnesota Job Satisfaction Questionnaire and the Physical Health Questionnaire (a part of the Standard Shiftwork Index. Results: The workers of quicker rotating 3-shift systems reported significantly higher scores of family-to-work facilitation (F(3, 165 = 4.175, p = 0.007 and a higher level of constructive style of marital communication (Engagement F(3, 165 = 2.761, p = 0.044 than the workers of slower rotating 2-shift systems. There were no differences between the groups of workers with regard to health and job satisfaction. Conclusions: A higher level of work–family facilitation and a more constructive style of marital communication were found among the workers of faster rotating 3-shift system when compared to the workers of a slower rotating 2-shift system (afternoon, night. This may indicate that the fast rotating shift system in contrary to the slower rotating one is more friendly for the work and family domains and for the relationship between them. Int J Occup Med Environ Health 2017;30(1:121–131
Shift work, circadian gene variants and risk of breast cancer.
Grundy, Anne; Schuetz, Johanna M; Lai, Agnes S; Janoo-Gilani, Rozmin; Leach, Stephen; Burstyn, Igor; Richardson, Harriet; Brooks-Wilson, Angela; Spinelli, John J; Aronson, Kristan J
Circadian (clock) genes have been linked with several functions relevant to cancer, and epidemiologic research has suggested relationships with breast cancer risk for variants in NPAS2, CLOCK, CRY2 and TIMELESS. Increased breast cancer risk has also been observed among shift workers, suggesting potential interactions in relationships of circadian genes with breast cancer. Relationships with breast cancer of 100 SNPs in 14 clock-related genes, as well as potential interactions with shift work history, were investigated in a case-control study (1042 cases, 1051 controls). Odds ratios in an additive genetic model for European-ancestry participants (645 cases, 806 controls) were calculated, using a two-step correction for multiple testing: within each gene through permutation testing (10,000 permutations), and correcting for the false discovery rate across genes. Interactions of genotypes with ethnicity and shift work (breast cancer and one SNP (rs3027188 in PER1) was marginally significant; however, none were significant following adjustment for the false discovery rate. No significant interaction with shift work history was detected. If shift work causes circadian disruption, this was not reflected in associations between clock gene variants and breast cancer risk in this study. Larger studies are needed to assess interactions with longer durations (>30 years) of shift work that have been associated with breast cancer. Copyright © 2013. Published by Elsevier Ltd.
Application-Oriented Optimal Shift Schedule Extraction for a Dual-Motor Electric Bus with Automated Manual Transmission
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Mingjie Zhao
Full Text Available The conventional battery electric buses (BEBs have limited potential to optimize the energy consumption and reach a better dynamic performance. A practical dual-motor equipped with 4-speed Automated Manual Transmission (AMT propulsion system is proposed, which can eliminate the traction interruption in conventional AMT. A discrete model of the dual-motor-AMT electric bus (DMAEB is built and used to optimize the gear shift schedule. Dynamic programming (DP algorithm is applied to find the optimal results where the efficiency and shift time of each gear are considered to handle the application problem of global optimization. A rational penalty factor and a proper shift time delay based on bench test results are set to reduce the shift frequency by 82.5% in Chinese-World Transient Vehicle Cycle (C-WTVC. Two perspectives of applicable shift rule extraction methods, i.e., the classification method based on optimal operating points and clustering method based on optimal shifting points, are explored and compared. Eventually, the hardware-in-the-loop (HIL simulation results demonstrate that the proposed structure and extracted shift schedule can realize a significant improvement in reducing energy loss by 20.13% compared to traditional empirical strategies.
[Night work, shift work: Breast cancer risk factor?].
Benabu, J-C; Stoll, F; Gonzalez, M; Mathelin, C
The aim of this review was to determine the link between night/shift work and breast cancer. The analysed articles were taken from the PUBMED database between 1996 and 2015. The keywords used were "breast cancer risk", "night work" and "shift work". In total, 25 articles were selected. Night/shift workers are more at risk to develop a breast cancer (relative risk (RR) between 1.09; 95% CI: 1.02-1.20 and 1.48; 95% CI: 1.36-1.61 in the meta-analyses). However, this risk is not found by some cohort and case-control studies. The circadian rhythm disruption, responsible of disorderliness of melatonin secretion, could be one of the mechanisms involved in the increase of that risk. Hormonal status of night/shift workers, their geographic origin, their lifestyle and their vitamin D deficiency appear as other mechanisms potentially responsible for increased risk of cancer in this professional population. Moreover, a dose-effect connection may exist, with an increase of the risk with the number of years of night/shift work. Night/shift work is associated with a moderate increased risk of breast cancer, especially among women who worked over 20 years. Recommendations concerning the breast monitoring in this population could be diffused. The benefit of melatonin supplementation remains to be assessed. Copyright © 2015. Published by Elsevier SAS.
How shift scheduling practices contribute to fatigue amongst freight rail operating employees: Findings from Canadian accident investigations.
Rudin-Brown, Christina M; Harris, Sarah; Rosberg, Ari
Canada's freight rail system moves 70% of the country's surface goods and almost half of all exports (RAC, 2016). These include dangerous goods. Anonymous survey of freight rail operating employees conducted by the Teamsters Canada Rail Conference (TCRC, 2014) revealed that many do not report getting enough sleep because of their work schedules, and that fatigue may be affecting their performance at work. Besides general impairments in attention and cognitive functioning, fatigue in railway operating employees slows reaction time to safety alarms and impairs conformance to train operating requirements. Shift scheduling practices can contribute to sleep-related fatigue by restricting sleep opportunities, requiring extended periods of wakefulness and by disrupting daily (circadian) rhythms. The primary goal of accident investigation is to identify causal and contributing factors so that similar occurrences can be prevented. A database search of Transportation Safety Board (TSB) rail investigation reports published in the 21-year period from 1995 to 2015 identified 18 that cited sleep-related fatigue of freight rail operating employees as a causal, contributing, or risk finding. This number represents about 20% of TSB rail investigations from the same period in which a human factors aspect of freight train activities was a primary cause. Exploration of accident themes suggests that management of fatigue and shift scheduling in the freight rail industry is a complex issue that is often not conducive to employee circadian rhythms and sleep requirements. It also suggests that current shift scheduling and fatigue management practices may be insufficient to mitigate the associated safety risk. Railway fatigue management systems that are based on the principles of modern sleep science are needed to improve scheduling practices and mitigate the ongoing safety risk. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.
Cervical Cancer: Reality and Paradigm Shift
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Alfredo Quiñones Ceballos
Full Text Available Invasive cervical carcinoma usually reaches its highest frequency between 35-50 years of age. The Cuban prevention program screens the female population aged 25 to 60 years using the Pap smear and reexamines them every three years. Despite this effort, advanced cancer is diagnosed in young women as well as in those 40 to 60 years of age.
Mechanisms of breast cancer risk in shift workers: association of telomere shortening with the duration and intensity of night work.
Samulin Erdem, Johanna; Notø, Heidi Ødegaard; Skare, Øivind; Lie, Jenny-Anne S; Petersen-Øverleir, Marte; Reszka, Edyta; Pepłońska, Beata; Zienolddiny, Shanbeh
Occupational factors such as shiftwork and especially night work that involves disruption of the circadian rhythm may contribute to increased breast cancer risk. Circadian disruption may also affect telomere length (TL). While short TL generally is associated with increased cancer risk, its association with breast cancer risk is inconclusive. We suggest that working schedules might be an important factor in assessment of effects of TL on breast cancer risk. Moreover, telomere shortening might be a potential mechanism for night work-related breast cancer. In this study, effects of shift work on TL and its association with breast cancer risk were investigated in a nested breast cancer case-control study of Norwegian nurses. TL was assessed by qPCR in DNA from 563 breast cancer patients and 619 controls. Here, we demonstrate that TL is affected by intensive night work schedules, as work with six consecutive night for a period of more than 5 years was associated with decreased telomere lengths (-3.18, 95% CI: -6.46 to -0.58, P = 0.016). Furthermore, telomere shortening is associated with increased breast cancer risk in workers with long periods of consecutive night shifts. Thus, nurses with longer telomere lengths had a lower risk for breast cancer if they had worked more than four (OR: 0.37, 95% CI: 0.16-0.79, P = 0.014) or five (OR: 0.31, 95% CI: 0.10-0.83, P = 0.029) consecutive night shifts for a period of 5 years or more. These data suggest that telomere shortening is associated with the duration and intensity of night work and may be a contributing factor for breast cancer risk among female shift workers. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Night Shift Work and Risk of Breast Cancer.
Hansen, Johnni
Night work is increasingly common and a necessity in certain sectors of the modern 24-h society. The embedded exposure to light-at-night, which suppresses the nocturnal hormone melatonin with oncostatic properties and circadian disruption, i.e., misalignment between internal and external night and between cells and organs, are suggested as main mechanisms involved in carcinogenesis. In 2007, the International Agency for Research on Cancer (IARC) classified shift work that involves circadian disruption as probably carcinogenic to humans based on limited evidence from eight epidemiologic studies on breast cancer, in addition to sufficient evidence from animal experiments. The aim of this review is a critical update of the IARC evaluation, including subsequent and the most recent epidemiologic evidence on breast cancer risk after night work. After 2007, in total nine new case-control studies, one case-cohort study, and eight cohort studies are published, which triples the number of studies. Further, two previous cohorts have been updated with extended follow-up. The assessment of night shift work is different in all of the 26 existing studies. There is some evidence that high number of consecutive night shifts has impact on the extent of circadian disruption, and thereby increased breast cancer risk, but this information is missing in almost all cohort studies. This in combination with short-term follow-up of aging cohorts may explain why some cohort studies may have null findings. The more recent case-control studies have contributed interesting results concerning breast cancer subtypes in relation to both menopausal status and different hormonal subtypes. The large differences in definitions of both exposure and outcome may contribute to the observed heterogeneity of results from studies of night work and breast cancer, which overall points in the direction of an increased breast cancer risk, in particular after over 20 years of night shifts. Overall, there is a
[A study on scheduling periodic examinations for the early detection of breast cancer in Korea].
Jeong, Seong Hwa; Kang, Dae Ryong; Hur, Nam Wook; Kim, Jinheum; Lee, Soon Young; Jung, Sang Hyuk; Nam, Chung Mo
The purposes of this study were to propose a screening schedule for the early detection of breast cancer among Korean women, as based on the statistical model, and to compare the efficacy of the proposed screening schedule with the current recommendations. The development of the screening schedule for breast cancer closely followed the work of Lee and Zelen (1998). We calculated the age-specific breast cancer incidence rate from the Korea Central Cancer Registry (2003), and then we estimated the scheduling of periodic examinations for the early detection of breast cancer, using mammography, and based on the threshold method. The efficacy of the derived screening schedule was evaluated by the schedule sensitivity. For estimating the screening schedule threshold method, we set the threshold value as the probability of being in the preclinical stage at age 35, the sensitivity of mammography as 0.9 and the mean sojourn time in the preclinical stage as 4 years. This method generated 14 examinations within the age interval [40, 69] of 40.0, 41.3, 42.7, 44.1, 45.4, 46.7, 48.0, 49.3, 51.0, 53.2, 55.3, 57.1, 59.0 and 63.6 years, and the schedule sensitivity was 75.4%. The proposed screening schedule detected 85.2% (74.5/87.4) of the cases that could have been detected by annual screening, but it required only about 48.7% (14.0/30.0) of the total number of examinations. We also examined the threshold screening schedules for a range of sensitivities of mammography and the mean sojourn time in the preclinical stage. The proposed screening schedule for breast cancer with using the threshold method will be helpful to provide guidelines for a public health program for choosing an effective screening schedule for breast cancer among Korean women.
Scheduling and shift work characteristics associated with risk for occupational injury in newly licensed registered nurses: An observational study.
Stimpfel, Amy Witkoski; Brewer, Carol S; Kovner, Christine T
Registered nurses across the globe bear a heavy injury burden. Every shift, nurses are exposed to a variety of hazards that can jeopardize their health, which negatively impacts their ability to provide high-quality patient care. Previous research suggests that inexperienced, or newly licensed nurses, may have an increased risk for certain occupational injuries. However, the current knowledge base is insufficient to fully understand how work hours influence newly licensed nurses' occupational injury, given the significant variation in hospital organization and work characteristics. To describe newly licensed nurses' shift work characteristics and determine the association between shift type and scheduling characteristics and nurse injury, before and after adjusting for individual and combined effects of demographics, external context, organizational context, and work context, following the Organization of Work model. This study is a secondary analysis of a nationally representative survey of newly licensed registered nurses using a cross-sectional design. The analytic sample includes 1744 newly licensed registered nurses from 34 states and the District of Columbia who reported working in a hospital and were within 6-18 months of passing their state licensure exam at the time of survey administration. Descriptive statistics were calculated, followed by bivariate and multivariate Poisson regression models to assess the relationship between shift type and scheduling characteristics and nurse injury. Lastly, full models with the addition of demographics, external context, organizational context, and work context variables were calculated. The majority (79%) of newly licensed nurses worked 12-h shifts, a near majority worked night shift (44%), and over half (61%) worked overtime (mandatory or voluntary) weekly. Nurses working weekly overtime were associated with a 32% [incidence rate ratio (IRR) 1.32, CI 1.07-1.62] increase in the risk of a needle stick and nurses
Night shift work, chronotype and prostate cancer risk in the MCC-Spain case-control study.
Papantoniou, Kyriaki; Castaño-Vinyals, Gemma; Espinosa, Ana; Aragonés, Nuria; Pérez-Gómez, Beatriz; Burgos, Javier; Gómez-Acebo, Inés; Llorca, Javier; Peiró, Rosana; Jimenez-Moleón, Jose Juan; Arredondo, Francisco; Tardón, Adonina; Pollan, Marina; Kogevinas, Manolis
Night shift work has been classified as a probable human carcinogen based on experimental studies and limited human evidence on breast cancer. Evidence on other common cancers, such as prostate cancer, is scarce. Chronotype is an individual characteristic that may relate to night work adaptation. We evaluated night shift work with relation to prostate cancer, taking into account chronotype and disease severity in a population based case-control study in Spain. We included 1,095 prostate cancer cases and 1,388 randomly selected population controls. We collected detailed information on shift schedules (permanent vs. rotating, time schedules, duration, frequency), using lifetime occupational history. Sociodemographic and lifestyle factors were assessed by face-to-face interviews and chronotype through a validated questionnaire. We used unconditional logistic regression analysis adjusting for potential confounders. Subjects who had worked at least for one year in night shift work had a slightly higher prostate cancer risk [Odds Ratio (OR) 1.14; 95%CI 0.94, 1.37] compared with never night workers; this risk increased with longer duration of exposure (≥ 28 years: OR 1.37; 95%CI 1.05, 1.81; p-trend = 0.047). Risks were more pronounced for high risk tumors [D'Amico classification, Relative Risk Ratio (RRR) 1.40; 95%CI 1.05, 1.86], particularly among subjects with longer duration of exposure (≥28 years: RRR 1.63; 95%CI 1.08, 2.45; p-trend = 0.027). Overall risk was higher among subjects with an evening chronotype, but also increased in morning chronotypes after long-term night work. In this large population based study, we found an association between night shift work and prostate cancer particularly for tumors with worse prognosis. © 2014 UICC.
Is the Class Schedule the Only Difference between Morning and Afternoon Shift Schools in Mexico?
Cardenas Denham, Sergio
Double-shift schooling has been implemented in Mexico for several decades as a strategy to achieve universal access to basic education. This study provides evidence on the existence of social inequalities related to the implementation of this schooling model. Using quantitative data from several databases including the National Census, the…
Development and Validation of A Scheduled Shifts Staffing (ASSiST) Measure of Unit-Level Staffing in Nursing Homes.
Cummings, Greta G; Doupe, Malcolm; Ginsburg, Liane; McGregor, Margaret J; Norton, Peter G; Estabrooks, Carole A
To (a) describe A Scheduled Shifts Staffing measure (ASSiST) to derive care aide worked hours per resident day (HCA WHRD) at facility and unit levels in nursing homes, (b) report reliability through comparisons to administrative staffing data; (c) report validity by examining associations between HCA WHRD, staff outcomes (job satisfaction, emotional exhaustion), and resident quality indicators (QIs) (e.g. falls, delirium, stage 2+ pressure ulcers), and (d) explore intrafacility variation in staffing intensity levels related to unit-level variation in resident and staff outcomes. We used data from 40 care units in 12 Canadian nursing homes between 2007 and 2012. Descriptive statistics and tests of association and difference described relationships of two measures of staffing with resident and staff outcomes. Annualized rates of HCA WHRD from both data sources compared well at the facility level (Pearson Product Correlation; R = 0.847, p validity, and reflects intrafacility variation in health care aide staffing levels.
Conflicts between employee preferences and ergonomic recommendations in shift scheduling: regulation based on consent is not sufficient
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Johannes Gärtner
Full Text Available OBJECTIVE: Contribution to the discussion of the role of participation/consent of employees in working hours regulation. METHODS: Exploratory analysis of conflicts between preferences of employees and ergonomic recommendations in shift scheduling by analysing a large number of participative shift scheduling projects. RESULTS: The analysis showed that very often the pursuit of higher income played the major role in the decision making process of employees and employees preferred working hours in conflict with health and safety principles. CONCLUSIONS: First, the consent of employees or the works council alone does not ensure ergonomically sound schedules. Besides consent, risk assessment procedures seem to be a promising but difficult approach. Secondly, more research is necessary to check the applicability of recommendations under various settings, to support the risk assessment processes and to improve regulatory approaches to working hours.OBJETIVO: Contribuir para a discussão do papel da participação/consentimento dos empregados na regulamentação das horas de trabalho. MÉTODOS: Realizou-se um estudo exploratório dos conflitos existentes entre as preferências dos empregados e as recomendações ergonômicas no planejamento de esquemas de trabalho em turnos, analisando-se um grande número de projetos participativos de planejamento dos turnos. RESULTADOS: O estudo mostrou que, com freqüência, a busca por um rendimento maior teve um papel importante no processo de tomada de decisão dos empregados, quando estes optaram pelas horas de trabalho em oposição aos princípios de saúde e segurança. CONCLUSÕES: Em primeiro lugar, o consentimento dos empregados ou da comissão de trabalhadores por si só não garante horários salutares do ponto de vista ergonômico. Além do consentimento, processos de avaliação de risco parecem ser uma abordagem promissora embora complicada. Em segundo lugar, fazem-se necessários mais estudos para
Brain cancer probed by native fluorescence and stokes shift spectroscopy
Zhou, Yan; Liu, Cheng-hui; He, Yong; Pu, Yang; Li, Qingbo; Wang, Wei; Alfano, Robert R.
Optical biopsy spectroscopy was applied to diagnosis human brain cancer in vitro. The spectra of native fluorescence, Stokes shift and excitation spectra were obtained from malignant meningioma, benign, normal meningeal tissues and acoustic neuroma benign tissues. The wide excitation wavelength ranges were used to establish the criterion for distinguishing brain diseases. The alteration of fluorescence spectra between normal and abnormal brain tissues were identified by the characteristic fluorophores under the excitation with UV to visible wavelength range. It was found that the ratios of the peak intensities and peak position in both spectra of fluorescence and Stokes shift may be used to diagnose human brain meninges diseases. The preliminary analysis of fluorescence spectral data from cancer and normal meningeal tissues by basic biochemical component analysis model (BBCA) and Bayes classification model based on statistical methods revealed the changes of components, and classified the difference between cancer and normal human brain meningeal tissues in a predictions accuracy rate is 0.93 in comparison with histopathology and immunohistochemistry reports (gold standard).
Restless Legs Syndrome/Willis–Ekbom Disease Is Prevalent in Working Nurses, but Seems Not to Be Associated with Shift Work Schedules
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Siri Waage
Full Text Available Insomnia and excessive sleepiness are among the most commonly reported sleep problems related to shift work. Sleep-related movement disorders have, however, received far less attention in relation to such work schedules. The objective of this study was to investigate the association between different shift work schedules and the prevalence of Restless legs syndrome/Willis–Ekbom disease (RLS/WED in a large sample of Norwegian nurses. Our hypothesis was that shift working nurses would report higher prevalence of RLS/WED compared to day workers. A total of 1,788 nurses with different work schedules (day work, two-shift rotation, night work, three shift rotation participated in a cohort study, started in 2008/2009. Four questions about RLS/WED based on the diagnostic criteria were included in wave 4 (2012. RLS/WED prevalence rates across different shift schedules were explored by the Pearson chi-square test. Logistic regression analysis was used to assess the association between RLS/WED and work schedules and shift work disorder (SWD with adjustment for sex, age, marital status, smoking, and caffeine use. In total, 90.0% of the nurses were females, mean age 36.5 years (SD = 8.6, range 25–67. The overall prevalence of RLS/WED was 26.8%. We found no significant differences between the prevalence of RLS/WED across the different shift schedules, ranging from 23.3% (day work to 29.4% (night work. There was a significant difference (p < 0.001 in the prevalence of RLS/WED between nurses having SWD (33.5% compared to nurses not having SWD (23.8%. SWD remained significantly associated with RLS/WED in the adjusted logistic regression analysis (1.56, CI: 1.24–1.97. This study did not support the hypothesis. RLS/WED was associated with SWD, which might indicate that nurses vulnerable to shift work also are sensitive to other complaints related to a misalignment of the biological clock.
Association of Sleep Duration, Sleep Quality and Shift-Work Schedule in Relation to Hypertension Prevalence in Chinese Adult Males: A Cross-Sectional Survey.
Lu, Kai; Chen, Jia; Wang, Li; Wang, Changying; Ding, Rongjing; Wu, Shouling; Hu, Dayi
Background: Previous studies indicated that measurement of sleep only by duration and quality may be biased. This study aimed to investigate the interactive association of self-reported sleep duration, quality and shift-work schedule with hypertension prevalence in Chinese adult males. Methods: A total of 4519 Chinese adult males (≥18 years) were enrolled into the cross-sectional survey. Sleep attributes were measured from the responses to the standard Pittsburgh Sleep Quality Index and relevant questions in a structured questionnaire survey. The association of sleep duration, quality and shift-work schedule with hypertension prevalence was analyzed using multivariate logistic regression, considering the interaction between them or not. Results: Taking the potential interaction of the three aspects of sleep into consideration, only short sleep duration combined with poor sleep quality was found to be related to hypertension prevalence in Chinese adult males (odds ratio (OR): 1.74, 95% confidence interval (CI): 1.31-2.31), which could be modified by occasional and frequent shift-work schedule (OR: 1.43, 95% CI: 1.05-1.95; OR: 1.97, 95% CI: 1.40-2.79). Conclusions: Short sleep duration was not associated with the prevalence of hypertension in Chinese adult males unless poor sleep quality exists, which could be further modified by shift-work schedule. Assessment of sleep by measuring sleep duration only was not sufficient when exploring the association of sleep with hypertension.
Case-control study of shift-work and breast cancer risk in Danish nurses: impact of shift systems.
Hansen, Johnni; Stevens, Richard G
Working outside normal daytime hours is increasing worldwide and is now one of the most widespread potential carcinogenic occupational exposures. There is sufficient evidence in experimental animals that light exposure during the biologic night increases tumour growth and limited epidemiologic evidence that night shift-work cause breast cancer. Existing studies had crude definitions of shift-work and did not discriminate between shift-work systems (e.g. permanent versus rotating or evening versus night). We performed an interview based nested case-control study within a nationwide cohort of Danish nurses, including detailed information on lifetime shift-work and potential confounders. Cases of primary breast cancer (n=310) were identified from the nationwide Danish Cancer Registry. Four control nurses were selected for each case by incidence density sampling. Odds rations (ORs) and 95% confidence intervals (CIs) were estimated by conditional logistic regression, with adjustment for potential confounders. Overall, nurses who worked rotating shifts after midnight had a significantly increased OR (1.8; CI 1.2-2.8) for breast cancer compared to nurses with permanent day work. No association was found in a small group of nurses with evening work and no night work (OR=0.9; 0.4-1.9). The subgroup of nurses with periods of permanent night shift in addition to rotating night and day shifts experienced an OR of 2.9 (1.1-8.0). For nurses working after midnight compared to nurses never ending work before midnight, OR in the third tertile of cumulative number of shifts was 2.2 (1.5-3.2). In an analysis of different rotating shift systems, the highest OR (2.6; 1.8-3.8) was observed for long-term day-night rotating shifts. The results provide further evidence that night shift-work may increase the risk for breast cancer and suggest that the largest impact on risk is associated with the most disruptive shifts. Danish Cancer Society and National Programme of Environmental Health
Night-shift work and breast cancer risk in a cohort of Chinese women
National Research Council Canada - National Science Library
Pronk, Anjoeka; Ji, Bu-Tian; Shu, Xiao-Ou; Xue, Shouzheng; Yang, Gong; Li, Hong-Lan; Rothman, Nathaniel; Gao, Yu-Tang; Zheng, Wei; Chow, Wong-Ho
Shift work involving disruption of circadian rhythms has been classified as a probable cause of human cancer by the International Agency for Research on Cancer, based on limited epidemiologic evidence...
Radiobiological modeling of interplay between accelerated repopulation and altered fractionation schedules in head and neck cancer
Directory of Open Access Journals (Sweden)
Marcu Loredana
Full Text Available Head and neck cancer represents a challenge for radiation oncologists due to accelerated repopulation of cancer cells during treatment. This study aims to simulate, using Monte Carlo methods, the response of a virtual head and neck tumor to both conventional and altered fractionation schedules in radiotherapy when accelerated repopulation is considered. Although clinical trials are indispensable for evaluation of novel therapeutic techniques, they are time-consuming processes which involve many complex and variable factors for success. Models can overcome some of the limitations encountered by trials as they are able to simulate in less complex environment tumor cell kinetics and dynamics, interaction processes between cells and ionizing radiation and their outcome. Conventional, hyperfractionated and accelerated treatment schedules have been implemented in a previously developed tumor growth model which also incorporates tumor repopulation during treatment. This study focuses on the influence of three main treatment-related parameters, dose per fraction, inter fraction interval and length of treatment gap and gap timing based on RTOG trial data on head and neck cancer, on tumor control. The model has shown that conventionally fractionated radiotherapy is not able to eradicate the stem population of the tumor. Therefore, new techniques such as hyperfractionated/ accelerated radiotherapy schedules should be employed. Furthermore, the correct selection of schedule-related parameters (dose per fraction, time between fractions, treatment gap scheduling is crucial in overcoming accelerated repopulation. Modeling of treatment regimens and their input parameters can offer better understanding of the radiobiological interactions and also treatment outcome.
Mechanisms of Breast Cancer in Shift Workers: DNA Methylation in Five Core Circadian Genes in Nurses Working Night Shifts.
Samulin Erdem, Johanna; Skare, Øivind; Petersen-Øverleir, Marte; Notø, Heidi Ødegaard; Lie, Jenny-Anne S; Reszka, Edyta; Pepłońska, Beata; Zienolddiny, Shanbeh
Shift work has been suggested to be associated with breast cancer risk, and circadian disruption in shift workers is hypothesized as one of the mechanisms of increased cancer risk. There is, however, insufficient molecular evidence supporting this hypothesis. Using the quantitative methodology of pyrosequencing, epigenetic changes in 5-methyl cytosine (5mC) in five circadian genes CLOCK, BMAL1, CRY1, PER1 and PER2 in female nurses working night shift work (278 breast cancer cases, 280 controls) were analyzed. In breast cancer cases, a medium exposure to night work was associated with increased methylation levels of the CLOCK (p=0.050), BMAL1 (p=0.001) and CRY1 (p=0.040) genes, compared with controls. Within the cases, analysis of the effects of shift work on the methylation patterns showed that methylation of CRY1 was lower in those who had worked night shift and had a high exposure (p=0.006) compared with cases that had worked only days. For cases with a medium exposure to night work, an increase in BMAL1 (p=0.003) and PER1 (p=0.035) methylation was observed compared with day working (unexposed) cases. The methylation levels of the five core circadian genes were also analyzed in relation to the estrogen and progesterone receptors status of the tumors in the cases, and no correlations were observed. Furthermore, nineteen polymorphisms in the five circadian genes were assessed for their effects on the methylation levels of the respective genes, but no associations were found. In summary, our data suggest that epigenetic regulation of CLOCK, BMAL1, CRY1 and PER1 may contribute to breast cancer in shift workers.
Sleep duration as a mediator between an alternating day and night shift work schedule and metabolic syndrome among female hospital employees.
Korsiak, Jill; Tranmer, Joan; Day, Andrew; Aronson, Kristan J
The main objective was to determine whether sleep duration on work shifts mediates the relationship between a current alternating day and night shift work schedule and metabolic syndrome among female hospital employees. The secondary objective was to assess whether cumulative lifetime shift work exposure was associated with metabolic syndrome. In this cross-sectional study of 294 female hospital employees, sleep duration was measured with the ActiGraph GT3X+. Shift work status was determined through self-report. Investigation of the total, direct and indirect effects between shift work, sleep duration on work shifts and metabolic syndrome was conducted using regression path analysis. Logistic regression was used to determine the association between cumulative shift work exposure and metabolic syndrome. Shift work is strongly associated with metabolic syndrome (ORTotal=2.72, 95% CI 1.38 to 5.36), and the relationship is attenuated when work shift sleep duration is added to the model (ORDirect=1.18, 95% CI 0.49 to 2.89). Sleep duration is an important intermediate between shift work and metabolic syndrome (ORIndirect=2.25, 95% CI 1.27 to 4.26). Cumulative shift work exposure is not associated with metabolic syndrome in this population. Sleep duration mediates the association between a current alternating day-night shift work pattern and metabolic syndrome. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Stress and sleep in nurses employed in "3 × 8" and "2 × 12" fast rotating shift schedules.
Costa, Giovanni; Anelli, Matteo M; Castellini, Giovanna; Fustinoni, Silvia; Neri, Luca
We compared two "3 × 8" shift rotas with backward rotation and quick return (morning and night shift in the same day) in a 5- or 6-day shift cycle, and a "2 × 12" shift rota with forward rotation in a 5-d shift cycle. A total of 294 nurses (72.6% women, mean age 33.8) were examined in a survey on work-related stress, including the Standard Shiftwork Index. Ten nurses per each shift roster recorded their activity and rest periods by actigraphy, rated sleepiness and sleep quality, and collected salivary cortisol throughout the whole shift cycle. Nurses engaged in the "2 × 12" rota showed lower levels of sleep disturbances and, according to actigraphy, sleep duration was more balanced and less fragmented than in the "3 × 8" rosters. The counter-clockwise shift rotation and quick return of "3 × 8" schedules reduce possibility of sleep and recovery. The insertion of a morning shift before the day with quick return increases night sleep by about 1 h. Nurses who take a nap during the night shift require 40% less sleep in the morning after. The "2 × 12" clockwise roster, in spite of 50% increased length of shift, allows a better recovery and more satisfying leisure times, thanks to longer intervals between work periods. Sleepiness increased more during the night than day shifts in all rosters, but without significant difference between 8-h and 12-h rosters. However, the significantly higher level at the start of the night shift in the "3 × 8" rotas points out that the fast backward rotation with quick return puts the subjects in less efficient operational conditions. Some personal characteristics, such as morningness, lability to overcome drowsiness, flexibility of sleeping habits and age were significantly associated to sleep disturbances in nurses engaged in the "3 × 8" rotas, but not in the "2 × 12" schedule.
A compromise phase position for permanent night shift workers: circadian phase after two night shifts with scheduled sleep and light/dark exposure.
Lee, Clara; Smith, Mark R; Eastman, Charmane I
Night shift work is associated with a myriad of health and safety risks. Phase-shifting the circadian clock such that it is more aligned with night work and day sleep is one way to attenuate these risks. However, workers will not be satisfied with complete adaptation to night work if it leaves them misaligned during days off. Therefore, the goal of this set of studies is to produce a compromise phase position in which individuals working night shifts delay their circadian clocks to a position that is more compatible with nighttime work and daytime sleep yet is not incompatible with late nighttime sleep on days off. This is the first in the set of studies describing the magnitude of circadian phase delays that occurs on progressively later days within a series of night shifts interspersed with days off. The series will be ended on various days in order to take a "snapshot" of circadian phase. In this set of studies, subjects sleep from 23:00 to 7:00 h for three weeks. Following this baseline period, there is a series of night shifts (23:00 to 07:00 h) and days off. Experimental subjects receive five 15 min intermittent bright light pulses (approximately 3500 lux; approximately 1100 microW/cm2) once per hour during the night shifts, wear sunglasses that attenuate all visible wavelengths--especially short wavelengths ("blue-blockers")--while traveling home after the shifts, and sleep in the dark (08:30-15:30 h) after each night shift. Control subjects remain in typical dim room light (light, and sleep whenever they want after the night shifts. Circadian phase is determined from the circadian rhythm of melatonin collected during a dim light phase assessment at the beginning and end of each study. The sleepiest time of day, approximated by the body temperature minimum (Tmin), is estimated by adding 7 h to the dim light melatonin onset. In this first study, circadian phase was measured after two night shifts and day sleep periods. The Tmin of the experimental subjects (n
Treatment schedule-dependent effect of 5-fluorouracil and platinum derivatives in colorectal cancer cells.
Takara, Kohji; Fujita, Megumi; Minegaki, Tetsuya; Yamamoto, Kazuhiro; Takahashi, Minoru; Yokoyama, Teruyoshi; Okumura, Katsuhiko
Combination chemotherapy for treating cancer often is superior in clinical efficacy to monotherapy. The aim of this study was to investigate the schedule-dependent effect of 5-fluorouracil (5-FU) and platinum derivatives (cisplatin or oxaliplatin) in colorectal cancer (CRC) cell lines, and to explore factors affecting it. Two human CRC-derived cell lines, DLD-1 and HCT116, were used. Three treatment schedules were tested, and growth inhibitory effects were evaluated with a WST-1 assay. Combined effects were assessed with isobolograms and a combination index. Cellular accumulation and DNA-binding of platinum were measured with inductively coupled plasma mass spectrometry. Exposure to 5-FU followed by cisplatin produced synergistic effects in DLD-1 cells, and the amount of platinum bound to DNA was substantially increased as compared with that for other schedules. 5-FU and oxaliplatin also tended to be synergistic when 5-FU was given first, but no significant change in the cellular kinetics of platinum was observed. On the other hand, in HCT116 cells, the combined effects of 5-FU and platinum derivatives were comparable among the three schedules. Exposure to 5-FU followed by cisplatin had a synergistic effect in DLD-1 cells, suggesting that the amount of platinum bound to DNA contributes to this result. Also, the effect was dependent on the type of platinum derivative and cell. Copyright © 2011 Elsevier B.V. All rights reserved.
Effects of requested, forced and denied shift schedule change on work ability and health of nurses in Europe -Results from the European NEXT-Study
Background Previous cross-sectional findings from the European Nurses Early Exit Study (NEXT) show that nurses who were dissatisfied with their work schedule tended to consider leaving the nursing profession. Mediating factors in this decision process may be caused by self-perceived poor work ability and/or health. The aim of this paper is to investigate changes in work ability and general health among nurses in relation to requested, forced and denied change of shift schedule. Methods Longitudinal data from the NEXT Study was used. In total 11,102 nurses from Belgium, Germany, Finland, the Netherlands, Poland, Slovakia, France and Italy completed both the 'basic questionnaire' (t1) and the '12 month follow-up questionnaire' (t2). To examine the time-effect (repeated measures) and the group-effect of five defined groups of nurses on the Work Ability Index (WAI) and general health (SF36), an adjusted 2-way analysis of covariance (ANCOVA) was performed. Results The nurses who wanted to, but could not change their shifts during the 12 month follow-up had the lowest initial and follow-up scores for WAI (t1: 37.6, t2: 36.6, p Shift pattern change in line with the nurses' wishes was associated with improved work ability and to a lesser comparatively low extent with increased decline in health scores. A forced change of shift against the nurses' will was significantly associated with a deteriorating work ability and health. Conclusions The findings would suggest that nurses' desire to change their shift patterns may be an indicator for perceived low work ability and/or low health. The results also indicate that fulfilling nurses' wishes with respect to their shift work pattern may improve their personal resources such as work ability and – to somewhat lesser extent – health. Disregarding nurses' preferences, however, bears the risk for further resource deterioration. The findings imply that shift schedule organization may constitute a valuable
Kidney cancer progression linked to shifts in tumor metabolism
Investigators in The Cancer Genome Atlas Research Network have uncovered a connection between how tumor cells use energy from metabolic processes and the aggressiveness of the most common form of kidney cancer, clear cell renal cell carcinoma.
Cancer research in need of a scientific revolution: Using 'paradigm shift' as a method of investigation.
Wion, Didier; Appaix, Florence; Burruss, Meriwether; Berger, Francois; van der Sanden, Boudewijn
Despite important human and financial resources and considerable accumulation of scientific publications, patents, and clinical trials, cancer research has been slow in achieving a therapeutic revolution similar to the one that occurred in the last century for infectious diseases. It has been proposed that science proceeds not only by accumulating data but also through paradigm shifts. Here, we propose to use the concept of 'paradigm shift' as a method of investigation when dominant paradigms fail to achieve their promises. The first step in using the 'paradigm shift' method in cancer research requires identifying its founding paradigms. In this review, two of these founding paradigms will be discussed: (i) the reification of cancer as a tumour mass and (ii) the translation of the concepts issued from infectious disease in cancer research. We show how these founding paradigms can generate biases that lead to over-diagnosis and over-treatment and also hamper the development of curative cancer therapies. We apply the 'paradigm shift' method to produce perspective reversals consistent with current experimental evidence. The 'paradigm shift' method enlightens the existence of a tumour physiologic-prophylactic-pathologic continuum. It integrates the target/antitarget concept and that cancer is also an extracellular disease. The 'paradigm shift' method has immediate implications for cancer prevention and therapy. It could be a general method of investigation for other diseases awaiting therapy.
Night shift work and stomach cancer risk in the MCC-Spain study.
Gyarmati, Georgina; Turner, Michelle C; Castaño-Vinyals, Gemma; Espinosa, Ana; Papantoniou, Kyriaki; Alguacil, Juan; Costas, Laura; Pérez-Gómez, Beatriz; Martin Sanchez, Vicente; Ardanaz, Eva; Moreno, Victor; Gómez-Acebo, Inés; Fernández-Tardon, Guillermo; Villanueva Ballester, Vicent; Capelo, Rocio; Chirlaque, Maria-Dolores; Santibáñez, Miguel; Pollán, Marina; Aragonés, Nuria; Kogevinas, Manolis
Night shift work has been classified as a probable human carcinogen by the International Agency for Research on Cancer, based on experimental studies and limited evidence on human breast cancer risk. Evidence at other cancer sites is scarce. We evaluated the association between night shift work and stomach cancer risk in a population-based case-control study. A total of 374 incident stomach adenocarcinoma cases and 2481 population controls were included from the MCC-Spain study. Detailed data on lifetime night shift work were collected including permanent and rotating shifts, and their cumulative duration (years). Adjusted unconditional logistic regression models were used in analysis. A total of 25.7% of cases and 22.5% of controls reported ever being a night shift worker. There was a weak positive, non-significant association between ever having had worked for at least 1 year in permanent night shifts and stomach cancer risk compared to never having worked night shifts (OR=1.2, 95% CI 0.9 to 1.8). However, there was an inverse 'U' shaped relationship with cumulative duration of permanent night shifts, with the highest risk observed in the intermediate duration category (OR 10-20 years=2.0, 95% CI 1.1 to 3.6) (p for trend=0.19). There was no association with ever having had worked in rotating night shifts (OR=0.9, 95% CI 0.6 to 1.2) and no trend according to cumulative duration (p for trend=0.68). We found no clear evidence concerning an association between night shift work and stomach cancer risk. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Self-Reported Recovery from 2-Week 12-Hour Shift Work Schedules: A 14-Day Follow-Up
Directory of Open Access Journals (Sweden)
Suzanne L. Merkus
Conclusion: After 2-week 12-hour night and swing shifts, only the course for sleep quality differed from that of day work. Sleep quality was poorer for night and swing shift workers on the 1st day off and remained poorer for the 14-day follow-up. This showed that while working at night had no effect on feeling rested, tiredness, and energy levels, it had a relatively long-lasting effect on sleep quality.
Short-term effects of night shift work on breast cancer risk
DEFF Research Database (Denmark)
Vistisen, H. T.; Garde, A. H.; Frydenberg, M.
.80-1.01] was observed for workers ever working night shifts during the follow-up period compared with workers only working day shifts after adjustment for age, age at first child, parity, family history of breast or ovarian cancer, sex hormones, medications related to alcoholism, family educational level, mammography...
Increased risk of breast cancer associated with long-term shift work in Canada.
Grundy, Anne; Richardson, Harriet; Burstyn, Igor; Lohrisch, Caroline; SenGupta, Sandip K; Lai, Agnes S; Lee, Derrick; Spinelli, John J; Aronson, Kristan J
Long-term night work has been suggested as a risk factor for breast cancer; however, additional studies with more comprehensive methods of exposure assessment to capture the diversity of shift patterns are needed. As well, few previous studies have considered the role of hormone receptor subtype. Relationships between night shift work and breast cancer were examined among 1134 breast cancer cases and 1179 controls, frequency-matched by age in Vancouver, British Columbia, and Kingston, Ontario. Self-reported lifetime occupational histories were assessed for night shift work, and hormone receptor status obtained from tumour pathology records. With approximately one-third of cases and controls ever employed in night shift work, associations with duration demonstrated no relationship between either 0-14 or 15-29 years, while an association was apparent for ≥30 years (OR=2.21, 95% CI 1.14 to 4.31). This association with long-term night shift work is robust to alternative definitions of prolonged shift work, with similar results for both health and non-health care workers. Long-term night shift work in a diverse mix of occupations is associated with increased breast cancer risk and not limited to nurses, as in most previous studies.
Night-shift work and breast cancer risk in a cohort of Chinese women
Pronk, A.; Ji, B.T.; Shu, X.O.; Xue, S.; Yang, G.; Li, H.L.; Rothman, N.; Gao, Y.T.; Zheng, W.; Chow, W.H.
Shift work involving disruption of circadian rhythms has been classified as a probable cause of human cancer by the International Agency for Research on Cancer, based on limited epidemiologic evidence and abundant experimental evidence. The authors investigated this association in a population-based
Psychoneuroimmunology and cancer: a decade of discovery, paradigm shifts, and methodological innovations.
Green McDonald, Paige; O'Connell, Mary; Lutgendorf, Susan K
This article introduces the supplement Advances in Cancer and Brain, Behavior, and Immunity and outlines important discoveries, paradigm shifts, and methodological innovations that have emerged in the past decade to advance mechanistic and translational understanding of biobehavioral influences on tumor biology, cancer treatment-related sequelae, and cancer outcomes. We offer a heuristic framework for research on biobehavioral pathways in cancer. The shifting survivorship landscape is highlighted, and we propose that the changing demographics suggest prudent adoption of a life course perspective of cancer and cancer survivorship. We note opportunities for psychoneuroimmunology (PNI) research to ameliorate the long-term, unintended consequences of aggressive curative intent and call attention to the critical role of reciprocal translational pathways between animal and human studies. Lastly, we briefly summarize the articles included in this compilation and offer our perspectives on future research directions. Published by Elsevier Inc.
[Night shift work and prolactin as a breast cancer risk factor].
Bukowska, Agnieszka; Pepłońska, Beata
Prolactin - a hormone secreted in a circadian rhythm acts as a regulator of growth and development of the mammary glands. It has been observed that working at night increases breast cancer risk in women. Night shift work, probably carcinogenic to humans (Group 2A IARC), can disrupt a circadian rhythm, and thus potentially alter the rhythm of prolactin secretion. The aim of our work was to review epidemiological evidence on the association between prolactin and the risk of breast cancer and the influence of work at night on prolactin secretion. Search was done in the Medline database by keywords (shift work, work at night, risk of breast cancer and prolactin). 'The increased proliferation of breast cells activated by prolactin can promote the development of cancer. The results of the largest epidemiological prospective studies suggest the association between prolactin levels and the risk of breast cancer in women. So far, only seven studies have investigated the association between work at night and prolactin secretion. In three studies lower concentrations of prolactin have been observed in night shift workers. No relationship between the night shift work duration and prolactin level in women have been reported. Night shift work can modify the profile of prolactin secretion in night workers, probably decreasing the secretion of this hormone at night. It is therefore unlikely that prolactin plays an important role in the development of breast cancer in women working at night. This conclusion is based on the results of a few epidemiological studies.
[Promotion of home shifts for terminal cancer patients through intervention of visitor palliative care team].
Shiraishi, Ko; Chigira, Mayumi; Tsuyuki, Naoko; Hozaki, Kyoko; Murotsu, Keizo; Umeki, Mikiko; Harada, Naohiro; Hirata, Satomi; Otsuka, Yuko; Hara, Hiroko
It has been recommended that terminal cancer patients be shifted from the hospital to their homes. In our hospital, a visitor palliative care team was started for the purpose of the early introduction of palliative care, and home shifts were promoted. The results of home shifts by the visitor palliative care team from 2008 to 2012 were examined. Home shifts were possible for 27 cases out of 108 cases intervened. In 12 cases, there were at-home deaths, and the median at-home period was 55 days. In the group that could not be shifted, the at-home death rate and application rate of nursing care insurance were low. Additionally, the length of stay (median) for patients who died in hospitalization was 8 days for the group that could be shifted and 17 days for the group that could not be shifted. It was felt that effective communication with local health care facilities is important for a successful home shift. Early and adequate preparations for the treatment and care of terminal cancer patients undergoing home shift are important, and in this regard, a review of the current provisions of nursing care insurance is necessary.
Preoperative chemoradiation for locally advanced rectal cancer: comparison of three radiation dose and fractionation schedules
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Park, Shin Hyung; Kim, Jae Chul [Dept. of Radiation Oncology, Kyungpook National University School of Medicine, Daegu (Korea, Republic of)
The standard radiation dose for patients with locally rectal cancer treated with preoperative chemoradiotherapy is 45–50 Gy in 25–28 fractions. We aimed to assess whether a difference exists within this dose fractionation range. A retrospective analysis was performed to compare three dose fractionation schedules. Patients received 50 Gy in 25 fractions (group A), 50.4 Gy in 28 fractions (group B), or 45 Gy in 25 fractions (group C) to the whole pelvis, as well as concurrent 5-fluorouracil. Radical resection was scheduled for 8 weeks after concurrent chemoradiotherapy. Between September 2010 and August 2013, 175 patients were treated with preoperative chemoradiotherapy at our institution. Among those patients, 154 were eligible for analysis (55, 50, and 49 patients in groups A, B, and C, respectively). After the median follow-up period of 29 months (range, 5 to 48 months), no differences were found between the 3 groups regarding pathologic complete remission rate, tumor regression grade, treatment-related toxicity, 2-year locoregional recurrence-free survival, distant metastasis-free survival, disease-free survival, or overall survival. The circumferential resection margin width was a prognostic factor for 2-year locoregional recurrence-free survival, whereas ypN category was associated with distant metastasis-free survival, disease-free survival, and overall survival. High tumor regression grading score was correlated with 2-year distant metastasis-free survival and disease-free survival in univariate analysis. Three different radiation dose fractionation schedules, within the dose range recommended by the National Comprehensive Cancer Network, had no impact on pathologic tumor regression and early clinical outcome for locally advanced rectal cancer.
Exosomes and Metabolic Function in Mice Exposed to Alternating Dark-Light Cycles Mimicking Night Shift Work Schedules
Directory of Open Access Journals (Sweden)
Abdelnaby Khalyfa
Full Text Available Sleep is an important modulator of metabolic function. Disruptions of sleep in circadian rhythm are common in modern societies and are associated with increased risk of developing cardiometabolic disorders. Exosomes are ubiquitous extracellular vesicles that may play a mechanistic role in metabolic derangements. We hypothesized that alternating dark-light cycles mimicking shift work in mice would alter fecal microbiota and colonic epithelium permeability and alter plasma exosome cargo and metabolic function. C57BL/6 mice were randomly assigned to (i control day light (CL, or (ii inverted dark-light every 2 weeks for 8 weeks (IN. Body weight, fat mass and HOMA-IR were measured, along with Tregs, metabolic, and resident macrophages in visceral white adipose tissue (vWAT. Fecal water samples were incubated with confluent colonic epithelium cell cultures in electric cell-substrate impedance sensing (ECIS arrays, and plasma exosomes were added to differentiated adipocytes and insulin-induced pAKT/AKT expression changes were assessed by western blots. Mice exposed to IN showed elevated HOMA-IR, and their fecal samples showed altered microbiota which promote increased permeability of the colonic epithelial cell barrier. Plasma exosomes decreased pAKT/AKT responses to exogenous insulin compared to CL, and altered expression of circadian clock genes. Inflammatory macrophages (Ly-6chigh were increased in IN-exposed vWAT, while Tregs were decreased. Thus, gut microbiota and the cargo of plasma exosomes are altered by periodic shifts in environmental lighting, and effectively alter metabolic function, possibly via induction of systemic inflammation and altered clock expression in target tissues. Further exploration of exosomal miRNA signatures in shift workers and their putative metabolic organ cell targets appears warranted.
Early alternating chemotherapy and radiotherapy schedule in limited disease stage small cell lung cancer
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Purohit, A.; Charloux, A.; Dietemann, A.; Quoix, E. [Strasbourg-1 Univ., 67 (France); Jung, G.-M.; Schumacher, C. [Centre Paul-Strauss, 67 - Strasbourg (France); Fraisse, P. [Hopital de Hautepierre, Strasbourg (France). Service de Pneumologie
44 patients with limited small cell lung cancer were treated with six cycles of chemotherapy (cisplatinum 60 mg/m{sup 2}day 1, doxorubicin 40 mg/m{sup 2}day 1, etoposide 100 mg/m{sup 2}days 1-3) alternating with three courses of mediastinal irradiation, the first one starting 7 days after the first day of chemotherapy. A total dose of 55 Gy was delivered. Prophylactic cranial irradiation (30 Gy after the third cycle of chemotherapy) was left to the physician`s discretion. 4 patients had radical surgery before combined modality treatment. 29 patients finished the scheduled program. The complete response rate (bronchoscopically confirmed) was 25.6% after two cycles of chemotherapy and 41% at the end of treatment. Median survival time was 17.2 months, with an estimated survival of 32% at 2 years. Main toxicity was haematological with one early toxic death and six premature interruptions of treatment. We conclude that this treatment modality is feasible and efficacious. Prospective studies comparing chemotherapy with alternating or concurrent early radiotherapy schedules in limited disease small cell lung cancer are needed to determine the best treatment modality. (author).
Night-shift work and risk of breast cancer: a systematic review and meta-analysis.
Kamdar, Biren B; Tergas, Ana I; Mateen, Farrah J; Bhayani, Neil H; Oh, Jiwon
A 2007 report by the International Agency for Research on Cancer classified night-shift work as possibly carcinogenic to humans, emphasizing, in particular, its association with breast cancer. Since this report and the publication of the last systematic review on this topic, several new studies have examined this association. Hence, to provide a comprehensive update on this topic, we performed a systematic review and meta-analysis. We searched Medline, Embase, CINAHL, Web of Science (Conference Proceedings), and ProQuest dissertations for studies published before March 1, 2012, along with a manual search of articles that cited or referenced the included studies. Included were observational case-control or cohort studies examining the association between night-shift work and breast carcinogenesis in women, which all ascertained and quantified night-shift work exposure. The search yielded 15 eligible studies for inclusion in the systematic review and meta-analysis. Using random-effects models, the pooled relative risk (RR) and 95 % confidence intervals (CIs) of breast cancer for individuals with ever night-shift work exposure was 1.21 (95 % CI, 1.00-1.47, p = 0.056, I (2) = 76 %), for short-term night-shift workers (work exposure and nurses working night-shifts long-term were at increased risk of breast cancer, however, these findings were limited by unmeasured confounding. Overall, given substantial heterogeneity observed between studies in this meta-analysis, we conclude there is weak evidence to support previous reports that night-shift work is associated with increased breast cancer risk.
Shift work and colorectal cancer risk in the MCC-Spain case-control study.
Papantoniou, Kyriaki; Castaño-Vinyals, Gemma; Espinosa, Ana; Turner, Michelle C; Alonso-Aguado, Maria Henar; Martin, Vicente; Aragonés, Nuria; Pérez-Gómez, Beatriz; Pozo, Benito Mirón; Gómez-Acebo, Inés; Ardanaz, Eva; Altzibar, Jone M; Peiro, Rosana; Tardon, Adonina; Lorca, José Andrés; Chirlaque, Maria Dolores; García-Palomo, Andrés; Jimenez-Moleon, Jose Juan; Ierssen, Trinidad; Ederra, Maria; Amiano, Pilar; Pollan, Marina; Moreno, Victor; Kogevinas, Manolis
Objectives Shift work that involves circadian disruption has been associated with a higher cancer risk. Most epidemiological studies to date have focused on breast cancer risk and evidence for other common tumors is limited. We evaluated the risk for colorectal cancer (CRC) in relation to shift work history in a population-based case-control study in Spain. Methods This analysis included 1626 incident CRC cases and 3378 randomly selected population controls of both sexes, enrolled in 11 regions of Spain. Sociodemographic and lifestyle information was assessed in face-to-face interviews. Shift work was assessed in detail throughout lifetime occupational history. We estimated the risk of colon and rectal cancer associated with rotating and permanent shift work (ever, cumulative duration, age of first exposure) using unconditional logistic regression analysis adjusting for potential confounders. Results Having ever performed rotating shift work (morning, evening and/or night) was associated with an increased risk for CRC [odds ratio (OR) 1.22, 95% confidence interval (95% CI) 1.04-1.43], as compared to day workers. Having ever worked permanent night shifts (≥3 nights/month) was not associated with CRC risk (OR 0.79, 95% CI 0.62-1.00). OR increased with increasing lifetime cumulative duration of rotating shift work (P-value for trend 0.005) and were highest among subjects in the top quartiles of exposure (3 rdquartile, 20-34 years, OR 1.38, 95%CI 1.06-1.81; 4 thquartile, ≥35 years, OR 1.36, 95% CI 1.02-1.79). Conclusions These data suggest that rotating shift work may increase the risk of CRC especially after long-term exposures.
Rotating Night-Shift Work and the Risk of Breast Cancer in the Nurses' Health Studies.
Wegrzyn, Lani R; Tamimi, Rulla M; Rosner, Bernard A; Brown, Susan B; Stevens, Richard G; Eliassen, A Heather; Laden, Francine; Willett, Walter C; Hankinson, Susan E; Schernhammer, Eva S
In 2007, the International Agency for Research on Cancer declared shift work that involved circadian disruption to be a "probable" carcinogen (group 2A), noting that human evidence was limited. Using data from 2 prospective cohort studies, the Nurses' Health Study (1988-2012; n = 78,516) and Nurses' Health Study II (1989-2013; n = 114,559), we examined associations between rotating night-shift work and breast cancer risk. In the 2 cohorts, there were a total of 9,541 incident invasive breast malignancies and 24 years of follow-up. In the Nurses' Health Study, women with 30 years or more of shift work did not have a higher risk of breast cancer (hazard ratio (HR) = 0.95, 95% confidence interval (95% CI): 0.77, 1.17; P for trend = 0.63) compared with those who never did shift work, although follow-up occurred primarily after retirement from shift work. Among participants in the Nurses' Health Study II, who were younger than participants in the other cohort, the risk of breast cancer was significantly higher in women with 20 years or more of shift work at baseline, reflecting young-adult exposure (HR = 2.15, 95% CI: 1.23, 3.73; P for trend = 0.23), and was marginally significantly higher for women with 20 years or more of cumulative shift work when we used updated exposure information (HR = 1.40, 95% CI: 1.00, 1.97; P for trend = 0.74). In conclusion, long-term rotating night-shift work was associated with a higher risk of breast cancer, particularly among women who performed shift work during young adulthood. Further studies should explore the role of shift work timing on breast cancer risk. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: email@example.com.
Turnos alternantes: fadiga mental de enfermagem Turnos alternantes: fatiga mental en enfermería Shift schedule: mental fatigue in nursing
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Maria Helena Palucci Marziale
tres unidades de internación diferentes de un hospital universitario. Los resultados sugieren que la alternancia existente entre los turnos es perjudicial a la salud y a la vida socio familiar y profesional de esas enfermeras, las cuales revelaron insatisfacción por el esquema de trabajo y presentaron síntomas y señales de fatiga mental. La incidencia de los síntomas fue mayor en la turno de la noche, si relacionado con el de la mañana, el cual por su vez, fue mayor que el de la tarde, comparados los valores del comiengo y del final de los turnos, evidenciándose con mayor frecuencia los síntomas de embotamiento y disturbios del sueño. Indicios de fatiga fueron detectados a través del Flicker en el siguiente orden: turno de la mañana mayor que el de la noche, siendo este último mayor que el de la tarde, cuando comparados los valores del comienzo y el final de los turnos. En contrapartida, en la verificación del tiempo de Reacción simple, los indicios de fatiga fueron presentados en el turno de la noche en frecuencia mayor que la del turno de la mañana, la cual fue mayor que la de la tarde.The goal of the present study was to detect signs and symptoms of mental fatigue in nurses working in the hospital with shift schedule. The signs and symptoms of mental fatigue were measured by a subjective indicator, composed of a check list and two objective indicators called critical frequency of light fusion (Flicker, and Reaction Time to auditive stimulus (RTs. During fifteen consecutive days, morning, afternoon and night shifts of 12 nurses working in three different units of a university hospital were analyzed. The great rotation in work schedule, when in just one week a nurse can work up to three different shifts, is hazardous to the health, social, familiar and professional life of those nurses, who were not satisfied with the work schedule adopted by the institution and showed signs and symptoms of mental fatigue. The incidence of symptoms was greater for the
Night-shift work, sleep duration, daytime napping, and breast cancer risk.
Wang, Pan; Ren, Fang-Mei; Lin, Ying; Su, Feng-Xi; Jia, Wei-Hua; Su, Xue-Fen; Tang, Lu-Ying; Ren, Ze-Fang
Sleep habits vary among different countries, and sleep problems may cause various health problems. The aim of our study was to evaluate the separate and combined associations of night-shift work, sleep duration, and daytime napping with breast cancer risk among the Chinese population. This study conducted face-to-face interviews with 712 women diagnosed with incident invasive breast cancer before treatment and 742 age-matched controls. Information on sleep habits, demographic characteristics, and suspected or established risk factors of breast cancer were collected from the two groups. Multivariate logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). Night-shift work was associated with an increased risk of breast cancer [OR (95% CI): 1.34 (1.05-1.72)]. Compared to women with a sleep duration of 6.1-8.9 h/day, women who had shorter [(≤6.0 h/day) (OR (95% CI): 1.53 (1.10-2.12)] and longer (≥9.0 h/day) sleep duration [(OR (95% CI): 1.59 (1.17-2.17)] had an increased risk of breast cancer. In addition, daytime napping was associated with a reduced risk of breast cancer among night-shift workers [OR (95% CI): 0.57 (0.36-0.90)], but no association was found among women who never had night-shift work [OR (95% CI): 1.01 (0.75-1.35)] (P for interaction = 0.054). Night-shift work and longer sleep duration also synergistically increased breast cancer risk [OR (95% CI): 3.69 (1.94-7.02)] (P for interaction = 0.009). Sleep problems, including night-shift work, and shorter and longer sleep duration, are associated with an increased breast cancer risk. In particular, the combined effects of night-shift work with no daytime napping or longer sleep duration are greater than the independent effects. Copyright © 2014 Elsevier B.V. All rights reserved.
Cancer Diagnosis Epigenomics Scientific Workflow Scheduling in the Cloud Computing Environment Using an Improved PSO Algorithm
N, Sadhasivam; R, Balamurugan; M, Pandi
Objective: Epigenetic modifications involving DNA methylation and histone statud are responsible for the stable maintenance of cellular phenotypes. Abnormalities may be causally involved in cancer development and therefore could have diagnostic potential. The field of epigenomics refers to all epigenetic modifications implicated in control of gene expression, with a focus on better understanding of human biology in both normal and pathological states. Epigenomics scientific workflow is essentially a data processing pipeline to automate the execution of various genome sequencing operations or tasks. Cloud platform is a popular computing platform for deploying large scale epigenomics scientific workflow. Its dynamic environment provides various resources to scientific users on a pay-per-use billing model. Scheduling epigenomics scientific workflow tasks is a complicated problem in cloud platform. We here focused on application of an improved particle swam optimization (IPSO) algorithm for this purpose. Methods: The IPSO algorithm was applied to find suitable resources and allocate epigenomics tasks so that the total cost was minimized for detection of epigenetic abnormalities of potential application for cancer diagnosis. Result: The results showed that IPSO based task to resource mapping reduced total cost by 6.83 percent as compared to the traditional PSO algorithm. Conclusion: The results for various cancer diagnosis tasks showed that IPSO based task to resource mapping can achieve better costs when compared to PSO based mapping for epigenomics scientific application workflow. Creative Commons Attribution License
The effect of Stokes shift in the discrimination of urine of cervical cancer from normal subjects
Rajasekaran, Ramu; Brindha, Elumalai; Aruna, Prakasa Rao; Koteeswaran, Dornadula; Ganesan, Singaravelu
Stokes shift spectroscopy has been considered as a potential tool in characterization of multiple components present in tissues and biofluids. Since, the intensity and resolution of the fluorophores depends on the Stokes shift, different opinion has been reflected by the researchers in fixing the Stokes shift. Also, not many studies have been reported on the characterization of biofluids and especially on the diagnosis of cancer. Urine is considered as an important diagnostic biofluid as it is rich in many metabolites where many of them are native fluorophores. In this study, we aimed at characterizing the urine of normal subjects and patients with cervical cancer as function of different Stokes shift. It is observed that Neopterin and Riboflavin are the main fluorophores contribute to the variation between normal and cervical cancer subjects. Ratio variables based linear discriminant analysis shows that the Stokes shift of 40 nm and 60 nm may be considered for better characterization with better signal to noise ratio when compared to others.
Night-shift work and breast cancer--a systematic review and meta-analysis.
Ijaz, Sharea; Verbeek, Jos; Seidler, Andreas; Lindbohm, Marja-Liisa; Ojajärvi, Anneli; Orsini, Nicola; Costa, Giovanni; Neuvonen, Kaisa
The aim of this review was to synthesize the evidence on the potential relationship between nightshift work and breast cancer. We searched multiple databases for studies comparing women in shift work to those with no-shift work reporting incidence of breast cancer. We calculated incremental risk ratios (RR) per five years of night-shift work and per 300 night shift increases in exposure and combined these in a random effects dose-response meta-analysis. We assessed study quality in ten domains of bias. We identified 16 studies: 12 case-control and 4 cohort studies. There was a 9% risk increase per five years of night-shift work exposure in case-control studies [RR 1.09, 95% confidence interval (95% CI) 1.02-1.20; I (2) = 37%, 9 studies], but not in cohort studies (RR 1.01, 95% CI 0.97-1.05; I (2) = 53%, 3 studies). Heterogeneity was significant overall (I (2) = 55%, 12 studies). Results for 300 night shifts were similar (RR 1.04, 95% CI 1.00-1.10; I (2) = 58%, 8 studies). Sensitivity analysis using exposure transformations such as cubic splines, a fixed-effect model, or including only better quality studies did not change the results. None of the 16 studies had a low risk of bias, and 6 studies had a moderate risk. Based on the low quality of exposure data and the difference in effect by study design, our findings indicate insufficient evidence for a link between night-shift work and breast cancer. Objective prospective exposure measurement is needed in future studies.
Associations among rotating night shift work, sleep and skin cancer in Nurses' Health Study II participants.
Heckman, Carolyn J; Kloss, Jacqueline D; Feskanich, Diane; Culnan, Elizabeth; Schernhammer, Eva S
Night shift work and sleep duration have been associated with breast and other cancers. Results from the few prior studies of night shift work and skin cancer risk have been mixed and not fully accounted for other potentially important health-related variables (eg, sleep characteristics). This study evaluated the relationship between rotating night shift work and skin cancer risk and included additional skin cancer risk factors and sleep-related variables. The current study used data from 74 323 Nurses' Health Study (NHS) II participants. Cox proportional hazards models were used to estimate multivariable-adjusted HRs and 95% CIs for skin cancers across categories of shift work and sleep duration. Over 10 years of follow-up, 4308 basal cell carcinoma (BCC), 334 squamous cell carcinoma (SCC) and 212 melanoma cases were identified. Longer duration of rotating night shifts was associated with a linear decline in risk of BCC (HR=0.93, 95% CI 0.90 to 0.97 per 5-year increase). Shift work was not significantly associated with either melanoma (HR=1.02, 95% CI 0.86 to 1.21) or SCC (HR=0.92, 95% CI 0.80 to 1.06). A short sleep duration (≤6 hours per day) was associated with lower risks of melanoma (HR=0.68, 95% CI 0.46 to 0.98) and BCC (HR=0.93, 95% CI 0.86 to 1.00) compared with the most common report of 7 hours. SCC was not associated with duration of sleep (HR=0.94, 95% CI 0.83 to 1.06). Longer duration of rotating night shift work and shorter sleep duration were associated with lower risk of some skin cancers. Further research is needed to confirm and identify the mechanisms underlying these associations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Do night and around-the-clock firefighters' shift schedules induce deviation in tau from 24 hours of systolic and diastolic blood pressure circadian rhythms?
Reinberg, Alain E; Smolensky, Michael H; Riedel, Marc; Riedel, Cedric; Brousse, Eric; Touitou, Yvan
Systolic (S) and diastolic (D) blood pressures (BP) [SBP and DBP] are circadian rhythmic with period (τ) in healthy persons assumed to be maintained at 24.0h. We tested this assumption in a sample of 30 healthy career (mean >12 yrs) 30-to-46 yr-old male Caucasian French firefighters (FFs) categorized into three groups according to work schedule and duties: Group A - 12 FFs working 12h day, 12h night, and occasionally 24h shifts and whose primary duties are firefighting plus paramedical and road rescue services; Group B - 9 FFs working mostly 12h day and 12h night shifts and whose duties are answering incoming emergency calls and coordinating service vehicle dispatch from fire stations with Group A personnel; Group C - 9 day shift (09:00-17:00h) FFs charged with administrative tasks. SBP and DBP, both in winter and in summer studies of the same FFs, were sampled by ambulatory BP monitoring every 1h between 06:00-23:00h and every 2h between 23:01-05:59h, respectively, their approximate off-duty wake and sleep spans, for 7 consecutive days. Activity (wrist actigraphy) was also sampled at 1-min intervals. Prominent τ of each variable was derived by a power spectrum program written for unequal-interval time series data, and between-group differences in incidence of τ≠24h of FFs were assessed by chi square test. Circadian rhythm disruption (τ≠24h) of either the SBP or DBP rhythm occurred almost exclusively in night and 24h shift FFs of Group A and B, but almost never in day shift FFs of Group C, and it was not associated with altered τ from 24.0h of the circadian activity rhythm. In summer, occurrence of τ≠24 for FFs of Group A and B differed from that for FFs of Group C in SBP (p=0.042) and DBP (p=0.015); no such differences were found in winter (p>0.10). Overall, manifestation of prominent τ≠24h of SBP or DBP time series was greater in summer than winter, 27.6% versus 16.7%, when workload of Group B FFs, i.e. number of incoming emergency telephone
Rectal cancer patients' quality of life with a temporary stoma: shifting perspectives.
Neuman, Heather B; Park, Jason; Fuzesi, Sarah; Temple, Larissa K
Patients with rectal cancer who have a temporary ostomy report good quality of life despite identifying a number of stoma-related difficulties. This study aimed to qualitatively explore the experiences of patients with rectal cancer who have a temporary ileostomy to better understand the discordant findings of previous quantitative quality-of-life studies. We conducted in-depth qualitative interviews with patients with stage I to III rectal cancer who underwent sphincter-preserving surgery that resulted in a temporary ileostomy. Twenty-six patients (54% male, median age 54) participated. Sixty-five percent had stage III disease, and 88% received neoadjuvant therapy. Interviews examined preoperative expectations, overall experience, and stoma impact on quality of life. With the use of grounded theory, 2 investigators independently performed line-by-line content analysis to identify key themes. Analysis continued until data saturation. Two major themes were identified: stoma-related difficulties and perceived response shift. Patients reported difficulty in exercise, sleep, social activities, sexuality, and clothing. Patients' perception of quality of life with a temporary stoma appears to have undergone a response shift through recalibration of their standards for measuring quality of life (internal measurement scale altered by side effects of neoadjuvant/adjuvant treatment, temporary nature of stoma, and accommodation to stoma) and reconceptualization of what "good quality of life" is (stoma difficulties were felt to be less important in comparison with cancer-related mortality). Although qualitative research is, by design, not generalizable, these data support our previous quantitative work. This convergence of findings suggests that our data may be representative. A temporary ileostomy represents significant difficulties for patients with rectal cancer. However, because of response shift, these difficulties may not be perceived as important to overall quality of
A Bayesian adaptive phase I-II trial design for optimizing the schedule of therapeutic cancer vaccines.
Cunanan, Kristen M; Koopmeiners, Joseph S
Phase I-II clinical trials refer to the class of designs that evaluate both the safety and efficacy of a novel therapeutic agent in a single trial. Typically, Phase I-II oncology trials take the form of dose-escalation studies, where initial subjects are treated at the lowest dose level and subsequent subjects are treated at progressively higher doses until the optimal dose is identified. While dose-escalation designs are well-motivated in the case of traditional chemotherapeutic agents, an alternate approach may be considered for therapeutic cancer vaccines, where an investigator's main objective is to evaluate the safety and efficacy of a set of dosing schedules or adjuvant combinations rather than to compare the safety and efficacy of progressively higher dose levels. We present a two-stage, Bayesian adaptive Phase I-II trial design to evaluate the safety and efficacy of therapeutic cancer vaccines. In the first stage, we determine whether a vaccination schedule achieves a minimum level of performance by comparing the toxicity and immune response rates to historical benchmarks. Vaccination schedules that achieve a minimum level of performance are compared using their magnitudes of immune response. If the superiority of a single schedule cannot be established after the first stage, Bayesian posterior predictive probabilities are used to determine the additional sample size required to identify the optimal vaccination schedule in a second stage. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Randomized Trial of a Pre-Surgical Scheduled Reduced Smoking Intervention for Patients Newly Diagnosed with Cancer
Ostroff, Jamie S.; Burkhalter, Jack E.; Cinciripini, Paul M.; Li, Yuelin; Shiyko, Mariya P.; Lam, Cho Y.; Hay, Jennifer L.; Dhingra, Lara K.; Lord-Bessen, Jennifer; Holland, Susan M.; Manna, Ruth
Objective Cancer patients are advised to quit smoking to reduce treatment complications and future cancer risk. This study's main objective was to evaluate the efficacy of a novel, pre-surgical cessation intervention in newly diagnosed cancer patients scheduled for surgical hospitalization. Methods We conducted a parallel-arm, randomized controlled trial comparing the efficacy of our hospital-based, tobacco cessation "best practices" treatment model (BP; cessation counseling and nicotine replacement therapy) with BP enhanced by a behavioral tapering regimen (scheduled reduced smoking; BP+SRS) administered by a handheld computer before hospitalization for surgery. Cessation outcomes were short (hospital admission and three months) and longer-term (6 months) biochemically-verified smoking abstinence. We hypothesized that BP+SRS would be superior to BP alone. One hundred eighty-five smokers were enrolled. Results Overall, 7-day-point prevalence, confirmed abstinence rates at six months for BP alone (32%) and BP+SRS (32%) were high; however, no main effect of treatment was observed. Patients who were older and diagnosed with lung cancer were more likely to quit smoking. Conclusions Compared to best practices for treating tobacco dependence, a pre-surgical, scheduled reduced smoking intervention did not improve abstinence rates among newly diagnosed cancer patients. PMID:23895203
The Air Traffic Controller Work-Shift Scheduling Problem in Spain from a Multiobjective Perspective: A Metaheuristic and Regular Expression-Based Approach
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Faustino Tello
Full Text Available We address an air traffic control operator (ATCo work-shift scheduling problem. We consider a multiple objective perspective where the number of ATCos is fixed in advance and a set of ATCo labor conditions have to be satisfied. The objectives deal with the ATCo work and rest periods and positions, the structure of the solution, the number of control center changes, or the distribution of the ATCo workloads. We propose a three-phase problem-solving methodology. In the first phase, a heuristic is used to derive infeasible initial solutions on the basis of templates. Then, a multiple independent run of the simulated annealing metaheuristic is conducted aimed at reaching feasible solutions in the second phase. Finally, a multiple independent simulated annealing run is again conducted from the initial feasible solutions to optimize the objective functions. To do this, we transform the multiple to single optimization problem by using the rank-order centroid function. In the search processes in phases 2 and 3, we use regular expressions to check the ATCo labor conditions in the visited solutions. This provides high testing speed. The proposed approach is illustrated using a real example, and the optimal solution which is reached outperforms an existing template-based reference solution.
Nested case-control study of night shift work and breast cancer risk among women in the Danish military.
Hansen, Johnni; Lassen, Christina F
Growing but limited evidence suggests that night shift work is associated with breast cancer. The authors conducted a nationwide case-control study nested within a cohort of 18,551 female military employees born in 1929-1968 to investigate the risk for breast cancer after night shift work and to explore the role of leisure time sun exposure and diurnal preference. The authors documented 218 cases of breast cancer (1990-2003) and selected 899 age-matched controls from the cohort by incidence density sampling. Information on shift work, sun exposure habits, diurnal preference and other potential confounders was obtained from a structured questionnaire. ORs were estimated by multivariate conditional logistic regression. Overall, the authors observed an adjusted OR of 1.4 (95% CI 0.9 to 2.1) among women with ever compared with never night shifts. The RR for breast cancer tended to increase with increasing number of years of night shift work (p=0.03) and with cumulative number of shifts (p=0.02),with a neutral risk for fewer than three night shifts per week. The OR for the group with the highest tertile of cumulative exposure was 2.3 (95% CI 1.2 to 4.6). The most pronounced effect of night shift work on breast cancer risk was observed in women with morning chronotype preference and intense night shifts (OR=3.9, 95% CI 1.6 to 9.5). Night shift workers tended to sunbathe more frequently than day workers. The results indicate that frequent night shift work increases the risk for breast cancer and suggest a higher risk with longer duration of intense night shifts. Women with morning preference who worked on night shifts tended to have a higher risk than those with evening preference.
A New Model for Predicting Acute Mucosal Toxicity in Head-and-Neck Cancer Patients Undergoing Radiotherapy With Altered Schedules
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Strigari, Lidia, E-mail: email@example.com [Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Rome (Italy); Pedicini, Piernicola [Department of Medical Physics, Regional Cancer Hospital C.R.O.B, Rionero in Vulture (Italy); D' Andrea, Marco [Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Rome (Italy); Pinnaro, Paola; Marucci, Laura; Giordano, Carolina [Department of Radiotherapy, Regina Elena National Cancer Institute, Rome (Italy); Benassi, Marcello [Department of Medical Physics, Istituto Scientifico Romagnolo per lo Studio e la Cura dei tumori, Meldola (Italy)
Purpose: One of the worst radiation-induced acute effects in treating head-and-neck (HN) cancer is grade 3 or higher acute (oral and pharyngeal) mucosal toxicity (AMT), caused by the killing/depletion of mucosa cells. Here we aim to testing a predictive model of the AMT in HN cancer patients receiving different radiotherapy schedules. Methods and Materials: Various radiotherapeutic schedules have been reviewed and classified as tolerable or intolerable based on AMT severity. A modified normal tissue complication probability (NTCP) model has been investigated to describe AMT data in radiotherapy regimens, both conventional and altered in dose and overall treatment time (OTT). We tested the hypothesis that such a model could also be applied to identify intolerable treatment and to predict AMT. This AMT NTCP model has been compared with other published predictive models to identify schedules that are either tolerable or intolerable. The area under the curve (AUC) was calculated for all models, assuming treatment tolerance as the gold standard. The correlation between AMT and the predicted toxicity rate was assessed by a Pearson correlation test. Results: The AMT NTCP model was able to distinguish between acceptable and intolerable schedules among the data available for the study (AUC = 0.84, 95% confidence interval = 0.75-0.92). In the equivalent dose at 2 Gy/fraction (EQD2) vs OTT space, the proposed model shows a trend similar to that of models proposed by other authors, but was superior in detecting some intolerable schedules. Moreover, it was able to predict the incidence of {>=}G3 AMT. Conclusion: The proposed model is able to predict {>=}G3 AMT after HN cancer radiotherapy, and could be useful for designing altered/hypofractionated schedules to reduce the incidence of AMT.
Sleep disruption, chronotype, shift work, and prostate cancer risk and mortality: a 30-year prospective cohort study of Finnish twins.
Dickerman, Barbra A; Markt, Sarah C; Koskenvuo, Markku; Hublin, Christer; Pukkala, Eero; Mucci, Lorelei A; Kaprio, Jaakko
Sleep disruption and shift work have been associated with cancer risk, but epidemiologic evidence for prostate cancer remains limited. We aimed to prospectively investigate the association between midlife sleep- and circadian-related parameters and later prostate cancer risk and mortality in a population-based cohort of Finnish twins. Data were drawn from the Older Finnish Twin Cohort and included 11,370 twins followed from 1981 to 2012. Over the study period, 602 incident cases of prostate cancer and 110 deaths from prostate cancer occurred. Cox regression was used to evaluate associations between midlife sleep duration, sleep quality, chronotype, and shift work with prostate cancer risk and prostate cancer-specific mortality. Within-pair co-twin analyses were employed to account for potential familial confounding. Compared to "definite morning" types, "somewhat evening" types had a significantly increased risk of prostate cancer (HR 1.3; 95 % CI 1.1, 1.6). Chronotype significantly modified the relationship between shift work and prostate cancer risk (p-interaction shift work and prostate cancer risk in the overall analyses and no significant association between any sleep- or circadian-related parameter and risk in co-twin analyses. Neither sleep- nor circadian-related parameters were significantly associated with prostate cancer-specific mortality. The association between sleep disruption, chronotype, and shift work with prostate cancer risk and mortality has never before been studied in a prospective study of male twins. Our findings suggest that chronotype may be associated with prostate cancer risk and modify the association between shift work and prostate cancer risk. Future studies of circadian disruption and prostate cancer should account for this individual-level characteristic.
Breast cancer risk and night shift work in a case-control study in a Spanish population.
Papantoniou, Kyriaki; Castaño-Vinyals, Gemma; Espinosa, Ana; Aragonés, Nuria; Pérez-Gómez, Beatriz; Ardanaz, Eva; Altzibar, Jone Miren; Sanchez, Vicente Martin; Gómez-Acebo, Inés; Llorca, Javier; Muñoz, David; Tardón, Adonina; Peiró, Rosana; Marcos-Gragera, Rafael; Pollan, Marina; Kogevinas, Manolis
Epidemiologic and animal data indicate that night shift work might increase the risk for breast cancer. We evaluated the association of night work with different clinical types of breast cancer in a population based case-control study (MCC-Spain study) taking into account chronotype, an individual characteristic that may relate to night shift work adaptation. Lifetime occupational history was assessed by face-to-face interviews and shift work information was available for 1708 breast cancer cases and 1778 population controls from 10 Spanish regions, enrolled from 2008 to 2013. We evaluated three shift work domains, including shift work type (permanent vs rotating), lifetime cumulative duration and frequency. We estimated odds ratios (OR) for night work compared to day work using unconditional logistic regression models adjusting for confounders. Having ever worked permanent or rotating night shift was associated with an increased risk for breast cancer compared to day workers [odds ratio (OR) 1.18; 95 % CI 0.97, 1.43]. Chronotype was differentially associated with breast cancer depending on the duration of night shift work. Risk was higher in women with invasive tumors (OR 1.23; 95 % CI 1.00, 1.51) and for estrogen and progestagen positive tumors among premenopausal women (OR 1.44; 95 % CI 1.05, 1.99). Having ever performed night shift was associated with a small increased risk for breast cancer and especially in subgroups of women with particular hormone related characteristics.
Gemcitabine and cisplatin in locally advanced and metastatic bladder cancer; 3- or 4-week schedule?
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Als, Anne Birgitte; Sengeløv, Lisa; Von Der Maase, Hans
BACKGROUND: Chemotherapy with gemcitabine and cisplatin (GC) is an active regimen in advanced transitional cell carcinoma (TCC). Traditionally, GC has been administered as a 4-week schedule. However, an alternative 3-week schedule may be more feasible. Long-term survival data for the alternative 3......-week schedule and comparisons of the feasibility and toxicity between the two schedules have not previously been published. MATERIAL AND METHODS: We performed a retrospective analysis of patients with stage IV TCC, treated with GC by a standard 4-week or by an alternative 3-week schedule. RESULTS...
Theoretical and Experimental Estimations of Volumetric Inductive Phase Shift in Breast Cancer Tissue
González, C. A.; Lozano, L. M.; Uscanga, M. C.; Silva, J. G.; Polo, S. M.
Impedance measurements based on magnetic induction for breast cancer detection has been proposed in some studies. This study evaluates theoretical and experimentally the use of a non-invasive technique based on magnetic induction for detection of patho-physiological conditions in breast cancer tissue associated to its volumetric electrical conductivity changes through inductive phase shift measurements. An induction coils-breast 3D pixel model was designed and tested. The model involves two circular coils coaxially centered and a human breast volume centrally placed with respect to the coils. A time-harmonic numerical simulation study addressed the effects of frequency-dependent electrical properties of tumoral tissue on the volumetric inductive phase shift of the breast model measured with the circular coils as inductor and sensor elements. Experimentally; five female volunteer patients with infiltrating ductal carcinoma previously diagnosed by the radiology and oncology departments of the Specialty Clinic for Women of the Mexican Army were measured by an experimental inductive spectrometer and the use of an ergonomic inductor-sensor coil designed to estimate the volumetric inductive phase shift in human breast tissue. Theoretical and experimental inductive phase shift estimations were developed at four frequencies: 0.01, 0.1, 1 and 10 MHz. The theoretical estimations were qualitatively in agreement with the experimental findings. Important increments in volumetric inductive phase shift measurements were evident at 0.01MHz in theoretical and experimental observations. The results suggest that the tested technique has the potential to detect pathological conditions in breast tissue associated to cancer by non-invasive monitoring. Further complementary studies are warranted to confirm the observations.
Shift work disorder: overview and diagnosis.
Roth, Thomas
Shift work disorder is a type of sleep disorder that occurs when an individual is unable to successfully synchronize his or her internal clock with a work schedule that requires staying awake and working when it is dark and sleeping when it is light. Approximately 10% of shift workers suffer from this disorder, which seriously impairs their ability to function. Shift work disorder is associated with increased risk of gastrointestinal problems, cancer, depression, heart disease, excessive sleepiness and accidents, and decreased productivity. This report describes the prevalence, diagnostic criteria, differential diagnosis, and clinical consequences of shift work disorder to help clinicians recognize this impairing condition. © Copyright 2012 Physicians Postgraduate Press, Inc.
Noninvasive discrimination between human normal and cancer cells by analysis of intracellular distribution of phase-shift data.
Takagi, Mutsumi; Tokunaga, Naochika
Aiming to establish a method for the noninvasive discrimination of cancer cells from normal cells in adherent culture, we investigated to employ all phase shift data for all pixels inside a cell. The bird's-eye views of phase shifts of human prostate epithelial cells (PRECs) and human prostatic carcinoma epithelial cell (PC-3) lines acquired by phase-shifting laser microscopy showed tableland and cone shapes, respectively, while treatment of PRECs with cytochalasin D resulted in the cone shape. So, the profile of phase shift in both sections towards the x- and y-axes of the views through the peaks of the phase shifts in PRECs and PC-3 cells were trapezoid-like and triangle-like, respectively. Typical profiles of phase shifts in a section in PRECs or PC-3 cells were calculated by averaging from 10 cells and smoothing. Cancer index is defined as the deduction of sums of the squared difference between a real cell and the typical profiles for a PREC and a PC-3 cell. The cancer indices for PC-3 and hepatocellular carcinoma cell lines were positive, while those for PRECs and human normal cryopreserved hepatocytes were negative. Cancer indices along the major axis of fibroblast-like cells of normal mesenchymal stem cells and the osteosarcoma cell line were negative and positive, respectively. Consequently, several cancer cells could be noninvasively discriminated from normal cells by calculating the cancer index employing phase shift for all pixels inside the cells.
Differentiation of cancerous and normal brain tissue using label free fluorescence and Stokes shift spectroscopy
Zhou, Yan; Wang, Leana; Liu, Cheng-hui; He, Yong; Yu, Xinguang; Cheng, Gangge; Wang, Peng; Shu, Cheng; Alfano, Robert R.
In this report, optical biopsy was applied to diagnose human brain cancer in vitro for the identification of brain cancer from normal tissues by native fluorescence and Stokes shift spectra (SSS). 77 brain specimens including three types of human brain tissues (normal, glioma and brain metastasis of lung cancers) were studied. In order to observe spectral changes of fluorophores via fluorescence, the selected excitation wavelength of UV at 300 and 340 nm for emission spectra and a different Stokes Shift spectra with intervals Δλ = 40 nm were measured. The fluorescence spectra and SSS from multiple key native molecular markers, such as tryptophan, collagen, NADH, alanine, ceroid and lipofuscin were observed in normal and diseased brain tissues. Two diagnostic criteria were established based on the ratios of the peak intensities and peak position in both fluorescence and SSS spectra. It was observed that the ratio of the spectral peak intensity of tryptophan (340 nm) to NADH (440 nm) increased in glioma, meningioma (benign), malignant meninges tumor, and brain metastasis of lung cancer tissues in comparison with normal tissues. The ratio of the SS spectral peak (Δλ = 40 nm) intensities from 292 nm to 366 nm had risen similarly in all grades of tumors.
Detection of cervical cancer by fluorescence emission and stokes' shift spectra of blood and urine
Masilamani, V.; Vijmasi, T.; AlSalhi, M.; Govindarajan, K.; VijayaRaghavan, A. P.; Rai, Ram Rathan
In this paper we present the results of a study to distinguish cervical cancer patients [ N=50] from healthy subjects [N=50] based on the Fluorescence Emission Spectra [FES] and Stokes' Shift Spectra [SSS] of blood and urine. FES was obtained from the cellular fraction of blood and urine by excitation at 400 nm. SSS was obtained from blood plasma and urine with Δλ of 70nm. In the FES of blood cellular fraction, the ratio of intensity of the two bands due to neutral porphyrin and basic porphyrin [I630 / I580] was 1 for normal controls and 3 for cervical cancers. In the SSS of plasma, the average ratio of intensity of the two bands due to tryptophan and collagen [I305 nm / I340 nm] was 1.9 for normal controls, 1.1 for early cervical cancers and 0.9 for advanced cervical cancers In the SSS of urine, the ratio of intensity of the two bands due to flavin and NADH [I450 nm / I360 nm] was 0.2 for normal controls and 0.8 for cancer patients. A discriminant analysis combining all three parameters showed a sensitivity of 80% and specificity of 78% for this technique. In this study we show that fluorescence spectroscopy of blood and urine could develop into a promising technique for non-invasive diagnosis and screening of cervical cancers and would appropriately supplement or complement currently used techniques.
Night Shift Work and Breast Cancer Incidence: Three Prospective Studies and Meta-analysis of Published Studies.
Travis, Ruth C; Balkwill, Angela; Fensom, Georgina K; Appleby, Paul N; Reeves, Gillian K; Wang, Xiao-Si; Roddam, Andrew W; Gathani, Toral; Peto, Richard; Green, Jane; Key, Timothy J; Beral, Valerie
It has been proposed that night shift work could increase breast cancer incidence. A 2007 World Health Organization review concluded, mainly from animal evidence, that shift work involving circadian disruption is probably carcinogenic to humans. We therefore aimed to generate prospective epidemiological evidence on night shift work and breast cancer incidence. Overall, 522 246 Million Women Study, 22 559 EPIC-Oxford, and 251 045 UK Biobank participants answered questions on shift work and were followed for incident cancer. Cox regression yielded multivariable-adjusted breast cancer incidence rate ratios (RRs) and 95% confidence intervals (CIs) for night shift work vs no night shift work, and likelihood ratio tests for interaction were used to assess heterogeneity. Our meta-analyses combined these and relative risks from the seven previously published prospective studies (1.4 million women in total), using inverse-variance weighted averages of the study-specific log RRs. In the Million Women Study, EPIC-Oxford, and UK Biobank, respectively, 673, 28, and 67 women who reported night shift work developed breast cancer, and the RRs for any vs no night shift work were 1.00 (95% CI = 0.92 to 1.08), 1.07 (95% CI = 0.71 to 1.62), and 0.78 (95% CI = 0.61 to 1.00). In the Million Women Study, the RR for 20 or more years of night shift work was 1.00 (95% CI = 0.81 to 1.23), with no statistically significant heterogeneity by sleep patterns or breast cancer risk factors. Our meta-analysis of all 10 prospective studies included 4660 breast cancers in women reporting night shift work; compared with other women, the combined relative risks were 0.99 (95% CI = 0.95 to 1.03) for any night shift work, 1.01 (95% CI = 0.93 to 1.10) for 20 or more years of night shift work, and 1.00 (95% CI = 0.87 to 1.14) for 30 or more years. The totality of the prospective evidence shows that night shift work, including long-term shift work, has little or no effect on
Prostate cancer and quality of life: analysis of response shift using triangulation between methods.
Serdà I Ferrer, Bernat-Carles; Valle, Arantza Del; Marcos-Gragera, Rafael
Quality of life (QoL) after prostate cancer treatment is uncertain. Patient responses to QoL questions shift for a number of reasons: measurement intervals no longer have the same psychological anchors (recalibration), the importance attributed to different QoL domains changes over time (reprioritization), and the definition of QoL differs throughout the disease continuum (reconceptualization). Therefore, the aim of this study was to describe QoL response shift in a cohort of 66 men with prostate cancer. The method involved carrying out a sequential triangulation between quantitative and qualitative methods. Patients were assessed at baseline (P1), followed by a posttest (P2) and a then-test measurement (P3). The difference between P3 and P1 was used to determine the response shift effect (recalibration). From baseline to posttest, QoL significantly decreased. The recalibration then-test confirmed a low QoL in all periods evaluated. Coping mechanisms were found to differ by age group, with older men less concerned about side effects than younger men. Health professionals should be alert to QoL changes over time and possible side effects, should coping skills fail. Copyright 2014, SLACK Incorporated.
Association between shift work and risk of prostate cancer: a systematic review and meta-analysis of observational studies.
Gan, Yong; Li, Liqing; Zhang, Liangwen; Yan, Shijiao; Gao, Chao; Hu, Sai; Qiao, Yan; Tang, Sha; Wang, Chao; Lu, Zuxun
Observational studies suggest that shift work may be associated with prostate cancer. However, the results are inconsistent. The objective of this study is to quantitatively assess the association between shift work and the risk of prostate cancer. Relevant studies were identified by a comprehensive search of the PubMed, Embase, Web of Science, and China National Knowledge Infrastructure databases to September 2017. We also reviewed the reference lists from retrieved articles. Observational studies that reported relative risk (RR) with 95% confidence intervals (CIs) for the association between shift work and the risk of prostate cancer were included. A linear and nonlinear dose-response meta-analysis was performed. Fifteen studies with 16 independent reports involving 2,546,822 individuals and 10,715 patients with prostate cancer were included. The pooled adjusted RR for the association between ever exposure to shift work and prostate cancer risk was 1.23 (95% CI, 1.08-1.41; Pshift work was identified (P for nonlinearity=0.001). Subgroup analysis demonstrated that a higher pooled RR of prostate cancer for studies among Asian populations (RR=1.98, 95% CI, 1.34-2.93; P=0.618). A positive association was observed in rotating shift groups (RR=1.10, 95% CI, 1.00-1.26; P=0.156), but not in other shift groups. Integrated evidence from this meta-analysis suggests that shift work is significantly associated with an increased risk of prostate cancer, and a nonlinear association between duration of shift work and prostate cancer was found. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.com.
Schedule-dependent therapeutic effects of gemcitabine combined with uracil-tegafur in a human pancreatic cancer xenograft model.
Tsujie, Masanori; Nakamori, Shoji; Nakahira, Shin; Takeda, Setsuo; Takahashi, Yuji; Hayashi, Nobuyasu; Okami, Jiro; Nagano, Hiroaki; Dono, Keizo; Umeshita, Koji; Sakon, Masato; Monden, Morito
Gemcitabine is taken up by cells mainly via human equilibrative nucleoside transporter 1 (hENT1). Pretreatment of cancer cell lines with 5-fluorouracil (5-FU) leads to an increase in the expression of hENT1 and augments the effect of single-agent gemcitabine treatment in vitro. The purpose of the present study was to evaluate the relationship between the schedules of gemcitabine/uracil-tegafur (UFT) combination therapy and their effects in pancreatic cancer in vivo. The expression level of hENT1 mRNA was examined using 6 types of human pancreatic cancer cell lines treated with 5-FU and MiaPaCa-2 xenograft tumors in BALB/c nu/nu mice treated with UFT. A [H] gemcitabine cellular uptake assay was performed using MiaPaCa-2 cells treated with 5-FU. We compared the effects of 6 different schedules of treatment using UFT and/or gemcitabine on MiaPaCa-2 xenograft tumors. MiaPaCa-2 cell line was one of the lines that showed the highest rate of 5-FU-induced increase in the hENT1 mRNA level. Gemcitabine uptake was significantly increased when cells were treated with 5-FU. Treatment with UFT significantly increased the hENT1 mRNA expression in MiaPaCa-2 tumors. A significant growth inhibition of MiaPaCa-2 tumors was observed in the mice treated with UFT followed by gemcitabine as compared with either untreated mice or UFT alone-treated mice. Our results suggest that the schedule in which the gemcitabine is administered after UFT may be the optimal combination for gemcitabine/UFT treatment in pancreatic cancer.
A meta-analysis on dose-response relationship between night shift work and the risk of breast cancer.
Wang, F; Yeung, K L; Chan, W C; Kwok, C C H; Leung, S L; Wu, C; Chan, E Y Y; Yu, I T S; Yang, X R; Tse, L A
This study aimed to conduct a systematic review to sum up evidence of the associations between different aspects of night shift work and female breast cancer using a dose-response meta-analysis approach. We systematicly searched all cohort and case-control studies published in English on MEDLINE, Embase, PSYCInfo, APC Journal Club and Global Health, from January 1971 to May 2013. We extracted effect measures (relative risk, RR; odd ratio, OR; or hazard ratio, HR) from individual studies to generate pooled results using meta-analysis approaches. A log-linear dose-response regression model was used to evaluate the relationship between various indicators of exposure to night shift work and breast cancer risk. Downs and Black scale was applied to assess the methodological quality of included studies. Ten studies were included in the meta-analysis. A pooled adjusted relative risk for the association between 'ever exposed to night shift work' and breast cancer was 1.19 [95% confidence interval (CI) 1.05-1.35]. Further meta-analyses on dose-response relationship showed that every 5-year increase of exposure to night shift work would correspondingly enhance the risk of breast cancer of the female by 3% (pooled RR = 1.03, 95% CI 1.01-1.05; Pheterogeneity breast cancer risk. This systematic review updated the evidence that a positive dose-response relationship is likely to present for breast cancer with increasing years of employment and cumulative shifts involved in the work.
Aberrant Splicing in Cancer: Mediators of Malignant Progression through an Imperfect Splice Program Shift.
Luz, Felipe Andrés Cordero; Brígido, Paula Cristina; Moraes, Alberto Silva; Silva, Marcelo José Barbosa
Although the efforts to understand the genetic basis of cancer allowed advances in diagnosis and therapy, little is known about other molecular bases. Splicing is a key event in gene expression, controlling the excision of introns decoded inside genes and being responsible for 80% of the proteome amplification through events of alternative splicing. Growing data from the last decade point to deregulation of splicing events as crucial in carcinogenesis and tumor progression. Several alterations in splicing events were observed in cancer, caused by either missexpression of or detrimental mutations in some splicing factors, and appear to be critical in carcinogenesis and key events during tumor progression. Notwithstanding, it is difficult to determine whether it is a cause or consequence of cancer and/or tumorigenesis. Most reviews focus on the generated isoforms of deregulated splicing pattern, while others mainly summarize deregulated splicing factors observed in cancer. In this review, events associated with carcinogenesis and tumor progression mainly, and epithelial-to-mesenchymal transition, which is also implicated in alternative splicing regulation, will be progressively discussed in the light of a new perspective, suggesting that splicing deregulation mediates cell reprogramming in tumor progression by an imperfect shift of the splice program. © 2016 S. Karger AG, Basel.
DEFF Research Database (Denmark)
Brewer, Robert S.; Verdezoto, Nervo; Holst, Thomas
in a student dormitory and found that players did not shift their electricity use, because they were unwilling to change their schedules and found it easier to focus on reducing electricity use. Based on our findings, we discuss the implications for encouraging shifting, and also the challenges of integrating......Modern electrical grids are increasingly reliant on generation from renewable sources that can vary from hour to hour. This variability has led to the desire to shift the times of the day when electricity is consumed to better match generation. One way to achieve these shifts is by encouraging...... people to change their behavior at home. Leveraging prior research on encouraging reductions in residential energy use through game play, we introduce ShareBuddy: a casual mobile game intended to encourage players not only to reduce, but also to shift their electricity use. We conducted two field studies...
Short-term effects of night shift work on breast cancer risk: a cohort study of payroll data.
Vistisen, Helene Tilma; Garde, Anne Helene; Frydenberg, Morten; Christiansen, Peer; Hansen, Åse Marie; Andersen, Johnni; Bonde, Jens Peter E; Kolstad, Henrik A
Objectives The objective was to examine if night shift work is a short-term risk factor for breast cancer, including combined estrogen receptor (ER) and human epidermal growth factor 2 (HER2) breast cancer subtypes. Methods The cohort comprised 155 540 public sector female workers in Denmark who were followed from 2007-2012. Day-to-day work-hour information was available from payroll registers and 1245 incident cases of breast cancer were identified in national cancer registries together with receptor subtype information. Results A rate ratio (RR) of 0.90 [95% confidence interval (95% CI) 0.80-1.01] was observed for workers ever working night shifts during the follow-up period compared with workers only working day shifts after adjustment for age, age at first child, parity, family history of breast or ovarian cancer, sex hormones, medications related to alcoholism, family educational level, mammography screening, and other potential confounders. Comparable results were seen for the inception population of employees with first recorded employment after 2007. Modestly increased RR were suggested for breast cancer subtypes characterized by a positive HER2 status irrespective of ER status. Conclusions These findings do not support an overall short-term effect of night shift work on breast cancer risk. Future studies should explore further the impact of HER2 status.
Transoral surgery for laryngo-pharyngeal cancer - The paradigm shift of the head and cancer treatment.
Tateya, Ichiro; Shiotani, Akihiro; Satou, Yasuo; Tomifuji, Masayuki; Morita, Shuko; Muto, Manabu; Ito, Juichi
Transoral surgery is a less invasive treatment that is becoming a major strategy in the treatment of laryngo-pharyngeal cancer. It is a minimally invasive approach that has no skin incision and limits the extent of tissue dissection, disruption of speech and swallowing muscles, blood loss, damage to major neurovascular structures, and injury to normal tissue. Transoral approaches to the laryngo-pharynx, except for early glottis cancer, had been limited traditionally to tumors that can be observed directly and manipulated with standard instrumentation and lighting. Since the 1990s, transoral laser microsurgery (TLM) has been used as an organ preservation strategy with good oncological control and good functional results, although it has not been widely used because of its technical difficulty. Recently, transoral robotic surgery (TORS) is becoming popular as a new treatment modality for laryngo-pharyngeal cancer, and surgical robots are used widely in the world since United States FDA approval in 2009. In spite of the global spread of TORS, it has not been approved by the Japan FDA, which has led to the development of other low-cost transoral surgical techniques in Japan. Transoral videolaryngoscopic surgery (TOVS) was developed as a new transoral surgery system for laryngo-pharyngeal lesions to address the problems of TLM. In TOVS, a rigid endoscope is used to visualize the surgical field instead of a microscope and the advantages of TOVS include the wide operative field and working space achieved using the distending laryngoscope and videolaryngoscope. Also, with the spread of narrow band imaging (NBI), endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), which are widely used for superficial cancers in the gastrointestinal tract, have been applied for the superficial laryngo-pharyngeal cancer. Both EMR and ESD are performed mainly by gastroenterologists with a sharp dissector and magnifying endoscopy (ME)-NBI with minimal surgical margin
Wives' Shift Work Schedules and Husbands' and Wives' Well-Being in Dual-Earner Couples with Children: A within-Couple Analysis
Chait Barnett, Rosalind; Gareis, Karen C.; Brennan, Robert T.
In a sample of 55 dual-earner families with children aged 8 to 14 in which the mothers are registered nurses regularly working either day shifts (typically 7:00 a.m. to 3:00 p.m.) or evening shifts (typically 3:00 p.m. to 11:00 p.m.), we estimated the within-couple relationship between the wife's work variables (i.e., work shift, work hours, and…
Response to Dr Stevens' letter ref. Visitisen et al: "Short-term effects of night shift work on breast cancer risk: a cohort study of payroll data"
DEFF Research Database (Denmark)
Kolstad, Henrik A; Garde, Anne Helene; Hansen, Åse Marie
We thank Dr Richard Stevens for his comments (1) on our recent article that showed no increased risk of breast cancer following recent night shift work when compared with recent day shift work (2). This finding was based on linkage of day-by-day information on working hours and breast cancer...... definitions of shifts affect the risk of breast cancer, which will be possible using this type of data. We only had information on working hours from 2007 and onwards, and night shift work prior to 2007 could have confounded our analyses towards no effect but only if inversely associated with night shift work...... rather robust evidence of no short-term breast cancer risk following recent night shift work. It must, however, be stressed that data did not allow assessment of a possible long-term risk. Reference 1. Stevens R. Letter ref. Vitisen et al: "Short-term effects of night shift work on breast cancer risk...
Psychosocial aspects of work and health in the North Sea oil and gas industry. Pt. 3: Sleep, mood, and performance in relation to offshore shift rotation schedules. Pt. 4: The offshore environment in the mid-1990s: a survey of psychosocial factors
Energy Technology Data Exchange (ETDEWEB)
This report describes a study of offshore shift rotation patterns, the aim of which was to compare fixed-shift and rollover schedules in terms of sleep, mood, and cognitive performance. Two rollover patterns, night followed by days (7N + 7D) and days followed by nights (7D + 7N), and one fixed-shift pattern in which day and night shifts were worked on alternate tours (14D + 14N), were studied. Data were collected on four North Sea oil and gas platforms. For analysis purposes, the two-week work cycle was divided into three test phases, each covering three consecutive shifts. Prior to the first two phases, ``practice`` shifts (during which data were collected but not analysed) were scheduled, and phases were separated by one or two ``rest`` shifts (during which no data were collected). Assessments were carried out at the start, middle, and end of each test shift. (author)
Flotillin-1 protein is upregulated in human endometrial cancer and localization shifts from epithelial to stromal with increasing tumor grade.
Winship, Amy Louise; Rainczuk, Kate; Dimitriadis, Evdokia
Endometrial cancer is the most common invasive gynecological malignancy. Flotillin-1 is an integral membrane protein and estrogen responsive gene. Flotillin-1 expression and localization in human endometrial cancers grades 1-3 was investigated using real-time RT-PCR and immunohistochemistry. Flotillin-1 mRNA levels were unchanged in endometrial cancer versus benign endometrium. Flotillin-1 protein was significantly reduced in the epithelial compartment with increasing tumor grade, although levels increased in the tumor stroma across grades. We have identified a novel factor in human endometrial cancer and observed a shift in epithelial to stromal localization with increasing tumor grade in women.
Scheduling delay in suspected cases of oral cancer Atraso de agendamento em casos suspeitos de câncer bucal
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Luciana Meneses Souza
Full Text Available The objective of the study was to evaluate scheduling delay of dental exams in the city of São Paulo of patients suspected of having oral cancer. A cross-sectional study was performed in which telephone conversations simulated clinical situations that represented two types of patients: one presenting symptoms suggestive of oral cancer (CA, and another one suggesting the need for prostheses (PR. The scheduling delay was evaluated by the days until an appointment for care; and among public offices, by type of schedule (emergency or routine. Negative binomial regression was used (95% statistical significance. Five hundred and seventy-five public and private dental offices participated in the study. The mean scheduling delay for the CA group was 2.88 days, and for the PR group, 4.34 days (p = 0.01. The mean scheduling delay was shorter in private dental offices (2.59 days than in offices that accepted health insurance (2.74 days (p = 0.01; the delay was shorter when performed by the dentist rather than by the dental assistant, 2.45 versus 4.21 days (p = 0.01. In public services, 69% of patients in the cancer group were sent to the emergency service. Dental services were accessible for scheduling clinical examinations among patients suspected of having oral cancer.O objetivo do estudo foi avaliar o atraso de agendamento de pacientes com suspeita de câncer bucal aos exames odontológicos na cidade de São Paulo. Realizou-se estudo transversal, em que conversações telefônicas simularam situações clínicas, representando dois tipos de pacientes-padrão: um com sintomas sugestivos de câncer bucal e outro com necessidade de prótese. O atraso do agendamento foi avaliado pelo tempo de agendamento para a consulta e, no caso de estabelecimentos públicos, pelo tipo de agendamento (rotina ou urgência. Utilizou-se regressão binomial negativa (95% de nível de significância. Participaram do estudo 575 estabelecimentos públicos e privados. O tempo m
Collagen Matrix Density Drives the Metabolic Shift in Breast Cancer Cells
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Brett A. Morris
Full Text Available Increased breast density attributed to collagen I deposition is associated with a 4–6 fold increased risk of developing breast cancer. Here, we assessed cellular metabolic reprogramming of mammary carcinoma cells in response to increased collagen matrix density using an in vitro 3D model. Our initial observations demonstrated changes in functional metabolism in both normal mammary epithelial cells and mammary carcinoma cells in response to changes in matrix density. Further, mammary carcinoma cells grown in high density collagen matrices displayed decreased oxygen consumption and glucose metabolism via the tricarboxylic acid (TCA cycle compared to cells cultured in low density matrices. Despite decreased glucose entry into the TCA cycle, levels of glucose uptake, cell viability, and ROS were not different between high and low density matrices. Interestingly, under high density conditions the contribution of glutamine as a fuel source to drive the TCA cycle was significantly enhanced. These alterations in functional metabolism mirrored significant changes in the expression of metabolic genes involved in glycolysis, oxidative phosphorylation, and the serine synthesis pathway. This study highlights the broad importance of the collagen microenvironment to cellular expression profiles, and shows that changes in density of the collagen microenvironment can modulate metabolic shifts of cancer cells.
Shift work that involves circadian disruption and breast cancer: a first application of chronobiological theory and the consequent challenges.
Fritschi, Lin; Valérie Groß, J; Wild, Ursula; Heyworth, Jane S; Glass, Deborah C; Erren, Thomas C
In 2007, the International Agency for Research on Cancer classified shift work involving circadian disruption (CD) as probably carcinogenic to humans. Circadian disruption could be conceptualised as the overlap of activity, such as work, with an individual's biological night. The latter can be approximated from a worker's chronotype (or morning/evening preference). Few previous studies have taken chronotype into account when assessing CD caused by shift work. Our objective was to test the hypothesis that women working during their biological night would be at increased risk of breast cancer. We used data from our case-control study of breast cancer to investigate associations between shift work involving CD and breast cancer risks. Previously, we had assumed that everyone working in jobs which involved work for two or more shifts between midnight and 05:00 hours was equally exposed to CD. In the present analyses, we reclassified as unexposed those who had a late chronotype in which their preferred bedtime was 2 hours after the end of their shift. Only 30 of 1385 night jobs changed classification and the overall finding (OR 1.17, 95% CI 0.98 to 1.41) was not different to the original finding when chronotype was not considered. We found virtually no difference between our new and old classifications of exposure. However, we were not able to calculate the total number of chronodisrupted shifts over a lifetime in order to assess dose and nor were we able to determine how many women were exposed to CD when doing shifts which began before midnight. Our first practical application highlights challenges for future chronobiology-based research. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Self-reported shift work, recall bias, and belief about disease causation in a case-control study of breast cancer.
Lizama, Natalia; Heyworth, Jane; Thomson, Allyson; Slevin, Terry; Fritschi, Lin
Recall bias is a potential source of misclassification in case-control studies. Studies have shown that the association between exposure and disease can differ according to participants' beliefs or knowledge about the effect of that exposure on disease. We investigated the association between belief about breast cancer causation and self-reported shift work exposure in a case-control study. Women completed a questionnaire asking whether they believed that shift work caused cancer either before or after reporting their history of shift work. We measured: whether belief modified the association between reported shift work and disease; whether belief was associated with reported shift work exposure; and whether being prompted to recall shift work exposure was associated with an increased likelihood of believing that shift work increased breast cancer risk. There was a significant association between believing shift work increased breast cancer risk and reporting exposure to shift work. Being prompted to recall shift work was not associated with a belief that shift work increased risk. The association between pre-existing belief about breast cancer risk and reported shift work is likely to be due to exposed individuals believing that exposure increases risk, rather than resulting from recall bias. Copyright © 2017 Elsevier Ltd. All rights reserved.
Association of primary tumour FDG uptake with clinical, histopathological and molecular characteristics in breast cancer patients scheduled for neoadjuvant chemotherapy
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Koolen, B.B.; Aukema, T.S. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Surgical Oncology, Amsterdam (Netherlands); Vrancken Peeters, M.J.T.F.D.; Rutgers, E.J.T. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Surgical Oncology, Amsterdam (Netherlands); Wesseling, J.; Lips, E.H. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Pathology and Experimental Therapy, Amsterdam (Netherlands); Vogel, W.V.; Valdes Olmos, R.A. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Werkhoven, E. van [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Biometrics, Amsterdam (Netherlands); Gilhuijs, K.G.A. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Radiology, Amsterdam (Netherlands); University Medical Centre Utrecht, Department of Radiology, Utrecht (Netherlands); Rodenhuis, S. [Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Medical Oncology, Amsterdam (Netherlands)
The aim of this study was to evaluate the association of primary tumour {sup 18}F-fluorodeoxyglucose (FDG) uptake with clinical, histopathological and molecular characteristics of breast cancer patients scheduled for neoadjuvant chemotherapy. Second, we wished to establish for which patients pretreatment positron emission tomography (PET)/CT could safely be omitted because of low FDG uptake. PET/CT was performed in 214 primary stage II or III breast cancer patients in the prone position with hanging breasts. Tumour FDG uptake was qualitatively evaluated to determine the possibility of response monitoring with PET/CT and was quantitatively assessed using maximum standardized uptake values (SUV{sub max}). FDG uptake was compared with age, TNM stage, histology, hormone and human epidermal growth factor receptor 2 status, grade, Ki-67 and molecular subtype in univariable and multivariable analyses. In 203 tumours (95 %) FDG uptake was considered sufficient for response monitoring. No subgroup of patients with consistently low tumour FDG uptake could be identified. In a univariable analysis, SUV{sub max} was significantly higher in patients with distant metastases at staging examination, non-lobular carcinomas, tumours with negative hormone receptors, triple negative tumours, grade 3 tumours, and in tumours with a high proliferation index (Ki-67 expression). After multiple linear regression analysis, triple negative and grade 3 tumours were significantly associated with a higher SUV{sub max}. Primary tumour FDG uptake in breast cancer patients scheduled for neoadjuvant chemotherapy is significantly higher in tumours with prognostically unfavourable characteristics. Based on tumour characteristics associated with low tumour FDG uptake, this study was unable to identify a subgroup of patients unlikely to benefit from pretreatment PET/CT. (orig.)
Analysis of polymorphisms in the circadian-related genes and breast cancer risk in Norwegian nurses working night shifts.
Zienolddiny, Shanbeh; Haugen, Aage; Lie, Jenny-Anne Sigstad; Kjuus, Helge; Anmarkrud, Kristine Haugen; Kjærheim, Kristina
Some studies have suggested that night work may be associated with an increased risk of breast cancer in nurses. We aimed to explore the role of circadian gene polymorphisms in the susceptibility to night work-related breast cancer risk. We conducted a nested case-control study of Norwegian nurses comprising 563 breast cancer cases and 619 controls within a cohort of 49,402 Norwegian nurses ages 35 to 74 years. We studied 60 single-nucleotide polymorphisms (SNPs) in 17 genes involved in the regulation of the circadian rhythm in cases and controls. The data were analyzed in relation to the two exposure variables "maximum number of consecutive night shifts ever worked" and "maximum number of consecutive night shifts worked for at least 5 years." The odds of breast cancer associated with each SNP was calculated in the main effects analysis and in relation to night shift work. The statistically significant odds ratios were tested for noteworthiness using two Bayesian tests: false positive report probability (FPRP) and Bayesian false discovery probability (BFDP). In the main effects analysis, CC carriers of rs4238989 and GG carriers of rs3760138 in the AANAT gene had increased risk of breast cancer, whereas TT carriers of BMAL1 rs2278749 and TT carriers of CLOCK rs3749474 had reduced risk. The associations were found to be noteworthy using both the FPRP and BFDP tests. With regard to the effect of polymorphisms and night work, several significant associations were observed. After applying FPRP and BFDP in women with at least four night shifts, an increased risk of breast cancer was associated with variant alleles of SNPs in the genes AANAT (rs3760138, rs4238989), BMAL1 (rs2290035, rs2278749, rs969485) and ROR-b (rs3750420). In women with three consecutive night shifts, a reduced risk of breast cancer was associated with carriage of variant alleles of SNPs in CLOCK (rs3749474), BMAL1 (rs2278749), BMAL2 (rs2306074), CSNK1E (rs5757037), NPAS2 (rs17024926), ROR-b (rs3903529
Comparison of accelerated and rapid schedules for monovalent hepatitis B and combined hepatitis A/B vaccines in children with cancer.
Köksal, Yavuz; Varan, Ali; Aydin, G Burca; Sari, Neriman; Yazici, Nalan; Yalcin, Bilgehan; Kutluk, Tezer; Akyuz, Canan; Büyükpamukçu, Münevver
The aim of this study was to determine the efficacy of immunization against hepatitis A and B infections with "rapid" or "accelerated" schedules in children with cancer receiving chemotherapy. Fifty-one children were recruited to receive either vaccination schedule, in the "rapid vaccination schedule"; hepatitis B (group I) or combined hepatitis A/B vaccines (group III) were administered at months 0, 1, 2, and 12; in the "accelerated vaccination schedule," hepatitis B (group II) or combined hepatitis A/B (group IV) vaccines were administered on days 0, 7, 21, and 365 intramuscularly. The seroconversion rates at months 1 and 3 were 35.7 and 57.1% in group I and 25 and 18.8% in group II, respectively. Group I developed higher seroconversion rates at month 3. In group III the seroconversion rates for hepatitis B at months 1 and 3 were 54.5 and 60% and in group IV 50 and 70%, respectively. For hepatitis A, the seroconversion rates at months 1 and 3 were 81.8 and 90% in group III and 80 and 88.9% in group IV, respectively. The accelerated vaccination schedule seems to have no advantage in children receiving cancer chemotherapy except for high antibody levels at month 1. In conclusion, the accelerated vaccination schedules are not good choices for cancer patients. The combined hepatitis A/B vaccine is more effective than monovalent vaccine in cancer patients, which probably can be explained by an adjuvant effect of the antigens. The seroconversion of hepatitis A by the combined hepatitis A/B vaccination is very good in cancer patients.
Association of shift-work, daytime napping, and nighttime sleep with cancer incidence and cancer-caused mortality in Dongfeng-tongji cohort study.
Bai, Yansen; Li, Xiaoliang; Wang, Ke; Chen, Shi; Wang, Suhan; Chen, Zhuowang; Wu, Xiulong; Fu, Wenshan; Wei, Sheng; Yuan, Jing; Yao, Ping; Miao, Xiaoping; Zhang, Xiaomin; He, Meian; Yang, Handong; Wu, Tangchun; Guo, Huan
Few studies investigated the combined effects of night-shift work, daytime napping, and nighttime sleep on cancer incidence and mortality. A total of 25,377 participants were included in this study. Information on sleep habits, cancer incidences, and mortalities were collected. Cox proportional hazards models were used to calculate the adjusted hazard ratios and 95% confidence intervals (HRs, 95%CIs). Male subjects experienced ≥20 years of night-shift work, or without daytime napping had an increased risk of cancer, when compared with males who did not have night-shift work or napped for 1-30 min [HR (95%CI) = 1.27 (1.01-1.59) and 2.03 (1.01-4.13), respectively]. Nighttime sleep for ≥10 h was associated with a separate 40% and 59% increased risk of cancer [HR (95%CI) = 1.40 (1.04-1.88)] and cancer-caused mortality [HR (95%CI) = 1.59 (1.01-2.49)] than sleep for 7-8 h/night. Combined effects of three sleep habits were further identified. Male participants with at least two above risk sleep habits had a 43% increased risk of cancer [HR (95%CI) = 1.43 (1.07-2.01)] and a 2.07-fold increased cancer-caused mortality [HR (95%CI) = 2.07 (1.25-3.29)] than those who did not have any above risk sleep habits. However, no significant associations were observed among women. Long night-shift work history, without daytime napping, and long nighttime sleep duration were independently and jointly associated with higher cancer incidence among males. KEY MESSAGES Night-shift work of ≥20 years, without napping, and nighttime sleep of ≥10 h were associated with increased cancer incidence. Nighttime sleep ≥10 h was associated with a 2.07-fold increased cancer-caused mortality among males. Combined effects of night-shift work ≥20 years, without napping, and nighttime sleep ≥10 h on increasing cancer incidence were existed among males.
Shift work and cancer risk: potential mechanistic roles of circadian disruption, light at night, and sleep deprivation.
Haus, Erhard L; Smolensky, Michael H
Shift work that includes a nighttime rotation has become an unavoidable attribute of today's 24-h society. The related disruption of the human circadian time organization leads in the short-term to an array of jet-lag-like symptoms, and in the long-run it may contribute to weight gain/obesity, metabolic syndrome/type II diabetes, and cardiovascular disease. Epidemiologic studies also suggest increased cancer risk, especially for breast cancer, in night and rotating female shift workers. If confirmed in more controlled and detailed studies, the carcinogenic effect of night and shift work will constitute additional serious medical, economic, and social problems for a substantial proportion of the working population. Here, we examine the possible multiple and interconnected cancer-promoting mechanisms as a consequence of shift work, i.e., repeated disruption of the circadian system, pineal hormone melatonin suppression by exposure to light at night, sleep-deprivation-caused impairment of the immune system, plus metabolic changes favoring obesity and generation of proinflammatory reactive oxygen species. Copyright © 2012 Elsevier Ltd. All rights reserved.
Early detection of disease and scheduling of screening examinations.
Lee, Sandra; Huang, Hui; Zelen, Marvin
Special examinations exist for many chronic diseases, which can diagnose the disease while it is asymptomatic, with no signs or symptoms. The earlier detection of disease may lead to more cures or longer survival. This possibility has led to public health programs which recommend populations to have periodic screening examinations for detecting specific chronic diseases, for example, cancer, diabetes, cardiovascular disease and so on. Such examination schedules when embedded in a public health program are invariably costly and are ordinarily not chosen on the basis of possible trade-offs in costs and benefits for different screening schedules. The possible candidate number of examination schedules is so large that it is not feasible to carry out clinical trials to compare different schedules. Instead, this problem can be investigated by developing a theoretical model which can predict the eventual disease specific mortality for different examination schedules. We have developed such a model. It is a stochastic model which assumes that i) the natural history of the disease is progressive and ii) any benefit from earlier diagnosis is due to a change in the distribution of disease stages at diagnosis (stage shift). The model is general and can be applied to any chronic disease which satisfies our two basic assumptions. We discuss the basic ideas of schedule sensitivity and lifetime schedule sensitivity and its relation to the reduction in disease specific mortality. Our theory is illustrated by applications to breast cancer screening. The investigation of schedules compares not only examination schedules with equal intervals between examinations but also staggered schedules using the threshold method. (Examinations are carried out when an individual's risk status reaches a preassigned threshold value.).
Harmonious personnel scheduling
Fijn van Draat, Laurens; Post, Gerhard F.; Veltman, Bart; Winkelhuijzen, Wessel
The area of personnel scheduling is very broad. Here we focus on the 'shift assignment problem'. Our aim is to discuss how ORTEC HARMONY handles this planning problem. In particular we go into the structure of the optimization engine in ORTEC HARMONY, which uses techniques from genetic algorithms,
[Medical surveillance for shift and night work].
Roscelli, F
Shift and night work are recognized as risk factors for health and safety; they are related to a wide range of public health problems ranging from cardiovascular disease and cancer to mental disorders and accidents. Occupational health physicians should evaluate workers' fitness for shift and night work before their assignment, at regular intervals, and if health problems connected with shift work occur. The evaluation should be accompanied by a careful job analysis to ensure that shift schedules are arranged according to ergonomic criteria. This arrangement can reduce health problems and make coping with irregular working hours possible, even for people suffering from contraindicative illnesses. Both health disorders representing absolute or relative contraindication and actual work conditions should be taken into account. Health checks should be aimed at detecting early signs of intolerance, such as sleeping and digestive trouble, drug consumption, accidents, and female reproductive function problems.
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Magalhaes, Marcus V.; Fraga, Eder T. [PETROBRAS, Rio de Janeiro, RJ (Brazil); Shah, Nilay [Imperial College, London (United Kingdom)
This work addresses the refinery scheduling problem using mathematical programming techniques. The solution adopted was to decompose the entire refinery model into a crude oil scheduling and a product scheduling problem. The envelope for the crude oil scheduling problem is composed of a terminal, a pipeline and the crude area of a refinery, including the crude distillation units. The solution method adopted includes a decomposition technique based on the topology of the system. The envelope for the product scheduling comprises all tanks, process units and products found in a refinery. Once crude scheduling decisions are Also available the product scheduling is solved using a rolling horizon algorithm. All models were tested with real data from PETROBRAS' REFAP refinery, located in Canoas, Southern Brazil. (author)
Different Schedule-Dependent Effects of Epigenetic Modifiers on Cytotoxicity by Anticancer Drugs in Colorectal Cancer Cells.
Hosokawa, Mika; Tanaka, Shota; Ueda, Kumiko; Iwakawa, Seigo
Limited information is currently available on how to apply epigenetic modifiers to current colorectal cancer (CRC) chemotherapy. The purpose of this study is to clarify the schedule-dependent effects of combined treatment with conventional anticancer drugs and epigenetic modifiers in human CRC cells. Cytotoxicity in 4 CRC cell lines (SW480, HT29, SW48, and HCT116) was measured using the WST-8 assay. As epigenetic modifiers, 3 DNA methyltransferase (DNMT) inhibitors such as decitabine (DAC), azacytidine (AC), and zebularine (Zeb), and 3 histone deacetylase (HDAC) inhibitors including trichostatin A (TSA), suberoylanilide hydroxamic acid (SAHA), and valproic acid (VPA) were used. Combination effects were analyzed by the isobologram method. SW480 cells showed the lowest sensitivity to the anticancer drugs 5-fluorouracil, SN-38 (the active form of irinotecan), and oxaliplatin. In SW480 cells, epigenetic modifiers other than VPA showed the most significant synergistic effects when used before anticancer drugs, while VPA showed synergistic effects in co- or post-treatment. In the 3 other CRC cells, synergistic effects were less frequent and weaker. The dose of anticancer drugs may be reduced by combining epigenetic modifiers in SW480 cells, which are less sensitive to anticancer drugs, unlike the more sensitive HT29, SW48, and HCT116 cell lines. These results provide useful information for understanding how to incorporate epigenetic modifiers into current CRC chemotherapy.
Cancer treatment scheduling and dynamic heterogeneity in social dilemmas of tumour acidity and vasculature.
Kaznatcheev, Artem; Vander Velde, Robert; Scott, Jacob G; Basanta, David
Tumours are diverse ecosystems with persistent heterogeneity in various cancer hallmarks like self-sufficiency of growth factor production for angiogenesis and reprogramming of energy metabolism for aerobic glycolysis. This heterogeneity has consequences for diagnosis, treatment and disease progression. We introduce the double goods game to study the dynamics of these traits using evolutionary game theory. We model glycolytic acid production as a public good for all tumour cells and oxygen from vascularisation via vascular endothelial growth factor production as a club good benefiting non-glycolytic tumour cells. This results in three viable phenotypic strategies: glycolytic, angiogenic and aerobic non-angiogenic. We classify the dynamics into three qualitatively distinct regimes: (1) fully glycolytic; (2) fully angiogenic; or (3) polyclonal in all three cell types. The third regime allows for dynamic heterogeneity even with linear goods, something that was not possible in prior public good models that considered glycolysis or growth factor production in isolation. The cyclic dynamics of the polyclonal regime stress the importance of timing for anti-glycolysis treatments like lonidamine. The existence of qualitatively different dynamic regimes highlights the order effects of treatments. In particular, we consider the potential of vascular normalisation as a neoadjuvant therapy before follow-up with interventions like buffer therapy.
Prostate cancer patients' quality of life assessments across the primary treatment trajectory: 'True' change or response shift?
Gerlich, Christian; Schuler, Michael; Jelitte, Matthias; Neuderth, Silke; Flentje, Michael; Graefen, Markus; Krüger, Alexander; Mehnert, Anja; Faller, Hermann
Background Self-report questionnaires are widely used to assess changes in quality of life (QoL) during the course of cancer treatment. However, comparing baseline scores to follow-up scores is only justified if patients' internal measurement standards have not changed over time, that is, no response shift occurred. We aimed to examine response shift in terms of reconceptualization, reprioritization and recalibration among prostate cancer patients. Material and methods We included 402 newly diagnosed patients (mean age 65 years) and assessed QoL at the beginning of cancer treatment and three months later. QoL was measured with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). We employed structural equation modeling testing measurement invariance between occasions to disentangle 'true' change and change in the measurement model (response shift). Results We found reprioritization effects for both the Physical Functioning and Role Functioning subscales of the EORTC QLQ-C30, indicating that both had gained importance for representing the latent construct of QoL at follow-up. These effects added to the worsening effect evident in the latent construct, thus rendering observed changes even more pronounced. In addition, we found recalibration effects for both the Emotional Functioning and Cognitive Functioning subscales indicating judgments becoming more lenient over time. These effects counteracted 'true' negative changes thus obscuring any substantial changes on the observed level. Conclusion Our results suggest that changes observed in some subscales of the EORTC QLQ-C30 should not be taken at face value as they may be affected by patients' changed measurement standards.
Paradigm shift in cancer treatment: Cancer treatment as a metabolic disease – fusion of Eastern and Western medicine
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Reo Hamaguchi
Full Text Available Current standard therapies for cancer, including surgery, anti-cancer drugs, and radiotherapy, are thought to contribute to the improvement in the survival rates of cancer patients. However, such standard therapies have 3 major problems: in advanced cancers, it is unlikely that standard cancer treatments will cure the disease; adverse side effects that accompany standard cancer treatments put many patients in distress; and a large amount of medical expenditure is required for new and expensive anti-cancer drugs. These problems may be viewed as a result of establishing treatments without any consideration regarding the root cause of the cancer. Otto Warburg suggested that particular changes in the energy metabolism of cells, which are associated with a shortage of oxygen, are the root cause of cancer. Cancer cells have unique metabolic characteristics, and thus we believe that it is important to treat cancer as a metabolic disease. More specifically, not only is it important to suppress cancer cell metabolism, but it is also important to improve the chronic inflammation that is associated with the development and progression of cancer, and to support the functions of immune cells. This type of view of cancer treatment coincides with the principles of Chinese medicine, which has a history of 4000 years, such as "fuzheng quxie" and "zhibing qiuben", which can assist in the establishment of cancer treatments for patients. In this article, we discuss cancer treatments from the view of cancer as a metabolic disease and their association with Chinese medicine, and introduce some clinical cases along with a review of the literature.
Phase-shift, stimuli-responsive perfluorocarbon nanodroplets for drug delivery to cancer.
Rapoport, Natalya
This review focuses on phase-shift perfluorocarbon nanoemulsions whose action depends on an ultrasound-triggered phase shift from a liquid to gas state. For drug-loaded perfluorocarbon nanoemulsions, microbubbles are formed under the action of tumor-directed ultrasound and drug is released locally into tumor volume in this process. This review covers in detail mechanisms involved in the droplet-to-bubble transition as well as mechanisms of ultrasound-mediated drug delivery. Copyright © 2012 Wiley Periodicals, Inc.
Fibulin-5 localisation in human endometrial cancer shifts from epithelial to stromal with increasing tumour grade, and silencing promotes endometrial epithelial cancer cell proliferation.
Winship, Amy Louise; Rainczuk, Kate; Ton, Amanda; Dimitriadis, Eva
Endometrial cancer is the most common invasive gynaecological malignancy. While endocrine, genetic and inflammatory factors are thought to contribute to its pathogenesis, its precise etiology and molecular regulators remain poorly understood. Fibulin-5 is an extracellular matrix (ECM) protein that inhibits cell growth and invasion in several cancer cell types and is downregulated in a number of types of human cancer. However, it is unknown whether fibulin-5 plays a role in endometrial tumourigenesis. In the current report, the expression and localisation of fibulin-5 in type I endometrioid human endometrial cancers of grades (G) 1-3 was investigated using reverse transcription-quantitative polymerase chain reaction and immunohistochemistry. Fibulin-5 mRNA was found to be significantly reduced in whole tumour tissues from women across G1-3 compared with benign endometrium (Pendometrial epithelial cancer cells expressing fibulin-5 stimulated cell adhesion and proliferation in vitro . Fibulin-5 mRNA expression in Ishikawa cells was induced by transforming growth factor-β and fibulin-5 in turn activated extracellular signal-regulated kinases (ERK1/2), suggesting that it may act via the mitogen-activated protein kinase pathway. In summary, the present study identified fibulin-5 as a downregulated ECM gene in human endometrial cancer and observed a shift from epithelial to stromal protein localisation with increasing tumour grade in women. These data suggest that loss of fibulin-5 function may promote endometrial cancer progression by enhancing epithelial cell adhesion and proliferation.
Adjuvant cyclophosphamide, methotrexate, and fluorouracil in premonopausal patients with node-positive breast cancer: indirect comparison of dose and schedule in DBCG trials 77, 82, and 89
DEFF Research Database (Denmark)
Ejlertsen, B.; Mouridsen, H.T.; Jensen, M.B.
Cancer Cooperative Group (DBCG), and two succeeding randomised trials in premenopausal patients with node positive breast cancer used three-weekly or four-weekly intravenous CMF in one of the treatment arms. RESULTS: Between November 1977 and January 2001 these trials included 2 213 patients who...... in premenopausal patients with node positive breast cancer when shifting from classical CMF to intravenous regimens with lower dose-intensity. Caution is required in the interpretation of these results due to the non-experimental study design Udgivelsesdato: 2008...
Letting the cat out of the bag: shifting practices of cancer disclosure in Singapore.
Tan, Melinda Si Yun; Narasimhalu, Kaavya; Ong, Simon Yew Kuang
Communication between patients and physicians is crucial in the disclosure of cancer diagnosis. Although westernisation of Asian societies has resulted in increased awareness of patient autonomy, the family continues to play an important influencing role in the disclosure process. Therefore, in this study, we aimed to characterise the experience of physicians with the disclosure of cancer diagnosis in a westernised Asian population. Oncologists at a tertiary hospital were approached to participate in this study. Information pertaining to the extent and approach to disclosure was collated. Logistic regression analysis was performed to characterise factors pertaining to the willingness of physicians to fully disclose a diagnosis of cancer. In all, 25 oncologists (mean age 38 years; 72% men) responded to the survey. A majority of oncologists disclosed a cancer diagnosis directly to the patient over the first few visits. The main reason behind partial or non-disclosure was family objection. Ordinal logistic regression analysis showed that family resistance was the only significant predictor of reluctance to disclose a cancer diagnosis (p = 0.01). In this pilot study, contrary to previous reports, we found that oncologists were more likely to disclose a diagnosis of cancer to the patient first, that they do not accede fully to the family's request for non-disclosure and that family resistance was the only significant predictor of reluctance to disclose a diagnosis of cancer.
Response to Dr Stevens' letter ref. Visitisen et al: "Short-term effects of night shift work on breast cancer risk: a cohort study of payroll data"
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Kolstad, Henrik A; Garde, Anne Helene; Hansen, Åse Marie
definitions of shifts affect the risk of breast cancer, which will be possible using this type of data. We only had information on working hours from 2007 and onwards, and night shift work prior to 2007 could have confounded our analyses towards no effect but only if inversely associated with night shift work......We thank Dr Richard Stevens for his comments (1) on our recent article that showed no increased risk of breast cancer following recent night shift work when compared with recent day shift work (2). This finding was based on linkage of day-by-day information on working hours and breast cancer...... incidence data. Results are thus less likely to have been biased by differential misclassification than findings from earlier studies relying on self-report (3). We defined a night shift as ≥3 hours of work between 24:00-05:00 hours and a day shift as ≥3 hours work between 6:00-20:00 hours. This day shift...
Cervical cancer screening in the era of HPV vaccination: A review of shifting paradigms in cytopathology.
Barroeta, Julieta E; Adhikari-Guragain, Deepti; Grotkowski, Carolyn E
Significant changes in cervical cancer screening practice, guidelines, and prevention of cervical cancer have taken place in recent years including the raising of initial cervical cancer screening age, changes in frequency of cytology screening, and the adoption of high risk HPV and cytology co-testing for some patients; the introduction of the bivalent, quadrivalent, and 9-valent HPV vaccines; and the recent approval of high risk HPV testing as primary screening with the use of cytology as triage in positive cases. This review discusses the significance of primary HPV screening, the impact of HPV vaccination in the prevalence of cervical cancer and its precursors, the interplay between high risk HPV testing and vaccination, and the implications for clinical and cytological management. Future strategies for cervical screening in the post-vaccination era are also discussed. © 2017 Wiley Periodicals, Inc.
Unravelling biology and shifting paradigms in cancer with single-cell sequencing.
Baslan, Timour; Hicks, James
The fundamental operative unit of a cancer is the genetically and epigenetically innovative single cell. Whether proliferating or quiescent, in the primary tumour mass or disseminated elsewhere, single cells govern the parameters that dictate all facets of the biology of cancer. Thus, single-cell analyses provide the ultimate level of resolution in our quest for a fundamental understanding of this disease. Historically, this quest has been hampered by technological shortcomings. In this Opinion article, we argue that the rapidly evolving field of single-cell sequencing has unshackled the cancer research community of these shortcomings. From furthering an elemental understanding of intra-tumoural genetic heterogeneity and cancer genome evolution to illuminating the governing principles of disease relapse and metastasis, we posit that single-cell sequencing promises to unravel the biology of all facets of this disease.
Evidence of Stage Shift in Women Diagnosed With Ovarian Cancer During Phase II of the United Kingdom Familial Ovarian Cancer Screening Study.
Rosenthal, Adam N; Fraser, Lindsay S M; Philpott, Susan; Manchanda, Ranjit; Burnell, Matthew; Badman, Philip; Hadwin, Richard; Rizzuto, Ivana; Benjamin, Elizabeth; Singh, Naveena; Evans, D Gareth; Eccles, Diana M; Ryan, Andy; Liston, Robert; Dawnay, Anne; Ford, Jeremy; Gunu, Richard; Mackay, James; Skates, Steven J; Menon, Usha; Jacobs, Ian J
Purpose To establish the performance of screening with serum cancer antigen 125 (CA-125), interpreted using the risk of ovarian cancer algorithm (ROCA), and transvaginal sonography (TVS) for women at high risk of ovarian cancer (OC) or fallopian tube cancer (FTC). Patients and Methods Women whose estimated lifetime risk of OC/FTC was ≥ 10% were recruited at 42 centers in the United Kingdom and underwent ROCA screening every 4 months. TVS occurred annually if ROCA results were normal or within 2 months of an abnormal ROCA result. Risk-reducing salpingo-oophorectomy (RRSO) was encouraged throughout the study. Participants were observed via cancer registries, questionnaires, and notification by centers. Performance was calculated after censoring 365 days after prior screen, with modeling of occult cancers detected at RRSO. Results Between June 14, 2007, and May 15, 2012, 4,348 women underwent 13,728 women-years of screening. The median follow-up time was 4.8 years. Nineteen patients were diagnosed with invasive OC/FTC within 1 year of prior screening (13 diagnoses were screen-detected and six were occult at RRSO). No symptomatic interval cancers occurred. Ten (52.6%) of the total 19 diagnoses were stage I to II OC/FTC (CI, 28.9% to 75.6%). Of the 13 screen-detected cancers, five (38.5%) were stage I to II (CI, 13.9% to 68.4%). Of the six occult cancers, five (83.3%) were stage I to II (CI, 35.9% to 99.6%). Modeled sensitivity, positive predictive value, and negative predictive value for OC/FTC detection within 1 year were 94.7% (CI, 74.0% to 99.9%), 10.8% (6.5% to 16.5%), and 100% (CI, 100% to 100%), respectively. Seven (36.8%) of the 19 cancers diagnosed cancers diagnosed > 1 year after screening ended (CI, 72.7% to 99.9%; P cancers diagnosed cancers subsequently diagnosed (CI, 46.5% to 90.3%; P = .09). Conclusion ROCA-based screening is an option for women at high risk of OC/FTC who defer or decline RRSO, given its high sensitivity and significant stage shift
Outcomes Associated With 3 Treatment Schedules of High-Dose-Rate Brachytherapy Monotherapy for Favorable-Risk Prostate Cancer
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Jawad, Maha Saada; Dilworth, Joshua T.; Gustafson, Gary S.; Ye, Hong; Wallace, Michelle [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Martinez, Alvaro [Michigan HealthCare Professionals/21" s" t Century Oncology, Farmington Hills, Michigan (United States); Chen, Peter Y. [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Krauss, Daniel J., E-mail: email@example.com [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States)
years. Conclusions: The acute and chronic toxicity profiles associated with these 3 HDR brachytherapy schedules were similar and were well tolerated. Acceptable grade 2, minimal grade 3, and no grade 4 or 5 toxicities were seen. This, combined with the fact that the clinical outcomes were similar, leads to the conclusion that all 3 regimens may be acceptable options for the management of low-risk to intermediate-risk prostate cancer.
Nontraditional work schedules for pharmacists.
Mahaney, Lynnae; Sanborn, Michael; Alexander, Emily
Nontraditional work schedules for pharmacists at three institutions are described. The demand for pharmacists and health care in general continues to increase, yet significant material changes are occurring in the pharmacy work force. These changing demographics, coupled with historical vacancy rates and turnover trends for pharmacy staff, require an increased emphasis on workplace changes that can improve staff recruitment and retention. At William S. Middleton Memorial Veterans Affairs Hospital in Madison, Wisconsin, creative pharmacist work schedules and roles are now mainstays to the recruitment and retention of staff. The major challenge that such scheduling presents is the 8 hours needed to prepare a six-week schedule. Baylor Medical Center at Grapevine in Dallas, Texas, has a total of 45 pharmacy employees, and slightly less than half of the 24.5 full-time-equivalent staff work full-time, with most preferring to work one, two, or three days per week. As long as the coverage needs of the facility are met, Envision Telepharmacy in Alpine, Texas, allows almost any scheduling arrangement preferred by individual pharmacists or the pharmacist group covering the facility. Staffing involves a great variety of shift lengths and intervals, with shifts ranging from 2 to 10 hours. Pharmacy leaders must be increasingly aware of opportunities to provide staff with unique scheduling and operational enhancements that can provide for a better work-life balance. Compressed workweeks, job-sharing, and team scheduling were the most common types of alternative work schedules implemented at three different institutions.
Vallières, Annie; Azaiez, Aïda; Moreau, Vincent; LeBlanc, Mélanie; Morin, Charles M
Shift work disorder involves insomnia and/or excessive sleepiness associated with the work schedule. The present study examined the impact of insomnia on the perceived physical and psychological health of adults working on night and rotating shift schedules compared to day workers. A total of 418 adults (51% women, mean age 41.4 years), including 51 night workers, 158 rotating shift workers, and 209 day workers were selected from an epidemiological study. An algorithm was used to classify each participant of the two groups (working night or rotating shifts) according to the presence or absence of insomnia symptoms. Each of these individuals was paired with a day worker according to gender, age, and income. Participants completed several questionnaires measuring sleep, health, and psychological variables. Night and rotating shift workers with insomnia presented a sleep profile similar to that of day workers with insomnia. Sleep time was more strongly related to insomnia than to shift work per se. Participants with insomnia in the three groups complained of anxiety, depression, and fatigue, and reported consuming equal amounts of sleep-aid medication. Insomnia also contributed to chronic pain and otorhinolaryngology problems, especially among rotating shift workers. Work productivity and absenteeism were more strongly related to insomnia. The present study highlights insomnia as an important component of the sleep difficulties experienced by shift workers. Insomnia may exacerbate certain physical and mental health problems of shift workers, and impair their quality of life. Copyright © 2014 Elsevier B.V. All rights reserved.
Pharmacokinetic and pharmacodynamic analysis of 5-aza-2'-deoxycytidine (decitabine in the design of its dose-schedule for cancer therapy
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Karahoca Metin
Full Text Available Abstract 5-Aza-2′-deoxycytidine (5-AZA-CdR, decitabine, an epigenetic drug that inhibits DNA methylation, is currently used to treat myelodysplastic syndrome (MDS, and is under investigation for treating acute myeloid leukemia (AML and other malignancies. 5-AZA-CdR can reactivate tumor suppressor genes silenced by aberrant DNA methylation, a frequent event in all types of cancer. Because this epigenetic change is reversible, it is a good target for 5-AZA-CdR therapy. We have reviewed the preclinical data of 5-AZA-CdR to analyze the concentrations and exposure times required to eradicate cancer stem cells. We analyzed the dose-schedules used in animal models that show potent antineoplastic activity of 5-AZA-CdR. We attempted to correlate the preclinical data with the responses obtained in clinical trials of 5-AZA-CdR in patients with cancer. The pharmacokinetics and drug distribution of 5-AZA-CdR are key parameters because adequate therapeutic drug levels are required to eliminate cancer stem cells in all anatomic compartments. The plasma half-life of 5-AZA-CdR in humans is approximately 20 minutes due to the high levels in the liver of cytidine deaminase, the enzyme that inactivates this analogue. This provides a rationale to use an inhibitor of cytidine deaminase in combination with 5-AZA-CdR. Low-dose 5-AZA-CdR is effective for MDS and AML and can induce complete remissions (CR. However, maintenance of CR with low-dose 5-AZA-CdR is difficult. Based on analyses of preclinical and clinical data, low dose 5-AZA-CdR has the potential to be an effective form of therapy in some patients with cancer. For patients who do not respond to low dose therapy we recommend dose-intensive treatment with 5-AZA-CdR. Patients who are candidates for intensive dose 5-AZA-CdR should have a good bone marrow status so as to permit adequate recovery from myelosuppression, the major toxicity of 5-AZA-CdR. Solid tumors are also interesting targets for therapy with 5
Ancestry-shift refinement mapping of the C6orf97-ESR1 breast cancer susceptibility locus.
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Simon N Stacey
Full Text Available We used an approach that we term ancestry-shift refinement mapping to investigate an association, originally discovered in a GWAS of a Chinese population, between rs2046210[T] and breast cancer susceptibility. The locus is on 6q25.1 in proximity to the C6orf97 and estrogen receptor alpha (ESR1 genes. We identified a panel of SNPs that are correlated with rs2046210 in Chinese, but not necessarily so in other ancestral populations, and genotyped them in breast cancer case:control samples of Asian, European, and African origin, a total of 10,176 cases and 13,286 controls. We found that rs2046210[T] does not confer substantial risk of breast cancer in Europeans and Africans (OR = 1.04, P = 0.099, and OR = 0.98, P = 0.77, respectively. Rather, in those ancestries, an association signal arises from a group of less common SNPs typified by rs9397435. The rs9397435[G] allele was found to confer risk of breast cancer in European (OR = 1.15, P = 1.2 x 10(-3, African (OR = 1.35, P = 0.014, and Asian (OR = 1.23, P = 2.9 x 10(-4 population samples. Combined over all ancestries, the OR was 1.19 (P = 3.9 x 10(-7, was without significant heterogeneity between ancestries (P(het = 0.36 and the SNP fully accounted for the association signal in each ancestry. Haplotypes bearing rs9397435[G] are well tagged by rs2046210[T] only in Asians. The rs9397435[G] allele showed associations with both estrogen receptor positive and estrogen receptor negative breast cancer. Using early-draft data from the 1,000 Genomes project, we found that the risk allele of a novel SNP (rs77275268, which is closely correlated with rs9397435, disrupts a partially methylated CpG sequence within a known CTCF binding site. These studies demonstrate that shifting the analysis among ancestral populations can provide valuable resolution in association mapping.
Ceasing intrathecal therapy in chronic non-cancer pain: an invitation to shift from biomedical focus to active management.
Directory of Open Access Journals (Sweden)
Chris Hayes
Full Text Available OBJECTIVE: To report long term experience (1997-2009 of intrathecal (IT therapy for chronic non-cancer pain in the context of our team's increasing emphasis on active management. DESIGN: Descriptive case series. SETTING: Australian tertiary multidisciplinary pain center, Hunter Integrated Pain Service (HIPS. INTERVENTION: This case series reports the changing use of IT implanted drug delivery systems (IDDSs for chronic non-cancer pain over 13 years. Initially IT therapy was used selectively following multidisciplinary assessment and double blind IT trial. Typical therapy combined opioid with clonidine. Multidimensional management was offered. Treatment strategy changed in 2003 due to HIPS experience of limited therapeutic gains and equivocal support for IT therapy in the literature. Subsequently IT therapy was no longer initiated for non-cancer pain and those on established regimes were encouraged to shift to oral/transdermal opioids with greater emphasis on active management. Patient education and consultation were key elements. Where IT cessation was elective gradual dose reduction commenced as an outpatient. In elective and urgent cases ketamine infusion and oral clonidine were used during hospital admissions to cover the switch to oral/transdermal opioids. Over the study period transition occurred to a broader management framework in which IT therapy for chronic non-cancer pain was no longer supported by HIPS. RESULTS: 25 patients were managed using IDDSs; 8 implanted by HIPS and 17 by other teams. Dose escalation and adverse effects were common. 24 of 25 patients ceased IT therapy; 7 (29% with urgent IDDS related complications, 16 (67% electively and 1 due to an unrelated death. The remaining patient returned to her original team to continue IT therapy. One post-explantation patient transferred to another team to recommence IT therapy. The remainder were successfully maintained on oral/transdermal opioids combined with active management.
Compact Stokes shift and fluorescence spectroscopic diagnostics LED ratiometer unit with no moving parts for cancer detection
Sordillo, Laura A.; Pu, Yang; Budansky, Yury; Alfano, R. R.
A compact Stokes shift and fluorescence spectroscopy (S3) LED device with no moving parts is presented. This device can be used diagnostically for the identification of the native biomolecules within cancerous tissue samples. This S3-LED ratiometer unit measures both the emission and absorption spectra of key native organic biomolecules within a tissue sample by using multiple wavelength LEDs (light emitting diodes) coupled to an optical fiber. Thus, an optical fingerprint of the sample can be obtained. This technique could be used to distinguish benign and malignant tissues, and to check for residual or recurrent carcinoma after treatment, thus reducing the necessity of second biopsies. The S3-LED ratiometer unit was tested in vitro on human breast malignant and normal paired tissue samples.
Response to Dr Stevens' letter ref. Visitisen et al: "Short-term effects of night shift work on breast cancer risk: a cohort study of payroll data".
Kolstad, Henrik A; Garde, Anne Helene; Hansen, Åse Marie; Frydenberg, Morten; Christiansen, Peer; Vistisen, Helene Tilma; Bonde, Jens Peter E
We thank Dr Richard Stevens for his comments (1) on our recent article that showed no increased risk of breast cancer following recent night shift work when compared with recent day shift work (2). This finding was based on linkage of day-by-day information on working hours and breast cancer incidence data. Results are thus less likely to have been biased by differential misclassification than findings from earlier studies relying on self-report (3). We defined a night shift as ≥3 hours of work between 24:00-05:00 hours and a day shift as ≥3 hours work between 6:00-20:00 hours. This day shift definition did not exclude shifts starting before 05:00 or ending after 24:00 hours. However, this affected only 0.02% and 0.3% of all day shifts, respectively. This diminutive misclassification, that is expected to be non-differential, can hardly explain our negative findings. It is suggested that shifts that begin after 07:00 and end before 18:00 would constitute a more sensible baseline comparison group. Since the biological mechanism is not certain, it is not obvious to us if this will be a more appropriate reference than the present. However, we agree that future studies should test how different definitions of shifts affect the risk of breast cancer, which will be possible using this type of data. We only had information on working hours from 2007 and onwards, and night shift work prior to 2007 could have confounded our analyses towards no effect but only if inversely associated with night shift work in 2007 or later. We find this unlikely. Left truncation could also have biased findings towards the null. We therefore supplemented analyses of the total study population with analyses of the one-third of the population with first recorded employment in 2008 or later (the inception population). Even if the mean age was 35.5 years - and many undoubtedly had been working (with and without night shifts) prior to 2008 - this population should be less affected by such
Sleep deprivation due to shift work.
Costa, Giovanni
Sleep deprivation due to shift work is related to perturbation of the sleep/wake cycle, associated with the modified activity/rest pattern. This may cause a significant disruption of circadian rhythms of biologic functions, driven by the body clock located in the suprachiasmatic nuclei of the hypothalamus. Shift and night workers have to change sleep times and strategies according to their duty periods; consequently, both sleep length and quality can be considerably affected depending on the variable start and finish times on different shifts. About 10% of night and rotating shift workers, aged between 18 and 65 years, have been estimated to have a diagnosable "shift-work sleep disorder," according to the International Classification of Sleep Disorders, version 2 (ICSD-2). In the long run, this may lead to persistent and severe disturbances of sleep, chronic fatigue and psychoneurotic syndromes, besides being a risk or aggravating factor for accidents, gastrointestinal, cardiovascular, and reproductive disorders, as well as, probably, for cancer. Preventive and corrective actions deal with the organization of shift schedules according to ergonomic criteria, careful health surveillance, appropriate education and training on effective countermeasures, in particular, sleep hygiene and napping. © 2015 Elsevier B.V. All rights reserved.
Determining optimal maintenance schedules for adjuvant intravesical bacillus Calmette-Guerin immunotherapy in non-muscle-invasive bladder cancer: a systematic review and network meta-analysis.
Huang, Zixiong; Liu, Huixin; Wang, Yizeng; Zhang, Chunfang; Xu, Tao
To figure out optimal bacillus Calmette-Guerin (BCG) maintenance schedules for non-muscle-invasive bladder cancer (NMIBC) patients by comparing different schedules in a systematic review using conventional and network meta-analysis. Literature was searched in the databases of Medline, Embase, Cochrane library, Clinicaltrials.gov, Wanfang, CNKI and SinoMed in April 2016 and 9 randomized clinical trials comparing intravesical BCG maintenance therapy with BCG induction-only therapy or comparing different BCG maintenance schedules (induction-only, 1 year, 1.5 year, 2 year, 3 year maintenance) in NMIBC patients were included. Conventional and network meta-analyses within a Bayesian framework were performed to calculate odds ratios of tumor recurrence, progression and side effects (cystitis, hematuria, general malaise and fever). The surface under the cumulative ranking curve (SUCRA) mean ranking was used to obtain schedule hierarchy. Data from 1951 patients showed that longer-term maintenance BCG therapy does not significantly decrease tumor recurrence and progression rate of NMIBC compared to shorter-term maintenance BCG therapy. However, longer-maintenance therapy does not increase side effect incidence compared to induction-only therapy. According to SUCRA results, induction-only therapy has the highest probability of recurrence and progression but least probability of side effects. Longer BCG maintenance therapy (such as 3 years) is not superior to shorter maintenance therapy (such as 1 year). But maintenance therapy overall is better than induction-only BCG therapy while not increasing side effects. Though further evidence and clinical practice with balanced confounding factors (risk stratification and BCG strain) are wished for, the current study suggests the common use of 1 year intravesical BCG instillation for NMIBC patients.
Shift work, night work, and the risk of prostate cancer: A meta-analysis based on 9 cohort studies.
Du, Hong-Bing; Bin, Kai-Yun; Liu, Wen-Hong; Yang, Feng-Sheng
Epidemiology studies suggested that shift work or night work may be linked to prostate cancer (PCa); the relationship, however, remains controversy. PubMed, ScienceDirect, and Embase (Ovid) databases were searched before (started from the building of the databases) February 4, 2017 for eligible cohort studies. We pooled the evidence included by a random- or fixed-effect model, according to the heterogeneity. A predefined subgroup analysis was conducted to see the potential discrepancy between groups. Sensitivity analysis was used to test whether our results were stale. Nine cohort studies were eligible for meta-analysis with 2,570,790 male subjects. Our meta-analysis showed that, under the fixed-effect model, the pooled relevant risk (RR) of PCa was 1.05 (95% confidence interval [CI]: 1.00, 1.11; P = .06; I = 24.00%) for men who had ever engaged in night shift work; and under the random-effect model, the pooled RR was 1.08 (0.99, 1.17; P = .08; I = 24.00%). Subgroup analysis showed the RR of PCa among males in western countries was 1.05 (95% CI: 0.99, 1.11; P = .09; I = 0.00%), while among Asian countries it was 2.45 (95% CI: 1.19, 5.04; P = .02; I = 0.00%); and the RR was 1.04 (95% CI: 0.95, 1.14; P = .40; I = 29.20%) for the high-quality group compared with 1.21 (95% CI: 1.03, 1.41; P = .02; I = 0.00%) for the moderate/low-quality group. Sensitivity analysis showed robust results. Based on the current evidence of cohort studies, we found no obvious association between night shift work and PCa. However, our subgroup analysis suggests that night shift work may increase the risk of PCa in Asian men. Some evidence of a small study effect was observed in this meta-analysis.
Predicting the stage shift as a result of breast cancer screening in low- and middle-income countries: a proof of concept.
Zelle, Sten G; Baltussen, Rob; Otten, Johannes D M; Heijnsdijk, Eveline A M; van Schoor, Guido; Broeders, Mireille J M
To provide proof of concept for a simple model to estimate the stage shift as a result of breast cancer screening in low- and middle-income countries (LMICs). Stage shift is an essential early detection indicator and an important proxy for the performance and possible further impact of screening programmes. Our model could help LIMCs to choose appropriate control strategies. We assessed our model concept in three steps. First, we calculated the proportional performance rates (i.e. index number Z) based on 16 screening rounds of the Nijmegen Screening Program (384,884 screened women). Second, we used linear regression to assess the association between Z and the amount of stage shift observed in the programme. Third, we hypothesized how Z could be used to estimate the stage shift as a result of breast cancer screening in LMICs. Stage shifts can be estimated by the proportional performance rates (Zs) using linear regression. Zs calculated for each screening round are highly associated with the observed stage shifts in the Nijmegen Screening Program (Pearson's R: 0.798, R square: 0.637). Our model can predict the stage shifts in the Nijmegen Screening Program, and could be applied to settings with different characteristics, although it should not be straightforwardly used to estimate the impact on mortality. Further research should investigate the extrapolation of our model to other settings. As stage shift is an essential screening performance indicator, our model could provide important information on the performance of breast cancer screening programmes that LMICs consider implementing. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
The evaluation of the relationship between the level of disclosure of cancer in terminally ill patients with cancer and the quality of terminal care in these patients and their families using the Support Team Assessment Schedule.
Nakajima, Nobuhisa; Hata, Yoshinobu; Onishi, Hideki; Ishida, Mayumi
To examine the relationship between informing patients of cancer and the quality of terminal care. This was a study of 87 consecutive terminally ill cancer patients who died during the last 27-month period. Notification of cancer was classified into 4 groups (A, B, C, and D, respectively): "nondisclosure," "disclosure of cancer diagnosis," "disclosure of life threatening," and "disclosure of poor prognosis." We evaluated the quality of palliative care using Support Team Assessment Schedule-Japanese (STAS-J). A, B, C, and D groups included 8, 22, 37, and 20 cases, respectively. Regarding physical symptoms, no marked difference was noted. Anxiety was significantly reduced, and the recognition of disease conditions and the level of communication were significantly higher in the groups that received specific information (P terminal care.
Impact of response shift on time to deterioration in quality of life scores in breast cancer patients.
Directory of Open Access Journals (Sweden)
Zeinab Hamidou
Full Text Available BACKGROUND: This prospective multicenter study aimed to study the impact of the recalibration component of response-shift (RS on time to deterioration (TTD in health related quality of life (QoL scores in breast cancer (BC patients and the influence of baseline QoL expectations on TTD. METHODS: The EORTC-QLQ-C30 and BR-23 questionnaires were used to assess the QoL in a prospective multicenter study at inclusion (T0, at the end of the first hospitalization (T1 and, three (T2 and 6 months after the first hospitalization (T3. Recalibration was investigated by the then-test method. QoL expectancy was assessed at diagnosis. Deterioration was defined as a 5-point decrease in QoL scores, considered a minimal clinically important difference (MCID. TTD was estimated using the Kaplan-Meier method. Cox regression analyses were used to identify factors influencing TTD. RESULTS: From February 2006 to February 2008, 381 women were included. Recalibration of breast cancer patients' internal standards in the assessment of their QoL had an impact on TTD. Median TTD were significantly shorter when recalibration was not taken into account than when recalibration was taken into account for global health, role-functioning, social-functioning, body-image and side effects of systemic therapy. Cox multivariate analyses showed that for body image, when recalibration was taken into account, radiotherapy was associated with a shorter TTD (HR: 0.60[0.38-0.94], whereas, no significant impact of surgery type on TTD was observed. For global health, cognitive and social functioning dimensions, patients expecting a deterioration in their QoL at baseline had a significantly shorter TTD. CONCLUSIONS: Our results showed that RS and baseline QoL expectations were associated with time to deterioration in breast cancer patients.
Correlation of Computerized Tomography density patterns of lymph nodes with treatment results and outcome in head and neck cancer patients treated by 2 different chemoradiotherapy schedules
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Sweta Jaju
Full Text Available Aims/Background: Tumor necrosis is visualized on CT scan as non enhancing hypodense area. Necrotic areas contain less oxygen and results in poor response of chemo-radiotherapy. Literature review (1 has shown that for hypodense lesions in head and neck cancer the complete response rate is lower than the isodense lesions. Locally advanced head and neck cancer require the addition of surgery but after a radical dose of radiation that is, 7000 cGy, surgery become difficult but there is no tool initially that can be used for selection of patients after delivery of 4500 cGy, that is the dose after which surgery can be performed without much difficulty. The hypothesis is that, hypodense lymph nodes even when they are small will show less response to various schedules of chemoradiotherapy so hypodensity of lymph nodes can be used as a tool to select patient, who will go for surgery after initial 4500 cGy of radiotherapy. Surgery is usually performed 2 to 3 weeks after radiotherapy, so primary can be treated to full dose while the skin in region of lymph nodes radiation field will recover from acute radiation reaction. Correlation of C T density patterns of lymph nodes in head and neck cancer patients with treatment results when two different chemoradiotherapy schedules are used is studied. Materials and Methods: Eighty three patients with locally advanced head and neck cancer were treated with two schedules of concurrent chemoradiotherapy prospectively from August 2010 to July 2011. CT Scans of the entire neck region including primary were performed. An iodine based contrast material (150 ml was injected intravenously starting with a bolus of 50ml (3ml/s, followed by a slow (1ml/s infusion of the remaining dose. The total tumor volume of the primary and involved neck nodes was calculated as a cuboid volume using maximum dimension in each plane: Vc= (a x b x c. Nodal density was graded. Results and Conclusion: No statistically significant association
Is shift work making your patient sick? Emerging theories and therapies for treating shift work disorder.
Rosenberg, Russell; Doghramji, Paul P
"Shift work" is a term that applies to a wide array of nontraditional work schedules. Shift work disorder (SWD) is a circadian rhythm sleep disorder experienced by a subset of shift workers that is characterized by excessive sleepiness during work and/or insomnia during scheduled sleep times. It is estimated to affect up to 2 million Americans, and is associated with increased morbidity and mortality from metabolic risk factors, cardiovascular and gastrointestinal diseases, depression, accidents, and some kinds of cancers. Patient history is all that is needed to make a diagnosis with the International Classification of Sleep Disorders-Second Edition criteria as described herein. Circadian rhythm disorders, in which an underlying misalignment of circadian rhythm with the sleep-wake cycle occurs, may be treated by behavioral and pharmacologic approaches, including the use of hypnotics to improve the duration of sleep. However, evidence is limited with these approaches in patients diagnosed with SWD. Other treatment options may include pharmacologic interventions such as modafinil and armodafinil, which have shown efficacy in this population. Combined therapy can reduce insomnia and excessive sleepiness, and improve attention and alertness during work shifts and the subsequent commute home.
led several cost research initiatives in cloud computing, service-oriented architecture , and agile development and various independent schedule...systems and platforms. Manring is trained and experienced on a number of commercial parametric software cost models and risk analysis tools. She has...and he supports DoD and federal acquisition efforts with a focus on rapid and agile practices to speed solutions with the lowest practical program
Sgall, Jiri
We survey some recent results on scheduling unit jobs. The emphasis of the talk is both on presenting some basic techniques and providing an overview of the current state of the art. The techniques presented cover charging schemes, potential function arguments, and lower bounds based on Yao's principle. The studied problem is equivalent to the following buffer management problem: packets with specified weights and deadlines arrive at a network switch and need to be forwarded so that the total...
Nonstandard working schedules and health: the systematic search for a comprehensive model
Merkus, S.L.; Holte, K.A.; Huysmans, M.A.; van Mechelen, W.; van der Beek, A.J.
Background: Theoretical models on shift work fall short of describing relevant health-related pathways associated with the broader concept of nonstandard working schedules. Shift work models neither combine relevant working time characteristics applicable to nonstandard schedules nor include the
Amplified Fluorescence from Polyfluorene Nanoparticles with Dual State Emission and Aggregation Caused Red Shifted Emission for Live Cell Imaging and Cancer Theranostics.
Muthuraj, Balakrishnan; Mukherjee, Sudip; Patra, Chitta Ranjan; Iyer, Parameswar Krishnan
A newly synthesized polyfluorene derivative with pendant di(2-picolyl)amine (PF-DPA) shows dual state emission and aggregation caused red shifted emission that was utilized for cell imaging and cancer theranostics. PF-DPA was nontoxic to normal cells but showed cytotoxicity against cancer cells, suggesting its utility for cancer therapy. PF-DPA exhibits a large and unique red shifted emission at 556 nm at higher water ratio of THF:H2O (10:90) due to the formation of polymer nanoparticles or PDots spontaneously by intra- and intermolecular self-assembly induced aggregation. Dual state emission and aggregation caused red shifted emission (>100 nm) in PF-DPA homopolymer nanoparticles is very unique and attributed to the combined effect of intramolecular planarization and J-type aggregate formation in the PDots (25 ± 5 nm). The PF-DPA PDots exhibit bright green and orange fluorescence with exceptional live cell imaging properties and potential applications in cancer theranostics due to their selective cytotoxic nature toward cancer cells.
Estimating exponential scheduling preferences
DEFF Research Database (Denmark)
Hjorth, Katrine; Börjesson, Maria; Engelson, Leonid
time by maximising expected total utility over the day, their departure times are conditional on rates of utility derived at these locations. For forecasting and economic evaluation of planning alternatives, it is desirable to have simple forms of utility rates with few parameters. Several forms......Extended abstract Choice of departure time is a travel choice dimension that transportation planners often need to forecast in appraisal. A traveller may shift departure time in response to changes in expected travel time or travel time variability (TTV) or in response to time......-differentiated congestion pricing. The direction and size of such shifts depend on the traveller's scheduling preferences, i.e. his preferences for travelling and being at the origin and destination at different times of day (Vickrey, 1973). Moreover, the traveller's response to and economic value of TTV can be derived...
Tryptophan as key biomarker to detect gastrointestinal tract cancer using non-negative biochemical analysis of native fluorescence and Stokes Shift spectroscopy
Wang, Leana; Zhou, Yan; Liu, Cheng-hui; Zhou, Lixin; He, Yong; Pu, Yang; Nguyen, Thien An; Alfano, Robert R.
The objective of this study was to find out the emission spectral fingerprints for discrimination of human colorectal and gastric cancer from normal tissue in vitro by applying native fluorescence. The native fluorescence (NFL) and Stokes shift spectra of seventy-two human cancerous and normal colorectal (colon, rectum) and gastric tissues were analyzed using three selected excitation wavelengths (e.g. 300 nm, 320 nm and 340 nm). Three distinct biomarkers, tryptophan, collagen and reduced nicotinamide adenine dinucleotide hydrate (NADH), were found in the samples of cancerous and normal tissues from eighteen subjects. The spectral profiles of tryptophan exhibited a sharp peak in cancerous colon tissues under a 300 nm excitation when compared with normal tissues. The changes in compositions of tryptophan, collagen, and NADH were found between colon cancer and normal tissues under an excitation of 300 nm by the non-negative basic biochemical component analysis (BBCA) model.
Scheduling delay in suspected cases of oral cancer Atraso de agendamento em casos suspeitos de câncer bucal
National Research Council Canada - National Science Library
Luciana Meneses Souza; Edgard Michel-Crosato; Maria Gabriela Haye Biazevic; José Leopoldo Ferreira Antunes
... of São Paulo of patients suspected of having oral cancer. A cross-sectional study was performed in which telephone conversations simulated clinical situations that represented two types of patients...
N-3 poly-unsaturated fatty acids shift estrogen signaling to inhibit human breast cancer cell growth.
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Wenqing Cao
Full Text Available Although evidence has shown the regulating effect of n-3 poly-unsaturated fatty acid (n-3 PUFA on cell signaling transduction, it remains unknown whether n-3 PUFA treatment modulates estrogen signaling. The current study showed that docosahexaenoic acid (DHA, C22:6, eicosapentaenoic acid (EPA, C20:5 shifted the pro-survival and proliferative effect of estrogen to a pro-apoptotic effect in human breast cancer (BCa MCF-7 and T47D cells. 17 β-estradiol (E2 enhanced the inhibitory effect of n-3 PUFAs on BCa cell growth. The IC50 of DHA or EPA in MCF-7 cells decreased when combined with E2 (10 nM treatment (from 173 µM for DHA only to 113 µM for DHA+E2, and from 187 µm for EPA only to 130 µm for EPA+E2. E2 also augmented apoptosis in n-3 PUFA-treated BCa cells. In contrast, in cells treated with stearic acid (SA, C18:0 as well as cells not treated with fatty acid, E2 promoted breast cancer cell growth. Classical (nuclear estrogen receptors may not be involved in the pro-apoptotic effects of E2 on the n-3 PUFA-treated BCa cells because ERα agonist failed to elicit, and ERα knockdown failed to block E2 pro-apoptotic effects. Subsequent studies reveal that G protein coupled estrogen receptor 1 (GPER1 may mediate the pro-apoptotic effect of estrogen. N-3 PUFA treatment initiated the pro-apoptotic signaling of estrogen by increasing GPER1-cAMP-PKA signaling response, and blunting EGFR, Erk 1/2, and AKT activity. These findings may not only provide the evidence to link n-3 PUFAs biologic effects and the pro-apoptotic signaling of estrogen in breast cancer cells, but also shed new insight into the potential application of n-3 PUFAs in BCa treatment.
Establishing schedules for repeated doses of strontium and for concurrent chemotherapy in hormone-resistant patients with prostate cancer: measurement of blood and urine strontium levels.
Ben-Yosef, Rami; Pelled, Omer; Marko, Rachel; Vexler, Akiva; Teshuva, Avi; German, Uzi; Levita, Moshe; Kol, Rina
Strontium-89 (Sr-89) alone or with concurrent chemotherapy has a role in the treatment of patients with prostate cancer (PCP). The schedules for repeated doses of Sr-89 or for concurrent chemotherapy is undetermined. The objective of this study was to measure the effective half-life (Te) of Sr-89 using a detector available in a nuclear research facility. Blood and urine samples obtained from PCP treated with Sr-89 (Metastron, Amersham, U.K.) were measured for radioactivity with a High Pure Germanium (HPGe) detector in a gamma spectrometry system (Eurisys, France). Twenty-five urine and 22 blood samples were obtained from 8 patients during a period of 160 days after Metastron injection. Sr-89 radioactivity levels in blood and urine were quite low (radioactivity levels were moderately high and could be detected up to 160 days. Based on Sr-85 urine levels, the calculated Sr-89 Te ranged from 9.6 to 20.7 days. Sr-89 Te can be routinely calculated in PCP based on HPGe detection of Sr-85 radioactivity levels in urine. This measurement can establish schedules for either repeated doses of Sr-89 or concurrent chemotherapy.
Phase II study of a 3-day schedule with topotecan and cisplatin in patients with previously untreated small cell lung cancer and extensive disease
DEFF Research Database (Denmark)
Sorensen, M.; Lassen, Ulrik Niels; Jensen, Peter Buhl
INTRODUCTION: Treatment with a topoisomerase I inhibitor in combination with a platinum results in superior or equal survival compared with etoposide-based treatment in extensive disease small cell lung cancer (SCLC). Five-day topotecan is inconvenient and therefore shorter schedules of topotecan.......3-7.7), respectively. CONCLUSION: Three-day topotecan with cisplatin on day 3 is active and safe in extensive disease SCLC. An ongoing phase III randomized trial compares this combination to standard treatment Udgivelsesdato: 2008/8......, adequate organ functions and performance status less than 3 were eligible. Topotecan (2.0 mg/m, intravenously) was administered on days 1 to 3 with cisplatin (50 mg/m, intravenously) on day 3 every 3 weeks for a total of six cycles. RESULTS: Forty-three patients received 219 cycles of chemotherapy. Median...
The role of recalibration response shift in explaining bodily pain in cancer patients undergoing invasive surgery: an empirical investigation of the Sprangers and Schwartz model.
Visser, Mechteld R M; Oort, Frans J; van Lanschot, J Jan B; van der Velden, Jacobus; Kloek, Jaap J; Gouma, Dirk J; Schwartz, Carolyn E; Sprangers, Mirjam A G
This study aims to explain bodily pain using the Sprangers and Schwartz theoretical model (1999) on quality of life (QL) and response shift in its entirety. Response shift refers to the phenomenon that the meaning of a person's self-evaluation changes over time. In this model, response shift mediates effects of changes in health status (catalysts), stable characteristics of the person (antecedents), and coping mechanisms (mechanisms) on QL. Cancer patients (202) were assessed prior to and 3 months following surgery. Measures were for catalysts: type of operation and possibility of tumor resection; for antecedents: age, duration of pain, optimism, and rigidity; for mechanisms: post-traumatic growth, social comparisons, social support, denial, and acceptance; and for QL: bodily pain; for response shift: the pretest-minus-thentest bodily pain score, further referred to as recalibration response shift. Structural equation modeling and sequential regression analyses were used. The final model reached close fit (RMSEA = 0.03; 90% CI = 0.000-0.071; χ2 (18) = 21.13; p = 0.27). Significant effects were found for catalysts on mechanisms, antecedents on mechanisms, mechanisms on response shift, and response shift on bodily pain. Four extra model effects had to be permitted. Using sequential regression analysis, recalibration response shift added 4.4% to the total amount of 29.8% explained variance of bodily pain. Many effects as hypothesized by the model were found. Recalibration response shift had a unique albeit small contribution to the explanation of bodily pain. Copyright © 2012 John Wiley & Sons, Ltd.
A prospective cohort study to compare treatment results between 2 fractionation schedules of high-dose-rate intracavitary brachytherapy (HDR-ICBT) in patients with cervical cancer.
Huang, Eng-Yen; Sun, Li-Min; Lin, Hao; Lan, Jen-Hong; Chanchien, Chan-Chao; Huang, Yu-Jie; Wang, Chang-Yu; Wang, Chong-Jong
To compare the treatment results of 2 fractionation schedules for high-dose-rate intracavitary brachytherapy (HDR-ICBT) in patients with cervical cancer. From June 2001 through January 2008, 267 patients with stage IB-IVA cervical cancer were enrolled in the study. All patients underwent 4-field pelvic irradiation and HDR-ICBT. The median central and parametrial doses were 39.6 Gy and 45 Gy, respectively. Patient underwent either 6 Gy×4 (HDR-4) (n=144) or 4.5 Gy×6 (HDR-6) (n=123) to point A of ICBT using 192Ir isotope twice weekly. The rates of overall survival, locoregional failure, distant metastasis, proctitis, cystitis, and enterocolitis were compared between HDR-4 and HDR-6. There were no significant differences in the demographic data between HDR-4 and HDR-6 except for total treatment time. The 5-year proctitis rates were 23.0% and 21.5% in HDR-4 and HDR-6 (P=.399), respectively. The corresponding rates of grade 2-4 proctitis were 18.7% and 9.6% (P=.060). The corresponding rates of grades 3-4 proctitis were 5.2% and 1.3% (P=.231). Subgroup analysis revealed that HDR-4 significantly increased grade 2-4 proctitis in patients aged≥62 years old (P=.012) but not in patients agedschedules. The small fraction size of HDR-ICBT is associated with grade 2 proctitis without compromise of prognosis in elderly patients. This schedule is suggested for patients who tolerate an additional 2 applications of HDR-ICBT. Copyright © 2013 Elsevier Inc. All rights reserved.
Rotating shift work associated with obesity in men from northeastern Ontario.
Grundy, Anne; Cotterchio, Michelle; Kirsh, Victoria A; Nadalin, Victoria; Lightfoot, Nancy; Kreiger, Nancy
While some studies have suggested associations between shift work and obesity, few have been population-based or considered multiple shift schedules. Since obesity is linked with several chronic health conditions, understanding which types of shift work influence obesity is important and additional work with more detailed exposure assessment of shift work is warranted. Using multivariate polytomous logistic regression, we investigated the associations between shift work (evening/night, rotating and other shift schedules) and overweight and obesity as measured by body mass index cross-sectionally among 1561 men. These men had previously participated as population controls in a prostate cancer case-control study conducted in northeastern Ontario from 1995 to 1999. We obtained information on work history (including shift work), height and weight from the existing self-reported questionnaire data. We observed an association for ever (vs. never) having been employed in rotating shift work for both the overweight (OR [odds ratio] = 1.34; 95% CI [confidence interval]: 1.05-1.73) and obese (OR = 1.57; 95% CI: 1.12-2.21) groups. We also observed nonsignificant associations for ever (vs. never) having been employed in permanent evening/night shifts. In addition, we found a significant trend of increased risk for both overweight and obesity with increasing duration of rotating shift work. Both the positive association between rotating shift work and obesity and the suggested positive association for permanent evening/night shift work in this study are consistent with previous findings. Future population-based research that is able to build on our results while examining additional shift work characteristics will further clarify whether some shift patterns have a greater impact on obesity than others.
Rotating shift work associated with obesity in men from northeastern Ontario
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Anne Grundy
Full Text Available Introduction: While some studies have suggested associations between shift work and obesity, few have been population-based or considered multiple shift schedules. Since obesity is linked with several chronic health conditions, understanding which types of shift work influence obesity is important and additional work with more detailed exposure assessment of shift work is warranted. Methods: Using multivariate polytomous logistic regression, we investigated the associations between shift work (evening/night, rotating and other shift schedules and overweight and obesity as measured by body mass index cross-sectionally among 1561 men. These men had previously participated as population controls in a prostate cancer case-control study conducted in northeastern Ontario from 1995 to 1999. We obtained information on work history (including shift work, height and weight from the existing self-reported questionnaire data. Results: We observed an association for ever (vs. never having been employed in rotating shift work for both the overweight (OR [odds ratio] = 1.34; 95% CI [confidence interval]: 1.05–1.73 and obese (OR = 1.57; 95% CI: 1.12–2.21 groups. We also observed nonsignificant associations for ever (vs. never having been employed in permanent evening/night shifts. In addition, we found a significant trend of increased risk for both overweight and obesity with increasing duration of rotating shift work. Conclusion: Both the positive association between rotating shift work and obesity and the suggested positive association for permanent evening/night shift work in this study are consistent with previous findings. Future population-based research that is able to build on our results while examining additional shift work characteristics will further clarify whether some shift patterns have a greater impact on obesity than others.
An original accelerated radiotherapy schedule in stage III to IV head and neck cancers. Results in a multicenter setting
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Allal, A.S. [Geneva Univ. Hospital (Switzerland). Div. of Radiation Oncology; Monney, M.; Rosset, A.; Ozsahin, M. [Hopital Cantonal Universitaire, Lausanne (Switzerland). Inst. de Radiographie; Guillemin, C. [Cantonal Radiotherapy Department Sion (Switzerland)
Background: Accelerated radiotherapy delivery has recently been shown to be effective in overcoming repopulation during fractionated radiotherapy. The therapeutic ratio may be particularly favorable for 5-week regimens. This study reports the feasibility and results of a particular accelerated schedule in Stage III to IV head and neck carcinomas used in a multicenter setting. Patients and Methods: Seventy-four patients with Stage III (26 patients) or IV (48 patients) head and neck carcinomas were treated with a 5-week accelerated schedule (69.9 to 69.8 Gy in 41 to 40 fractions over a period of 35 to 36 days). Treatment began with 20 Gy in 10 daily fractions to initial involved sites, followed by bi-fractionated radiotherapy (2x1.6 Gy to 1.66 Gy/day) to a larger head and neck volume. Thirty-six (49%) patients received induction chemotherapy (median 3 cycles, range 1 to 4 cycles). Results: Grade 3 or 4 (RTOG) confluent mucositis was observed in 57 patients (77%) and Grade 3 dysphagia in 33 patients (44%). Grade 3 or 4 (RTOG-EORTC) late complications were scored in 10.5% of cases. The 5-year actuarial locoregional control rate was 56% (95% CI: 42 to 71). The 5-year overall actuarial survival was 32% (95% CI: 18 to 46). Induction chemotherapy was not associated with a more favorable outcome. Conclusions: This study demonstrates the feasibility of this schedule in a multicenter setting. The oncologic results appear similar to those obtained by other accelerated regimens, while the rate of late complications seems acceptable. Five-week accelerated regimens warrant further evaluation, particularly in conjunction with concomitant chemotherapy, in the framework of prospective trials. (orig.) [German] Hintergrund: Die Wirksamkeit der akzelerierten Bestrahlung in bezug auf die Bewaeltigung der Tumorzellrepopulation waehrend einer Radiotherapie ist vor kurzem nachgewiesen worden. Das Verhaeltnis zwischen therapeutischem Effekt und Toxizitaet duerfte fuer fuenfwoechige Schemen
Neurofibromatosis and breast cancer: Do we need to revise the mammographic screening schedule in patients of neurofibromatosis?
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Dinesh Pradhan
Full Text Available Neurofibromatosis type 1 (NF-1 is a neurocutaneous syndrome with autosomal dominant mode of inheritance and has a high propensity to develop benign and malignant nervous system tumors. Although uncommon, case reports describing the association of NF-1 and breast cancer are available in the literature. We illustrate one such case of NF-1, with no family history of the disorder and presenting with multifocal invasive carcinoma of the right breast, in an attempt to describe the association between these two entities. We also attempt to extensively review the current literature on the subject. Since patients with NF-1 are at an increased risk of developing breast cancer, we recommend strict adherence to careful clinical breast examination and annual screening mammographic examination starting at 40 years of age in all patients of NF-1.
Shift work and its effects on the cardiovascular system.
Mosendane, T; Mosendane, T; Raal, F J
The practice of shift-work scheduling has long been part of normal work duties in emergency services such as health and security. It is only recently, in the wake of growing job opportunities and booming industries, where more employees are needed to keep services running over 24-hour periods that studies on the effects of shift work on workers' health have begun to delve deeper. The desynchronisation that occurs in circadian rhythms, with respect to sleep cycles, predisposes employees to coronary heart disease, gastrointestinal disturbances, increased risk of breast cancer and poor pregnancy outcomes. This literature review focuses on circadian rhythms, their molecular components, disturbances of these rhythms as a result of shift work and the adverse effects thereof on the cardiovascular system.
Schedule-selective biochemical modulation of 5-fluorouracil in advanced colorectal cancer – a phase II study
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Savage Paul
Full Text Available Abstract Background 5-fluorouracil remains the standard therapy for patients with advanced/metastatic colorectal cancer. Pre-clinical studies have demonstrated the biological modulation of 5-fluorouracil by methotrexate and leucovorin. This phase II study was initiated to determine the activity and toxicity of sequential methotrexate – leucovorin and 5-fluorouracil chemotherapy in patients with advanced colorectal cancer. Methods Ninety-seven patients with metastatic colorectal cancer were enrolled onto the study. Methotrexate – 30 mg/m2 was administered every 6 hours for 6 doses followed by a 2 hour infusion of LV – 500 mg/m2. Midway through the leucovorin infusion, patients received 5-fluorouracil – 600 mg/m2. This constituted a cycle of therapy and was repeated every 2 weeks until progression. Results The median age was 64 yrs (34–84 and the Eastern Cooperative Group Oncology performance score was 0 in 37%, 1 in 55% and 2 in 8% of patients. Partial and complete responses were seen in 31% of patients with a median duration of response of 6.4 months. The overall median survival was 13.0 months. The estimated 1-year survival was 53.7%. Grade III and IV toxic effects were modest and included mucositis, nausea and vomiting. Conclusions This phase II study supports previously reported data demonstrating the modest clinical benefit of 5-FU modulation utilizing methotrexate and leucovorin in patients with metastatic colorectal cancer. Ongoing studies evaluating 5-fluorouracil modulation with more novel agents (Irinotecan and/or oxaliplatin are in progress and may prove encouraging.
The effect of gefitinib (Iressa, ZD1839) in combination with oxaliplatin is schedule-dependent in colon cancer cell lines.
Xu, Jian-Ming; Azzariti, Amalia; Colucci, Giuseppe; Paradiso, Angelo
Clinical trials of gefitinib (Iressa, ZD1839) in combination with cytotoxic agents have been carried out or are ongoing in several varieties of tumor. To provide a rationale for future clinical trials, the effects of combining gefitinib with oxaliplatin in different sequences of administration and different dose ratios in two colon cancer cell lines were evaluated. The colon cancer cell lines HT-29 and LoVo were used. The methods consisted of median effect and combination index analysis, Western blot, mass spectrometry, and a cell death ELISA. In vitro analysis demonstrated that the combination effects of the two agents were sequence-dependent. Changing the sequence of administration from gefitinib first to gefitinib last changed the combination effect from antagonism to synergy. The dose ratio between the two agents affected the combination effects. When equiactive doses of the two agents were used with the sequence gefitinib following oxaliplatin, the greatest level of synergism was obtained (CI=0.6+/-0.2, P=0.032). Further evaluation revealed that gefitinib significantly inhibited removal of Pt-DNA adducts ( P<0.05), providing a potential explanation for the sequence-dependent synergy observed with gefitinib following oxaliplatin. However, this effect was not dose-dependent. Additional studies demonstrated that gefitinib enhanced the effects of oxaliplatin by maintaining oxaliplatin-induced apoptosis, and equiactive dose of gefitinib following oxaliplatin induced prominent enhancement of apoptosis. Oxaliplatin followed by an equiactive relative dose of gefitinib is an appropriate combination for evaluation in colon cancer.
First line chemotherapy with gemcitabine in advanced non-small cell lung cancer elderly patients: a randomized phase II study of 3-week versus 4-week schedule.
Quoix, Elisabeth; Breton, Jean-Luc; Ducoloné, Alain; Mennecier, Bertrand; Depierre, Alain; Lemarié, Etienne; Moro-Sibilot, Denis; Germa, Caroline; Neidhardt, Anne-Catherine
This randomized phase II multicenter trial aimed at evaluating the efficacy and safety of the 4-week versus 3-week schedules of gemcitabine monotherapy in previously untreated elderly patients with advanced non-small cell lung cancer (NSCLC). Chemonaive patients with stage IIIB or IV NSCLC, and age between 70 and 90 years, were randomized to receive gemcitabine dose of either 1000 mg/m2 on days 1, 8, 15, every 28 days (arm Q4W), or 1125 mg/m2 on days 1 and 8, every 21 days (arm Q3W). From June 1999 to January 2001, 81 patients (42 on arm Q4W; 39 on arm Q3W) were included. The median age was 75 on both arms; most patients (82.7%) were male, and had a Karnofsky performance status of 80 or 90 (76.5%). For arms Q4W and Q3W, respectively, the median time to treatment failure was 83 days (95% CI, 69-98 days) versus 92 days (95% CI, 63-113), and the median survival was 154 days (95% CI, 108-227) versus 205 days (95% CI, 125-344). The objective response rate was higher on arm Q3W (28.2%) than on arm Q4W (14.3%). Total number of cycles administered was 132 on arm Q4W (median 3, range 1-10 cycles) and 169 on arm Q3W (median 4, range 1-9 cycles). Patients on arm Q4W and Q3W, respectively, received 100.1 and 99.8% of the planned weekly mean dose. The most common grade, three to four toxicities, was neutropenia (17.1% on arm Q4W versus 18.9% on arm Q3W) and thrombocytopenia (12.2% on arm Q4W versus 2.6% on arm Q3W). Although both 3- and 4-week gemcitabine regimens were safely and effectively administered in chemonaive elderly patients with advanced NSCLC, the 3-week schedule appears to be the more convenient for this population. Moreover, even if this is only a phase II study this 3-week schedule appears to be at least as efficient as the 4-week regimen.
Letter in reference to: "Short-term effects of night shift work on breast cancer risk: a cohort study of payroll data".
Stevens, Richard G
There are major flaws with the analyses in the Vistisen et al (1) cohort study examining if night shift work is a short-term risk factor for breast cancer. The crucial problem is the potential for exposure misclassification, which is very high. The authors' definition of day shift is "≥3 hours of work between 06:00-20:00 hours". This means that a worker on an 8-hour shift that begins at 03:00 hours would be classified as a day rather than night shift worker because he/she worked only two hours between 24:00-05:00 hours. Similarly, a second shifter might start work at 17:00 but not get off until 01:00 and yet still be classified as a "day shift" worker. This does not make sense as a baseline comparison group "unexposed" to work during the night hours. A sensible classification system would be to define "day shift" as any shift that begins after 07:00 and ends before 18:00 hours. This is straightforward and avoids all of the ambiguities inherent in the definition used by the authors. In addition, the authors claim that the "inception population" is less likely to have had past prior non-day work hours. However, this group has an average age of >35 years. It is inconceivable that all of these women were new graduates who started a public health sector job for the first time. Rather, the majority must surely have worked elsewhere for many years but then started in the regions covered only after 2006. This topic is too important, and this cohort too valuable, not to carefully define the baseline comparison group of "day workers" in a sensible manner. All the inferences rely crucially on this definition. The authors have the data to define the day-working baseline group in a way that avoids these obvious biases. That is why it is so frustrating that the authors chose to conduct the analyses as they did, with a highly flawed definition of "day work", when they could have done so much better. A highly flawed epidemiological report is worse than no report at all because
Barbero-Soto, E; Casas-Lino, M P; Fernandez-Robles, C; Foraz, K; Pojer, M; Saban, R; Schmidt, R; Solfaroli-Camillocci, M; Vergara-Fernandez, A
The Large Hadron Collider is now entering in its final phase before receiving beam, and the activities at CERN between 2007 and 2008 have shifted from installation work to the commissioning of the technical systems ("hardware commissioning"). Due to the unprecedented complexity of this machine, all the systems are or will be tested as far as possible before the cool-down starts. Systems are firstly tested individually before being globally tested together. The architecture of LHC, which is partitioned into eight cryogenically and electrically independent sectors, allows the commissioning on a sector by sector basis. When a sector reaches nominal cryogenic conditions, commissioning of the magnet powering system to nominal current for all magnets can be performed. This paper briefly describes the different activities to be performed during the powering tests of the superconducting magnet system and presents the scheduling issues raised by co-activities as well as the management of resources.
Phase I/II study of first-line irinotecan combined with 5-fluorouracil and folinic acid Mayo Clinic schedule in patients with advanced colorectal cancer
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Davidson Neville
Full Text Available Abstract Background This multicentre phase I/II study was designed to determine the maximum tolerated dose of irinotecan when combined with 5-fluorouracil and folinic acid according to the Mayo Clinic schedule and to evaluate the activity of this combination as first-line therapy in patients with advanced colorectal cancer. Methods Sixty-three patients received irinotecan (250 or 300 mg/m2, 30- to 90-minute intravenous infusion on day 1, immediately followed by folinic acid (20 mg/m2/day and 5-fluorouracil (425 mg/m2, 15-minute bolus infusion days 1 to 5, every four weeks. Results Diarrhoea was dose limiting at 300 mg/m2 irinotecan in combination with 5-fluorouracil and folinic acid, and this was determined to be the maximum tolerated dose. Grade 3–4 neutropenia was the most frequently reported toxicity. The recommended dose of irinotecan for the phase II part of the study was 250 mg/m2. The response rate for the evaluable patient population was 36% (13/36, and 44% (16 patients had stable disease (including 19% of minor response. For the intention-to-treat population, the response rate was 29% (14/49 and 35% (17 patients stable disease (including 14% of minor response. The median time to progression was 7.0 months and the median survival was 12.0 months. Grade 3–4 non-haematological drug-related toxicities included delayed diarrhoea, stomatitis, fatigue, and nausea/vomiting. There were three deaths due to septic shock that were possibly or probably treatment-related. Conclusions This regimen of irinotecan in combination with the Mayo Clinic schedule of bolus 5-fluorouracil/folinic acid every four weeks showed activity as first-line therapy in patients with advanced colorectal cancer. In keeping with other published results of studies using bolus 5-fluorouracil combined with irinotecan, the use of this regimen is limited by a relatively high rate of grade 3–4 neutropenia, and the combination of irinotecan and infusional 5-fluorouracil
Night-shift work increases morbidity of breast cancer and all-cause mortality: a meta-analysis of 16 prospective cohort studies.
Lin, Xiaoti; Chen, Weiyu; Wei, Fengqin; Ying, Mingang; Wei, Weidong; Xie, Xiaoming
Night-shift work (NSW) has previously been related to incidents of breast cancer and all-cause mortality, but many published studies have reported inconclusive results. The aim of the present study was to quantify a potential dose-effect relationship between NSW and morbidity of breast cancer, and to evaluate the association between NSW and risk of all-cause mortality. The outcomes included NSW, morbidity of breast cancer, cardiovascular mortality, cancer-related mortality, and all-cause mortality. Sixteen investigations were included, involving 2,020,641 participants, 10,004 incident breast cancer cases, 7185 cancer-related deaths, 4820 cardiovascular end points, and 2480 all-cause mortalities. The summary risk ratio (RR) of incident breast cancer for an increase of NSW was 1.057 [95% confidence interval (CI) 1.014-1.102; test for heterogeneity p = 0.358, I(2) = 9.2%]. The combined RR (95% CI) of breast cancer risk for NSW vs daytime work was: 1.029 (0.969-1.093) in the 20-year exposure lengths. The overall RR was 1.089 (95% CI 1.016-1.166) in a fixed-effects model (test for heterogeneity p = 0.838, I(2) = 0%) comparing rotating NSW and day work. Night-shift work was associated with an increased risk of cardiovascular death (RR 1.027, 95% CI 1.001-1.053), and all-cause death 1.253 (95% CI 0.786-1.997). In summary, NSW increased the risk of breast cancer morbidity by: 1.9% for 5 years, 2.5% for 5-10 years, 7.4% for 10-20 years, and 8.8% for >20-years of NSW. Additionally, rotating NSW enhanced the morbidity of breast cancer by 8.9%. Moreover, NSW was associated with a 2.7% increase in cardiovascular death. Copyright © 2015. Published by Elsevier B.V.
A randomized phase III multicenter trial comparing irinotecan in combination with the Nordic bolus 5-FU and folinic acid schedule or the bolus/infused de Gramont schedule (Lv5FU2) in patients with metastatic colorectal cancer
DEFF Research Database (Denmark)
Glimelius, B; Sørbye, H; Balteskard, L
not differ (4% versus 6%, P = 0.3). Grade 3/4 neutropenia (11% versus 5%, P = 0.01) and grade 2 alopecia (18% versus 9%, P = 0.002) were more common in the FLIRI group. The 60-day mortality was 2.4% versus 2.1%. CONCLUSIONS: Irinotecan with the bolus Nordic schedule (FLIRI) is a convenient treatment with PFS...... and OS comparable to irinotecan with the Lv5FU2 schedule. Neutropenia and alopecia are more prevalent, but both regimens are equally well tolerated....
[Long-term results and cause of failure analysis in larynx cancer patients irradiated conventionally and with accelerated fractionation schedules in 1995-1998].
Szutkowski, Zbigniew; Kawecki, Andrzej; Jarząbski, Andrzej
The clinical material consists of 217 patients with squamous cell carcinoma in supraglottic and glottic larynx in clinical stage T1-3N0M0 irradiated radically in Warsaw Oncology Centre in 1995-1998. All patients were treated with Co-60, according to two schedules of fractionation, with maintenance of the consistent therapeutic protocol. The same team of doctors worked on the treatment of patients and on the follow-up as well. The clinical material is a part of a three-phased clinical trial KBN 0295. In the course of observation, the progression of cancer was not observed in 157 patients, among whom, 66% were treated conventionally and 79% with accelerated fractionation method. 60 cases of loco-regional recurrences were noted, among which 55 were regional. The majority of failure cases was observed until the 30(th) of the month after the radiotherapy ended. In conventional fractionation treatment, recurrences in T1 were 8/31 (26%), in T2 22/59 (37%) and in T3 8/20 (40%). In patients treated with AF, recurrences were T1 5/39 (13%), T2 15/55 (27%) and T3 2/13 (15%) respectively. The percentage of primary site tumour recurrences for each localization and kind of treatment was analysed. In CF 28/78 (37%) of glottic tumour recurrences and 10/34 (29%) of supraglottic tumour, recurrences were observed. In AF, 12/71 (17%) and 10/36 (28%) were observed respectively. In 48 cases salvage surgery was used, and 12 patients were not qualified because of tumour massive progression or because they refused to have a surgery. Among 34 cases (16%) of the second primary tumour or distant methastases, 25 were observed with glottic cancer, among which 23 were observed in early stages, and 9 cases with supraglottic cancer, among which, 6 showed early stage of tumour. In only 3 cases out of all the patients, distant methastases were confirmed in histopatology examination. The main cause of failure in larynx cancer patients in stage T1 is that 3N0M0 are local recurrences. Second primary or
The Nightingale study: rationale, study design and baseline characteristics of a prospective cohort study on shift work and breast cancer risk among nurses.
Pijpe, Anouk; Slottje, Pauline; van Pelt, Cres; Stehmann, Floor; Kromhout, Hans; van Leeuwen, Flora E; Vermeulen, Roel C H; Rookus, Matti A
Evidence for the carcinogenicity of shift work in humans is limited because of significant heterogeneity of the results, thus more in-depth research in needed. The Nightingale Study is a nationwide prospective cohort study on occupational exposures and risks of chronic diseases among female nurses and focuses on the potential association between shift work and risk of breast cancer. The study design, methods, and baseline characteristics of the cohort are described. The source population for the cohort comprised 18 to 65 year old women who were registered as having completed training to be a nurse in the nationwide register for healthcare professionals in the Netherlands. Eligible women were invited to complete a web-based questionnaire including full job history, a detailed section on all domains of shift work (shift system, cumulative exposure, and shift intensity) and potential confounding factors, and an informed consent form for linkage with national (disease) registries. Women were also asked to donate toenail clippings as a source of DNA for genetic analyses. Between October 6, 2011 and February 1, 2012, 31% of the 192,931 women who were invited to participate completed the questionnaire, yielding a sample size of 59,947 cohort members. The mean age of the participants was 46.9 year (standard deviation 11.0 years). Toenail clippings were provided by 23,439 participants (39%). Results from the Nightingale Study will contribute to the scientific evidence of potential shift work-related health risks among nurses and will help develop preventive measures and policy aimed at reducing these risks.
The Nightingale study: rationale, study design and baseline characteristics of a prospective cohort study on shift work and breast cancer risk among nurses
Background Evidence for the carcinogenicity of shift work in humans is limited because of significant heterogeneity of the results, thus more in-depth research in needed. The Nightingale Study is a nationwide prospective cohort study on occupational exposures and risks of chronic diseases among female nurses and focuses on the potential association between shift work and risk of breast cancer. The study design, methods, and baseline characteristics of the cohort are described. Methods/Design The source population for the cohort comprised 18 to 65 year old women who were registered as having completed training to be a nurse in the nationwide register for healthcare professionals in the Netherlands. Eligible women were invited to complete a web-based questionnaire including full job history, a detailed section on all domains of shift work (shift system, cumulative exposure, and shift intensity) and potential confounding factors, and an informed consent form for linkage with national (disease) registries. Women were also asked to donate toenail clippings as a source of DNA for genetic analyses. Between October 6, 2011 and February 1, 2012, 31% of the 192,931 women who were invited to participate completed the questionnaire, yielding a sample size of 59,947 cohort members. The mean age of the participants was 46.9 year (standard deviation 11.0 years). Toenail clippings were provided by 23,439 participants (39%). Discussion Results from the Nightingale Study will contribute to the scientific evidence of potential shift work-related health risks among nurses and will help develop preventive measures and policy aimed at reducing these risks. PMID:24475944
Records Control Schedules Repository
National Archives and Records Administration — The Records Control Schedules (RCS) repository provides access to scanned versions of records schedules, or Standard Form 115, Request for Records Disposition...
Evaluation of Acute Toxicity and Symptoms Palliation in a Hypofractionated Weekly Schedule of External Radiotherapy for Elderly Patients with Muscular Invasive Bladder Cancer
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Vassilis Kouloulias
Full Text Available Aim To evaluate acute toxicity and symptoms palliation of a weekly hypofractionated 3DCRT schedule as radical treatment in elderly patients with organ confined bladder cancer cT1-2N0. Materials and Methods Between February 2005 and June 2011, 58 prospectively selected patients diagnosed with organ confined bladder cancer were treated with external 3DCRT (4-field arrangement. All candidates were medically inoperable, with poor performance status, and with age ranged from 75 to 88 years (median 78. A dose of 36 Gy in 6 weekly fractions was prescribed. The primary study endpoints were the evaluation of haematuria, dysuria, frequency and pain palliation as well as the acute toxicity according to the RTOG/EORTC scale: an assessment was performed at baseline, during and 3 months after radiotherapy, while the maximum reported score was taken into account. Results The gastrointestinal acute toxicities were 13/58 (22.4% and 5/58 (5.6%, for grade I and II respectively. The genitourinary acute toxicities were 19/58 (32.7% and 10/58 (17.2%, for grade I and II respectively. In terms of clinical outcome, 55/58 patients (94.8% reported palliation of haematuria, while 19 out of 58 reported no change in frequency and dysuria. All patients reported significant improvement (P < 0.01 for pain, concerning the visual analogue score before and after radiotherapy. The median progression free survival was 14 months. CONCLUSIONS The incidence of patient-reported acute toxicity following weekly hypofractionated external 3DCRT is low while the symptom palliation compares very favorably with other reported outcomes.
Clinical implications in the shift of syndecan-1 expression from the cell membrane to the cytoplasm in bladder cancer.
Miyake, Makito; Lawton, Adrienne; Dai, Yunfeng; Chang, Myron; Mengual, Lourdes; Alcaraz, Antonio; Goodison, Steve; Rosser, Charles J
To determine the diagnostic and prognostic capability of urinary and tumoral syndecan-1 (SDC-1) levels in patients with cancer of the urinary bladder. SDC-1 levels were quantitated by enzyme-linked immunosorbent assay (ELISA) in 308 subjects (102 cancer subjects and 206 non-cancer subjects) to assess its diagnostic capabilities in voided urine. The performance of SDC-1 was evaluated using the area under the curve of a receiver operating characteristic curve. In addition, immunohistochemical (IHC) staining assessed SDC-1 protein expression in 193 bladder specimens (185 cancer subjects and 8 non-cancer subjects). Outcomes were correlated to SDC-1 levels. Mean urinary levels of SDC-1 did not differ between the cancer subjects and the non-cancer subjects, however, the mean urinary levels of SDC-1 were reduced in high-grade compared to low-grade disease (p SDC-1 in normal tissue, low-grade tumors and NMIBC, to a distinctly cytoplasmic localization in high-grade tumors and MIBC was observed in tissue specimens. Alone urinary SDC-1 may not be a diagnostic biomarker for bladder cancer, but its urinary levels and cellular localization were associated with the differentiation status of patients with bladder tumors. Further studies are warranted to define the potential role for SDC-1 in bladder cancer progression.
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Yücel ÖZTÜRKOĞLU
Full Text Available ÖZ: Müşteri tatmininin her geçen gün daha da zorlaştığı hizmet sektörlerinde, işverenler sunulan hizmetin kalitesini arttırmak ve hizmetin devamlılığını sağlamak için yeni arayışlar içine girmekteler. İşverenler, müşteriden önce hizmeti sunan kişilerin memnuniyetini sağlayarak rekabet gücünü arttırma yollarına başvurmaktadırlar. Bu yollardan biri de çalışma sürelerinin esnekleştirilmesidir. Bu çalışmada, hizmet sektörleri arasında önemli bir yere sahip olan hastanelerde ki hemşire çizelgeleme problemi için tam sayılı matematiksel bir model oluşturulmuştur. Oluşturulan modelde, klasik çizelgeleme modellerinin aksine hemşirelerin işe başlama saatlerine esneklik getirilmiştir. Modelin başlıca amacı, hemşirelerin kendi tercihlerine göre haftalık çizelgelerinin oluşturulmasıdır. Oluşturulan model, gerçek veriler kullanılarak bir üniversite hastanesinin genel cerrahi bölümünde denenmiştir. Modelin, %99,6 oranında hemşire tercihlerini yerine getirdiği görülmektedir. Anahtar Kelimeler: Esnek Çalışma Saatleri, Hemşire Çizelgelemesi, Matematiksel Model, Tam Sayılı Programlama. ABSTRACT: In the service industry, customer satisfaction becomes more difficult with each passing day, employers have looked for new paradigms and ways to make service quality better and to keep service facilities reliable. Therefore, with the purpose of increasing their competitive power, employers give more importance to their employees who have direct relation with customers than they do to their customer. One of the new paradigms is make working hours flexible. In this study, an integer programming model is proposed for the nurse scheduling problem in the hospitals which are one of the most important service industries. On the contrary of classical nurse scheduling model, developed model has made flexible to starting time. The main aim of the model is make a schedule for nurses according to
Scheduling IT Staff at a Bank: A Mathematical Programming Approach
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M. Labidi
Full Text Available We address a real-world optimization problem: the scheduling of a Bank Information Technologies (IT staff. This problem can be defined as the process of constructing optimized work schedules for staff. In a general sense, it requires the allocation of suitably qualified staff to specific shifts to meet the demands for services of an organization while observing workplace regulations and attempting to satisfy individual work preferences. A monthly shift schedule is prepared to determine the shift duties of each staff considering shift coverage requirements, seniority-based workload rules, and staff work preferences. Due to the large number of conflicting constraints, a multiobjective programming model has been proposed to automate the schedule generation process. The suggested mathematical model has been implemented using Lingo software. The results indicate that high quality solutions can be obtained within a few seconds compared to the manually prepared schedules.
3D image-based adapted high-dose-rate brachytherapy in cervical cancer with and without interstitial needles: measurement of applicator shift between imaging and dose delivery
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Leif Karlsson
Full Text Available Purpose: Using 3D image-guided adaptive brachytherapy for cervical cancer treatment, it often means that patients are transported and moved during the treatment procedure. The purpose of this study was to determine the intra-fractional longitudinal applicator shift in relation to the high risk clinical target volume (HR-CTV by comparing geometries at imaging and dose delivery for patients with and without needles. Material and methods : Measurements were performed in 33 patients (71 fractions, where 25 fractions were without and 46 were with interstitial needles. Gold markers were placed in the lower part of the cervix as a surrogate for HR-CTV, enabling distance measurements between HR-CTV and the ring applicator. Shifts of the applicator relative to the markers were determined using planning computed tomography (CT images used for planning, and the radiographs obtained at dose delivery. Differences in the physical D90 for HR-CTV due to applicator shifts were simulated individually in the treatment planning system to provide the relative dose variation. Results : The maximum distances of the applicator shifts, in relation to the markers, were 3.6 mm (caudal, and –2.5 mm (cranial. There was a significant displacement of –0.7 mm (SD = 0.9 mm without needles, while with needles there was no significant shift. The relative dose variation showed a significant increase in D90 HR-CTV of 1.6% (SD = 2.6% when not using needles, and no significant dose variation was found when using needles. Conclusions : The results from this study showed that there was a small longitudinal displacement of the ring applicator and a significant difference in displacement between using interstitial needles or not.
Prescribed Travel Schedules for Fatigue Management
Whitmire, Alexandra; Johnston, Smith; Lockley, Steven
The NASA Fatigue Management Team is developing recommendations for managing fatigue during travel and for shift work operations, as Clinical Practice Guidelines for the Management of Circadian Desynchrony in ISS Operations. The Guidelines provide the International Space Station (ISS ) flight surgeons and other operational clinicians with evidence-based recommendations for mitigating fatigue and other factors related to sleep loss and circadian desynchronization. As much international travel is involved both before and after flight, the guidelines provide recommendations for: pre-flight training, in-flight operations, and post-flight rehabilitation. The objective of is to standardize the process by which care is provided to crewmembers, ground controllers, and other support personnel such as trainers, when overseas travel or schedule shifting is required. Proper scheduling of countermeasures - light, darkness, melatonin, diet, exercise, and medications - is the cornerstone for facilitating circadian adaptation, improving sleep, enhancing alertness, and optimizing performance. The Guidelines provide, among other things, prescribed travel schedules that outline the specific implementation of these mitigation strategies. Each travel schedule offers evidence based protocols for properly using the NASA identified countermeasures for fatigue. This presentation will describe the travel implementation schedules and how these can be used to alleviate the effects of jet lag and/or schedule shifts.
Adaptation of Shift Sequence Based Method for High Number in Shifts Rostering Problem for Health Care Workers
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Mindaugas Liogys
Full Text Available Purpose—is to investigate a shift sequence-based approach efficiency then problem consisting of a high number of shifts. Research objectives:• Solve health care workers rostering problem using a shift sequence based method.• Measure its efficiency then number of shifts increases. Design/methodology/approach—Usually rostering problems are highly constrained.Constraints are classified to soft and hard constraints. Soft and hard constraints of the problem are additionally classified to: sequence constraints, schedule constraints and roster constraints. Sequence constraints are considered when constructing shift sequences. Schedule constraints are considered when constructing a schedule. Roster constraints are applied, then constructing overall solution, i.e. combining all schedules.Shift sequence based approach consists of two stages:• Shift sequences construction,• The construction of schedules.In the shift sequences construction stage, the shift sequences are constructed for each set of health care workers of different skill, considering sequence constraints. Shifts sequences are ranked by their penalties for easier retrieval in later stage.In schedules construction stage, schedules for each health care worker are constructed iteratively, using the shift sequences produced in stage 1. Shift sequence based method is an adaptive iterative method where health care workers who received the highest schedule penalties in the last iteration are scheduled first at the current iteration. During the roster construction, and after a schedule has been generated for the current health care worker, an improvement method based on an efficient greedy local search is carried out on the partial roster. It simply swaps any pair of shifts between two health care workers in the (partial roster, as long as the swaps satisfy hard constraints and decrease the roster penalty.Findings—Using shift sequence method for solving health care workers rostering
Adaptation of Shift Sequence Based Method for High Number in Shifts Rostering Problem for Health Care Workers
Directory of Open Access Journals (Sweden)
Mindaugas Liogys
Full Text Available Purpose—is to investigate a shift sequence-based approach efficiency then problem consisting of a high number of shifts.Research objectives:• Solve health care workers rostering problem using a shift sequence based method.• Measure its efficiency then number of shifts increases.Design/methodology/approach—Usually rostering problems are highly constrained. Constraints are classified to soft and hard constraints. Soft and hard constraints of the problem are additionally classified to: sequence constraints, schedule constraints and roster constraints. Sequence constraints are considered when constructing shift sequences. Schedule constraints are considered when constructing a schedule. Roster constraints are applied, then constructing overall solution, i.e. combining all schedules.Shift sequence based approach consists of two stages:• Shift sequences construction,• The construction of schedules.In the shift sequences construction stage, the shift sequences are constructed for each set of health care workers of different skill, considering sequence constraints. Shifts sequences are ranked by their penalties for easier retrieval in later stage.In schedules construction stage, schedules for each health care worker are constructed iteratively, using the shift sequences produced in stage 1.Shift sequence based method is an adaptive iterative method where health care workers who received the highest schedule penalties in the last iteration are scheduled first at the current iteration.During the roster construction, and after a schedule has been generated for the current health care worker, an improvement method based on an efficient greedy local search is carried out on the partial roster. It simply swaps any pair of shifts between two health care workers in the (partial roster, as long as the swaps satisfy hard constraints and decrease the roster penalty.Findings—Using shift sequence method for solving health care workers rostering problem
Two schedules of chemotherapy for patients with non-small cell lung cancer in poor performance status: a phase II randomized trial.
Zwitter, Matjaz; Kovac, Viljem; Rajer, Mirjana; Vrankar, Martina; Smrdel, Uros
We present experience from a phase II randomized clinical trial, comparing standard gemcitabine as monotherapy with low-dose gemcitabine in long infusion in a doublet with cisplatin at reduced dose for patients with non-small cell lung cancer (NSCLC) and who are unfit for standard platin-based chemotherapy. Eligible patients had microscopically confirmed NSCLC in stage IIIB (wet) or IV, were chemo-naive, and were in poor performance status or presented with significant comorbidity. Standard treatment with gemcitabine, 1250 mg/m in 20-30 min on days 1 and 8 as monotherapy (arm A) was compared with low-dose gemcitabine in long infusion (200 mg/m in 6 h on day 1) and cisplatin at 60 mg/m on day 2 (arm B). Both treatment schedules were repeated every 3 weeks until disease progression, unacceptable toxicity, or to a maximum of six cycles. A total of 112 patients (83 male, 29 female, median age 66 years) were randomized between arm A (57 patients) and B (55 patients). The two groups were balanced for prognostic factors. Fifty-three patients in arm A and 52 in arm B received at least one application of chemotherapy and were evaluable for toxicity and response. The median number of cycles was four and five for arms A and B, respectively. Except for grade 3 anemia (one patient in arm A and two in arm B), no other major toxicity was seen. Regarding response to treatment, arm B was superior: 1 complete response and 13 partial remissions (response rate 26.9%) as compared with five partial remissions (response rate 9.4%) in arm A (Psuperior to monotherapy with gemcitabine in standard doses, and is suitable for patients with NSCLC who cannot tolerate a standard platin-based doublet.
Phase II study evaluating 2 dosing schedules of oral foretinib (GSK1363089, cMET/VEGFR2 inhibitor, in patients with metastatic gastric cancer.
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Manish A Shah
Full Text Available PURPOSE: The receptors for hepatocyte and vascular endothelial cell growth factors (MET and VEGFR2, respectively are critical oncogenic mediators in gastric adenocarcinoma. The purpose is to examine the safety and efficacy of foretinib, an oral multikinase inhibitor targeting MET, RON, AXL, TIE-2, and VEGFR2 receptors, for the treatment of metastatic gastric adenocarcinoma. PATIENTS AND METHODS: Foretinib safety and tolerability, and objective response rate (ORR were evaluated in patients using intermittent (240 mg/day, for 5 days every 2 weeks or daily (80 mg/day dosing schedules. Thirty evaluable patients were required to achieve alpha = 0.10 and beta = 0.2 to test the alternative hypothesis that single-agent foretinib would result in an ORR of ≥ 25%. Up to 10 additional patients could be enrolled to ensure at least eight with MET amplification. Correlative studies included tumor MET amplification, MET signaling, pharmacokinetics and plasma biomarkers of foretinib activity. RESULTS: From March 2007 until October 2009, 74 patients were enrolled; 74% male; median age, 61 years (range, 25-88; 93% had received prior therapy. Best response was stable disease (SD in 10 (23% patients receiving intermittent dosing and five (20% receiving daily dosing; SD duration was 1.9-7.2 months (median 3.2 months. Of 67 patients with tumor samples, 3 had MET amplification, one of whom had SD. Treatment-related adverse events occurred in 91% of patients. Rates of hypertension (35% vs. 15% and elevated aspartate aminotransferase (23% vs. 8% were higher with intermittent dosing. In both patients with high baseline tumor phospho-MET (pMET, the pMET:total MET protein ratio decreased with foretinib treatment. CONCLUSION: These results indicate that few gastric carcinomas are driven solely by MET and VEGFR2, and underscore the diverse molecular oncogenesis of this disease. Despite evidence of MET inhibition by foretinib, single-agent foretinib lacked efficacy in
Predictive global trends in the incidence and mortality of pancreatic cancer based on geographic location, socio-economic status, and demographic shift.
Are, Chandrakanth; Chowdhury, Sanjib; Ahmad, Humera; Ravipati, Advaitaa; Song, Tianqiang; Shrikandhe, Shailesh; Smith, Lynette
Pancreatic Cancer (PC) is a lethal malignancy that accounts for about 4% of cancer-related deaths worldwide. The aim of this study is to describe the influence of geography (based on WHO regions), socio-economic development (based on Human Development Index [HDI]) and demographic shift on the temporal trends in global incidence and mortality of PC. Data (2012-2030) relating to the incidence, mortality of PC and demographic shifts based on WHO regions and HDI areas were extracted from GLOBOCAN 2012. Linear regression was used to evaluate trends in total incidence and mortality. We noted a definite association between PC and higher socio-economic status. Advanced age (age ≥65) contributed to the rising burden in all socio-economic regions of the world except in the Low Human Development (LHD) countries where the disease predominantly affected population global burden of PC is expected to rise significantly over the next few decades regardless of geographic location, socio-economic development, age and gender. Advance knowledge of this data can help formulate strategies to specifically target countries and populations that promote public health policy to tackle this lethal disease on the global stage. J. Surg. Oncol. 2016;114:736-742. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Immunization Schedules for Adults
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Monfette, Ronald J.
Argues that college publications, including class schedules, must be accurate, timely, and easy to read and follow. Describes Schoolcraft College's unified format approach to publications marketing. Offers suggestions on the design, format, and distribution of class schedules. (DMM)
Liver cancer-derived hepatitis C virus core proteins shift TGF-beta responses from tumor suppression to epithelial-mesenchymal transition.
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Serena Battaglia
Full Text Available BACKGROUND: Chronic hepatitis C virus (HCV infection and associated liver cirrhosis represent a major risk factor for hepatocellular carcinoma (HCC development. TGF-beta is an important driver of liver fibrogenesis and cancer; however, its actual impact in human cancer progression is still poorly known. The aim of this study was to investigate the role of HCC-derived HCV core natural variants on cancer progression through their impact on TGF-beta signaling. PRINCIPAL FINDINGS: We provide evidence that HCC-derived core protein expression in primary human or mouse hepatocyte alleviates TGF-beta responses in terms or growth inhibition or apoptosis. Instead, in these hepatocytes TGF-beta was still able to induce an epithelial to mesenchymal transition (EMT, a process that contributes to the promotion of cell invasion and metastasis. Moreover, we demonstrate that different thresholds of Smad3 activation dictate the TGF-beta responses in hepatic cells and that HCV core protein, by decreasing Smad3 activation, may switch TGF-beta growth inhibitory effects to tumor promoting responses. CONCLUSION/SIGNIFICANCE: Our data illustrate the capacity of hepatocytes to develop EMT and plasticity under TGF-beta, emphasize the role of HCV core protein in the dynamic of these effects and provide evidence for a paradigm whereby a viral protein implicated in oncogenesis is capable to shift TGF-beta responses from cytostatic effects to EMT development.
Granfeldt, Caroline
Several industries use what is called rotating workforce scheduling. This often means that employees are needed around the clock seven days a week, and that they have a schedule which repeats itself after some weeks. This thesis gives an introduction to this kind of scheduling and presents a review of previous work done in the field. Two different optimization models for rotating workforce scheduling are formulated and compared, and some examples are created to demonstrate how the addition of...
Section 207(f)(2) of the E-Gov Act requires federal agencies to develop an inventory and establish a schedule of information to be published on their Web sites, make those schedules available for public comment. To post the schedules on the web site.
Parental Work Schedules and Children's Cognitive Trajectories
Han, Wen-Jui; Fox, Liana E.
Previous work has shown an association between mothers' nonstandard work schedules and children's well-being. We built on this research by examining the relationship between parental shift work and children's reading and math trajectories from age 5-6 to 13-14. Using data (N = 7,105) from the National Longitudinal Survey of Youth and growth-curve…
{sup 1}H NMR metabolomics identification of markers of hypoxia-induced metabolic shifts in a breast cancer model system
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Weljie, Aalim M., E-mail: firstname.lastname@example.com [University of Calgary, Department of Biological Sciences (Canada); Bondareva, Alla [Department of Comparative Biology and Experimental Medicine (Canada); Zang, Ping [University of Calgary, Department of Chemistry (Canada); Jirik, Frank R. [McCaig Institute for Bone and Joint Health, Department of Biochemistry and Molecular Biology (Canada)
Hypoxia can promote invasive behavior in cancer cells and alters the response to therapeutic intervention as a result of changes in the expression many genes, including genes involved in intermediary metabolism. Although metabolomics technologies are capable of simultaneously measuring a wide range of metabolites in an untargeted manner, these methods have been relatively under utilized in the study of cancer cell responses to hypoxia. Thus, {sup 1}H NMR metabolomics was used to examine the effects of hypoxia in the MDA-MB-231 human breast cancer cell line, both in vitro and in vivo. Cell cultures were compared with respect to their metabolic responses during growth under either hypoxic (1% O{sub 2}) or normoxic conditions. Orthogonal partial least squares discriminant analysis (OPLS-DA) was used to identify a set of metabolites that were responsive to hypoxia. Via intracardiac administration, MDA-MB-231 cells were also used to generate widespread metastatic disease in immuno-compromised mice. Serum metabolite analysis was conducted to compare animals with and without a large tumor burden. Intriguingly, using a cross-plot of the OPLS loadings, both the in vitro and in vivo samples yielded a subset of metabolites that were significantly altered by hypoxia. These included primarily energy metabolites and amino acids, indicative of known alterations in energy metabolism, and possibly protein synthesis or catabolism. The results suggest that the metabolite pattern identified might prove useful as a marker for intra-tumoral hypoxia.
DEFF Research Database (Denmark)
Blaagaard, Bolette
within journalistic practice of keeping up the idea as well as the practice of journalistic objectivity. Working on from Schudson (2003), Schudson and Anderson (2009) and Tumber and Prentoulis' (2003) analyses of journalistic professionalism, the article develops the idea of journalistic objectivity...... further on the question of how the students address and react to this paradigmatic shift....
Intracellular Assembly of Nuclear-Targeted Gold Nanosphere Enables Selective Plasmonic Photothermal Therapy of Cancer by Shifting Their Absorption Wavelength toward Near-Infrared Region.
Panikkanvalappil, Sajanlal R; Hooshmand, Nasrin; El-Sayed, Mostafa A
Despite the important applications of near-infrared (NIR) absorbing nanomaterials in plasmonic photothermal therapy (PPT), their high yield synthesis and nonspecific heating during the active- and passive-targeted cancer therapeutic strategies remain challenging. In the present work, we systematically demonstrate that in situ aggregation of typical non-NIR absorbing plasmonic nanoparticles at the nuclear region of the cells could translate them into an effective NIR photoabsorber in plasmonic photothermal therapy of cancer due to a significant shift of the plasmonic absorption band to the NIR region. We evaluated the potential of nuclear-targeted AuNSs as photoabsorber at various stages of endocytosis by virtue of their inherent in situ assembling capabilities at the nuclear region of the cells, which has been considered as one of the most thermolabile structures within the cells, to selectively destruct cancer cells with minimal damage to healthy cells. Various plasmonic nanoparticles such as rods and cubes have been exploited to elucidate the role of plasmonic field coupling in assembled nanoparticles and their subsequent killing efficiency. The NIR absorbing capabilities of aggregated AuNSs have been further demonstrated both experimentally and theoretically using discrete dipolar approximation (DDA) techniques, which was in concordance with the observed results in plasmonic photothermal therapeutic studies. While the current work was able to demonstrate the utility of non-NIR absorbing plasmonic nanoparticles as a potential alternative for plasmonic photothermal therapy by inducing localized plasmonic heating at the nuclear region of the cells, these findings could potentially open up new possibilities in developing more efficient nanoparticles for efficient cancer treatment modalities.
The glycolytic shift in fumarate-hydratase-deficient kidney cancer lowers AMPK levels, increases anabolic propensities and lowers cellular iron levels
Tong, Winghang
Inactivation of the TCA cycle enzyme, fumarate hydratase (FH), drives a metabolic shift to aerobic glycolysis in FH-deficient kidney tumors and cell lines from patients with hereditary leiomyomatosis renal cell cancer (HLRCC), resulting in decreased levels of AMP-activated kinase (AMPK) and p53 tumor suppressor, and activation of the anabolic factors, acetyl-CoA carboxylase and ribosomal protein S6. Reduced AMPK levels lead to diminished expression of the DMT1 iron transporter, and the resulting cytosolic iron deficiency activates the iron regulatory proteins, IRP1 and IRP2, and increases expression of the hypoxia inducible factor HIF-1α, but not HIF-2α. Silencing of HIF-1α or activation of AMPK diminishes invasive activities, indicating that alterations of HIF-1α and AMPK contribute to the oncogenic growth of FH-deficient cells. © 2011 Elsevier Inc.
Ticagrelor shift from PLATO to PEGASUS: Vanished mortality benefit, excess cancer deaths, massive discontinuations, and overshooting target events.
Serebruany, Victor L
After the successful PLATO, failed both PHILO and ATLANTIC, PEGASUS trial assessed efficacy and safety of ticagrelor (120 mg/day and 180 mg/day) on top of aspirin versus aspirin alone beyond 1 year in patients with stable coronary disease. Similar to PLATO, PEGASUS revealed reduction of composite primary endpoint after ticagrelor at expense of extra bleeding. However, there were major fundamental differences between the trial outcomes. Hence, the shift of evidence with ticagrelor from PLATO to PEGASUS trials has been comprehended. In contrast to PLATO, in PEGASUS there were more premature permanent ticagrelor discontinuations (PPTD): RR=1.35; 95%CI 1.29-1.42, pPLATO, but rather discover additional shortcomings. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Adaptation to shift work: physiologically based modeling of the effects of lighting and shifts' start time.
Postnova, Svetlana; Robinson, Peter A; Postnov, Dmitry D
Shift work has become an integral part of our life with almost 20% of the population being involved in different shift schedules in developed countries. However, the atypical work times, especially the night shifts, are associated with reduced quality and quantity of sleep that leads to increase of sleepiness often culminating in accidents. It has been demonstrated that shift workers' sleepiness can be improved by a proper scheduling of light exposure and optimizing shifts timing. Here, an integrated physiologically-based model of sleep-wake cycles is used to predict adaptation to shift work in different light conditions and for different shift start times for a schedule of four consecutive days of work. The integrated model combines a model of the ascending arousal system in the brain that controls the sleep-wake switch and a human circadian pacemaker model. To validate the application of the integrated model and demonstrate its utility, its dynamics are adjusted to achieve a fit to published experimental results showing adaptation of night shift workers (n = 8) in conditions of either bright or regular lighting. Further, the model is used to predict the shift workers' adaptation to the same shift schedule, but for conditions not considered in the experiment. The model demonstrates that the intensity of shift light can be reduced fourfold from that used in the experiment and still produce good adaptation to night work. The model predicts that sleepiness of the workers during night shifts on a protocol with either bright or regular lighting can be significantly improved by starting the shift earlier in the night, e.g.; at 21:00 instead of 00:00. Finally, the study predicts that people of the same chronotype, i.e. with identical sleep times in normal conditions, can have drastically different responses to shift work depending on their intrinsic circadian and homeostatic parameters.
Adaptation to shift work: physiologically based modeling of the effects of lighting and shifts' start time.
Directory of Open Access Journals (Sweden)
Svetlana Postnova
Full Text Available Shift work has become an integral part of our life with almost 20% of the population being involved in different shift schedules in developed countries. However, the atypical work times, especially the night shifts, are associated with reduced quality and quantity of sleep that leads to increase of sleepiness often culminating in accidents. It has been demonstrated that shift workers' sleepiness can be improved by a proper scheduling of light exposure and optimizing shifts timing. Here, an integrated physiologically-based model of sleep-wake cycles is used to predict adaptation to shift work in different light conditions and for different shift start times for a schedule of four consecutive days of work. The integrated model combines a model of the ascending arousal system in the brain that controls the sleep-wake switch and a human circadian pacemaker model. To validate the application of the integrated model and demonstrate its utility, its dynamics are adjusted to achieve a fit to published experimental results showing adaptation of night shift workers (n = 8 in conditions of either bright or regular lighting. Further, the model is used to predict the shift workers' adaptation to the same shift schedule, but for conditions not considered in the experiment. The model demonstrates that the intensity of shift light can be reduced fourfold from that used in the experiment and still produce good adaptation to night work. The model predicts that sleepiness of the workers during night shifts on a protocol with either bright or regular lighting can be significantly improved by starting the shift earlier in the night, e.g.; at 21:00 instead of 00:00. Finally, the study predicts that people of the same chronotype, i.e. with identical sleep times in normal conditions, can have drastically different responses to shift work depending on their intrinsic circadian and homeostatic parameters.
Optimal schedules of light exposure for rapidly correcting circadian misalignment.
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Kirill Serkh
Full Text Available Jet lag arises from a misalignment of circadian biological timing with the timing of human activity, and is caused by rapid transmeridian travel. Jet lag's symptoms, such as depressed cognitive alertness, also arise from work and social schedules misaligned with the timing of the circadian clock. Using experimentally validated mathematical models, we develop a new methodology to find mathematically optimal schedules of light exposure and avoidance for rapidly re-entraining the human circadian system. In simulations, our schedules are found to significantly outperform other recently proposed schedules. Moreover, our schedules appear to be significantly more robust to both noise in light and to inter-individual variations in endogenous circadian period than other proposed schedules. By comparing the optimal schedules for thousands of different situations, and by using general mathematical arguments, we are also able to translate our findings into general principles of optimal circadian re-entrainment. These principles include: 1 a class of schedules where circadian amplitude is only slightly perturbed, optimal for dim light and for small shifts 2 another class of schedules where shifting occurs along the shortest path in phase-space, optimal for bright light and for large shifts 3 the determination that short light pulses are less effective than sustained light if the goal is to re-entrain quickly, and 4 the determination that length of daytime should be significantly shorter when delaying the clock than when advancing it.
Developing optimal nurses work schedule using integer programming
Shahidin, Ainon Mardhiyah; Said, Mohd Syazwan Md; Said, Noor Hizwan Mohamad; Sazali, Noor Izatie Amaliena
Time management is the art of arranging, organizing and scheduling one's time for the purpose of generating more effective work and productivity. Scheduling is the process of deciding how to commit resources between varieties of possible tasks. Thus, it is crucial for every organization to have a good work schedule for their staffs. The job of Ward nurses at hospitals runs for 24 hours every day. Therefore, nurses will be working using shift scheduling. This study is aimed to solve the nurse scheduling problem at an emergency ward of a private hospital. A 7-day work schedule for 7 consecutive weeks satisfying all the constraints set by the hospital will be developed using Integer Programming. The work schedule for the nurses obtained gives an optimal solution where all the constraints are being satisfied successfully.
Cancer Theranostic Nanoparticles Self-Assembled from Amphiphilic Small Molecules with Equilibrium Shift-Induced Renal Clearance.
Ma, Yuan; Mou, Quanbing; Sun, Mo; Yu, Chunyang; Li, Jianqi; Huang, Xiaohua; Zhu, Xinyuan; Yan, Deyue; Shen, Jian
Nano drug delivery systems have emerged as promising candidates for cancer therapy, whereas their uncertainly complete elimination from the body within specific timescales restricts their clinical translation. Compared with hepatic clearance of nanoparticles, renal excretion of small molecules is preferred to minimize the agent-induced toxicity. Herein, we construct in vivo renal-clearable nanoparticles, which are self-assembled from amphiphilic small molecules holding the capabilities of magnetic resonance imaging (MRI) and chemotherapy. The assembled nanoparticles can accumulate in tumor tissues for their nano-characteristics, while the small molecules dismantled from the nanoparticles can be efficiently cleared by kidneys. The renal-clearable nanoparticles exhibit excellent tumor-inhibition performance as well as low side effects and negligible chronic toxicity. These results demonstrate a potential strategy for small molecular nano drug delivery systems with obvious anticancer effect and low-toxic metabolism pathway for clinical applications.
Combinatory CPU Scheduling Algorithm
Saeeda Bibi; Farooque Azam; Yasir Chaudhry
Central Processing Unit (CPU) plays a significant role in computer system by transferring its control among different processes. As CPU is a central component, hence it must be used efficiently. Operating system performs an essential task that is known as CPU scheduling for efficient utilization of CPU. CPU scheduling has strong effect on resource utilization as well as overall performance of the system. In this paper, a new CPU scheduling algorithm called Combinatory is proposed that combine...
Solving cyclical nurse scheduling problem using preemptive goal programming
Sundari, V. E.; Mardiyati, S.
Nurse scheduling system in a hospital is being modeled as a preemptive goal programming problem that is solved by using LINGO software with the objective function to minimize deviation variable at each goal. The scheduling is done cyclically, so every nurse is treated fairly since they have the same work shift portion with the other nurses. By paying attention to the hospital's rules regarding nursing work shift cyclically, it can be obtained that numbers of nurse needed in every ward are 18 nurses and the numbers of scheduling periods are 18 periods where every period consists of 21 days.
Stenger, M. B.; Hargens, A. R.; Dulchavsky, S. A.; Arbeille, P.; Danielson, R. W.; Ebert, D. J.; Garcia, K. M.; Johnston, S. L.; Laurie, S. S.; Lee, S. M. C.;
Introduction. NASA's Human Research Program is focused on addressing health risks associated with long-duration missions on the International Space Station (ISS) and future exploration-class missions beyond low Earth orbit. Visual acuity changes observed after short-duration missions were largely transient, but now more than 50 percent of ISS astronauts have experienced more profound, chronic changes with objective structural findings such as optic disc edema, globe flattening and choroidal folds. These structural and functional changes are referred to as the visual impairment and intracranial pressure (VIIP) syndrome. Development of VIIP symptoms may be related to elevated intracranial pressure (ICP) secondary to spaceflight-induced cephalad fluid shifts, but this hypothesis has not been tested. The purpose of this study is to characterize fluid distribution and compartmentalization associated with long-duration spaceflight and to determine if a relation exists with vision changes and other elements of the VIIP syndrome. We also seek to determine whether the magnitude of fluid shifts during spaceflight, as well as any VIIP-related effects of those shifts, are predicted by the crewmember's pre-flight status and responses to acute hemodynamic manipulations, specifically posture changes and lower body negative pressure. Methods. We will examine a variety of physiologic variables in 10 long-duration ISS crewmembers using the test conditions and timeline presented in the figure below. Measures include: (1) fluid compartmentalization (total body water by D2O, extracellular fluid by NaBr, intracellular fluid by calculation, plasma volume by CO rebreathe, interstitial fluid by calculation); (2) forehead/eyelids, tibia, and calcaneus tissue thickness (by ultrasound); (3) vascular dimensions by ultrasound (jugular veins, cerebral and carotid arteries, vertebral arteries and veins, portal vein); (4) vascular dynamics by MRI (head/neck blood flow, cerebrospinal fluid
Measuring prostate-specific quality of life in prostate cancer patients scheduled for radiotherapy or radical prostatectomy and reference men in Germany and Canada using the Patient Oriented Prostate Utility Scale-Psychometric (PORPUS-P
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Kuechler Thomas
Full Text Available Abstract Background The PORPUS-P is a short questionnaire for measuring prostate-specific quality of life (QoL, which was designed in Canada for use in prostate cancer (PC patients. We aimed to generate a German version and compare PORPUS-P scores of German reference men from the general population, and German and Canadian patients with newly diagnosed PC who were scheduled to receive radical prostatectomy (RP or radiotherapy (RT. Methods The study sample consisted of 988 reference men, 121 German and 66 Canadian PC patients scheduled for RT, and 371 German and 68 Canadian PC patients scheduled for RP. All men completed the PORPUS-P (German postal questionnaire, Canada personal interview. Data were gathered from PC patients before the start of therapy. Results Canadian patients were better educated than the German patients, and fewer were retired. Patients scheduled to receive RT were older and more were retired. German RT patients had lower D'Amico risk scores and pre-treatment Gleason scores than RP patients, and Canadian RT patients had higher pre-treatment PSA than RP patients. Urinary and sexual dysfunction were seen in PC patients (especially RT patients, but were also common in the German reference men. Crude mean PORPUS-P scores differed statistically significant between German RT and RP and Canadian RP and RT patients, with RT patients having higher QoL scores. The differences in age-adjusted mean PORPUS-P scores between reference men and RP patients were not clinically significant, while RT patients had (clinically significantly lower scores than the reference men. Conclusion The German translation of the PORPUS-P appears to be a short and feasible tool for assessing prostate-specific QoL. Although we found a similar response pattern, Canadian and German PC patients scheduled to receive RT or RP rated their pre-treatment quality of life on different levels, which reveals the need for national reference data. Problems in several Qo
Work at night and breast cancer--report on evidence-based options for preventive actions
DEFF Research Database (Denmark)
Bonde, Jens Peter; Hansen, Johnni; Kolstad, Henrik Albert
In 2007, the International Agency for Research on Cancer classified shift work involving circadian disruption as probably carcinogenic to humans (group 2A), primarily based on experimental and epidemiologic evidence for breast cancer. In order to examine options for evidence-based preventive...... by suppression of melatonin secretion. Work during the night is widespread worldwide. To provide additional evidence-based recommendations on prevention of diseases related to night shift work, large studies on the impact of various shift schedules and type of light on circadian rhythms need to be conducted...
Fiebiger, Leo J.
The design and implementation of a rotating class schedule which was put into effect in the Charlo High School, Charlo, Montana in September 1969 is discussed in this paper. The schedule, described in this report, consists of a 75-minute period followed by 2, 60-minute periods in the morning and 4, 45-minute afternoon periods. The program…
Logan, J. R.; Pulvermacher, M. K.
Range Scheduling Aid (RSA) is presented in the form of the viewgraphs. The following subject areas are covered: satellite control network; current and new approaches to range scheduling; MITRE tasking; RSA features; RSA display; constraint based analytic capability; RSA architecture; and RSA benefits.
Safety of a 3-weekly schedule of carboplatin plus pegylated liposomal doxorubicin as first line chemotherapy in patients with ovarian cancer: preliminary results of the MITO-2 randomized trial
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D'Arco Alfonso
Full Text Available Abstract Background The MITO-2 (Multicentre Italian Trials in Ovarian cancer study is a randomized phase III trial comparing carboplatin plus paclitaxel to carboplatin plus pegylated liposomal doxorubicin in first-line chemotherapy of patients with ovarian cancer. Due to the paucity of published phase I data on the 3-weekly experimental schedule used, an early safety analysis was planned. Methods Patients with ovarian cancer (stage Ic-IV, aged 2, every 3 weeks or to carboplatin AUC 5 plus pegylated liposomal doxorubicin 30 mg/m2, every 3 weeks. Treatment was planned for 6 cycles. Toxicity was coded according to the NCI-CTC version 2.0. Results The pre-planned safety analysis was performed in July 2004. Data from the first 50 patients treated with carboplatin plus pegylated liposomal doxorubicin were evaluated. Median age was 60 years (range 34–75. Forty-three patients (86% completed 6 cycles. Two thirds of the patients had at least one cycle delayed due to toxicity, but 63% of the cycles were administered on time. In most cases the reason for chemotherapy delay was neutropenia or other hematological toxicity. No delay due to palmar-plantar erythrodysesthesia (PPE was recorded. No toxic death was recorded. Reported hematological toxicities were: grade (G 3 anemia 16%, G3/G4 neutropenia 36% and 10% respectively, G3/4 thrombocytopenia 22% and 4% respectively. Non-haematological toxicity was infrequent: pulmonary G1 6%, heart rhythm G1 4%, liver toxicity G1 6%, G2 4% and G3 2%. Complete hair loss was reported in 6% of patients, and G1 neuropathy in 2%. PPE was recorded in 14% of the cases (G1 10%, G2 2%, G3 2%. Conclusion This safety analysis shows that the adopted schedule of carboplatin plus pegylated liposomal doxorubicin given every 3 weeks is feasible as first line treatment in ovarian cancer patients, although 37% of the cycles were delayed due to haematological toxicity. Toxicities that are common with standard combination of carboplatin
Safety of a 3-weekly schedule of carboplatin plus pegylated liposomal doxorubicin as first line chemotherapy in patients with ovarian cancer: preliminary results of the MITO-2 randomized trial.
Pignata, Sandro; Scambia, Giovanni; Savarese, Antonella; Breda, Enrico; Scollo, Paolo; De Vivo, Rocco; Rossi, Emanuela; Gebbia, Vittorio; Natale, Donato; Del Gaizo, Filomena; Naglieri, Emanuele; Ferro, Antonella; Musso, Pietro; D'Arco, Alfonso Maria; Sorio, Roberto; Pisano, Carmela; Di Maio, Massimo; Signoriello, Giuseppe; Annunziata, Annalisa; Perrone, Francesco
The MITO-2 (Multicentre Italian Trials in Ovarian cancer) study is a randomized phase III trial comparing carboplatin plus paclitaxel to carboplatin plus pegylated liposomal doxorubicin in first-line chemotherapy of patients with ovarian cancer. Due to the paucity of published phase I data on the 3-weekly experimental schedule used, an early safety analysis was planned. Patients with ovarian cancer (stage Ic-IV), aged liposomal doxorubicin 30 mg/m2, every 3 weeks. Treatment was planned for 6 cycles. Toxicity was coded according to the NCI-CTC version 2.0. The pre-planned safety analysis was performed in July 2004. Data from the first 50 patients treated with carboplatin plus pegylated liposomal doxorubicin were evaluated. Median age was 60 years (range 34-75). Forty-three patients (86%) completed 6 cycles. Two thirds of the patients had at least one cycle delayed due to toxicity, but 63% of the cycles were administered on time. In most cases the reason for chemotherapy delay was neutropenia or other hematological toxicity. No delay due to palmar-plantar erythrodysesthesia (PPE) was recorded. No toxic death was recorded. Reported hematological toxicities were: grade (G) 3 anemia 16%, G3/G4 neutropenia 36% and 10% respectively, G3/4 thrombocytopenia 22% and 4% respectively. Non-haematological toxicity was infrequent: pulmonary G1 6%, heart rhythm G1 4%, liver toxicity G1 6%, G2 4% and G3 2%. Complete hair loss was reported in 6% of patients, and G1 neuropathy in 2%. PPE was recorded in 14% of the cases (G1 10%, G2 2%, G3 2%). This safety analysis shows that the adopted schedule of carboplatin plus pegylated liposomal doxorubicin given every 3 weeks is feasible as first line treatment in ovarian cancer patients, although 37% of the cycles were delayed due to haematological toxicity. Toxicities that are common with standard combination of carboplatin plus paclitaxel (neurotoxicity and hair loss) are infrequent with this experimental schedule, and skin toxicity appears
Shifting paradigms in the estimation of survival for castration-resistant prostate cancer: A tertiary academic center experience.
Afshar, Mehran; Evison, Felicity; James, Nicholas D; Patel, Prashant
Castration-resistant prostate cancer (CRPC) has retained a guarded prognosis, with historical survival estimates of 18 to 24 months. However, the landscape of available therapy has changed, and the emphasis has altered from supportive to active treatment. Few large series from real-world populations exist in the contemporary era with fully mature survival data to confirm the indication based on clinical trials that patients with CRPC are surviving far longer than the historical estimates. We aim to review a large patient cohort with CRPC and provide mature survival data. Using the electronic histopathology database at Queen Elizabeth Hospital, Birmingham, UK, all prostate-specific antigentest results between April 2006 and September 2007 were extracted, and patients satisfying the American Society for Radiation Oncology (ASTRO) definition of hormone failure were identified. Electronic records were reviewed and variables were collected, including survival, treatment, biochemistry, histopathology, and demographics. Probability of survival, and of developing metastasis or CRPC, was determined using the Kaplan-Meier method. Patients were stratified into 3 groups, namely, D0--no metastasis at diagnosis but later appearance, D1--no metastasis at diagnosis or at last follow-up, and D2--metastasis at diagnosis. From 8,062 patient-prostate-specific antigen episodes, we identified 447 patients meeting the criteria. A notes review revealed 147 patients with CRPC. Median overall survival (OS) from diagnosis was 84.7 months (95% CI: 73-89), and 129 deaths had occurred (88%). Median OS from diagnosis for D0, D1, and D2 patients was 100.4, 180.1, and 58.9 months, respectively (P< 0.0001), and median OS from CRPC was 40 months (95% CI: 31-58), 82.9 (95% CI: 72-94; P = 0.0125), and 38.7 months (95% CI: 33-46), respectively. One-quarter of patients survived 6 years after development of CRPC. Metastasis is the key prognostic event. Some current international guidelines quote ≤19
DEFF Research Database (Denmark)
Garofalo, Orsola; Rott, Christina
by the spokesperson if there is room for shifting blame. The increased punishment results from the messenger's style of delivery: spokespersons are more likely than decision makers to express emotional regret instead of rational need. Receivers seem to punish the former style of communication because they view......Decision makers frequently have a spokesperson communicate their decisions. In this paper, we address two questions. First, does it matter who communicates an unfair decision? Second, does it matter how the unfair decision is communicated? We conduct a modified dictator game experiment in which...... either the decision maker or a spokesperson communicates the decided allocation to recipients, who then determine whether to punish either of them. We find that receivers punish both the decision maker and the spokesperson more often, and more heavily, for unfair allocations communicated...
Chemical shift effect predicting lymph node status in rectal cancer using high-resolution MR imaging with node-for-node matched histopathological validation
Energy Technology Data Exchange (ETDEWEB)
Zhang, Hongmei; Zhang, Chongda; Ye, Feng; Liu, Yuan; Zhou, Chunwu [Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Diagnostic Radiology, National Cancer Center/Cancer Hospital, ChaoYang District, Beijing (China); Zheng, Zhaoxu [Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Colorectal Oncology, National Cancer Center/Cancer Hospital, ChaoYang District, Beijing (China); Zou, Shuangmei [Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Pathology, National Cancer Center/Cancer Hospital, ChaoYang District, Beijing (China)
To evaluate the value of the chemical shift effect (CSE) as well as other criteria for the prediction of lymph node status. Twenty-nine patients who underwent radical surgery of rectal cancers were studied with pre- and postoperative specimen MRI. Lymph nodes were harvested from transverse whole-mount specimens and compared with in vivo and ex vivo images to obtain a precise slice-for-section match. Preoperative MR characteristics including CSE, as well as other predictors, were evaluated by two readers independently between benign and metastatic nodes. A total of 255 benign and 35 metastatic nodes were obtained; 71.4% and 69.4% of benign nodes were detected with regular CSE for two readers, whereas 80.0% and 74.3% of metastatic nodes with absence of CSE. The CSE rendered areas under the ROC curve (AUC) of 0.879 and 0.845 for predicting nodal status for two readers. The criteria of nodal location, border, signal intensity and minimum distance to the rectal wall were also useful but with AUCs (0.629-0.743) lower than those of CSE. CSE is a reliable predictor for differentiating benign from metastatic nodes. Additional criteria should be taken into account when it is difficult to determine the nodal status by using only a single predictor. (orig.)
Adaptive auto-regulation of androgen receptor provides a paradigm shifting rationale for bipolar androgen therapy (BAT) for castrate resistant human prostate cancer.
Isaacs, John T; D'Antonio, Jason M; Chen, Shuangling; Antony, Lizamma; Dalrymple, Susan P; Ndikuyeze, Georges H; Luo, Jun; Denmeade, Samuel R
Cell culture/xenograft and gene arrays of clinical material document that development of castration resistant prostate cancer (CRPC) cells involves acquisition of adaptive auto-regulation resulting in >25-fold increase in Androgen Receptor (AR) protein expression in a low androgen environment. Such adaptive AR increase paradoxically is a liability in castrated hosts, however, when supraphysiologic androgen is acutely replaced. Cell synchronization/anti-androgen response is due to AR binding to replication complexes (RC) at origin of replication sites (ORS) in early G1 associated with licensing/restricting DNA for single round of duplication during S-phase. When CRPC cells are acutely exposed to supraphysiologic androgen, adaptively increased nuclear AR is over-stabilized, preventing sufficient degradation in mitosis, inhibiting DNA re-licensing, and thus death in the subsequent cell cycle. These mechanistic results and the fact that AR/RC binding occurs in metastatic CRPCs directly from patients provides a paradigm shifting rationale for bipolar androgen therapy (BAT) in patient progressing on chronic androgen ablation. BAT involves giving sequential cycles alternating between periods of acute supraphysiologic androgen followed by acute ablation to take advantage of vulnerability produced by adaptive auto-regulation and binding of AR to RC in CRPC cells. BAT therapy is effective in xenografts and based upon positive results has entered clinical testing. Copyright © 2012 Wiley Periodicals, Inc.
Simulated Night Shift Disrupts Circadian Rhythms of Immune Functions in Humans.
Cuesta, Marc; Boudreau, Philippe; Dubeau-Laramée, Geneviève; Cermakian, Nicolas; Boivin, Diane B
Recent research unveiled a circadian regulation of the immune system in rodents, yet little is known about rhythms of immune functions in humans and how they are affected by circadian disruption. In this study, we assessed rhythms of cytokine secretion by immune cells and tested their response to simulated night shifts. PBMCs were collected from nine participants kept in constant posture over 24 h under a day-oriented schedule (baseline) and after 3 d under a night-oriented schedule. Monocytes and T lymphocytes were stimulated with LPS and PHA, respectively. At baseline, a bimodal rhythmic secretion was detected for IL-1β, IL-6, and TNF-α: a night peak was primarily due to a higher responsiveness of monocytes, and a day peak was partly due to a higher proportion of monocytes. A rhythmic release was also observed for IL-2 and IFN-γ, with a nighttime peak due to a higher cell count and responsiveness of T lymphocytes. Following night shifts, with the exception of IL-2, cytokine secretion was still rhythmic but with peak levels phase advanced by 4.5-6 h, whereas the rhythm in monocyte and T lymphocyte numbers was not shifted. This suggests distinct mechanisms of regulation between responsiveness to stimuli and cell numbers of the human immune system. Under a night-oriented schedule, only cytokine release was partly shifted in response to the change in the sleep-wake cycle. This led to a desynchronization of rhythmic immune parameters, which might contribute to the increased risk for infection, autoimmune diseases, cardiovascular and metabolic disorders, and cancer reported in shift workers. Copyright © 2016 by The American Association of Immunologists, Inc.
Directory of Open Access Journals (Sweden)
William R. Veal
Full Text Available This study examined the effects of a tri-schedule on the academic achievement of students in a high school. The tri-schedule consists of traditional, 4x4 block, and hybrid schedules running at the same time in the same high school. Effectiveness of the schedules was determined from the state mandated test of basic skills in reading, language, and mathematics. Students who were in a particular schedule their freshman year were tested at the beginning of their sophomore year. A statistical ANCOVA test was performed using the schedule types as independent variables and cognitive skill index and GPA as covariates. For reading and language, there was no statistically significant difference in test results. There was a statistical difference mathematics-computation. Block mathematics is an ideal format for obtaining more credits in mathematics, but the block format does little for mathematics achievement and conceptual understanding. The results have content specific implications for schools, administrations, and school boards who are considering block scheduling adoption.
Shift Work in Nurses: Contribution of Phenotypes and Genotypes to Adaptation
Gamble, Karen L.; Motsinger-Reif, Alison A.; Hida, Akiko; Borsetti, Hugo M.; Servick, Stein V.; Ciarleglio, Christopher M.; Robbins, Sam; Hicks, Jennifer; Carver, Krista; Hamilton, Nalo; Wells, Nancy; Summar, Marshall L.; McMahon, Douglas G.; Johnson, Carl Hirschie
Background Daily cycles of sleep/wake, hormones, and physiological processes are often misaligned with behavioral patterns during shift work, leading to an increased risk of developing cardiovascular/metabolic/gastrointestinal disorders, some types of cancer, and mental disorders including depression and anxiety. It is unclear how sleep timing, chronotype, and circadian clock gene variation contribute to adaptation to shift work. Methods Newly defined sleep strategies, chronotype, and genotype for polymorphisms in circadian clock genes were assessed in 388 hospital day- and night-shift nurses. Results Night-shift nurses who used sleep deprivation as a means to switch to and from diurnal sleep on work days (∼25%) were the most poorly adapted to their work schedule. Chronotype also influenced efficacy of adaptation. In addition, polymorphisms in CLOCK, NPAS2, PER2, and PER3 were significantly associated with outcomes such as alcohol/caffeine consumption and sleepiness, as well as sleep phase, inertia and duration in both single- and multi-locus models. Many of these results were specific to shift type suggesting an interaction between genotype and environment (in this case, shift work). Conclusions Sleep strategy, chronotype, and genotype contribute to the adaptation of the circadian system to an environment that switches frequently and/or irregularly between different schedules of the light-dark cycle and social/workplace time. This study of shift work nurses illustrates how an environmental "stress" to the temporal organization of physiology and metabolism can have behavioral and health-related consequences. Because nurses are a key component of health care, these findings could have important implications for health-care policy. PMID:21533241
Shift work in nurses: contribution of phenotypes and genotypes to adaptation.
Directory of Open Access Journals (Sweden)
Karen L Gamble
Full Text Available Daily cycles of sleep/wake, hormones, and physiological processes are often misaligned with behavioral patterns during shift work, leading to an increased risk of developing cardiovascular/metabolic/gastrointestinal disorders, some types of cancer, and mental disorders including depression and anxiety. It is unclear how sleep timing, chronotype, and circadian clock gene variation contribute to adaptation to shift work.Newly defined sleep strategies, chronotype, and genotype for polymorphisms in circadian clock genes were assessed in 388 hospital day- and night-shift nurses.Night-shift nurses who used sleep deprivation as a means to switch to and from diurnal sleep on work days (∼25% were the most poorly adapted to their work schedule. Chronotype also influenced efficacy of adaptation. In addition, polymorphisms in CLOCK, NPAS2, PER2, and PER3 were significantly associated with outcomes such as alcohol/caffeine consumption and sleepiness, as well as sleep phase, inertia and duration in both single- and multi-locus models. Many of these results were specific to shift type suggesting an interaction between genotype and environment (in this case, shift work.Sleep strategy, chronotype, and genotype contribute to the adaptation of the circadian system to an environment that switches frequently and/or irregularly between different schedules of the light-dark cycle and social/workplace time. This study of shift work nurses illustrates how an environmental "stress" to the temporal organization of physiology and metabolism can have behavioral and health-related consequences. Because nurses are a key component of health care, these findings could have important implications for health-care policy.
Shift work in nurses: contribution of phenotypes and genotypes to adaptation.
Gamble, Karen L; Motsinger-Reif, Alison A; Hida, Akiko; Borsetti, Hugo M; Servick, Stein V; Ciarleglio, Christopher M; Robbins, Sam; Hicks, Jennifer; Carver, Krista; Hamilton, Nalo; Wells, Nancy; Summar, Marshall L; McMahon, Douglas G; Johnson, Carl Hirschie
Daily cycles of sleep/wake, hormones, and physiological processes are often misaligned with behavioral patterns during shift work, leading to an increased risk of developing cardiovascular/metabolic/gastrointestinal disorders, some types of cancer, and mental disorders including depression and anxiety. It is unclear how sleep timing, chronotype, and circadian clock gene variation contribute to adaptation to shift work. Newly defined sleep strategies, chronotype, and genotype for polymorphisms in circadian clock genes were assessed in 388 hospital day- and night-shift nurses. Night-shift nurses who used sleep deprivation as a means to switch to and from diurnal sleep on work days (∼25%) were the most poorly adapted to their work schedule. Chronotype also influenced efficacy of adaptation. In addition, polymorphisms in CLOCK, NPAS2, PER2, and PER3 were significantly associated with outcomes such as alcohol/caffeine consumption and sleepiness, as well as sleep phase, inertia and duration in both single- and multi-locus models. Many of these results were specific to shift type suggesting an interaction between genotype and environment (in this case, shift work). Sleep strategy, chronotype, and genotype contribute to the adaptation of the circadian system to an environment that switches frequently and/or irregularly between different schedules of the light-dark cycle and social/workplace time. This study of shift work nurses illustrates how an environmental "stress" to the temporal organization of physiology and metabolism can have behavioral and health-related consequences. Because nurses are a key component of health care, these findings could have important implications for health-care policy.
Scheduling for production teams
Directory of Open Access Journals (Sweden)
Yuri Mauergauz
Full Text Available This paper presents a method of calendar (weekly scheduling for production teams, when the average orders utility function is used as the quality criterion. The method is based on the concept of "production intensity", which is a dynamic parameter of production process. Applied software package allows scheduling for medium quantity of jobs. The result of software application is the team load on the planning horizon. The computed schedule may be corrected and recalculated in interactive mode. Current load of every team is taken into account at each recalculation. The method may be used for any combination of complex and specialized teams.
DEFF Research Database (Denmark)
Mizouni, Rabeb; Lazarova-Molnar, Sanja
overrun both their budget and time. To improve the quality of initial project plans, we show in this paper the importance of (1) reflecting features' priorities/risk in task schedules and (2) considering uncertainties related to human factors in plan schedules. To make simulation tasks reflect features....... By comparing EPS to classical schedules, EPS simulation provides more accurate results with regards to project goals. These instructions give you guidelines for preparing papers for Journal of Software (JSW). Use this document as a template if you are using Microsoft Word 6.0 or later. Otherwise, use...
Goal programming for cyclical auxiliary police scheduling at UiTM Cawangan Perlis
Mustapar, Wasilatul Effah; Nasir, Diana Sirmayunie Mohd; Nor, Nor Azriani Mohamad; Abas, Sharifah Fhahriyah Syed
Constructing a good and fair schedule for shift workers poses a great challenge as it requires a lot of time and effort. In this study, goal programming has been applied on scheduling to achieve the hard and soft constraints for a cyclical schedule that would ease the head of auxiliary police at building new schedules. To accomplish this goal, shift types were assigned in order to provide a fair schedule that takes into account the auxiliary police's policies and preferences. The model was run using Lingo software. Three out of four goals set for the study were achieved. In addition, the results considered an equal allocation for every auxiliary police, namely 70% for total duty and 30% for the day. Furthermore, the schedule was able to cyclically generate another 10 sets schedule. More importantly, the model has provided unbiased scheduling of auxiliary policies which led to high satisfaction in auxiliary police management.
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The CERN Council held its 125th session on 20 June. Highlights of the meeting included confirmation that the LHC is on schedule for a 2007 start-up, and the announcement of a new organizational structure in 2004.
This schedule indicates plans for completion of risk assessments, proposed interim decisions and interim decisions for pesticides in the Registration Review program, EPA reviews all registered pesticides at least every 15 years as required by FIFRA.
Fee Schedules - General Information
U.S. Department of Health & Human Services — A fee schedule is a complete listing of fees used by Medicare to pay doctors or other providers-suppliers. This comprehensive listing of fee maximums is used to...
Probabilistic Bisimulation for Realistic Schedulers
DEFF Research Database (Denmark)
Eisentraut, Christian; Godskesen, Jens Christian; Hermanns, Holger
. This holds in the classical context of arbitrary schedulers, but it has been argued that this class of schedulers is unrealistically powerful. This paper studies a strictly coarser notion of bisimilarity, which still enjoys these properties in the context of realistic subclasses of schedulers: Trace...... distribution equivalence is implied for partial information schedulers, and compositionality is preserved by distributed schedulers. The intersection of the two scheduler classes thus spans a coarser and still reasonable compositional theory of behavioral semantics....
Robert, Yves
Reviewing classical methods, realistic models, and algorithms, this book offers a through introduction to scheduling. Coverage includes fundamental concepts and basic methods, recent research, and applications with a special focus on distributed systems and computational grids. Other topics include online scheduling, stochastic task-resource systems, and platform models. Examples, theorems, and pedagogical proofs create an interactive learning format. Though rigorous, the book provides enough background to be self-contained and fully accessible to computer scientists, mathematicians, and resea
Energy Technology Data Exchange (ETDEWEB)
Schaffer, Jr.; W.F.
The schedule for the installation of the PAR slurry loop experiment in the South Facility of the ORR has been reviewed and revised. The design, fabrications and Installation is approximately two weeks behind schedule at this time due to many factors; however, indications are that this time can be made up. Design is estimated to be 75% complete, fabrication 32% complete and installation 12% complete.
Kotamaki, M
The goal during the last few months has been to freeze and baseline as much as possible the schedules of various ATLAS systems and activities. The main motivations for the re-baselining of the schedules have been the new LHC schedule aiming at first collisions in early 2006 and the encountered delays in civil engineering as well as in the production of some of the detectors. The process was started by first preparing a new installation schedule that takes into account all the new external constraints and the new ATLAS staging scenario. The installation schedule version 3 was approved in the March EB and it provides the Ready For Installation (RFI) milestones for each system, i.e. the date when the system should be available for the start of the installation. TCn is now interacting with the systems aiming at a more realistic and resource loaded version 4 before the end of the year. Using the new RFI milestones as driving dates a new summary schedule has been prepared, or is under preparation, for each system....
Association between rotating night shift work and metabolic syndrome in Korean workers: differences between 8-hour and 12-hour rotating shift work.
Oh, Jae-Il; Yim, Hyeon Woo
This study aimed to analyze the association between the shift work schedule and metabolic syndrome (MetS). This is a retrospective longitudinal study based on the 2015 health checkup data of 2,090 workers evaluated for MetS in 2010 at a general hospital in Korea. The participants were divided according to their shift work schedule into daytime, three-shift (8-hour rotation), and two-shift (12-hour rotation) workers. The index that indicates the association between the shift work schedule and MetS is the odds ratio (OR) calculated using multivariate logistic regression. The analysis for the entire group of workers indicated that there was positive association between two-shift rotation and MetS (OR=1.58, 95% confidence interval [CI]: 1.09, 2.29). In the analysis of rotating night-shift workers, the years of rotating night shifts, frequency of night-shift work, and sleep disturbance were added to the confounding variables, and two-shift work remained positively associated with MetS (OR=1.72, 95% CI: 1.10, 2.70). The risk of MetS differs based on the shift work schedules they engage in. Hence, structural changes to the shift work schedules are required to prevent MetS in night-shift workers.
The impact of rotating shift work on eating patterns and self ...
African Journals Online (AJOL)
nurses on the day- shift schedule. All responders in the study group and 40.9% of ... Nurses worked on three-shift schedule: five day shifts (07.00 e. 17.00hrs), followed by three night shifts ( 17.00 '4 .... Medicine second year students (2001 class) for data collection and Mr H. Misiri for advises in statistical analysis of the data.
The human factors of implementing shift work in logging operations.
Mitchell, D L; Gallagher, T V; Thomas, R E
A fairly recent development in the forest industry is the use of shift work in logging in the southeastern U.S. Logging company owners are implementing shift work as an opportunity to increase production and potentially reduce the cost of producing each unit of wood, without consideration of the potential impacts on the logging crew. There are many documented physiological and psychological impacts on workers from shift work in a variety of industries, although few address forestry workers in the U.S. Semi-structured interviews were performed to gather information about how logging company owners were implementing shift work in seven southeastern states. Data collected during the interviews included employee turnover, shift hours, shift scheduling, safety considerations, and production impacts. Various work schedules were employed. The majority of the schedules encompassed less than 24 hours per day. Permanent and rotating shift schedules were found. None of the logging company owners used more than two crews in a 24-hour period. Additional safety precautions were implemented as a result of working after dark. No in-woods worker accidents or injuries were reported by any of those interviewed. Results indicate that a variety of work schedules can be successfully implemented in the southeastern logging industry.
Enabling a New Planning and Scheduling Paradigm
Jaap, John; Davis, Elizabeth
The Flight Projects Directorate at NASA's Marshall Space Flight Center is developing a new planning and scheduling environment and a new scheduling algorithm to enable a paradigm shift in planning and scheduling concepts. Over the past 33 years Marshall has developed and evolved a paradigm for generating payload timelines for Skylab, Spacelab, various other Shuttle payloads, and the International Space Station. The current paradigm starts by collecting the requirements, called "tasks models," from the scientists and technologists for the tasks that they want to be done. Because of shortcomings in the current modeling schema, some requirements are entered as notes. Next a cadre with knowledge of vehicle and hardware modifies these models to encompass and be compatible with the hardware model; again, notes are added when the modeling schema does not provide a better way to represent the requirements. Finally, another cadre further modifies the models to be compatible with the scheduling engine. This last cadre also submits the models to the scheduling engine or builds the timeline manually to accommodate requirements that are expressed in notes. A future paradigm would provide a scheduling engine that accepts separate science models and hardware models. The modeling schema would have the capability to represent all the requirements without resorting to notes. Furthermore, the scheduling engine would not require that the models be modified to account for the capabilities (limitations) of the scheduling engine. The enabling technology under development at Marshall has three major components. (1) A new modeling schema allows expressing all the requirements of the tasks without resorting to notes or awkward contrivances. The chosen modeling schema is both maximally expressive and easy to use. It utilizes graphics methods to show hierarchies of task constraints and networks of temporal relationships. (2) A new scheduling algorithm automatically schedules the models
Routing and scheduling problems
DEFF Research Database (Denmark)
Reinhardt, Line Blander
of a connection between two locations. This could be an urban bus schedule where busses are routed and this routing creates a bus schedule which the passengers between locations use. In this thesis various routing and scheduling problems will be presented. The topics covered will be routing from an origin...... set cost making the cost of the individual vehicle routes inter-dependant. Depending on the problem type, the size of the problems and time available for solving, different solution methods can be applicable. In this thesis both heuristic methods and several exact methods are investigated depending...... on the problems needed to be solved. The solution methods applied to the problems cover dynamic programming for multi constrained shortest paths, Branch-and-cut for liner shipping, Simulated annealing for transporting assisted passengers in airports, branch-cut-and-price for vehicle routing with time windows...
Lamont, M
The scheduling limits for a typical long year taking into account technical stops, machine development, spe- cial physics runs are presented. An attempt is then made to outline a ten year post LS1 schedule taking into account the disparate requirements outlined in the previous talks in this session. The demands on the planned long shutdowns and the impact of these demands on their proposed length will be discussed. The option of using ion running as a pre-shutdown cool-down period will be addressed.
Intelligent retail logistics scheduling
Energy Technology Data Exchange (ETDEWEB)
Rowe, J.; Jewers, K. [Stamford House, London (United Kingdom); Codd, A.; Alcock, A. [Inference Corp., Slough, Berkshire (United Kingdom)
The Supply Chain Integrated Ordering Network (SCION) Depot Bookings system automates the planning and scheduling of perishable and non-perishable commodities and the vehicles that carry them into J. Sainsbury depots. This is a strategic initiative, enabling the business to make the key move from weekly to daily ordering. The system is mission critical, managing the inwards flow of commodities from suppliers into J. Sainsbury`s depots. The system leverages Al techniques to provide a business solution that meets challenging functional and performance needs. The SCION Depot Bookings system is operational providing schedules for 22 depots across the UK.
Automated Scheduling Via Artificial Intelligence
Biefeld, Eric W.; Cooper, Lynne P.
Artificial-intelligence software that automates scheduling developed in Operations Mission Planner (OMP) research project. Software used in both generation of new schedules and modification of existing schedules in view of changes in tasks and/or available resources. Approach based on iterative refinement. Although project focused upon scheduling of operations of scientific instruments and other equipment aboard spacecraft, also applicable to such terrestrial problems as scheduling production in factory.
Directory of Open Access Journals (Sweden)
Shahnazari-Shahrezaei, P.
Full Text Available Nurse scheduling is a type of manpower allocation problem that tries to satisfy hospital managers objectives and nurses preferences as much as possible by generating fair shift schedules. This paper presents a nurse scheduling problem based on a real case study, and proposes two meta-heuristics a differential evolution algorithm (DE and a greedy randomised adaptive search procedure (GRASP to solve it. To investigate the efficiency of the proposed algorithms, two problems are solved. Furthermore, some comparison metrics are applied to examine the reliability of the proposed algorithms. The computational results in this paper show that the proposed DE outperforms the GRASP.
[Sleep quality of nurses working in shifts - Hungarian adaptation of the Bergen Shift Work Sleep Questionnaire].
Fusz, Katalin; Tóth, Ákos; Fullér, Noémi; Müller, Ágnes; Oláh, András
Sleep disorders among shift workers are common problems due to the disturbed circadian rhythm. The Bergen Shift Work Sleep Questionnaire assesses discrete sleep problems related to work shifts (day, evening and night shifts) and rest days. The aim of the study was to develop the Hungarian version of this questionnaire and to compare the sleep quality of nurses in different work schedules. 326 nurses working in shifts filled in the questionnaire. The authors made convergent and discriminant validation of the questionnaire with the Athens Insomnia Scale and the Perceived Stress Questionnaire. The questionnaire based on psychometric characteristics was suitable to assess sleep disorders associated with shift work in a Hungarian sample. The frequency of discrete symptoms significantly (pshifts. Nurses experienced the worst sleep quality and daytime fatigue after the night shift. Nurses working in irregular shift system had worse sleep quality than nurses working in regular and flexible shift system (pworking in shifts should be assessed with the Hungarian version of the Bergen Shift Work Sleep Questionnaire on a nationally representative sample, and the least burdensome shift system could be established.
Physician satisfaction with a multi-platform digital scheduling system.
Directory of Open Access Journals (Sweden)
Rodrigo Octávio Deliberato
Full Text Available Physician shift schedules are regularly created manually, using paper or a shared online spreadsheet. Mistakes are not unusual, leading to last minute scrambles to cover a shift. We developed a web-based shift scheduling system and a mobile application tool to facilitate both the monthly scheduling and shift exchanges between physicians. The primary objective was to compare physician satisfaction before and after the mobile application implementation.Over a 9-month period, three surveys, using the 4-point Likert type scale were performed to assess the physician satisfaction. The first survey was conducted three months prior mobile application release, a second survey three months after implementation and the last survey six months after.51 (77% of the physicians answered the baseline survey. Of those, 32 (63% were males with a mean age of 37.8 ± 5.5 years. Prior to the mobile application implementation, 36 (70% of the responders were using more than one method to carry out shift exchanges and only 20 (40% were using the official department report sheet to document shift exchanges. The second and third survey were answered by 48 (73% physicians. Forty-eight (98% of them found the mobile application easy or very easy to install and 47 (96% did not want to go back to the previous method. Regarding physician satisfaction, at baseline 37% of the physicians were unsatisfied or very unsatisfied with shift scheduling. After the mobile application was implementation, only 4% reported being unsatisfied (OR = 0.11, p < 0.001. The satisfaction level improved from 63% to 96% between the first and the last survey. Satisfaction levels significantly increased between the three time points (OR = 13.33, p < 0.001.Our web and mobile phone-based scheduling system resulted in better physician satisfaction.
Physician satisfaction with a multi-platform digital scheduling system.
Deliberato, Rodrigo Octávio; Rocha, Leonardo Lima; Lima, Alex Heitor; Santiago, Caroline Reis Maia; Terra, Jose Cláudio Cyrineu; Dagan, Alon; Celi, Leo Anthony
Physician shift schedules are regularly created manually, using paper or a shared online spreadsheet. Mistakes are not unusual, leading to last minute scrambles to cover a shift. We developed a web-based shift scheduling system and a mobile application tool to facilitate both the monthly scheduling and shift exchanges between physicians. The primary objective was to compare physician satisfaction before and after the mobile application implementation. Over a 9-month period, three surveys, using the 4-point Likert type scale were performed to assess the physician satisfaction. The first survey was conducted three months prior mobile application release, a second survey three months after implementation and the last survey six months after. 51 (77%) of the physicians answered the baseline survey. Of those, 32 (63%) were males with a mean age of 37.8 ± 5.5 years. Prior to the mobile application implementation, 36 (70%) of the responders were using more than one method to carry out shift exchanges and only 20 (40%) were using the official department report sheet to document shift exchanges. The second and third survey were answered by 48 (73%) physicians. Forty-eight (98%) of them found the mobile application easy or very easy to install and 47 (96%) did not want to go back to the previous method. Regarding physician satisfaction, at baseline 37% of the physicians were unsatisfied or very unsatisfied with shift scheduling. After the mobile application was implementation, only 4% reported being unsatisfied (OR = 0.11, p scheduling system resulted in better physician satisfaction.
Effects of Port Congestion in the Gate Control List Scheduling of Time Sensitive Networks
DEFF Research Database (Denmark)
Kentis, Angelos Mimidis; Berger, Michael Stübert; Soler, José
is directly related with the delay; hence reducing it can be beneficial within the TSN paradigm. This paper investigates the effects of port congestion, in the duration of the network wide schedule. A congested port can make scheduling more complex, leading to longer network-wide schedules. To verify this......, the same set of experiments was repeated, with and without considering port congestion during path allocation. The computed paths were given as input to an implementation of the shifting bottleneck heuristic algorithm. The shifting bottleneck heuristic, computed the network-wide gating schedule...
[Occupational diseases and night-shift work].
Bayon, Virginie; Léger, Damien
Shift and night work concern every year more and more workers, specifically women. Recent recommendations on good practice for the medical surveillance of shift and night workers have been edited in France. They confirmed that this kind of organisation, unavoidable in some economical sectors is associated with a significant higher risk of sleep and wake disorders, cardiovascular disorders, overweight and obesity, breath cancer. Specific surveillance of shift and night workers is recommended in occupational health.
CMS multicore scheduling strategy
Energy Technology Data Exchange (ETDEWEB)
Perez-Calero Yzquierdo, Antonio [Madrid, CIEMAT; Hernandez, Jose [Madrid, CIEMAT; Holzman, Burt [Fermilab; Majewski, Krista [Fermilab; McCrea, Alison [UC, San Diego
In the next years, processor architectures based on much larger numbers of cores will be most likely the model to continue 'Moore's Law' style throughput gains. This not only results in many more jobs in parallel running the LHC Run 1 era monolithic applications, but also the memory requirements of these processes push the workernode architectures to the limit. One solution is parallelizing the application itself, through forking and memory sharing or through threaded frameworks. CMS is following all of these approaches and has a comprehensive strategy to schedule multicore jobs on the GRID based on the glideinWMS submission infrastructure. The main component of the scheduling strategy, a pilot-based model with dynamic partitioning of resources that allows the transition to multicore or whole-node scheduling without disallowing the use of single-core jobs, is described. This contribution also presents the experiences made with the proposed multicore scheduling schema and gives an outlook of further developments working towards the restart of the LHC in 2015.
Iterative robust multiprocessor scheduling
Adyanthaya, S.; Geilen, M.; Basten, T.; Voeten, J.; Schiffelers, R.
General purpose platforms are characterized by unpredictable timing behavior. Real-time schedules of tasks on general purpose platforms need to be robust against variations in task execution times. We define robustness in terms of the expected number of tasks that miss deadlines. We present an
Decentralized Ground Staff Scheduling
DEFF Research Database (Denmark)
Sørensen, M. D.; Clausen, Jens
Typically, ground staff scheduling is centrally planned for each terminal in an airport. The advantage of this is that the staff is efficiently utilized, but a disadvantage is that staff spends considerable time walking between stands. In this paper a decentralized approach for ground staff...
The shifting beverage landscape.
Storey, Maureen
STOREY, M.L. The shifting beverage landscape. PHYSIOL BEHAV, 2010. - Simultaneous lifestyle changes have occurred in the last few decades, creating an imbalance in energy intake and energy expenditure that has led to overweight and obesity. Trends in the food supply show that total daily calories available per capita increased 28% since 1970. Total energy intake among men and women has also increased dramatically since that time. Some have suggested that intake of beverages has had a disproportional impact on obesity. Data collected by the Beverage Marketing Corporation between 1988-2008 demonstrate that, in reality, fewer calories per ounce are being produced by the beverage industry. Moreover, data from the National Cancer Institute show that soft drink intake represents 5.5% of daily calories. Data from NHANES 1999-2003 vs. 2003-06 may demonstrate a shift in beverage consumption for age/gender groups, ages 6 to>60years. The beverages provided in schools have significantly changed since 2006 when the beverage industry implemented School Beverage Guidelines. This voluntary action has removed full-calorie soft drinks from participating schools across the country. This shift to lower-calorie and smaller-portion beverages in school has led to a significant decrease in total beverage calories in schools. These data support the concept that to prevent and treat obesity, public health efforts should focus on energy balance and that a narrow focus on sweetened beverages is unlikely to have any meaningful impact on this complex problem. Copyright 2010 Elsevier Inc. All rights reserved.
The Effect of Biologically Effective Dose and Radiation Treatment Schedule on Overall Survival in Stage I Non-Small Cell Lung Cancer Patients Treated With Stereotactic Body Radiation Therapy
Energy Technology Data Exchange (ETDEWEB)
Stahl, John M. [Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut (United States); Ross, Rudi [21st Century Oncology, Fort Myers, Florida (United States); Harder, Eileen M.; Mancini, Brandon R. [Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut (United States); Soulos, Pamela R. [Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, Connecticut (United States); Finkelstein, Steven E.; Shafman, Timothy D.; Dosoretz, Arie P. [21st Century Oncology, Fort Myers, Florida (United States); Evans, Suzanne B.; Husain, Zain A.; Yu, James B. [Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut (United States); Gross, Cary P. [Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, Connecticut (United States); Decker, Roy H., E-mail: email@example.com [Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut (United States)
Purpose: To determine the effect of biologically effective dose (BED{sub 10}) and radiation treatment schedule on overall survival (OS) in patients with early-stage non-small cell lung cancer (NSCLC) undergoing stereotactic body radiation therapy (SBRT). Methods and Materials: Using data from 65 treatment centers in the United States, we retrospectively reviewed the records of T1-2 N0 NSCLC patients undergoing SBRT alone from 2006 to 2014. Biologically relevant covariates, including dose per fraction, number of fractions, and time between fractions, were used to quantify BED{sub 10} and radiation treatment schedule. The linear-quadratic equation was used to calculate BED{sub 10} and to generate a dichotomous dose variable of <105 Gy versus ≥105 Gy BED{sub 10}. The primary outcome was OS. We used the Kaplan-Meier method, the log–rank test, and Cox proportional hazards regression with propensity score matching to determine whether prescription BED{sub 10} was associated with OS. Results: We identified 747 patients who met inclusion criteria. The median BED{sub 10} was 132 Gy, and 59 (7.7%) had consecutive-day fractions. Median follow-up was 41 months, and 452 patients (60.5%) had died by the conclusion of the study. The 581 patients receiving ≥105 Gy BED{sub 10} had a median survival of 28 months, whereas the 166 patients receiving <105 Gy BED{sub 10} had a median survival of 22 months (log–rank, P=.01). Radiation treatment schedule was not a significant predictor of OS on univariable analysis. After adjusting for T stage, sex, tumor histology, and Eastern Cooperative Oncology Group performance status, BED{sub 10} ≥105 Gy versus <105 Gy remained significantly associated with improved OS (hazard ratio 0.78, 95% confidence interval 0.62-0.98, P=.03). Propensity score matching on imbalanced variables within high- and low-dose cohorts confirmed a survival benefit with higher prescription dose. Conclusions: We found that dose escalation to 105 Gy BED
Shift Work Disorder and Mental and Physical Effects of Shift Work
Directory of Open Access Journals (Sweden)
Pinar Guzel Ozdemir
Full Text Available With the growing prevalence of shift work all over the the world, the relationship between the daily lives of irregular lifestyles and rhythms is being investigated for those working as shift workers and their families. The effect of shift work on physical and mental health is a very important field of research in recent years. The onset and persistence of medical complications in shift workers includes impaired synchronization between work schedule rhythms and circadian clock. In this context, studies have been carried out showing the increased risk of sleep-wake disorders, gastrointestinal problems, and cardiovascular diseases. There is little information about the actual frequency, effect on health and treatment of shift work disorder, known as circadian rhythm sleep disorder. Shift work disorder includes insomnia and/or excessive sleepiness related with the work schedule. The aim of this rewiev, mentioning about the physical and mental effects of shift work, and to provide information about the diagnosis, clinic and treatment methods of shift-work disorder.
Mode Shift Control for a Hybrid Heavy-Duty Vehicle with Power-Split Transmission
Directory of Open Access Journals (Sweden)
Kun Huang
Full Text Available Given that power-split transmission (PST is considered to be a major powertrain technology for hybrid heavy-duty vehicles (HDVs, the development and application of PST in the HDVs make mode shift control an essential aspect of powertrain system design. This paper presents a shift schedule design and torque control strategy for a hybrid HDV with PST during mode shift, intended to reduce the output torque variation and improve the shift quality (SQ. Firstly, detailed dynamic models of the hybrid HDV are developed to analyze the mode shift characteristics. Then, a gear shift schedule calculation method including a dynamic shift schedule and an economic shift schedule is provided. Based on the dynamic models and the designed shift schedule, a mode shift performance simulator is built using MATLAB/Simulink, and simulations are carried out. Through analysis of the dynamic equations, it is seen that the inertia torques of the motor–generator lead to the occurrence of transition torque. To avoid the unwanted transition torque, we use a mode shift control strategy that coordinates the motor–generator torque to compensate for the transition torque. The simulation and experimental results demonstrate that the output torque variation during mode shift is effectively reduced by the proposed control strategy, thereby improving the SQ.
The effects of shift work on free-living physical activity and sedentary behavior.
Loprinzi, Paul D
Although occupation may influence physical activity and shift work schedule may influence cardiovascular disease risk factors, our understanding of the effects of shift work schedule on overall physical activity behavior and sedentary behavior is limited. Data from the 2005-2006 National Health and Nutrition Examination Survey were used. Shift work schedule was defined as regular daytime shift, evening, night, rotating or another schedule. Physical activity and sedentary behavior were assessed via accelerometry. 1536 adult participants (≥20years) indicated they currently work and provided data on all study variables. After adjustments, and compared to adults working a regular daytime shift, those working an evening (RR=0.41, p=0.001) and night (RR=0.30, p=0.001) shift, respectively, engaged in 59% and 70% less sustained (bouts) moderate-to-vigorous physical activity, but no differences occurred for overall moderate-to-vigorous physical activity. After adjustments, and compared to those working a regular daytime shift, those working a rotating shift engaged in more light-intensity physical activity (overall: β=26.3min/day; p=0.03; bouts: β=37.5, p=0.01) and less sedentary behavior (β=-28.5min/day, p=0.01). Shift work schedule differentially influences physical activity and sedentary behavior. Physical activity and sedentary intervention strategies may need to be tailored based on shift work schedule. Copyright © 2015 Elsevier Inc. All rights reserved.
Optimal sampling schedule for chemical exchange saturation transfer.
Tee, Y K; Khrapitchev, A A; Sibson, N R; Payne, S J; Chappell, M A
The sampling schedule for chemical exchange saturation transfer imaging is normally uniformly distributed across the saturation frequency offsets. When this kind of evenly distributed sampling schedule is used to quantify the chemical exchange saturation transfer effect using model-based analysis, some of the collected data are minimally informative to the parameters of interest. For example, changes in labile proton exchange rate and concentration mainly affect the magnetization near the resonance frequency of the labile pool. In this study, an optimal sampling schedule was designed for a more accurate quantification of amine proton exchange rate and concentration, and water center frequency shift based on an algorithm previously applied to magnetization transfer and arterial spin labeling. The resulting optimal sampling schedule samples repeatedly around the resonance frequency of the amine pool and also near to the water resonance to maximize the information present within the data for quantitative model-based analysis. Simulation and experimental results on tissue-like phantoms showed that greater accuracy and precision (>30% and >46%, respectively, for some cases) were achieved in the parameters of interest when using optimal sampling schedule compared with evenly distributed sampling schedule. Hence, the proposed optimal sampling schedule could replace evenly distributed sampling schedule in chemical exchange saturation transfer imaging to improve the quantification of the chemical exchange saturation transfer effect and parameter estimation. Copyright © 2013 Wiley Periodicals, Inc.
DPS - Dynamic Parallel Schedules
IEEE Press; Gerlach, S.; Hersch, R. D.
Dynamic Parallel Schedules (DPS) is a high-level framework for developing parallel applications on distributed memory computers (e.g. clusters of PC). Its model relies on compositional customizable split-compute-merge graphs of operations (directed acyclic flow graphs). The graphs and the mapping of operations to processing nodes are specified dynamically at runtime. DPS applications are pipelined and multithreaded by construction, ensuring a maximal overlap of computations and communications...
Does the pretreatment tumor sampling location correspond with metabolic activity on 18F-FDG PET/CT in breast cancer patients scheduled for neoadjuvant chemotherapy?
Energy Technology Data Exchange (ETDEWEB)
Koolen, Bas B., E-mail: email@example.com [Department of Nuclear Medicine, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Elshof, Lotte E. [Department of Nuclear Medicine, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Loo, Claudette E. [Department of Radiology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Wesseling, Jelle [Department of Pathology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Vrancken Peeters, Marie-Jeanne T.F.D. [Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Vogel, Wouter V. [Department of Nuclear Medicine, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Rutgers, Emiel J.Th. [Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands); Valdés Olmos, Renato A. [Department of Nuclear Medicine, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam (Netherlands)
Purpose: To define the correlation between the core biopsy location and the area with highest metabolic activity on 18F-FDG PET/CT in stage II–III breast cancer patients before neoadjuvant chemotherapy. Also, we would like to select a subgroup of patients in which PET/CT information may optimize tumor sampling. Methods: A PET/CT in prone position was acquired in 199 patients with 203 tumors. The distance and relative difference in standardized uptake value (SUV) between core biopsy localization (indicated by a marker) and area with highest degree of FDG uptake were evaluated. A distance ≥2 cm and a relative difference in SUV ≥25% were considered clinically relevant and a combination of both was defined as non-correspondence. Non-correspondence for different tumor characteristics (TNM stage, lesion morphology on MRI and PET/CT, histology, subtype, grade, and Ki-67) was assessed. Results: Non-correspondence was found in 28 (14%) of 203 tumors. Non-correspondence was significantly associated with T-stage, lesion morphology on MRI and PET/CT, tumor diameter, and histologic type. It was more often seen in tumors with a higher T-stage (p = 0.028), diffuse (non-mass) and multifocal tumors on MRI (p = 0.001), diffuse and multifocal tumors on PET/CT (p < 0.001), tumors >3 cm (p < 0.001), and lobular carcinomas (p < 0.001). No association was found with other features. Conclusion: Non-correspondence between the core biopsy location and area with highest FDG uptake is regularly seen in stage II–III breast cancer patients. PET/CT information and possibly FDG-guided biopsies are most likely to improve pretreatment tumor sampling in tumors >3 cm, lobular carcinomas, and diffuse and multifocal tumors.
Adapting immunisation schedules for children undergoing chemotherapy.
Fernández-Prada, María; Rodríguez-Martínez, María; García-García, Rebeca; García-Corte, María Dolores; Martínez-Ortega, Carmen
Children undergoing chemotherapy for cancer have special vaccination needs after completion of the treatment. The aim of this study was to evaluate the adaptation of post-chemotherapy vaccination schedules. An observational study was performed on a retrospective cohort that included all children aged from 0 to 14 years, who completed chemotherapy in a tertiary hospital between 2009 and 2015. Inclusion and exclusion criteria were applied. Immunisation was administered in accordance with the guidelines of the Vaccine Advisory Committee of the Spanish Association of Paediatrics. Primary Care immunisation and clinical records of the Preventive Medicine and Public Health Department were reviewed. Of the 99 children who had received chemotherapy, 51 (70.6% males) were included in the study. As regards the type of tumour, 54.9% had a solid organ tumour, and 45.1% had a haematological tumour. Post-chemotherapy immunisation was administered to 70.6%. The most common vaccines received were: diphtheria-tetanus-pertussis or diphtheria-tetanus (54.9%), meningococcus C (41.2%), and seasonal influenza (39.2%). The rate of adaptation of the immunisation schedule after chemotherapy was 9.8%. The pneumococcal conjugate vaccine against 7v or 13v was administered to 21.6% of study subjects. However, only 17.6% received polysaccharide 23v. None received vaccination against hepatitis A. No statistically significant differences were observed between adherence to immunisation schedules and type of tumour (P=.066), gender (P=.304), or age (P=.342). Post-chemotherapy immunisation of children with cancer is poor. The participation of health professionals in training programs and referral of paediatric cancer patients to Vaccine Units could improve the rate of schedule adaptation and proper immunisation of this population. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.
A hybrid shifting bottleneck-tabu search heuristic for the job shop total weighted tardiness problem
Bülbül, Kerem; Bulbul, Kerem
In this paper, we study the job shop scheduling problem with the objective of minimizing the total weighted tardiness. We propose a hybrid shifting bottleneck - tabu search (SB-TS) algorithm by replacing the reoptimization step in the shifting bottleneck (SB) algorithm by a tabu search (TS). In terms of the shifting bottleneck heuristic, the proposed tabu search optimizes the total weighted tardiness for partial schedules in which some machines are currently assumed to have infinite capacity...
Impacts of shift work on sleep and circadian rhythms.
Boivin, D B; Boudreau, P
Shift work comprises work schedules that extend beyond the typical "nine-to-five" workday, wherein schedules often comprise early work start, compressed work weeks with 12-hour shifts, and night work. According to recent American and European surveys, between 15 and 30% of adult workers are engaged in some type of shift work, with 19% of the European population reportedly working at least 2 hours between 22:00 and 05:00. The 2005 International Classification of Sleep Disorders estimates that a shift work sleep disorder can be found in 2-5% of workers. This disorder is characterized by excessive sleepiness and/or sleep disruption for at least one month in relation with the atypical work schedule. Individual tolerance to shift work remains a complex problem that is affected by the number of consecutive work hours and shifts, the rest periods, and the predictability of work schedules. Sleepiness usually occurs during night shifts and is maximal at the end of the night. Impaired vigilance and performance occur around times of increased sleepiness and can seriously compromise workers' health and safety. Indeed, workers suffering from a shift work sleep-wake disorder can fall asleep involuntarily at work or while driving back home after a night shift. Working on atypical shifts has important socioeconomic impacts as it leads to an increased risk of accidents, workers' impairment and danger to public safety, especially at night. The aim of the present review is to review the circadian and sleep-wake disturbances associated with shift work as well as their medical impacts. Copyright © 2014. Published by Elsevier SAS.
... Prostate cancer Lung cancer Colorectal cancer In US women, other than skin cancer the three most common cancers are: Breast cancer Lung cancer Colorectal cancer Some cancers are more common in certain parts of the world. For example, in Japan, there are many cases of stomach cancer . But ...
Visualization and Simulation in Scheduling
Directory of Open Access Journals (Sweden)
R. Čapek
Full Text Available This paper deals with the representation of scheduling results and it introduces a new tool for visualization and simulation in time scheduling called VISIS. The purpose of this tool is to provide an environment for visualization, e.g. in production line scheduling. The simulation also proposes a way to simulate the influence of a schedule on a user defined system, e.g. for designing filters in digital signal processing. VISIS arises from representing scheduling results using the well-known Gantt chart. The application is implemented in the Matlab programming environment using Simulink and the Virtual Reality toolbox.
Taking the lag out of jet lag through model-based schedule design.
Directory of Open Access Journals (Sweden)
Dennis A Dean
Full Text Available Travel across multiple time zones results in desynchronization of environmental time cues and the sleep-wake schedule from their normal phase relationships with the endogenous circadian system. Circadian misalignment can result in poor neurobehavioral performance, decreased sleep efficiency, and inappropriately timed physiological signals including gastrointestinal activity and hormone release. Frequent and repeated transmeridian travel is associated with long-term cognitive deficits, and rodents experimentally exposed to repeated schedule shifts have increased death rates. One approach to reduce the short-term circadian, sleep-wake, and performance problems is to use mathematical models of the circadian pacemaker to design countermeasures that rapidly shift the circadian pacemaker to align with the new schedule. In this paper, the use of mathematical models to design sleep-wake and countermeasure schedules for improved performance is demonstrated. We present an approach to designing interventions that combines an algorithm for optimal placement of countermeasures with a novel mode of schedule representation. With these methods, rapid circadian resynchrony and the resulting improvement in neurobehavioral performance can be quickly achieved even after moderate to large shifts in the sleep-wake schedule. The key schedule design inputs are endogenous circadian period length, desired sleep-wake schedule, length of intervention, background light level, and countermeasure strength. The new schedule representation facilitates schedule design, simulation studies, and experiment design and significantly decreases the amount of time to design an appropriate intervention. The method presented in this paper has direct implications for designing jet lag, shift-work, and non-24-hour schedules, including scheduling for extreme environments, such as in space, undersea, or in polar regions.
Scheduling theory, algorithms, and systems
Pinedo, Michael L
This new edition of the well-established text Scheduling: Theory, Algorithms, and Systems provides an up-to-date coverage of important theoretical models in the scheduling literature as well as important scheduling problems that appear in the real world. The accompanying website includes supplementary material in the form of slide-shows from industry as well as movies that show actual implementations of scheduling systems. The main structure of the book, as per previous editions, consists of three parts. The first part focuses on deterministic scheduling and the related combinatorial problems. The second part covers probabilistic scheduling models; in this part it is assumed that processing times and other problem data are random and not known in advance. The third part deals with scheduling in practice; it covers heuristics that are popular with practitioners and discusses system design and implementation issues. All three parts of this new edition have been revamped, streamlined, and extended. The reference...
miR-204 Shifts the Epithelial to Mesenchymal Transition in Concert with the Transcription Factors RUNX2, ETS1, and cMYB in Prostate Cancer Cell Line Model
Directory of Open Access Journals (Sweden)
Krassimira Todorova
Full Text Available Epithelial to mesenchymal transition is an essential step in advanced cancer development. Many master transcription factors shift their expression to drive this process, while noncoding RNAs families like miR-200 are found to restrict it. In this study we investigated how the tumor suppressor miR-204 and several transcription factors modulate main markers of mesenchymal transformation like E- and N-cadherin, SLUG, VEGF, and SOX-9 in prostate cancer cell line model (LNCaP, PC3, VCaP, and NCI-H660. We found that SLUG, E-cadherin, and N-cadherin are differentially modulated by miR-204, using miR-204 specific mimics and inhibitors and siRNA gene silencing (RUNX2, ETS-1, and cMYB. The genome perturbation associated TMPRSS2-ERG fusion coincided with shift from tumor-suppressor to tumor-promoting activity of this miRNA. The ability of miR-204 to suppress cancer cell viability and migration was lost in the fusion harboring cell lines. We found differential E-cadherin splicing corroborating to miR-204 modulatory effects. RUNX2, ETS1, and cMYB are involved in the regulation of E-cadherin, N-cadherin, and VEGFA expression. RUNX2 knockdown results in SOX9 downregulation, while ETS1 and cMYB silencing result in SOX9 upregulation in VCaP cells. Their expression was found to be also methylation dependent. Our study provides means for understanding cancer heterogeneity in regard to adapted therapeutic approaches development.
Autonomous Hybrid Priority Queueing for Scheduling Residential Energy Demands
Kalimullah, I. Q.; Shamroukh, M.; Sahar, N.; Shetty, S.
The advent of smart grid technologies has opened up opportunities to manage the energy consumption of the users within a residential smart grid system. Demand response management is particularly being employed to reduce the overall load on an electricity network which could in turn reduce outages and electricity costs. The objective of this paper is to develop an intelligible scheduler to optimize the energy available to a micro grid through hybrid queueing algorithm centered around the consumers' energy demands. This is achieved by shifting certain schedulable load appliances to light load hours. Various factors such as the type of demand, grid load, consumers' energy usage patterns and preferences are considered while formulating the logical constraints required for the algorithm. The algorithm thus obtained is then implemented in MATLAB workspace to simulate its execution by an Energy Consumption Scheduler (ECS) found within smart meters, which automatically finds the optimal energy consumption schedule tailor made to fit each consumer within the micro grid network.
DEFF Research Database (Denmark)
Andersson, Niclas; Christensen, Knud
The coordination of activities and resources in order to establish an effective production flow is central to the management of construction projects. The traditional technique for coordination of activities and resources in construction projects is the CPM-scheduling, which has been...... on the market. However, CPM is primarily an activity based method that takes the activity as the unit of focus and there is criticism raised, specifically in the case of construction projects, on the method for deficient management of construction work and continuous flow of resources. To seek solutions...
The Nightingale study: rationale, study design and baseline characteristics of a prospective cohort study on shift work and breast cancer risk among nurses.
Pijpe, Anouk; Slottje, Pauline; van Pelt, Cres; Stehmann, Floor; Kromhout, Hans; van Leeuwen, Flora E; Vermeulen, Roel C H; Rookus, Matti a
BACKGROUND: Evidence for the carcinogenicity of shift work in humans is limited because of significant heterogeneity of the results, thus more in-depth research in needed. The Nightingale Study is a nationwide prospective cohort study on occupational exposures and risks of chronic diseases among
A Randomized Phase 2 Study Comparing 2 Stereotactic Body Radiation Therapy Schedules for Medically Inoperable Patients With Stage I Peripheral Non-Small Cell Lung Cancer: NRG Oncology RTOG 0915 (NCCTG N0927)
Energy Technology Data Exchange (ETDEWEB)
Videtic, Gregory M.M., E-mail: email@example.com [The Cleveland Clinic, Cleveland, Ohio (United States); Hu, Chen [NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania (United States); Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Singh, Anurag K. [Roswell Park Cancer Institute, Buffalo, New York (United States); Chang, Joe Y. [MD Anderson Cancer Center, Houston, Texas (United States); Parker, William [McGill University Health Center, Montreal, Québec (Canada); Olivier, Kenneth R. [Mayo Clinic, Rochester, Minnesota (United States); Schild, Steven E. [Mayo Clinic, Scottsdale, Arizona (United States); Komaki, Ritsuko [MD Anderson Cancer Center, Houston, Texas (United States); Urbanic, James J. [Wake Forest School of Medicine, Winston-Salem, North Carolina (United States); Choy, Hak [The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas (United States)
Purpose: To compare 2 stereotactic body radiation therapy (SBRT) schedules for medically inoperable early-stage lung cancer to determine which produces the lowest rate of grade ≥3 protocol-specified adverse events (psAEs) at 1 year. Methods and Materials: Patients with biopsy-proven peripheral (≥2 cm from the central bronchial tree) T1 or T2, N0 (clinically node negative by positron emission tomography), M0 tumors were eligible. Patients were randomized to receive either 34 Gy in 1 fraction (arm 1) or 48 Gy in 4 consecutive daily fractions (arm 2). Rigorous central accreditation and quality assurance confirmed treatment per protocol guidelines. This study was designed to detect a psAEs rate >17% at a 10% significance level (1-sided) and 90% power. Secondary endpoints included rates of primary tumor control (PC), overall survival (OS), and disease-free survival (DFS) at 1 year. Designating the better of the 2 regimens was based on prespecified rules of psAEs and PC for each arm. Results: Ninety-four patients were accrued between September 2009 and March 2011. The median follow-up time was 30.2 months. Of 84 analyzable patients, 39 were in arm 1 and 45 in arm 2. Patient and tumor characteristics were balanced between arms. Four (10.3%) patients on arm 1 (95% confidence interval [CI] 2.9%-24.2%) and 6 (13.3%) patients on arm 2 (95% CI 5.1%-26.8%) experienced psAEs. The 2-year OS rate was 61.3% (95% CI 44.2%-74.6%) for arm 1 patients and 77.7% (95% CI 62.5%-87.3%) for arm 2. The 2-year DFS was 56.4% (95% CI 39.6%-70.2%) for arm 1 and 71.1% (95% CI 55.5%-82.1%) for arm 2. The 1-year PC rate was 97.0% (95% CI 84.2%-99.9%) for arm 1 and 92.7% (95% CI 80.1%-98.5%) for arm 2. Conclusions: 34 Gy in 1 fraction met the prespecified criteria and, of the 2 schedules, warrants further clinical research.
Developing algorithm for the critical care physician scheduling
Lee, Hyojun; Pah, Adam; Amaral, Luis; Northwestern Memorial Hospital Collaboration
Understanding the social network has enabled us to quantitatively study social phenomena such as behaviors in adoption and propagation of information. However, most work has been focusing on networks of large heterogeneous communities, and little attention has been paid to how work-relevant information spreads within networks of small and homogeneous groups of highly trained individuals, such as physicians. Within the professionals, the behavior patterns and the transmission of information relevant to the job are dependent not only on the social network between the employees but also on the schedules and teams that work together. In order to systematically investigate the dependence of the spread of ideas and adoption of innovations on a work-environment network, we sought to construct a model for the interaction network of critical care physicians at Northwestern Memorial Hospital (NMH) based on their work schedules. We inferred patterns and hidden rules from past work schedules such as turnover rates. Using the characteristics of the work schedules of the physicians and their turnover rates, we were able to create multi-year synthetic work schedules for a generic intensive care unit. The algorithm for creating shift schedules can be applied to other schedule dependent networks ARO1.
Prioritizing sleep for healthy work schedules
Directory of Open Access Journals (Sweden)
Takahashi Masaya
Full Text Available Abstract Good sleep is advantageous to the quality of life. Sleep-related benefits are particularly helpful for the working class, since poor or inadequate amounts of sleep degrade work productivity and overall health. This review paper explores the essential role of sleep in healthy work schedules and primarily focuses on the timing of sleep in relation to the work period (that is, before, during and after work. Data from laboratory, field and modeling studies indicate that consistent amounts of sleep prior to work are fundamental to improved performance and alertness in the workplace. In addition, planned naps taken during work maintain appropriate levels of waking function for both daytime and night-time work. Clearly, sufficient sleep after work is vital in promoting recovery from fatigue. Recent data also suggest that the time interval between shifts should be adjusted according to the biological timing of sleep. Although sleep is more likely to be replaced by job and other activities in the real life, research shows that it is worthwhile to revise the work schedules in order to optimize sleep before, sometime during and after the work period. Therefore, we suggest establishing work-sleep balance, similar to work-life balance, as a principle for designing and improving work schedules.
Influences on Dietary Choices during Day versus Night Shift in Shift Workers: A Mixed Methods Study.
Bonnell, Emily K; Huggins, Catherine E; Huggins, Chris T; McCaffrey, Tracy A; Palermo, Claire; Bonham, Maxine P
Shift work is associated with diet-related chronic conditions such as obesity and cardiovascular disease. This study aimed to explore factors influencing food choice and dietary intake in shift workers. A fixed mixed method study design was undertaken on a convenience sample of firefighters who continually work a rotating roster. Six focus groups (n = 41) were conducted to establish factors affecting dietary intake whilst at work. Dietary intake was assessed using repeated 24 h dietary recalls (n = 19). Interviews were audio recorded, transcribed verbatim, and interpreted using thematic analysis. Dietary data were entered into FoodWorks and analysed using Wilcoxon signed-rank test; p shift schedule; attitudes and decisions of co-workers; time and accessibility; and knowledge of the relationship between food and health. Participants reported consuming more discretionary foods and limited availability of healthy food choices on night shift. Energy intakes (kJ/day) did not differ between days that included a day or night shift but greater energy density (EDenergy, kJ/g/day) of the diet was observed on night shift compared with day shift. This study has identified a number of dietary-specific shift-related factors that may contribute to an increase in unhealthy behaviours in a shift-working population. Given the increased risk of developing chronic diseases, organisational change to support workers in this environment is warranted.
Influences on Dietary Choices during Day versus Night Shift in Shift Workers: A Mixed Methods Study
Directory of Open Access Journals (Sweden)
Emily K. Bonnell
Full Text Available Shift work is associated with diet-related chronic conditions such as obesity and cardiovascular disease. This study aimed to explore factors influencing food choice and dietary intake in shift workers. A fixed mixed method study design was undertaken on a convenience sample of firefighters who continually work a rotating roster. Six focus groups (n = 41 were conducted to establish factors affecting dietary intake whilst at work. Dietary intake was assessed using repeated 24 h dietary recalls (n = 19. Interviews were audio recorded, transcribed verbatim, and interpreted using thematic analysis. Dietary data were entered into FoodWorks and analysed using Wilcoxon signed-rank test; p < 0.05 was considered significant. Thematic analysis highlighted four key themes influencing dietary intake: shift schedule; attitudes and decisions of co-workers; time and accessibility; and knowledge of the relationship between food and health. Participants reported consuming more discretionary foods and limited availability of healthy food choices on night shift. Energy intakes (kJ/day did not differ between days that included a day or night shift but greater energy density (EDenergy, kJ/g/day of the diet was observed on night shift compared with day shift. This study has identified a number of dietary-specific shift-related factors that may contribute to an increase in unhealthy behaviours in a shift-working population. Given the increased risk of developing chronic diseases, organisational change to support workers in this environment is warranted.
Atypical work schedules are associated with poor sleep quality and mental health in Taiwan female nurses.
Lin, Pei-Chen; Chen, Chung-Hey; Pan, Shung-Mei; Pan, Chih-Hong; Chen, Chiou-Jong; Chen, Yao-Mei; Hung, Hsin-Chia; Wu, Ming-Tsang
To investigate the effects of shift work schedules on sleep quality and mental health in female nurses in south Taiwan. This study recruited 1,360 female registered nurses in the Kaohsiung area for the first survey, and among them, 769 nurses had a rotation shift schedule. Among the 769 rotation shift work nurses, 407 completed another second survey 6-10 months later. Data collection included demographic variables, work status, shift work schedule, sleep quality (Pittsburgh Sleep Quality Index), and mental health (Chinese Health Questionnaire-12). Nurses on rotation shift had the poor sleep quality and mental health compared to nurses on day shift. The nurses on rotation shift had a relatively higher OR of reporting poor sleep quality and poor mental health (OR, 2.26; 95% CI, 1.57-3.28; and OR, 1.91; 95% CI, 1.39-2.63, respectively). Additionally, rotation shift nurses who had ≥2 days off after their most recent night shifts showed significantly improved sleep quality and mental health (PSQI decreased of 1.23 and CHQ-12 decreased of 0.86, respectively). Comparison of sleep quality between the first and second surveys showed aggravated sleep quality only in nurses who had an increased frequency of night shifts. Female nurses who have a rotation shift work schedule tend to experience poor sleep quality and mental health, but their sleep quality and mental health improve if they have ≥2 days off after their most recent night shifts. This empirical information is useful for optimizing work schedules for nurses.
[Work schedules in the Hungarian health care system and the sleep quality of nurses].
Fusz, Katalin; Pakai, Annamária; Kívés, Zsuzsanna; Szunomár, Szilvia; Regős, Annamária; Oláh, András
One way of ensuring the continuity of health care is the shift work, which is burdensome and it can lead to sleep disturbances. The aim of the study was to measure the typical Hungarian nursing shift systems in hospitals, to analyse the causes of irregular work schedules, and to compare the sleep quality of nurses in different work schedules. 236 head nurses filled out the national online survey, and 217 nurses in clinics of the University of Pécs filled the Hungarian version of Bergen Shift Work Sleep Questionnaire. The head nurses provided data of 8697 nurses's schedules. 51.89% of nurses work in flexible shift system. 1944 employees work in regular shift system, most of them in the following order: 12-hour day shift and 12-hour night shift, followed by a one- or two-day rest. Where there is no system of shifts, the most frequent causes are the needs of nurses and the nurse shortage. Nurses who are working in irregular shift system had worse sleep quality than nurses who are working in flexible and regular shift system (p = 0.044). It would be helpful if the least burdensome shift system could be established.
Optimal Intermittent Dose Schedules for Chemotherapy Using Genetic Algorithm
Directory of Open Access Journals (Sweden)
Nadia ALAM
Full Text Available In this paper, a design method for optimal cancer chemotherapy schedules via genetic algorithm (GA is presented. The design targets the key objective of chemotherapy to minimize the size of cancer tumor after a predefined time with keeping toxic side effects in limit. This is a difficult target to achieve using conventional clinical methods due to poor therapeutic indices of existing anti-cancer drugs. Moreover, there are clinical limitations in treatment administration to maintain continuous treatment. Besides, carefully decided rest periods are recommended to for patient's comfort. Three intermittent drug scheduling schemes are presented in this paper where GA is used to optimize the dose quantities and timings by satisfying several treatment constraints. All three schemes are found to be effective in total elimination of cancer tumor after an agreed treatment length. The number of cancer cells is found zero at the end of the treatment for all three cases with tolerable toxicity. Finally, two of the schemes, "Fixed interval variable dose (FIVD and "Periodic dose" that are periodic in characteristic have been emphasized due to their additional simplicity in administration along with friendliness to patients. responses to the designed treatment schedules. Therefore the proposed design method is capable of planning effective, simple, patient friendly and acceptable chemotherapy schedules.
CERN. Geneva; Rodriguez Peon, Alberto
Workshop to introduce developers to the OpenShift platform available at CERN. Several use cases will be shown, including deploying an existing application into OpenShift. We expect attendees to realize about OpenShift features and general architecture of the service.
1993 Wholesale Power and Transmission Rate Schedules.
Energy Technology Data Exchange (ETDEWEB)
US Bonneville Power Administration
Bonneville Power Administration 1993 Wholesale Power Rate Schedules and General Rate Schedule Provisions and 1993 Transmission Rate Schedules and General Transmission Rate Schedule Provisions, contained herein, were approved on an interim basis effective October 1, 1993. These rate schedules and provisions were approved by the Federal Energy Commission, United States Department of Energy, in September, 1993. These rate schedules and provisions supersede the Administration`s Wholesale Power Rate Schedules and General Rate Schedule Provisions and Transmission Rate Schedules and General Transmission Rate Schedule Provisions effective October 1, 1991.
Schedules of Controlled Substances: Temporary Placement of 4-Fluoroisobutyryl Fentanyl into Schedule I. Temporary scheduling order.
The Administrator of the Drug Enforcement Administration is issuing this temporary scheduling order to schedule the synthetic opioid, N-(4-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)isobutyramide (4-fluoroisobutyryl fentanyl or para-fluoroisobutyryl fentanyl), and its isomers, esters, ethers, salts and salts of isomers, esters, and ethers, into schedule I pursuant to the temporary scheduling provisions of the Controlled Substances Act. This action is based on a finding by the Administrator that the placement of 4-fluoroisobutyryl fentanyl into schedule I of the Controlled Substances Act is necessary to avoid an imminent hazard to the public safety. As a result of this order, the regulatory controls and administrative, civil, and criminal sanctions applicable to schedule I controlled substances will be imposed on persons who handle (manufacture, distribute, reverse distribute, import, export, engage in research, conduct instructional activities or chemical analysis, or possess), or propose to handle, 4-fluoroisobutyryl fentanyl.
Optimal vaccination schedule search using genetic algorithm over MPI technology
Directory of Open Access Journals (Sweden)
Calonaci Cristiano
Full Text Available Abstract Background Immunological strategies that achieve the prevention of tumor growth are based on the presumption that the immune system, if triggered before tumor onset, could be able to defend from specific cancers. In supporting this assertion, in the last decade active immunization approaches prevented some virus-related cancers in humans. An immunopreventive cell vaccine for the non-virus-related human breast cancer has been recently developed. This vaccine, called Triplex, targets the HER-2-neu oncogene in HER-2/neu transgenic mice and has shown to almost completely prevent HER-2/neu-driven mammary carcinogenesis when administered with an intensive and life-long schedule. Methods To better understand the preventive efficacy of the Triplex vaccine in reduced schedules we employed a computational approach. The computer model developed allowed us to test in silico specific vaccination schedules in the quest for optimality. Specifically here we present a parallel genetic algorithm able to suggest optimal vaccination schedule. Results & Conclusions The enormous complexity of combinatorial space to be explored makes this approach the only possible one. The suggested schedule was then tested in vivo, giving good results. Finally, biologically relevant outcomes of optimization are presented.
Stochastic scheduling on unrelated machines
Skutella, Martin; Sviridenko, Maxim; Uetz, Marc Jochen; Mayr, Ernst W.; Portier, Natacha
Two important characteristics encountered in many real-world scheduling problems are heterogeneous processors and a certain degree of uncertainty about the sizes of jobs. In this paper we address both, and study for the first time a scheduling problem that combines the classical unrelated machine
Modeling the Cray memory scheduler
Energy Technology Data Exchange (ETDEWEB)
Wickham, K.L.; Litteer, G.L.
This report documents the results of a project to evaluate low cost modeling and simulation tools when applied to modeling the Cray memory scheduler. The specific tool used is described and the basics of the memory scheduler are covered. Results of simulations using the model are discussed and a favorable recommendation is made to make more use of this inexpensive technology.
Constraint-Based Scheduling System
Zweben, Monte; Eskey, Megan; Stock, Todd; Taylor, Will; Kanefsky, Bob; Drascher, Ellen; Deale, Michael; Daun, Brian; Davis, Gene
Report describes continuing development of software for constraint-based scheduling system implemented eventually on massively parallel computer. Based on machine learning as means of improving scheduling. Designed to learn when to change search strategy by analyzing search progress and learning general conditions under which resource bottleneck occurs.
Acquired cisplatin resistance in human ovarian A2780 cancer cells correlates with shift in taurine homeostasis and ability to volume regulate
DEFF Research Database (Denmark)
Sørensen, Belinda Halling; Thorsteinsdottir, Unnur Arna; Lambert, Ian Henry
Cisplatin resistance is a major challenge in the treatment of cancer and develops through reduced drug accumulation and an increased ability to avoid drug-induced cell damage, cell shrinkage, and hence initiation of apoptosis. Uptake and release of the semiessential amino acid taurine contribute...... to cell volume homeostasis, and taurine has been reported to have antiapoptotic effects. Here we find that volume-sensitive taurine release in cisplatin-sensitive [wild-type (WT)] human ovarian cancer A2780 cells is reduced in the presence of the phospholipase A2 inhibitor bromenol lactone, the 5......-lipoxygenase (5-LO) inhibitor ETH 615-139, and the cysteine leukotriene receptor 1 (CysLT1) antagonist zafirlukast and impaired by the anion channel blocker DIDS (4,4'-diisothiocyanatostilbene-2,2'-disulfonate). Comparing WT and cisplatin-resistant (RES) A2780 cells we also find that evasion of cisplatin...
Adaptive Auto-Regulation of Androgen Receptor Provides a Paradigm Shifting Rationale for Bipolar Androgen Therapy (BAT) for Castrate Resistant Human Prostate Cancer
Isaacs, John T.; D'Antonio, Jason M; Chen, Shuangling; Antony, Lizamma; Dalrymple, Susan P.; Ndikuyeze, Georges H.; Luo, Jun; Denmeade, Samuel R.
Cell culture/xenograft and gene arrays of clinical material document that development of castration resistant prostate cancer (CRPC) cells involves acquisition of adaptive auto-regulation resulting in > 25 fold increase in Androgen Receptor (AR) protein expression in a low androgen environment. Such adaptive AR increase paradoxically is a liability in castrated hosts; however, when supraphysiologic androgen is acutely replaced. Cell synchronization/anti-androgen response document this is due ...
Publications Section, DG-CO Group
The final edition (Nos 51-52/2011 and 1-2-3/2012) of the Bulletin this year will be published on Friday 16 December and will cover events at CERN from 19 December 2011 to 19 January 2012. Announcements for publication in this issue should reach the Communication Group or the Staff Association, as appropriate, by noon on Tuesday 13 December. Bulletin publication schedule for 2012 The table below lists the 2012 publication dates for the paper version of the Bulletin and the corresponding deadlines for the submission of announcements. Please note that all announcements must be submitted by 12.00 noon on Tuesdays at the latest. Bulletin No. Week number Submission of announcements (before 12.00 midday) Bulletin Web version Bulletin Printed version 4-5 Tuesday 17 January Fridays 20 and 27 January Wednesday25 January 6-7 Tuesday 31 January Fridays 3 and 10 February Wednesday 8 February 8-9 Tuesday 14 February Fridays 17 and 24 february Wednesday 22 Februa...
W. Zeuner
Introduction The endgame of CMS installation in the underground cavern is in full swing, with several major milestones having been passed since the last CMS week. The Tracker was installed inside the Vactank just before the CERN end-of-year shutdown. Shortly after the reopening in 2008, the two remaining endcap disks, YE-2 and YE-1, were lowered, marking the completion of eight years of assembly in the surface building SX5. The remaining tasks, before the detector can be closed for the Cosmic Run At Four Tesla (CRAFT), are the installation of the thermal shields, the cabling of the negative endcap, the cabling of the tracker and the beam pipe installation. In addition to these installation tasks, a test closure of the positive endcap is planned just before the installation of the central beam pipe. The schedule is tight and complicated but the goal to close CMS by the end of May for a cosmic test with magnetic field remains feasible. Safety With all large components now being underground, the shortage...
Multiuser Switched Diversity Scheduling Schemes
Shaqfeh, Mohammad; Alouini, Mohamed-Slim
Multiuser switched-diversity scheduling schemes were recently proposed in order to overcome the heavy feedback requirements of conventional opportunistic scheduling schemes by applying a threshold-based, distributed, and ordered scheduling mechanism. The main idea behind these schemes is that slight reduction in the prospected multiuser diversity gains is an acceptable trade-off for great savings in terms of required channel-state-information feedback messages. In this work, we characterize the achievable rate region of multiuser switched diversity systems and compare it with the rate region of full feedback multiuser diversity systems. We propose also a novel proportional fair multiuser switched-based scheduling scheme and we demonstrate that it can be optimized using a practical and distributed method to obtain the feedback thresholds. We finally demonstrate by numerical examples that switched-diversity scheduling schemes operate within 0.3 bits/sec/Hz from the ultimate network capacity of full feedback sys...
Shift work and its effects on the cardiovascular system
Mosendane, Thabo; Mosendane, Tshinakaho; Raal, Frederick J.
Summary The practice of shift-work scheduling has long been part of normal work duties in emergency services such as health and security. It is only recently, in the wake of growing job opportunities and booming industries, where more employees are needed to keep services running over 24-hour periods that studies on the effects of shift work on workers' health have begun to delve deeper. The desynchronisation that occurs in circadian rhythms, with respect to sleep cycles, predisposes employee...
Scheduling of anticancer drugs: Timing may be everything
Astrid A M van der Veldt; Lammertsma, Adriaan A; Smit, Egbert F.
Many cancer patients are treated with a combination of anticancer drugs. Here, we discuss the importance of drug scheduling and the need for studies that investigate the optimal timing of the various anticancer drugs. Positron emission tomography (PET) using radiolabeled anticancer drugs could be an important tool for those studies.
DEFF Research Database (Denmark)
Dohn, Anders Høeg
. The rostering process is non-trivial and especially when service is required around the clock, rostering may involve considerable effort from a designated planner. Therefore, in order to minimize costs and overstaffing, to maximize the utilization of available staff, and to ensure a high level of satisfaction......In a modern society, manpower can be both a scarce and an expensive resource. Skilled personnel is usually in high demand and accounts for a significant part of total expenses in many companies. When the work is divided in shifts, a roster is compiled to allocate these to the employees....... Mathematical and logic-based models are presented for the problems considered. Novel components are added to existing models and the modeling decisions are justified. In one case, the model is solved by a simple, but efficient greedy construction heuristic. In the remaining cases, column generation is applied...
Comparison of menstrual disorders in hospital nursing staff according to shift work pattern.
Albert-Sabater, Josep Amílcar; Martínez, José Miguel; Baste, Valborg; Moen, Bente E; Ronda-Perez, Elena
To assess the association between work in a rotating shift schedule and menstruation characteristics among nurse staff in a prospective study. Rotating shifts have been linked to alterations in the reproductive cycle. In the case of menstrual alterations, the conclusions are not clear. Prospective epidemiological study with follow-up over four months. All the female nurse staff (shifts and characteristics of their menstruation (duration, amount of blood, dysmenorrhoea). They had two types of shifts: (1) Rotating shift schedule (two mornings, two afternoons, one night and two days off) including morning shifts (8:00-15:00), afternoon/evening shifts (15:00-22:00) and night shifts (22:00-8:00), and (2) Day shift schedule including morning shifts (8:00-15:00) and/or afternoon/evening shifts (15:00-22:00). The crude and adjusted odds ratios with 95% confidence interval were calculated using logistic generalised estimating equations (GEE) taking into account the correlations of multiple cycles per worker. One hundred and thirteen workers on the rotating shift and 75 on the day shift participated, and information from 730 menstrual cycles were obtained. There were no differences in prolonged duration, dysmenorrhoea, prolonged duration dysmenorrhoea and excessive bleeding among nurses on rotating shift compared to those on the day shift. For prolonged duration of menstruation, workers with more than five years on the rotating shift showed a slightly lower (nonsignificant) risk compared with those with shift did not show increased risk of having menstrual disorders comparing with day staff. Shifts with short rotation cycles and a progressive sequence do not appear to cause menstrual disorders in nurse staff who work rotating shifts. © 2016 John Wiley & Sons Ltd.
A Benders decomposition-based Matheuristic for the Cardinality Constrained Shift Design Problem
DEFF Research Database (Denmark)
Lusby, Richard Martin; Larsen, Jesper; Range, Troels Martin
The Shift Design Problem is an important optimization problem which arises when scheduling personnel in industries that require continuous operation. Based on the forecast, required staffing levels for a set of time periods, a set of shift types that best covers the demand must be determined...... Integer Programming solver on instances with 1241 different shift types and remains competitive for larger cases with 2145 shift types. On all classes of problems the heuristic is able to quickly nd good solutions....
Effects of Shift Work and Sustained Operations: Operator Performance in Remotely Piloted Aircraft (OP-REPAIR)
National Research Council Canada - National Science Library
Thompson, William T; Lopez, Nadia; Hickey, Patrick; DaLuz, Christina; Caldwell, J. L; Tvaryanas, Anthony P
The introduction of unmanned aircraft systems (UAS) with "inhuman endurance" has led to operational requirements for extended duty days and varying shift schedules which are likely to reduce operator effectiveness because of fatigue...
Miller, Adam
A standard tutorial-based approach to using OpenShift and deploying custom or pre-built web applications to the OpenShift Online cloud.This book is for software developers and DevOps alike who are interested in learning how to use the OpenShift Platform-as-a-Service for developing and deploying applications, how the environment works on the back end, and how to deploy their very own open source Platform-as-a-Service based on the upstream OpenShift Origin project.
Robust and Flexible Scheduling with Evolutionary Computation
DEFF Research Database (Denmark)
Jensen, Mikkel T.
the cost of a neighbourhood of schedules. The scheduling algorithm attempts to find a small set of schedules with an acceptable level of performance. The approach is demonstrated to significantly improve the robustness and flexibility of the schedules while at the same time producing schedules with a low...
... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Schedule II. 1308.12 Section 1308.12 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE SCHEDULES OF CONTROLLED SUBSTANCES Schedules § 1308.12 Schedule II. (a) Schedule II shall consist of the drugs and other substances, by...
... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Schedule IV. 1308.14 Section 1308.14 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE SCHEDULES OF CONTROLLED SUBSTANCES Schedules § 1308.14 Schedule IV. (a) Schedule IV shall consist of the drugs and other substances, by...
... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Schedule I. 1308.11 Section 1308.11 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE SCHEDULES OF CONTROLLED SUBSTANCES Schedules § 1308.11 Schedule I. (a) Schedule I shall consist of the drugs and other substances, by whatever...
... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Schedule V. 1308.15 Section 1308.15 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE SCHEDULES OF CONTROLLED SUBSTANCES Schedules § 1308.15 Schedule V. (a) Schedule V shall consist of the drugs and other substances, by whatever...
Shift Work and Sleep Quality Among Urban Police Officers
Fekedulegn, Desta; Burchfiel, Cecil M.; Charles, Luenda E.; Hartley, Tara A.; Andrew, Michael E.; Violanti, John M.
Objective The aim of the study was to examine association of shift work with sleep quality in police officers. Methods Data were obtained from the Buffalo Cardio-Metabolic Occupational Police Stress study (n =363). An electronic work history database was used to define shift as day, afternoon, or night for three durations: past month, 1 year, and 15 years. Sleep quality was determined using the Pittsburgh Sleep Quality Index. Results The overall prevalence of poor sleep quality was 54%; 44% for day, 60% for afternoon, and 69% for night shift. Poor sleep quality was 70% more prevalent among night-shift officers (P shift (P =0.003) relative to officers working on the day shift. Conclusions Night and evening work schedules are associated with elevated prevalence of poor sleep quality among police officers. PMID:26949891
Analysis of feeder bus network design and scheduling problems.
Almasi, Mohammad Hadi; Mirzapour Mounes, Sina; Koting, Suhana; Karim, Mohamed Rehan
A growing concern for public transit is its inability to shift passenger's mode from private to public transport. In order to overcome this problem, a more developed feeder bus network and matched schedules will play important roles. The present paper aims to review some of the studies performed on Feeder Bus Network Design and Scheduling Problem (FNDSP) based on three distinctive parts of the FNDSP setup, namely, problem description, problem characteristics, and solution approaches. The problems consist of different subproblems including data preparation, feeder bus network design, route generation, and feeder bus scheduling. Subsequently, descriptive analysis and classification of previous works are presented to highlight the main characteristics and solution methods. Finally, some of the issues and trends for future research are identified. This paper is targeted at dealing with the FNDSP to exhibit strategic and tactical goals and also contributes to the unification of the field which might be a useful complement to the few existing reviews.
Constraint-based scheduling applying constraint programming to scheduling problems
Baptiste, Philippe; Nuijten, Wim
Constraint Programming is a problem-solving paradigm that establishes a clear distinction between two pivotal aspects of a problem: (1) a precise definition of the constraints that define the problem to be solved and (2) the algorithms and heuristics enabling the selection of decisions to solve the problem. It is because of these capabilities that Constraint Programming is increasingly being employed as a problem-solving tool to solve scheduling problems. Hence the development of Constraint-Based Scheduling as a field of study. The aim of this book is to provide an overview of the most widely used Constraint-Based Scheduling techniques. Following the principles of Constraint Programming, the book consists of three distinct parts: The first chapter introduces the basic principles of Constraint Programming and provides a model of the constraints that are the most often encountered in scheduling problems. Chapters 2, 3, 4, and 5 are focused on the propagation of resource constraints, which usually are responsibl...
A paradigm shift: Cancer therapy with peptide-based B-cell epitopes and peptide immunotherapeutics targeting multiple solid tumor types: Emerging concepts and validation of combination immunotherapy.
Kaumaya, Pravin T P
There is a recognizable and urgent need to speed the development and application of novel, more efficacious anti-cancer vaccine therapies that inhibit tumor progression and prevent acquisition of tumor resistance. We have created and established a portfolio of validated peptide epitopes against multiple receptor tyrosine kinases and we have identified the most biologically effective combinations of EGFR (HER-1), HER-2, HER-3, VEGF and IGF-1R peptide vaccines/mimics to selectively inhibit multiple receptors and signaling pathways. The strategy is based on the use of chimeric conformational B-cell epitope peptides incorporating "promiscuous" T-cell epitopes that afford the possibility of generating an enduring immune response, eliciting protein-reactive high-affinity anti-peptide antibodies as potential vaccines and peptide mimics that act as antagonists to receptor signaling that drive cancer metastasis. In this review we will summarize our ongoing studies based on the development of combinatorial immunotherapeutic strategies that act synergistically to enhance immune-mediated tumor killing aimed at addressing mechanisms of tumor resistance for several tumor types.
Cremers, Jan; Gramuglia, Alessia
The CLR-network examined in 2006 the phenomenon of undeclared labour, with specific regard to the construction sector. The resulting study, Shifting Employment: undeclared labour in construction (Shifting-study hereafter), gave evidence that this is an area particularly affected by undeclared
Shifted Independent Component Analysis
DEFF Research Database (Denmark)
Mørup, Morten; Madsen, Kristoffer Hougaard; Hansen, Lars Kai
Delayed mixing is a problem of theoretical interest and practical importance, e.g., in speech processing, bio-medical signal analysis and financial data modelling. Most previous analyses have been based on models with integer shifts, i.e., shifts by a number of samples, and have often been carried...
Gulati, Shekhar
If you are a web application developer who wants to use the OpenShift platform to host your next big idea but are looking for guidance on how to achieve this, then this book is the first step you need to take. This is a very accessible cookbook where no previous knowledge of OpenShift is needed.
Immunization Schedules for Infants and Children
... ACIP Vaccination Recommendations Why Immunize? Vaccines: The Basics Immunization Schedules for Infants and Children United States, 2017 ... any questions. View or Print a Schedule Recommended Immunizations for Children (Birth through 6 years) Schedule for ...
Circadian rhythms of melatonin, cortisol, and clock gene expression during simulated night shift work.
James, Francine O; Cermakian, Nicolas; Boivin, Diane B
The synchronization of peripheral circadian oscillators in humans living on atypical sleep/wake schedules is largely unknown. In this night shift work simulation, we evaluate clock gene expression in peripheral blood mononuclear cells (PBMCs) relative to reliable markers of the central circadian pacemaker. Participants were placed on a 10-hr delayed sleep/wake schedule simulating nighttime work followed by a daytime sleep episode. Baseline, intermediate and final circadian evaluations were performed in the temporal isolation laboratory. Five healthy candidates, 18-30 years. Polychromatic white light of (mean +/-SEM) 6,036 +/-326 lux (approximately 17,685 +/-955 W/m2) during night shifts; dim light exposure after each night shift; an 8-hr sleep/darkness episode beginning 2 hrs after the end of each night shift. Melatonin and cortisol in plasma; clock genes HPER1, HPER2 and HBMAL1 RNA in PBMCs. Following 9 days on the night schedule, hormonal rhythms were adapted to the shifted schedule. HPER1 and HPER2 expression in PBMCs displayed significant circadian rhythmicity, which was in a conventional relationship with the shifted sleep/wake schedule. Changes in the pattern of clock gene expression were apparent as of 3 days on the shifted sleep/wake schedule. This preliminary study is the first documentation of the effects of a shifted sleep/wake schedule on the circadian expression of both peripheral circadian oscillators in PBMCs and centrally-driven hormonal rhythms. In light of evidence associating clock gene expression with tissue function, the study of peripheral circadian oscillators has important implications for understanding medical disorders affecting night shift workers.
An Enabling Technology for New Planning and Scheduling Paradigms
Jaap, John; Davis, Elizabeth
The Night Projects Directorate at NASA's Marshall Space Flight Center is developing a new planning and scheduling environment and a new scheduling algorithm to enable a paradigm shift in planning and scheduling concepts. Over the past 33 years Marshall has developed and evolved a paradigm for generating payload timelines for Skylab, Spacelab, various other Shuttle payloads, and the International Space Station. The current paradigm starts by collecting the requirements, called ?ask models," from the scientists and technologists for the tasks that are to be scheduled. Because of shortcomings in the current modeling schema, some requirements are entered as notes. Next, a cadre with knowledge of vehicle and hardware modifies these models to encompass and be compatible with the hardware model; again, notes are added when the modeling schema does not provide a better way to represent the requirements. Finally, the models are modified to be compatible with the scheduling engine. Then the models are submitted to the scheduling engine for automatic scheduling or, when requirements are expressed in notes, the timeline is built manually. A future paradigm would provide a scheduling engine that accepts separate science models and hardware models. The modeling schema would have the capability to represent all the requirements without resorting to notes. Furthermore, the scheduling engine would not require that the models be modified to account for the capabilities (limitations) of the scheduling engine. The enabling technology under development at Marshall has three major components: (1) A new modeling schema allows expressing all the requirements of the tasks without resorting to notes or awkward contrivances. The chosen modeling schema is both maximally expressive and easy to use. It utilizes graphical methods to show hierarchies of task constraints and networks of temporal relationships. (2) A new scheduling algorithm automatically schedules the models without the
Multiagent scheduling models and algorithms
Agnetis, Alessandro; Gawiejnowicz, Stanisław; Pacciarelli, Dario; Soukhal, Ameur
This book presents multi-agent scheduling models in which subsets of jobs sharing the same resources are evaluated by different criteria. It discusses complexity results, approximation schemes, heuristics and exact algorithms.
General Services Administration — Schedule Sales Query presents sales volume figures as reported to GSA by contractors. The reports are generated as quarterly reports for the current year and the...
Executive Schedule C System (ESCS)
Office of Personnel Management — Used to store information on Federal employees in the Senior Executive Service (SES) and appointed employees in the Schedule C System. Every four years, just after...
Future aircraft networks and schedules
Shu, Yan
Because of the importance of air transportation scheduling, the emergence of small aircraft and the vision of future fuel-efficient aircraft, this thesis has focused on the study of aircraft scheduling and network design involving multiple types of aircraft and flight services. It develops models and solution algorithms for the schedule design problem and analyzes the computational results. First, based on the current development of small aircraft and on-demand flight services, this thesis expands a business model for integrating on-demand flight services with the traditional scheduled flight services. This thesis proposes a three-step approach to the design of aircraft schedules and networks from scratch under the model. In the first step, both a frequency assignment model for scheduled flights that incorporates a passenger path choice model and a frequency assignment model for on-demand flights that incorporates a passenger mode choice model are created. In the second step, a rough fleet assignment model that determines a set of flight legs, each of which is assigned an aircraft type and a rough departure time is constructed. In the third step, a timetable model that determines an exact departure time for each flight leg is developed. Based on the models proposed in the three steps, this thesis creates schedule design instances that involve almost all the major airports and markets in the United States. The instances of the frequency assignment model created in this thesis are large-scale non-convex mixed-integer programming problems, and this dissertation develops an overall network structure and proposes iterative algorithms for solving these instances. The instances of both the rough fleet assignment model and the timetable model created in this thesis are large-scale mixed-integer programming problems, and this dissertation develops subproblem schemes for solving these instances. Based on these solution algorithms, this dissertation also presents
Search Strategies for Scheduling Problems
Kypta, Tomáš
In the present work I compare the search strategies for solving scheduling problems from the view of constraint programming. The thesis is focused on scheduling problems containing alternative activities. An analysis of previously published various ways of modelling the problems is provided, next description and experimental comparison of search strategies targetting these models is provided. The influence of strategies on the speed of the solver is studied primarily. As a sideeffect the work...
Construction schedules slack time minimizing
Krzemiński, Michał
The article presents two copyright models for minimizing downtime working brigades. Models have been developed for construction schedules performed using the method of work uniform. Application of flow shop models is possible and useful for the implementation of large objects, which can be divided into plots. The article also presents a condition describing gives which model should be used, as well as a brief example of optimization schedule. The optimization results confirm the legitimacy of the work on the newly-developed models.
Non-clairvoyant Scheduling Games
Dürr, Christoph; Nguyen, Kim Thang
In a scheduling game, each player owns a job and chooses a machine to execute it. While the social cost is the maximal load over all machines (makespan), the cost (disutility) of each player is the completion time of its own job. In the game, players may follow selfish strategies to optimize their cost and therefore their behaviors do not necessarily lead the game to an equilibrium. Even in the case there is an equilibrium, its makespan might be much larger than the social optimum, and this inefficiency is measured by the price of anarchy - the worst ratio between the makespan of an equilibrium and the optimum. Coordination mechanisms aim to reduce the price of anarchy by designing scheduling policies that specify how jobs assigned to a same machine are to be scheduled. Typically these policies define the schedule according to the processing times as announced by the jobs. One could wonder if there are policies that do not require this knowledge, and still provide a good price of anarchy. This would make the processing times be private information and avoid the problem of truthfulness. In this paper we study these so-called non-clairvoyant policies. In particular, we study the RANDOM policy that schedules the jobs in a random order without preemption, and the EQUI policy that schedules the jobs in parallel using time-multiplexing, assigning each job an equal fraction of CPU time.
Shift work and circadian dysregulation of reproduction
Directory of Open Access Journals (Sweden)
Karen L. Gamble
Full Text Available Health impairments, including reproductive issues, are associated with working nights or rotating shifts. For example, shift work has been associated with an increased risk of irregular menstrual cycles, endometriosis, infertility, miscarriage, low birth weight or pre-term delivery, and reduced incidence of breastfeeding. Based on what is known about circadian regulation of endocrine rhythms in rodents (and much less in humans, the circadian clock is an integral regulatory part of the reproductive system. When this 24-h program is disordered by environmental perturbation (such as shift work or genetic alterations, the endocrine system can be impaired. The purpose of this review is to explore the hypothesis that misalignment of reproductive hormones with the environmental light-dark cycle and/or sleep wake rhythms can disrupt menstrual cycles, pregnancy, and parturition. We highlight the role of the circadian clock in regulating human reproductive physiology and shift work-induced pathology within each step of the reproductive axis while exploring potential mechanisms from the animal model literature. In addition to documenting the reproductive hazards of shift work, we also point out important gaps in our knowledge as critical areas for future investigation. For example, future studies should examine whether forced desynchronization disrupts gonadotropin secretion rhythms and whether there are sleep/wake schedules that are better or worse for the adaptation of the reproductive system to shift work. These studies are necessary in order to define not only whether or not shift-work induced circadian misalignment impairs reproductive capacity, but also to identify strategies for the future that can minimize this desynchronization.
Some effects of 8- vs 10-hour work schedules on the test performance/alertness of air traffic control specialists.
A 10-hour, 4-day rotating shift schedule worked by some Air Traffic Control Specialists (ATCSs) was compared to the more traditional 8-hour, 2-2-1 rapidly rotating schedule. Measures of performance and alertness were obtained from a group of 52 ATCSs...
Validity of self-reported exposure to shift work.
Härmä, Mikko; Koskinen, Aki; Ropponen, Annina; Puttonen, Sampsa; Karhula, Kati; Vahtera, Jussi; Kivimäki, Mika
To evaluate the validity of widely used questionnaire items on work schedule using objective registry data as reference. A cohort study of hospital employees who responded to a self-administered questionnaire on work schedule in 2008, 2012 and 2014 and were linked to individual-level pay-roll-based records on work shifts. For predictive validity, leisure-time fatigue was assessed. According to the survey data in 2014 (n=8896), 55% of the day workers had at least 1 year of earlier shift work experience. 8% of the night shift workers changed to day work during the follow-up. Using pay-roll data as reference, questions on 'shift work with night shifts' and 'permanent night work' showed high sensitivity (96% and 90%) and specificity (92% and 97%). Self-reported 'regular day work' showed moderate sensitivity (73%), but high specificity (99%) and 'shift work without night shifts' showed low sensitivity (62%) and moderate specificity (87%). In multivariate logistic regression analysis, the age-adjusted, sex-adjusted and baseline fatigue-adjusted association between 'shift work without night shifts' and leisure-time fatigue was lower for self-reported compared with objective assessment (1.30, 95% CI 0.94 to 1.82, n=1707 vs 1.89, 95% CI 1.06 to 3.39, n=1627). In contrast, shift work with night shifts, compared with permanent day work, was similarly associated with fatigue in the two assessments (2.04, 95% CI 1.62 to 2.57, n=2311 vs 1.82, 95% CI 1.28 to 2.58, n=1804). The validity of self-reported assessment of shift work varies between work schedules. Exposure misclassification in self-reported data may contribute to bias towards the null in shift work without night shifts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Instantaneous phase shifting deflectometry.
Trumper, Isaac; Choi, Heejoo; Kim, Dae Wook
An instantaneous phase shifting deflectometry measurement method is presented and implemented by measuring a time varying deformable mirror with an iPhone ® 6. The instantaneous method is based on multiplexing phase shifted fringe patterns with color, and decomposing them in x and y using Fourier techniques. Along with experimental data showing the capabilities of the instantaneous deflectometry system, a quantitative comparison with the Fourier transform profilometry method, which is a distinct phase measuring method from the phase shifting approach, is presented. Sources of error, nonlinear color-multiplexing induced error correction, and hardware limitations are discussed.
Adaptation to Shift Work: Physiologically Based Modeling of the Effects of Lighting and Shifts' Start Time
Postnova, Svetlana; Robinson, Peter A.; Postnov, Dmitry D.
Shift work has become an integral part of our life with almost 20% of the population being involved in different shift schedules in developed countries. However, the atypical work times, especially the night shifts, are associated with reduced quality and quantity of sleep that leads to increase of sleepiness often culminating in accidents. It has been demonstrated that shift workers' sleepiness can be improved by a proper scheduling of light exposure and optimizing shifts timing. Here, an integrated physiologically-based model of sleep-wake cycles is used to predict adaptation to shift work in different light conditions and for different shift start times for a schedule of four consecutive days of work. The integrated model combines a model of the ascending arousal system in the brain that controls the sleep-wake switch and a human circadian pacemaker model. To validate the application of the integrated model and demonstrate its utility, its dynamics are adjusted to achieve a fit to published experimental results showing adaptation of night shift workers (n = 8) in conditions of either bright or regular lighting. Further, the model is used to predict the shift workers' adaptation to the same shift schedule, but for conditions not considered in the experiment. The model demonstrates that the intensity of shift light can be reduced fourfold from that used in the experiment and still produce good adaptation to night work. The model predicts that sleepiness of the workers during night shifts on a protocol with either bright or regular lighting can be significantly improved by starting the shift earlier in the night, e.g.; at 21∶00 instead of 00∶00. Finally, the study predicts that people of the same chronotype, i.e. with identical sleep times in normal conditions, can have drastically different responses to shift work depending on their intrinsic circadian and homeostatic parameters. PMID:23308206
Benzo[a]pyrene-induced metabolic shift from glycolysis to pentose phosphate pathway in the human bladder cancer cell line RT4.
Verma, Nisha; Pink, Mario; Boland, Stefan; Rettenmeier, Albert W; Schmitz-Spanke, Simone
Benzo[a]pyrene (B[a]P), a well-known polyaromatic hydrocarbon, is known for its lung carcinogenicity, however, its role in bladder cancer development is still discussed. Comparative two-dimensional blue native SDS-PAGE analysis of protein complexes isolated from subcellular fractions of 0.5 µM B[a]P-exposed cells indicated a differential regulation of proteins involved in carbohydrate, fatty acid, and nucleotide metabolism, suggesting a possible metabolic flux redistribution. It appeared that B[a]P exposure led to a repression of enzymes (fructose-bisphosphate aldolase A, glucose-6-phosphate isomerase, lactate dehydrogenase) involved in glycolysis, and an up-regulation of proteins (glucose-6-phosphate 1-dehydrogenase, 6-phosphogluconolactonase) catalyzing the pentose phosphate pathway and one carbon metabolism (10-formyltetrahydrofolate dehydrogenase, bifunctional purine biosynthesis protein). Untargeted metabolomics further supported the proteomic data, a lower concentration of glycolytic metabolite was observed as compared to glutamine, xylulose and fatty acids. The analysis of the glutathione and NADPH/NADP+ content of the cells revealed a significant increase of these cofactors. Concomitantly, we did not observe any detectable increase in the production of ROS. With the present work, we shed light on an early phase of the metabolic stress response in which the urothelial cells are capable of counteracting oxidative stress by redirecting the metabolic flux from glycolysis to pentose phosphate pathway.
Effects of extended work shifts on employee fatigue, health satisfaction, work/family balance, and patient safety.
Estryn-Behar, M.; van der Heijden, Beatrice
12-hour shifts are quickly spreading in Europe. From our multivariate analysis concerning 25,924 European nurses, including twenty explanatory variables simultaneously, we found that work schedule itself is not a major determinant factor. Nurses aim to choose or accept night shifts or 12-hour shift
Shift Verification and Validation
Energy Technology Data Exchange (ETDEWEB)
Pandya, Tara M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Evans, Thomas M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Davidson, Gregory G [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Johnson, Seth R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Godfrey, Andrew T. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)
This documentation outlines the verification and validation of Shift for the Consortium for Advanced Simulation of Light Water Reactors (CASL). Five main types of problems were used for validation: small criticality benchmark problems; full-core reactor benchmarks for light water reactors; fixed-source coupled neutron-photon dosimetry benchmarks; depletion/burnup benchmarks; and full-core reactor performance benchmarks. We compared Shift results to measured data and other simulated Monte Carlo radiation transport code results, and found very good agreement in a variety of comparison measures. These include prediction of critical eigenvalue, radial and axial pin power distributions, rod worth, leakage spectra, and nuclide inventories over a burn cycle. Based on this validation of Shift, we are confident in Shift to provide reference results for CASL benchmarking.
Application of genetic algorithm for scheduling and schedule coordination problems
Energy Technology Data Exchange (ETDEWEB)
Shrivastava, P. [S. P. Engineering College, Dept. of Civil Engineering, Andheri (W), Mumbai (India); Dhingra, S. L. [ITT Bombay, Dept. of Civil Enginering, Mumbai (India); Gundaliya, P. J. [L. D. College of Engineeering, Dept. of Civil Engineering, Ahmedabad, Gujrat (India)
Problems of scheduling and schedule co-ordination and the conflicting objectives of transportation system users and transportation system operators are discussed. In schedule coordination problems time plays an important role. Users are interested in coordinating services within acceptable waiting time, whereas operators prefer to have lesser service and want to meet higher demands, which invariably increases waiting time. The problems are complex and conventional approaches to solving them are not useful. Genetic algorithm has been identified as an approach which performs well in solving such multi-objective problems. The general algorithmic approach has been found to be highly sensitive to penalties, but assuming that computational time is no constraint and realistic penalties can be decided in advance, judged in terms of their relative importance to outcomes, results can improve substantially. 13 refs., 3 tabs.
Multiuser switched diversity scheduling schemes
Shaqfeh, Mohammad
Multiuser switched-diversity scheduling schemes were recently proposed in order to overcome the heavy feedback requirements of conventional opportunistic scheduling schemes by applying a threshold-based, distributed, and ordered scheduling mechanism. The main idea behind these schemes is that slight reduction in the prospected multiuser diversity gains is an acceptable trade-off for great savings in terms of required channel-state-information feedback messages. In this work, we characterize the achievable rate region of multiuser switched diversity systems and compare it with the rate region of full feedback multiuser diversity systems. We propose also a novel proportional fair multiuser switched-based scheduling scheme and we demonstrate that it can be optimized using a practical and distributed method to obtain the feedback thresholds. We finally demonstrate by numerical examples that switched-diversity scheduling schemes operate within 0.3 bits/sec/Hz from the ultimate network capacity of full feedback systems in Rayleigh fading conditions. © 2012 IEEE.
Nurse Scheduling Using Genetic Algorithm
Directory of Open Access Journals (Sweden)
Komgrit Leksakul
Full Text Available This study applied engineering techniques to develop a nurse scheduling model that, while maintaining the highest level of service, simultaneously minimized hospital-staffing costs and equitably distributed overtime pay. In the mathematical model, the objective function was the sum of the overtime payment to all nurses and the standard deviation of the total overtime payment that each nurse received. Input data distributions were analyzed in order to formulate a simulation model to determine the optimal demand for nurses that met the hospital's service standards. To obtain the optimal nurse schedule with the number of nurses acquired from the simulation model, we proposed a genetic algorithm (GA with two-point crossover and random mutation. After running the algorithm, we compared the expenses and number of nurses between the existing and our proposed nurse schedules. For January 2013, the nurse schedule obtained by GA could save 12% in staffing expenses per month and 13% in number of nurses when compare with the existing schedule, while more equitably distributing overtime pay between all nurses.
Gain scheduling using the Youla parameterization
DEFF Research Database (Denmark)
Niemann, Hans Henrik; Stoustrup, Jakob
Gain scheduling controllers are considered in this paper. The gain scheduling problem where the scheduling parameter vector cannot be measured directly, but needs to be estimated is considered. An estimation of the scheduling vector has been derived by using the Youla parameterization. The use of...
Gain scheduling using the youla parameterization
DEFF Research Database (Denmark)
Niemann, H.H.; Stoustrup, Jakob
Gain scheduling controllers are considered in this paper. The gain scheduling problem where the scheduling parameter vector theta cannot be measured directly, but needs to be estimated is considered. An estimation of the scheduling vector theta has been derived by using the Youla parameterization...
Flexible Scheduling to Fit the Firefighters.
Cox, Clarice Robinson
Three flexible scheduling plans were tried in order that firefighters could take regular college courses despite their 24 hours on the 24 off work schedule. Plan one scheduled the firefighters into a regular Monday-Wednesday-Friday class which they attended every other week, making up missed material outside of class. Plan two scheduled special…
Atherosclerotic risk and social jetlag in rotating shift-workers : First evidence from a pilot study
Kantermann, Thomas; Duboutay, Françoise; Haubruge, Damien; Kerkhofs, Myriam; Schmidt-Trucksäss, Arno; Skene, Debra J
OBJECTIVE: The aim of this study was to identify atherosclerotic risk using pulse wave velocity (PWV) in steel workers employed in different shift-work rotations, and to elucidate its relationship to social jetlag and shift schedule details. PARTICIPANTS: Male workers in a steel factory (n=77, 32
Shift Work, Parenting Behaviors, and Children's Socioemotional Well-Being: A Within-Family Study
Barnett, Rosalind Chait; Gareis, Karen C.
Many U.S. employees with children work nonstandard hours, yet we know little about the linkages among maternal shift schedules, mothers' and fathers' parenting behaviors, and children's socioemotional outcomes. In a sample of 55 dual-earner families with children age 8 to 14 years and mothers working day versus evening shifts, the authors found…
Sleep and need for recovery in shift workers: do chronotype and age matter?
van de Ven, Hardy A; van der Klink, Jac J L; Vetter, Céline; Roenneberg, Till; Gordijn, Marijke; Koolhaas, Wendy; de Looze, Michiel P; Brouwer, Sandra; Bültmann, Ute
This study examined associations of chronotype and age with shift-specific assessments of main sleep duration, sleep quality and need for recovery in a cross-sectional study among N = 261 industrial shift workers (96.6% male). Logistic regression analyses were used, adjusted for gender, lifestyle, health, nap behaviour, season of assessment and shift schedule. Shift workers with latest versus earliest chronotype reported a shorter sleep duration (OR 11.68, 95% CI 3.31-41.17) and more awakenings complaints (OR 4.84, 95% CI 4.45-11.92) during morning shift periods. No associations were found between chronotype, sleep and need for recovery during evening and night shift periods. For age, no associations were found with any of the shift-specific outcome measures. The results stress the importance of including the concept of chronotype in shift work research and scheduling beyond the concept of age. Longitudinal research using shift-specific assessments of sleep and need for recovery are needed to confirm these results. Chronotype seems to better explain individual differences in sleep than age. In view of ageing societies, it might therefore be worthwhile to further examine the application of chronotype for individualised shift work schedules to facilitate healthy and sustainable employment.
Optimal randomized scheduling by replacement
Energy Technology Data Exchange (ETDEWEB)
Saias, I.
In the replacement scheduling problem, a system is composed of n processors drawn from a pool of p. The processors can become faulty while in operation and faulty processors never recover. A report is issued whenever a fault occurs. This report states only the existence of a fault but does not indicate its location. Based on this report, the scheduler can reconfigure the system and choose another set of n processors. The system operates satisfactorily as long as, upon report of a fault, the scheduler chooses n non-faulty processors. We provide a randomized protocol maximizing the expected number of faults the system can sustain before the occurrence of a crash. The optimality of the protocol is established by considering a closely related dual optimization problem. The game-theoretic technical difficulties that we solve in this paper are very general and encountered whenever proving the optimality of a randomized algorithm in parallel and distributed computation.
Environmental surveillance master sampling schedule
Energy Technology Data Exchange (ETDEWEB)
Bisping, L.E.
Environmental surveillance of the Hanford Site and surrounding areas is conducted by the Pacific Northwest National Laboratory (PNNL)(a) for the US Department of Energy (DOE). This document contains the planned 1997 schedules for routine collection of samples for the Surface Environmental Surveillance Project (SESP) and Drinking Water Monitoring Project. In addition, Section 3.0, Biota, also reflects a rotating collection schedule identifying the year a specific sample is scheduled for collection. The purpose of these monitoring projects is to evaluate levels of radioactive and nonradioactive pollutants in the Hanford environs, as required in DOE Order 5400.1, General Environmental Protection Program, and DOE Order 5400.5, Radiation Protection of the Public and the Environment. The sampling methods will be the same as those described in the Environmental Monitoring Plan, US Department of Energy, Richland Operations Office, DOE/RL91-50, Rev. 1, US Department of Energy, Richland, Washington.
Fuzzy scheduled RTDA controller design.
Srinivasan, K; Anbarasan, K
In this paper, the design and development of fuzzy scheduled robustness, tracking, disturbance rejection and overall aggressiveness (RTDA) controller design for non-linear processes are discussed. pH process is highly non-linear and the design of good controller for this process is always a challenging one due to large gain variation. Fuzzy scheduled RTDA controller design based on normalized integral square error (N_ISE) performance criteria for pH neutralization process is developed. The applicability of the proposed controller is tested for other different non-linear processes like type I diabetic process and conical tank process. The servo and regulatory performance of fuzzy scheduled RTDA controller design is compared with well-tuned internal model control (IMC) and dynamic matrix control (DMC)-based control schemes. Copyright © 2012 ISA. Published by Elsevier Ltd. All rights reserved.
Schedulability Analysis for Java Finalizers
DEFF Research Database (Denmark)
Bøgholm, Thomas; Hansen, Rene Rydhof; Ravn, Anders P.
Java finalizers perform clean-up and finalisation of objects at garbage collection time. In real-time Java profiles the use of finalizers is either discouraged (RTSJ, Ravenscar Java) or even disallowed (JSR-302), mainly because of the unpredictability of finalizers and in particular their impact...... on the schedulability analysis. In this paper we show that a controlled scoped memory model results in a structured and predictable execution of finalizers, more reminiscent of C++ destructors than Java finalizers. Furthermore, we incorporate finalizers into a (conservative) schedulability analysis for Predictable Java...... programs. Finally, we extend the SARTS tool for automated schedulability analysis of Java bytecode programs to handle finalizers in a fully automated way....
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.
Ferri, Paola; Guadi, Matteo; Marcheselli, Luigi; Balduzzi, Sara; Magnani, Daniela; Di Lorenzo, Rosaria
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. 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. 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. 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. 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.
Hubble Systems Optimize Hospital Schedules
Don Rosenthal, a former Ames Research Center computer scientist who helped design the Hubble Space Telescope's scheduling software, co-founded Allocade Inc. of Menlo Park, California, in 2004. Allocade's OnCue software helps hospitals reclaim unused capacity and optimize constantly changing schedules for imaging procedures. After starting to use the software, one medical center soon reported noticeable improvements in efficiency, including a 12 percent increase in procedure volume, 35 percent reduction in staff overtime, and significant reductions in backlog and technician phone time. Allocade now offers versions for outpatient and inpatient magnetic resonance imaging (MRI), ultrasound, interventional radiology, nuclear medicine, Positron Emission Tomography (PET), radiography, radiography-fluoroscopy, and mammography.
Schedulability Analysis for Java Finalizers
DEFF Research Database (Denmark)
Bøgholm, Thomas; Hansen, Rene Rydhof; Søndergaard, Hans
Java finalizers perform clean-up and finalisation of objects at garbage collection time. In real-time Java profiles the use of finalizers is either discouraged (RTSJ, Ravenscar Java) or even disallowed (JSR-302), mainly because of the unpredictability of finalizers and in particular their impact...... on the schedulability analysis. In this paper we show that a controlled scoped memory model results in a structured and predictable execution of finalizers, more reminiscent of C++ destructors than Java finalizers. Furthermore, we incorporate finalizers into a (conservative) schedulability analysis for Predictable Java...
Support system for process flow scheduling
Salomone, Enrique; Chiotti, Omar Juan Alfredo; Lerch, Juan
Process flow scheduling is a concept that refers to the scheduling of flow shop process plants, whose scheduling calculations are guided by the process structure. In a wide variety of high-volume process industries, the process flow scheduling concept implies an integrated structure for planning and scheduling. This integrated vision of the planning function and the very particular characteristics of the process industry production environment challenge the application of the most traditio...
Artificial intelligence approaches to astronomical observation scheduling
Johnston, Mark D.; Miller, Glenn
Automated scheduling will play an increasing role in future ground- and space-based observatory operations. Due to the complexity of the problem, artificial intelligence technology currently offers the greatest potential for the development of scheduling tools with sufficient power and flexibility to handle realistic scheduling situations. Summarized here are the main features of the observatory scheduling problem, how artificial intelligence (AI) techniques can be applied, and recent progress in AI scheduling for Hubble Space Telescope.
Protein Chemical Shift Prediction
Larsen, Anders S
The protein chemical shifts holds a large amount of information about the 3-dimensional structure of the protein. A number of chemical shift predictors based on the relationship between structures resolved with X-ray crystallography and the corresponding experimental chemical shifts have been developed. These empirical predictors are very accurate on X-ray structures but tends to be insensitive to small structural changes. To overcome this limitation it has been suggested to make chemical shift predictors based on quantum mechanical(QM) calculations. In this thesis the development of the QM derived chemical shift predictor Procs14 is presented. Procs14 is based on 2.35 million density functional theory(DFT) calculations on tripeptides and contains corrections for hydrogen bonding, ring current and the effect of the previous and following residue. Procs14 is capable at performing predictions for the 13CA, 13CB, 13CO, 15NH, 1HN and 1HA backbone atoms. In order to benchmark Procs14, a number of QM NMR calculatio...
Effects of an advanced sleep schedule and morning short wavelength light exposure on circadian phase in young adults with late sleep schedules.
Sharkey, Katherine M; Carskadon, Mary A; Figueiro, Mariana G; Zhu, Yong; Rea, Mark S
We examined the effects of an advanced sleep/wake schedule and morning short wavelength (blue) light in 25 adults (mean age±SD=21.8±3 years; 13 women) with late sleep schedules and subclinical features of delayed sleep phase disorder (DSPD). After a baseline week, participants kept individualized, fixed, advanced 7.5-h sleep schedules for 6days. Participants were randomly assigned to groups to receive "blue" (470nm, ∼225lux, n=12) or "dim" (<1lux, n=13) light for 1h after waking each day. Head-worn "Daysimeters" measured light exposure; actigraphs and sleep diaries confirmed schedule compliance. Salivary dim light melatonin onset (DLMO), self-reported sleep, and mood were examined with 2×2 ANOVA. After 6days, both groups showed significant circadian phase advances, but morning blue light was not associated with larger phase shifts than dim-light exposure. The average DLMO advances (mean±SD) were 1.5±1.1h in the dim light group and 1.4±0.7h in the blue light group. Adherence to a fixed advanced sleep/wake schedule resulted in significant circadian phase shifts in young adults with subclinical DSPD with or without morning blue light exposure. Light/dark exposures associated with fixed early sleep schedules are sufficient to advance circadian phase in young adults. Copyright © 2011 Elsevier B.V. All rights reserved.
Strain and health implications of nurses' shift work.
Buja, Alessandra; Zampieron, Alessandra; Mastrangelo, Giuseppe; Petean, Marco; Vinelli, Angela; Cerne, Diana; Baldo, Vincenzo
The study investigated whether nurses' different working schedules are associated with different levels of job-related strain, health symptoms and behavior. No reports have been accessible in the relevant literature on the possible association between shift work and job-related strain in nurses. This was a cross-sectional study conducted at a large university hospital in North-East Italy, involving 806 nurses working in selected departments. A multilevel logistic regression was applied to assess the association between work shift conditions and selected outcomes. Night shifts were associated not only with higher odds of having a high Job Demand, but also with lower odds of having a high Decision Authority and consequently with a stronger likelihood of having higher levels of Job Strain (high Job Demand score ≥ 38 and Low Decision Authority). The night shift was associated with various symptoms, particularly exhaustion (p = 0.039) and gastric pain (p = 0.020). Nurses' working schedules did not affect their job satisfaction scores. It has been confirmed that night shifts are a risk factor for nurses' health perception and working night shifts carries a considerable degree of strain. This is a condition that hospital nursing managements need to consider carefully to avoid burnout in nursing personnel and prevent an excessive turnover in this profession, which is a recurring problem for health care organizations.
Collaborative Scheduling between OSPPs and Gasholders in Steel Mill under Time-of-Use Power Price
Directory of Open Access Journals (Sweden)
Juxian Hao
Full Text Available Byproduct gases generated during steel production process are the main fuels for on-site power plants (OSPPs in steel enterprises. Recently, with the implementation of time-of-use (TOU power price in China, increasing attention has been paid to the collaborative scheduling between OSPPs and gasholders. However, the load shifting potential of OSPPs has seldom been discussed in previous studies. In this paper, a mixed integer linear programming (MILP-based scheduling model is built to evaluate the load shifting potential and the corresponding economic benefits. A case study is conducted on two steel enterprises with different configurations of OSPPs, and the optimal operation strategy is also discussed.
DEFF Research Database (Denmark)
Buus, Niels; Hoeck, Bente; Hamilton, Bridget Elizabeth
practices were described as highly conventionalised and locally situated, but with occasional opportunities for improvisation and negotiation between nurses. Finally, shift reports were described as multifunctional meetings, with individual and social effects for nurses and teams. CONCLUSION: Innovations...... in between-shift communications can benefit from this analysis, by providing for the many functions of handovers that are revealed in field studies. RELEVANCE TO CLINICAL PRACTICE: Leaders and practising nurses may consider what are the best opportunities for nurses to work up clinical knowledge......AIMS AND OBJECTIVES: To identify reporting practices that feature in studies of nurses' shift reports across diverse nursing specialities. The objectives were to perform an exhaustive systematic literature search and to critically review the quality and findings of qualitative field studies...
Precarious schedules linked with workplace aggression in a high-risk occupation.
Hurtado, David A; Dumet, Lisset M; Greenspan, Samuel A; Marino, Miguel; Bernard, Kimberly
Night work and prolonged work hours increase the risk for workplace aggression, however, the risk related to precarious schedules remains unknown. Cross-sectional study among Parole Probation Officers (PPOs) (n = 35). A precarious schedules index was created including the following indicators (a) experiencing one or more unexpected shifts during the last 4 weeks; (b) having minimal control over work hours; and (c) shifts notifications of less than a week. Generalized Poisson Regressions estimated the association between precarious schedules and self-reported client-based aggressive incidents (verbal, threating, property, or physical) during the last 12 months. Workplace aggression was highly prevalent (94.3%). PPOs who experienced precarious schedules (74.3% prevalence) had an adjusted rate of workplace aggression 1.55 times greater than PPOs without precarious schedules (IRR = 1.55, 95% CI 1.25, 1.97, P < 0.001). Precarious schedules were associated with workplace aggression. Further research ought to examine whether improving schedule predictability may reduce client-based aggression. © 2017 Wiley Periodicals, Inc.
Stochastic scheduling on unrelated machines
Skutella, Martin; Sviridenko, Maxim; Uetz, Marc Jochen
Two important characteristics encountered in many real-world scheduling problems are heterogeneous machines/processors and a certain degree of uncertainty about the actual sizes of jobs. The first characteristic entails machine dependent processing times of jobs and is captured by the classical
Endogenous scheduling preferences and congestion
DEFF Research Database (Denmark)
Fosgerau, Mogens; Small, Kenneth
Dynamic models of congestion so far rely on exogenous scheduling preferences of travelers, based for example on disutility of deviation from a preferred departure or arrival time for a trip. This paper provides a more fundamental view in which travelers derive utility just from consumption and le...
Lifetime improvement by battery scheduling
Jongerden, M.R.; Haverkort, Boudewijn R.H.M.
The use of mobile devices is often limited by the lifetime of its battery. For devices that have multiple batteries or that have the option to connect an extra battery, battery scheduling, thereby exploiting the recovery properties of the batteries, can help to extend the system lifetime. Due to the
Lifetime Improvement by Battery Scheduling
Jongerden, M.R.; Schmitt, Jens B.; Haverkort, Boudewijn R.H.M.
The use of mobile devices is often limited by the lifetime of their batteries. For devices that have multiple batteries or that have the option to connect an extra battery, battery scheduling, thereby exploiting the recovery properties of the batteries, can help to extend the system lifetime. Due to
Endogenous scheduling preferences and congestion
DEFF Research Database (Denmark)
Fosgerau, Mogens; Small, Kenneth
. Compared to the predictions of an analyst observing untolled equilibrium and taking scheduling preferences as exogenous, we find that both the optimal capacity and the marginal external cost of congestion have changed. The benefits of tolling are greater, and the optimal time varying toll is different....
DEFF Research Database (Denmark)
Stidsen, Thomas Jacob Riis; Pisinger, David; Vigo, Daniele
EURO-k conferences are among the largest Operations Research conferences in the world, typically including more than 2000 presentations. As opposed to many other conferences, EURO-k conferences are hierarchically organized, and the conference schedule should reflect this structure to make...
Robustness analysis of multiprocessor schedules
Adyanthaya, S.; Zhang, Z.; Geilen, M.; Voeten, J.; Basten, T.; Schiffelers, R.
Tasks executing on general purpose multiprocessor platforms exhibit variations in their execution times. As such, there is a need to explicitly consider robustness, i.e., tolerance to these fluctuations. This work aims to quantify the robustness of schedules of directed acyclic graphs (DAGs) on
Neurobehavioral, health, and safety consequences associated with shift work in safety-sensitive professions.
Barger, Laura K; Lockley, Steven W; Rajaratnam, Shantha M W; Landrigan, Christopher P
Almost 15% of the full-time workers in the United States are shift workers. We review the physiologic challenges inherent not only in traditional night or rotating shifts but also in extended-duration shifts and other nonstandard hours. The challenging schedules of those in particularly safety-sensitive professions such as police officers, firefighters, and health care providers are highlighted. Recent findings describing the neurobehavioral, health, and safety outcomes associated with shift work also are reviewed. Comprehensive fatigue management programs that include education, screening for common sleep disorders, and appropriate interventions need to be developed to minimize these negative consequences associated with shift work.
Intelligent perturbation algorithms for space scheduling optimization
Kurtzman, Clifford R.
Intelligent perturbation algorithms for space scheduling optimization are presented in the form of the viewgraphs. The following subject areas are covered: optimization of planning, scheduling, and manifesting; searching a discrete configuration space; heuristic algorithms used for optimization; use of heuristic methods on a sample scheduling problem; intelligent perturbation algorithms are iterative refinement techniques; properties of a good iterative search operator; dispatching examples of intelligent perturbation algorithm and perturbation operator attributes; scheduling implementations using intelligent perturbation algorithms; major advances in scheduling capabilities; the prototype ISF (industrial Space Facility) experiment scheduler; optimized schedule (max revenue); multi-variable optimization; Space Station design reference mission scheduling; ISF-TDRSS command scheduling demonstration; and example task - communications check.
Cremers, J.; Gramuglia, A.
The CLR-network examined in 2006 the phenomenon of undeclared labour, with specific regard to the construction sector. The resulting study, Shifting Employment: undeclared labour in construction, gave evidence that this is an area particularly affected by undeclared activities with one of the
DEFF Research Database (Denmark)
Nickelsen, Niels Christian Mossfeldt
with focus on shifting tasks was undertaken. Furthermore, the method of 'Interview to double' was used the analytical ambition being to explore the becoming of tasks and relations. Analytically the study draws predominantly on Stars notion of 'infrastructure'. Infrastructure is seen as human and non...
Integrated scheduling of tasks and gynecologists to improve patient appointment scheduling : a case study
van de Vrugt, Maartje; Luen-English, Samuel J.; Bastiaansen, W.A.P.; Kleinluchtenbeld, S.; Lardinois, W.T.P.; Pots, M.H.; Schoonbergen, D.H.; Hans, Erwin W.; Hurink, Johann L.; Boucherie, Richardus J.
Like many hospital departments, the gynecology department of the Jeroen Bosch Hospital experienced difficulties with scheduling outpatient appointments at the medically preferred times. Despite the time invested in creating the schedule, the compliance of the achieved schedules with the preferences
Project management with dynamic scheduling baseline scheduling, risk analysis and project control
Vanhoucke, Mario
The topic of this book is known as dynamic scheduling, and is used to refer to three dimensions of project management and scheduling: the construction of a baseline schedule and the analysis of a project schedule's risk as preparation of the project control phase during project progress. This dynamic scheduling point of view implicitly assumes that the usability of a project's baseline schedule is rather limited and only acts as a point of reference in the project life cycle.
Mathematical model for crane scheduling in mixed yard
Directory of Open Access Journals (Sweden)
Han Huihui
Full Text Available In mixed yards, the stacking status of the container is not in the order of the shipment, causing the efficiency of the process of loading and unloading decreased. Therefore, it is very important to come up with a method using the existing facilities to improve the efficiency and reduce the cost. In this paper(Produces the permission block, and copyright information Permission to make digital or hard copies of part or all of this work for personal or classroom use is granted without fee provided that copies are not made or distributed for profit or commercial advantage and that copies bear this notice and the full citation on the first page. Copyrights for third-party components of this work must be honored. For all other uses, contact the owner/author(s. We propose a method that sets a buffer in the yard to minimize the duration of the shifting process. To implement this method, the integer programming model is founded and the small scale accurate solution is used to implement the crane scheduling in the shifting process. The results showed that the model mentioned earlier can solve the problem of crane scheduling in the process of shifting with efficiency and provide strategic support for the management of yard.
Backfilling with Fairness and Slack for Parallel Job Scheduling
Sodan, Angela C.; Jin, Wei
Parallel job scheduling typically combines a basic policy like FCFS with backfilling, i.e. moving jobs to an earlier than their regular scheduling position if they do not delay the jobs ahead in the queue according to the rules of the backfilling approach applied. Commonly used are conservative and easy backfilling which either have worse response times but better predictability or better response times and poor predictability. The paper proposes a relaxation of conservative backfilling by permitting to shift jobs within certain constraints to backfill more jobs and reduce fragmentation and subsequently obtain better response times. At the same time, deviation from fairness is kept low and predictability remains high. The results of the experimentation evaluation show that the goals are met, with response-time performance lying as expected between conservative and easy backfilling.
Surveying air traffic control specialist perception of scheduling regulations
Thompson, Darrius E.
While there have been several studies conducted on air traffic controller fatigue, there is a lack of research on the subject since the scheduling policy changes that took place in 2012. The effectiveness of these changes has yet to be measured. The goal of this study was to investigate air traffic control specialist views towards the number of hours scheduled between shifts, changes in perception since 2012 regulation changes, and external factors that impact fatigue. A total of 54 FAA air traffic control specialist completed an online questionnaire. The results from the survey showed that the majority of respondents felt the 2012 regulation changes were not sufficient to address fatigue issues, and work with some amount sleep deprivation. The factors that appeared to have the most significant effect on fatigue included facility level, age group, availability of recuperative breaks, and children under 18 in the home.
Field Engineers' Scheduling at Oil Rigs: a Case Study
Directory of Open Access Journals (Sweden)
Y. S. Usmani
Full Text Available Oil exploration and production operations face a number of challenges. Professional planners have to design solutions for various practical problems or issues. However, the time consumed is often very extensive because of the large number of possible solutions. Further, the matter of choosing the best solution remains. The present paper investigates a problem related to leading companies in the energy and chemical manufacturing sector of the oil and gas industry. Each company's field engineers are expensive and valuable assets. Therefore, an optimized roster is rather important. In the present paper, the objective is to design a field engineers' schedule which would be both feasible and satisfying towards the various demands of rigs, with minimum operational cost to the company. An efficient and quick optimization technique is presented to schedule the shifts of field engineers.
Nurse perceptions of workplace environment: differences across shifts.
Teclaw, Robert; Osatuke, Katerine
To evaluate whether nurse work shift affected workplace perceptions. Although the importance of work schedule in shaping work attitudes, generally (and specifically for nurses) is well accepted, much work remains in characterising how and why nurses' perceptions might differ across shifts. Using an exploratory study of observational data, we examined whether shift influenced non-supervisory nurses' job perceptions in the Veterans Health Administration All Employee Survey (n = 14057; years 2008, 2010, 2012). The size of differences in item means (95% C.I.) across shifts was evaluated graphically. Using ordinal logistic regression, we accounted for the ordinal outcome variables and controlled for the demographic and survey year effects. Nurses' perceptions of workplace climate differed across shifts. Items with the greatest differences, consistent across years and analytic methods, involved supervisors and fairness. Night and weekend shift nurse ratings were more negative than for weekday shift nurses. Off-shift nurses are less satisfied with work/life balance, their supervisors and especially fairness. Overall satisfaction and turnover intention are not affected to the same extent. These results indicate several specific areas that nurse managers can address through workforce support and communication. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.
[Sleep disorders among physicians on shift work].
Schlafer, O; Wenzel, V; Högl, B
Sleep disorders in physicians who perform shift work can result in increased risks of health problems that negatively impact performance and patient safety. Even those who cope well with shift work are likely to suffer from sleep disorders. The aim of this manuscript is to discuss possible causes, contributing factors and consequences of sleep disorders in physicians and to identify measures that can improve adaptation to shift work and treatment strategies for shift work-associated sleep disorders. The risk factors that influence the development of sleep disorders in physicians are numerous and include genetic factors (15 % of the population), age (> 50 years), undiagnosed sleep apnea,, alcohol abuse as well as multiple stress factors inherent in clinical duties (including shift work), research, teaching and family obligations. Several studies have reported an increased risk for medical errors in sleep-deprived physicians. Shift workers have an increased risk for psychiatric and cardiovascular diseases and shift work may also be a contributing factor to cancer. A relationship has been reported not only with sleep deprivation and changes in food intake but also with diabetes mellitus, obesity, hypertension and coronary heart disease. Nicotine and alcohol consumption are more frequent among shift workers. Increased sickness and accident rates among physicians when commuting (especially after night shifts) have a socioeconomic impact. In order to reduce fatigue and to improve performance, short naps during shiftwork or naps plus caffeine, have been proposed as coping strategies; however, napping during adverse circadian phases is less effective, if not impossible when unable to fall asleep. Bright and blue light supports alertness during a night shift. After shiftwork, direct sunlight exposure to the retina can be avoided by using dark sunglasses or glasses with orange lenses for commuting home. The home environment for daytime sleeping after a night shift should be
The association between rotating shift work and increased occupational stress in nurses.
Lin, Pei-Chen; Chen, Chung-Hey; Pan, Shung-Mei; Chen, Yao-Mei; Pan, Chih-Hong; Hung, Hsin-Chia; Wu, Ming-Tsang
The aim of this study was to investigate whether rotating shift work increases occupational stress in nurses. This study measured shift work scheduling and occupational stress by using the Effort-Reward Imbalance model with self-reported questionnaires in a sample of 654 female nurses. Overcommitment risk was higher in nurses who worked rotating shifts than in those who worked day/non-night shifts (OR, 2.16; 95% CI, 1.03-4.66). However, an effort/reward imbalance was not directly associated with work schedules (OR, 1.88; 95% CI, 0.87-4.35). Among nurses working rotation rotating shifts, those who had 2 days off after their most recent night shifts showed an alleviated risk of overcommitment (OR, 0.52; 95% CI, 0.32-0.82), but those who had worked for at least one series of 7 consecutive work days per month had an increased risk of effort/reward imbalance (OR, 2.75; 95% CI, 1.69-4.48). Additionally, those who had little or no participation in planning working hours and shift scheduling and worked overtime at least three times per week during the preceding 2 months tended to have high stress. The nurses who worked rotating shifts tended to experience work-related stress, but their stress levels improved if they had at least 2 days off after their most recent night shift and if they were not scheduled to work 7 consecutive days. These empirical data can be used to optimize work schedules for nurses to alleviate work stress.
Cancer begins in your cells, which are the building blocks of your body. Normally, your body forms ... be benign or malignant. Benign tumors aren't cancer while malignant ones are. Cells from malignant tumors ...
Sustainable employability in shiftwork: related to types of work schedule rather than age.
Peters, Velibor; Engels, Josephine A; de Rijk, Angelique E; Nijhuis, Frans J N
There is scarce research on age and sustainable employability of nurses working in various types of work schedules. Earlier research showed that nurses working in work schedules differ regarding age. Different operationalisations of age might explain variations in sustainable employability. Therefore, the aim of this study was to investigate how nurses working in various types of work schedule differ regarding sustainable employability, and the role that age plays in these differences. Age was defined as chronological age, organisational age, life-span age, and functional age. Questionnaires were distributed to 974 Dutch nurses in residential elder care (response rate 51 %) with questions about the type of work schedule, aspects of sustainable employability, various operationalisations of age, and registered sickness absence data were used. Nurses working in various types of work schedules differed regarding aspects of sustainable employability, also when operationalisations of age were added. The 'life-span age' was directly related to aspects of sustainable employability. Statistically, work ability and job satisfaction were only explained by varying operationalisations of age. Nurses' sustainable employability appeared to be mainly related to differences between the types of work schedule rather than age. Fixed early shifts are characterised by the most positive aspects of sustainable employability, and three rotating schedules score worst. To improve sustainable employability, organisations should implement a system in which nurses with different types of work schedule are monitored in combination with their life-span perspective.
77 FR 64848 - Proposed Collection; Comment Request for Form 1120S, Schedule D, Schedule K-1, and Schedule M-3
..., etc., Schedule M-3 (Form 1120S), Net Income (Loss) Reconciliation for S Corporations With Total Assets... Losses and Built-In Gains, Schedule M-3 (Form 1120S), Net Income (Loss) Reconciliation for S Corporations With Total Assets of $10 Million or More, and Schedule K-1 (Form 1120S), Shareholder's Share of Income...
CMS Planning and Scheduling System
Kotamaki, M
The paper describes the procedures and the system to build and maintain the schedules needed to manage time, resources, and progress of the CMS project. The system is based on the decomposition of the project into work packages, which can be each considered as a complete project with its own structure. The system promotes the distribution of the decision making and responsibilities to lower levels in the organisation by providing a state-of-the-art system to formalise the external commitments of the work packages without limiting their ability to modify their internal schedules to best meet their commitments. The system lets the project management focus on the interfaces between the work packages and alerts the management immediately if a conflict arises. The proposed system simplifies the planning and management process and eliminates the need for a large, centralised project management system.
Rest requirements and rest management of personnel in shift work
Energy Technology Data Exchange (ETDEWEB)
Hammell, B.D. [PDG Environmental, Melbourne, FL (United States); Scheuerle, A. [Univ. of Texas, Houston, TX (United States)
A difficulty-weighted shift assignment scheme is proposed for use in prolonged and strenuous field operations such as emergency response, site testing, and short term hazardous waste remediation projects. The purpose of the work rotation plan is to increase productivity, safety, and moral of workers. Job weighting is accomplished by assigning adjustments to the mental and physical intensity of the task, the protective equipment worn, and the climatic conditions. The plan is based on medical studies of sleep deprivation, the effects of rest adjustments, and programs to reduce sleep deprivation and normalize shift schedules.
The CHI 2013 interactive schedule
DEFF Research Database (Denmark)
Satyanarayan, Arvind; Strazzulla, Daniel; Klokmose, Clemens Nylandsted
CHI 2013 offers over 500 separate events including paper presentations, panels, courses, case studies and special interest groups. Given the size of the conference, it is no longer practical to host live summaries of these events. Instead, a 30-second Video Preview summary of each event is availa...... with these displays using their mobile devices by either constructing custom video playlists or adding on-screen content to their personal schedule....
On Optimal Deadlock Detection Scheduling
Ling, Yibei; Chen, Shigang; Chiang, Cho-Yu Jason
Deadlock detection scheduling is an important, yet often overlooked problem that can significantly affect the overall performance of deadlock handling. Excessive initiation of deadlock detection increases overall message usage, resulting in degraded system performance in the absence of deadlocks; while insufficient initiation of deadlock detection increases the deadlock persistence time, resulting in an increased deadlock resolution cost in the presence of deadlocks. The investigation of this...
Nurse Scheduling Using Genetic Algorithm
Leksakul, Komgrit; Phetsawat, Sukrit
This study applied engineering techniques to develop a nurse scheduling model that, while maintaining the highest level of service, simultaneously minimized hospital-staffing costs and equitably distributed overtime pay. In the mathematical model, the objective function was the sum of the overtime payment to all nurses and the standard deviation of the total overtime payment that each nurse received. Input data distributions were analyzed in order to formulate a simulation model to determine ...
A Decision Support System for Academic Scheduling.
Burleson, Donald K.; Leivano, Rodrigo J.
Describes the use of a decision support system to operate on a database for academic scheduling. Discusses the scheduling environment, database subsystem, dialog subsystem, modeling subsystem, and output formats. (JM)
GSA eLibrary Schedules and Contracts
General Services Administration — GSA eLibrary (formerly Schedules e-Library) is the online source for the latest contract award information for: GSA Schedules; Department of Veterans Affairs (VA)...
DME Prosthetics Orthotics, and Supplies Fee Schedule
U.S. Department of Health & Human Services — Durable Medical Equipment, Prosthetics-Orthotics, and Supplies Fee Schedule. The list contains the fee schedule amounts, floors, and ceilings for all procedure codes...
How should periods without social interaction be scheduled? Children's preference for practical schedules of positive reinforcement.
Luczynski, Kevin C; Hanley, Gregory P
Several studies have shown that children prefer contingent reinforcement (CR) rather than yoked noncontingent reinforcement (NCR) when continuous reinforcement is programmed in the CR schedule. Preference has not, however, been evaluated for practical schedules that involve CR. In Study 1, we assessed 5 children's preference for obtaining social interaction via a multiple schedule (periods of fixed-ratio 1 reinforcement alternating with periods of extinction), a briefly signaled delayed reinforcement schedule, and an NCR schedule. The multiple schedule promoted the most efficient level of responding. In general, children chose to experience the multiple schedule and avoided the delay and NCR schedules, indicating that they preferred multiple schedules as the means to arrange practical schedules of social interaction. In Study 2, we evaluated potential controlling variables that influenced 1 child's preference for the multiple schedule and found that the strong positive contingency was the primary variable. © Society for the Experimental Analysis of Behavior.
Guidelines of Decommissioning Schedule Establishment
Energy Technology Data Exchange (ETDEWEB)
Oh, Jae Yong; Yun, Taesik; Kim, Younggook; Kim, Hee-Geun [KHNP CRI, Daejeon (Korea, Republic of)
Decommissioning has recently become an issue highlighted in Korea due to the Permanent Shutdown (PS) of Kori-1 plant. Since Korea Hydro and Nuclear Power (KHNP) Company decided the PS of Kori-1 instead of further continued operation, Kori-1 will be the first decommissioning plant of the commercial reactors in Korea. Korean regulatory authority demands Initial Decommissioning Plan (IDP) for all the plants in operation and under construction. In addition, decommissioning should be considered for the completion of the life cycle of NPPs. To date, Korea has no experience regarding decommissioning of the commercial reactor and a lot of uncertainties will be expected due to its site-specific factors. However, optimized decommissioning process schedule must be indispensable in the safety and economic efficiency of the project. Differed from USA, Korea has no experience and know-hows of the operation and site management for decommissioning. Hence, in Korea, establishment of decommissioning schedule has to give more weight to safety than precedent cases. More economical and rational schedule will be composed by collecting and analyzing the experience data and site-specific data and information as the decommissioning progresses. In a long-range outlook, KHNP having capability of NPP decommissioning will try to decommissioning business in Korea and foreign countries.
Split-shift work in relation to stress, health and psychosocial work factors among bus drivers.
Ihlström, Jonas; Kecklund, Göran; Anund, Anna
Shift work has been associated with poor health, sleep and fatigue problems and low satisfaction with working hours. However, one type of shift working, namely split shifts, have received little attention. This study examined stress, health and psychosocial aspects of split-shift schedules among bus drivers in urban transport. A questionnaire was distributed to drivers working more than 70% of full time which 235 drivers in total answered. In general, drivers working split-shift schedules (n = 146) did not differ from drivers not working such shifts (n = 83) as regards any of the outcome variables that were studied. However, when individual perceptions towards split-shift schedules were taken into account, a different picture appeared. Bus drivers who reported problems working split shifts (36%) reported poorer health, higher perceived stress, working hours interfering with social life, lower sleep quality, more persistent fatigue and lower general work satisfaction than those who did not view split shifts as a problem. Moreover, drivers who reported problems with split shifts also perceived lower possibilities to influence working hours, indicating lower work time control. This study indicates that split shifts were not associated with increased stress, poorer health and adverse psychosocial work factors for the entire study sample. However, the results showed that individual differences were important and approximately one third of the drivers reported problems with split shifts, which in turn was associated with stress, poor health and negative psychosocial work conditions. More research is needed to understand the individual and organizational determinants of tolerance to split shifts.
Self-optimization aspects for dynamic scheduling
Pereira, Ivo; Madureira, Ana Maria
Scheduling is a critical function that is present throughout many industries and applications. A great need exists for developing scheduling approaches that can be applied to a number of different scheduling problems with significant impact on performance of business organizations. A challenge is emerging in the design of scheduling support systems for manufacturing environments where dynamic adaptation and optimization become increasingly important. At this scenario, self-o...
Partially clairvoyant scheduling for aggregate constraints
Subramani, K.
The problem of partially clairvoyant scheduling is concerned with checking whether an ordered set of jobs, having nonconstant execution times and subject to a collection of imposed constraints, has a partially clairvoyant schedule. Variability of execution times of jobs and nontrivial relationships constraining their executions, are typical features of real-time systems. A partially clairvoyant scheduler parameterizes the schedule, in that the start time of a job in a sequence can depend u...
Andersson, Niclas; Christensen, Knud
The traditional method for planning, scheduling and controlling activities and resources in construction projects is the CPM-scheduling, which has been the predominant scheduling method since its introduction in the late 1950s. Over the years, CPM has proven to be a very powerful technique for planning, scheduling and controlling projects. However, criticism has been raised on the CPM method, specifically in the case of construction projects, for deficient management of construction work and ...
75 FR 7411 - Schedule of Water Charges
... COMMISSION 18 CFR Part 410 Schedule of Water Charges AGENCY: Delaware River Basin Commission. ACTION: Notice... Regulations--Water Supply Charges to revise the schedule of water charges. DATES: The Commission will hold a... the subject line ``Schedule of Water Charges.'' FOR FURTHER INFORMATION, CONTACT: Please contact Paula...
An improved scheduling algorithm for linear networks
Bader, Ahmed
In accordance with the present disclosure, embodiments of an exemplary scheduling controller module or device implement an improved scheduling process such that the targeted reduction in schedule length can be achieve while incurring minimal energy penalty by allowing for a large rate (or duration) selection alphabet.
21 CFR 1308.49 - Emergency scheduling.
... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Emergency scheduling. 1308.49 Section 1308.49 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE SCHEDULES OF CONTROLLED SUBSTANCES Hearings § 1308.49 Emergency scheduling. Pursuant to 21 U.S.C. 811(h) and without regard to the...
The nurse scheduling problem: a goal programming and nonlinear optimization approaches
Hakim, L.; Bakhtiar, T.; Jaharuddin
Nurses scheduling is an activity of allocating nurses to conduct a set of tasks at certain room at a hospital or health centre within a certain period. One of obstacles in the nurse scheduling is the lack of resources in order to fulfil the needs of the hospital. Nurse scheduling which is undertaken manually will be at risk of not fulfilling some nursing rules set by the hospital. Therefore, this study aimed to perform scheduling models that satisfy all the specific rules set by the management of Bogor State Hospital. We have developed three models to overcome the scheduling needs. Model 1 is designed to schedule nurses who are solely assigned to a certain inpatient unit and Model 2 is constructed to manage nurses who are assigned to an inpatient room as well as at Polyclinic room as conjunct nurses. As the assignment of nurses on each shift is uneven, then we propose Model 3 to minimize the variance of the workload in order to achieve equitable assignment on every shift. The first two models are formulated in goal programming framework, while the last model is in nonlinear optimization form.
Effects of extended work shifts on employee fatigue, health, satisfaction, work/family balance, and patient safety.
Estryn-Béhar, Madeleine; Van der Heijden, Beatrice I J M
12-hour shifts are quickly spreading in Europe. From our multivariate analysis concerning 25,924 European nurses, including twenty explanatory variables simultaneously, we found that work schedule itself is not a major determinant factor. Nurses aim to choose or accept night shifts or 12-hour shift in order to reduce their work/home conflicts, however, at the expense of the patient's safety, as well as their own health and safety. Therefore, it is important to develop measures, such as extended child care, association of nurses to the elaboration of their rota, 9- or 10-hour shifts in the afternoon, allowing naps during night shifts, and reduction of changing shifts with short notice. Work schedules must be organized in order to allow time for shift handover, social support and team building.
Nurse Scheduling by Cooperative GA with Effective Mutation Operator
Ohki, Makoto
In this paper, we propose an effective mutation operators for Cooperative Genetic Algorithm (CGA) to be applied to a practical Nurse Scheduling Problem (NSP). The nurse scheduling is a very difficult task, because NSP is a complex combinatorial optimizing problem for which many requirements must be considered. In real hospitals, the schedule changes frequently. The changes of the shift schedule yields various problems, for example, a fall in the nursing level. We describe a technique of the reoptimization of the nurse schedule in response to a change. The conventional CGA is superior in ability for local search by means of its crossover operator, but often stagnates at the unfavorable situation because it is inferior to ability for global search. When the optimization stagnates for long generation cycle, a searching point, population in this case, would be caught in a wide local minimum area. To escape such local minimum area, small change in a population should be required. Based on such consideration, we propose a mutation operator activated depending on the optimization speed. When the optimization stagnates, in other words, when the optimization speed decreases, the mutation yields small changes in the population. Then the population is able to escape from a local minimum area by means of the mutation. However, this mutation operator requires two well-defined parameters. This means that user have to consider the value of these parameters carefully. To solve this problem, we propose a periodic mutation operator which has only one parameter to define itself. This simplified mutation operator is effective over a wide range of the parameter value.
Fast multiprocessor scheduling with fixed task binding of large scale industrial cyber physical systems
Adyanthaya, S.; Geilen, M.; Basten, T.; Schiffelers, R.; Theelen, B.; Voeten, J.
Latest trends in embedded platform architectures show a steady shift from high frequency single core platforms to lower-frequency but highly-parallel execution platforms. Scheduling applications with stringent latency requirements on such multiprocessor platforms is challenging. Our work is
National Research Council Canada - National Science Library
Peiris-Pagès, Maria; Martinez-Outschoorn, Ubaldo E; Pestell, Richard G; Sotgia, Federica; Lisanti, Michael P
.... Cancer stem cells also seem to adapt their metabolism to microenvironmental changes by conveniently shifting energy production from one pathway to another, or by acquiring intermediate metabolic phenotypes...
Innovative scheduling to maintain clinical pharmacy services despite budget retrenchment.
Siegel, J; Schneider, P J; Moore, T D
A process is described in which staff scheduling was adjusted to maintain pharmaceutical services while achieving a 7% cutback in personnel costs. The pharmacy department in a 1000-bed university hospital was unable to achieve the necessary cost savings through reductions in sick leave and overtime hours. The pharmacy administration developed a plan that required pharmacists to work four 10-hour shifts per week and resulted in reduced hours of service. The pharmacists objected and proposed an alternative plan in which clinical service was maintained for 16 hours on weekdays and 12 hours on weekends. Pharmacist teams worked one flexible shift per week. Pharmacists developed an innovative staffing plan that allowed them to maintain a high level of practice and acceptable working hours.
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
Directory of Open Access Journals (Sweden)
Ferri P
Full Text Available Paola Ferri,1 Matteo Guadi,1 Luigi Marcheselli,1 Sara Balduzzi,1 Daniela Magnani,1 Rosaria Di Lorenzo2 1Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, 2Department of Mental Health, AUSL di Modena, Service of Psychiatric Diagnosis and Treatment, Modena, Italy 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. Keywords: shift work, night work
A planning language for activity scheduling
Zoch, David R.; Lavallee, David; Weinstein, Stuart; Tong, G. Michael
Mission planning and scheduling of spacecraft operations are becoming more complex at NASA. Described here are a mission planning process; a robust, flexible planning language for spacecraft and payload operations; and a software scheduling system that generates schedules based on planning language inputs. The mission planning process often involves many people and organizations. Consequently, a planning language is needed to facilitate communication, to provide a standard interface, and to represent flexible requirements. The software scheduling system interprets the planning language and uses the resource, time duration, constraint, and alternative plan flexibilities to resolve scheduling conflicts.
DEFF Research Database (Denmark)
Andersson, Niclas; Christensen, Knud
The traditional method for planning, scheduling and controlling activities and resources in construction projects is the CPM-scheduling, which has been the predominant scheduling method since its introduction in the late 1950s. Over the years, CPM has proven to be a very powerful technique...... for planning, scheduling and controlling projects. However, criticism has been raised on the CPM method, specifically in the case of construction projects, for deficient management of construction work and discontinuous flow of resources. Alternative scheduling techniques, often called repetitive or linear...
Cure Schedule for Stycast 2651/Catalyst 9.
Energy Technology Data Exchange (ETDEWEB)
Kropka, Jamie Michael [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); McCoy, John D. [New Mexico Inst. of Mining and Technology, Socorro, NM (United States)
The Emerson & Cuming technical data sheet (TDS) for Stycast 2651/Catalyst 9 lists three alternate cure schedules for the material, each of which would result in a different state of reaction and different material properties. Here, a cure schedule that attains full reaction of the material is defined. The use of this cure schedule will eliminate variance in material properties due to changes in the cure state of the material, and the cure schedule will serve as the method to make material prior to characterizing properties. The following recommendation uses one of the schedules within the TDS and adds a "post cure" to obtain full reaction.
Catastrophic shifts in ecosystems
Scheffer, Marten; Carpenter, Steve; Foley, Jonathan A.; Folke, Carl; Walker, Brian
All ecosystems are exposed to gradual changes in climate, nutrient loading, habitat fragmentation or biotic exploitation. Nature is usually assumed to respond to gradual change in a smooth way. However, studies on lakes, coral reefs, oceans, forests and arid lands have shown that smooth change can be interrupted by sudden drastic switches to a contrasting state. Although diverse events can trigger such shifts, recent studies show that a loss of resilience usually paves the way for a switch to an alternative state. This suggests that strategies for sustainable management of such ecosystems should focus on maintaining resilience.
Cardiovascular risk factors and primary selection into shift work.
Nabe-Nielsen, Kirsten; Garde, Anne Helene; Tüchsen, Finn; Hogh, Annie; Diderichsen, Finn
This study examined differences between future shift workers and future day workers as regards cardiovascular risk factors before they began different work schedules and the differences that remained after control for sociodemographic factors and general self-efficacy. Altogether 2870 newly educated social and health care workers filled out a questionnaire a few weeks before finishing their formal training and again 1 year after graduation. They answered questions on diabetes, hypertension, lifestyle habits, sociodemographic factors, and general self-efficacy. In the unadjusted analyses, baseline obesity was associated with fixed evening work at follow-up. Minimal or light-to-moderate leisure-time physical activity was associated with a decrease in the odds ratio (OR) for two or three shifts including night work. Smoking status was associated with fixed evening work, fixed night work, and two- or three- shift work including night work. After adjustment for sociodemographic factors and general self-efficacy, smoking was prospectively associated with fixed evening work [OR 1.56, 95% confidence interval (95% CI) 1.21-2.02] and fixed night work (OR 1.64, 95% CI 1.04-2.56). Being an ex-smoker was associated with two- or three-shift work including night work (OR 1.85, 95% CI 1.28-2.68). The association between two- and three-shift work and smoking was only of borderline significance (OR 1.37, 95% CI 1.00-1.87). Compared with future day workers, fixed evening or fixed night workers already smoked more before they began shift work. Being an ex-smoker was significantly associated with two- or three-shift work including night work. These results indicate that smoking status should not solely be treated as a mediator between some variants of shiftwork schedules and cardiovascular diseases but should also be considered a confounder.
A System for Automatically Generating Scheduling Heuristics
Morris, Robert
The goal of this research is to improve the performance of automated schedulers by designing and implementing an algorithm by automatically generating heuristics by selecting a schedule. The particular application selected by applying this method solves the problem of scheduling telescope observations, and is called the Associate Principal Astronomer. The input to the APA scheduler is a set of observation requests submitted by one or more astronomers. Each observation request specifies an observation program as well as scheduling constraints and preferences associated with the program. The scheduler employs greedy heuristic search to synthesize a schedule that satisfies all hard constraints of the domain and achieves a good score with respect to soft constraints expressed as an objective function established by an astronomer-user.
A Recovery Model for Production Scheduling: Combination of Disruption Management and Internet of Things
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Yang Jiang
Full Text Available It is difficult to generate the new schedule effectively for minimizing the negative impact when an unanticipated disruption occurs after a subset of tasks has been finished in production scheduling. In such cases, continuing with the original schedule may not be optimal or feasible. Based on disruption management and Internet of things (IoT, this study designs a real-time status analyzer to identify the disruption and propose a recovery model to deal with the disruption. The computational result proves that our algorithm is competitive with the existing heuristics. Furthermore, due to the tradeoff between all participators (mainly including customers, managers of production enterprise, and workers involved in production scheduling, our model is more effective than the total rescheduling and right-shift rescheduling.
Prolog-based system for nursing staff scheduling implemented on a personal computer.
Okada, M; Okada, M
An approach to the problem of nursing staff scheduling in a hospital is presented. For scheduling nurses, a variety of requirements with varied levels of significance has to be taken into account simultaneously. Because of the nature of the problem, where it is difficult to define what is the optimal solution in a strict sense, we aimed at automating scheduling by following the manual method in a faithful manner. A system for nurse scheduling has been implemented on a personal computer using Prolog. It determines favorable shift assignments on a day-to-day basis, referring to the information accumulated in the data base. In Prolog, various requirements can be expressed with relative ease, and the process of the manual method can be incorporated into the system in a natural way. The computer simulation has been conducted to test the system performance, and the obtained results demonstrated the validity of the approach.
Health consequences of shift work and insufficient sleep.
Kecklund, Göran; Axelsson, John
This review summarises the literature on shift work and its relation to insufficient sleep, chronic diseases, and accidents. It is based on 38 meta-analyses and 24 systematic reviews, with additional narrative reviews and articles used for outlining possible mechanisms by which shift work may cause accidents and adverse health. Evidence shows that the effect of shift work on sleep mainly concerns acute sleep loss in connection with night shifts and early morning shifts. A link also exists between shift work and accidents, type 2 diabetes (relative risk range 1.09-1.40), weight gain, coronary heart disease (relative risk 1.23), stroke (relative risk 1.05), and cancer (relative risk range 1.01-1.32), although the original studies showed mixed results. The relations of shift work to cardiometabolic diseases and accidents mimic those with insufficient sleep. Laboratory studies indicate that cardiometabolic stress and cognitive impairments are increased by shift work, as well as by sleep loss. Given that the health and safety consequences of shift work and insufficient sleep are very similar, they are likely to share common mechanisms. However, additional research is needed to determine whether insufficient sleep is a causal pathway for the adverse health effects associated with shift work. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Repetition and Translation Shifts
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Simon Zupan
Full Text Available Repetition manifests itself in different ways and at different levels of the text. The first basic type of repetition involves complete recurrences; in which a particular textual feature repeats in its entirety. The second type involves partial recurrences; in which the second repetition of the same textual feature includes certain modifications to the first occurrence. In the article; repetitive patterns in Edgar Allan Poe's short story "The Fall of the House of Usher" and its Slovene translation; "Konec Usherjeve hiše"; are compared. The author examines different kinds of repetitive patterns. Repetitions are compared at both the micro- and macrostructural levels. As detailed analyses have shown; considerable microstructural translation shifts occur in certain types of repetitive patterns. Since these are not only occasional; sporadic phenomena; but are of a relatively high frequency; they reduce the translated text's potential for achieving some of the gothic effects. The macrostructural textual property particularly affected by these shifts is the narrator's experience as described by the narrative; which suffers a reduction in intensity.
The effects of consecutive night shifts and shift length on cognitive performance and sleepiness: a field study.
Haidarimoghadam, Rashid; Kazemi, Reza; Motamedzadeh, Majid; Golmohamadi, Rostam; Soltanian, Alireza; Zoghipaydar, Mohamad Reza
The aim of this study was to evaluate the effects of consecutive night shifts (CNS) and shift length on cognitive performance and sleepiness. This study evaluated the sleepiness and performance of 30 control room operators (CROs) working in 7 nights, 7 days, 7 days off (7N7D7O) and 30 CROs working in 4 nights, 7 days, 3 nights, 7 days off (4N7D3N7O) shift patterns in a petrochemical complex on the last night shift before swinging into the day shift. To assess cognitive performance, the n-back test, continuous performance test and simple reaction time test were employed. To assess sleepiness, the Karolinska sleepiness scale was used. Both schedules indicated that the correct responses and response times of working memory were reduced (p = 0.001), while intentional errors and sleepiness increased during the shift work (p = 0.001). CNS had a significant impact on reaction time and commission errors (p = 0.001). The main duty of CROs at a petrochemical plant is checking hazardous processes which require appropriate alertness and cognitive performance. As a result, planning for appropriate working hours and suitable number of CNS in a rotating shift system is a contribution to improving CRO performance and enhancing safety.
A Benders Decomposition-Based Matheuristic for the Cardinality Constrained Shift Design Problem
DEFF Research Database (Denmark)
Lusby, Richard Martin; Range, Troels Martin; Larsen, Jesper
The Shift Design Problem is an important optimization problem which arises when scheduling personnel in industries that require continuous operation. Based on the forecast, required staffing levels for a set of time periods, a set of shift types that best covers the demand must be determined...... integer programming solver on instances with 1241 different shift types and remains competitive for larger cases with 2145 shift types. On all classes of problems the heuristic is able to quickly find good solutions. © 2016 Elsevier B.V. All rights reserved...
Shift work disorder, depression, and anxiety in the transition to rotating shifts: the role of sleep reactivity.
Kalmbach, David A; Pillai, Vivek; Cheng, Philip; Arnedt, J Todd; Drake, Christopher L
The aim of this study is to investigate premorbid sleep reactivity as a vulnerability to incident shift work disorder (SWD), and related changes in depression as well as anxiety following a transition to a rotating shifts work schedule. This is a longitudinal study with two waves of data collection. The community-based sample included normal sleeping non-shift workers (N = 96; 62.5% female; 47.9 ± 13.3 years) without a lifetime history of insomnia or baseline excessive daytime sleepiness who transitioned to rotating shift work one year later. Participants reported demographic characteristics, trait sleep reactivity on the Ford Insomnia Response to Stress Test, depression symptoms on the Quick Inventory of Depression Symptomatology, and anxiety symptoms on the Beck Anxiety Inventory. SWD was determined based on significant sleep disturbance and/or excessive sleepiness in the context of working in a rotating-shift schedule. Analyses revealed that the odds were over five times greater for highly sleep-reactive individuals to develop SWD after transitioning to rotating shifts (OR = 5.59, p = 0.04). Nearly 90% of participants who suffered from SWD were accurately identified as high risk at one year before disease onset. Furthermore, individuals who developed SWD reported greater increases in symptoms of depression and anxiety. Finally, analyses revealed significant indirect effects wherein high sleep reactivity increased risk for SWD, which led to greater severity of anxiety and depression symptoms. The Ford Insomnia Response to Stress Test (FIRST) accurately identifies a focused target population in which the premorbid psychobiological processes complicit in SWD onset and progression, as well as shift work-related depression and anxiety changes, can be better investigated, thus improving future preventative efforts. Copyright © 2015 Elsevier B.V. All rights reserved.
An observational study of shift length, crew familiarity, and occupational injury and illness in emergency medical services workers.
Weaver, Matthew D; Patterson, P Daniel; Fabio, Anthony; Moore, Charity G; Freiberg, Matthew S; Songer, Thomas J
Emergency medical services (EMS) clinicians are shift workers deployed in two-person teams. Extended shift duration, workplace fatigue, poor sleep and lack of familiarity with teammates are common in the EMS workforce and may contribute to workplace injury. We sought to examine the relationship between shift length and occupational injury while controlling for relevant shift work and teamwork factors. We obtained 3 years of shift schedules and occupational injury and illness reports were from 14 large EMS agencies. We abstracted shift length and additional scheduling and team characteristics from shift schedules. We matched occupational injury and illness reports to shift records and used hierarchical logistic regression models to test the relationship between shift length and occupational injury and illness while controlling for teammate familiarity. The cohort contained 966,082 shifts, 4382 employees and 950 outcome reports. Risk of occupational injury and illness was lower for shifts ≤8 h in duration (RR 0.70; 95% CI 0.51 to 0.96) compared with shifts >8 and ≤12 h. Relative to shifts >8 and ≤12 h, risk of injury was 60% greater (RR 1.60; 95% CI 1.22 to 2.10) for employees that worked shifts >16 and ≤24 h. Shift length is associated with increased risk of occupational injury and illness in this sample of EMS shift workers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Sleep pattern and decision making in physicians from mobile emergency care service with 12-hour work schedules.
Castro, Eleni de Araújo Sales; de Almondes, Katie Moraes
Shift work schedules are biological standpoint worse because compel the body to anticipate periods of wakefulness and sleep and thus eventually cause a disruption of biological rhythms. To evaluate the sleep pattern and decision making in physicians working in mobile units of emergency attention undergoing Day Shift and Rotating Shift. The study included 26 physicians. The instruments utilized were a sociodemographic questionnaire, the Pittsburgh Sleep Quality Index (PSQI), the Sleep Habits Questionnaire, the Epworth Sleepiness Scale and Chronotype Identification Questionnaire of Horne-Ostberg, the Iowa Gambling Task (IGT) and hypothetical scenarios of decision-making created according to the Policy-Capturing Technique. For inclusion and exclusion criteria, the participants answered the Chalder Fatigue Scale, the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI) and the Inventory of Stress Symptoms for adults of Lipp (ISSL). It was found good sleep quality for physicians on Day Shift schedule and bad sleep quality for physicians on Rotating Shift schedule. The IGT measure showed no impairment in decision-making, but the hypothetical scenarios revealed impairment decision-making during the Shift for both schedules. Good sleep quality was related to a better performance in decision-making. Good sleep quality seems to influence a better performance in decision-making.
Schedule optimization study implementation plan
Energy Technology Data Exchange (ETDEWEB)
This Implementation Plan is intended to provide a basis for improvements in the conduct of the Environmental Restoration (ER) Program at Hanford. The Plan is based on the findings of the Schedule Optimization Study (SOS) team which was convened for two weeks in September 1992 at the request of the U.S. Department of Energy (DOE) Richland Operations Office (RL). The need for the study arose out of a schedule dispute regarding the submission of the 1100-EM-1 Operable Unit (OU) Remedial Investigation/Feasibility Study (RI/FS) Work Plan. The SOS team was comprised of independent professionals from other federal agencies and the private sector experienced in environmental restoration within the federal system. The objective of the team was to examine reasons for the lengthy RI/FS process and recommend ways to expedite it. The SOS team issued their Final Report in December 1992. The report found the most serious impediments to cleanup relate to a series of management and policy issues which are within the control of the three parties managing and monitoring Hanford -- the DOE, U.S. Environmental Protection Agency (EPA), and the State of Washington Department of Ecology (Ecology). The SOS Report identified the following eight cross-cutting issues as the root of major impediments to the Hanford Site cleanup. Each of these eight issues is quoted from the SOS Report followed by a brief, general description of the proposed approach being developed.
Environmental surveillance master sampling schedule
Energy Technology Data Exchange (ETDEWEB)
Bisping, L.E.
This document contains the planned 1994 schedules for routine collection of samples for the Surface Environmental Surveillance Project (SESP), Drinking Water Project, and Ground-Water Surveillance Project. Samples are routinely collected for the SESP and analyzed to determine the quality of air, surface water, soil, sediment, wildlife, vegetation, foodstuffs, and farm products at Hanford Site and surrounding communities. The responsibility for monitoring the onsite drinking water falls outside the scope of the SESP. The Hanford Environmental Health Foundation is responsible for monitoring the nonradiological parameters as defined in the National Drinking Water Standards while PNL conducts the radiological monitoring of the onsite drinking water. PNL conducts the drinking water monitoring project concurrent with the SESP to promote efficiency and consistency, utilize the expertise developed over the years, and reduce costs associated with management, procedure development, data management, quality control and reporting. The ground-water sampling schedule identifies ground-water sampling events used by PNL for environmental surveillance of the Hanford Site.
[Sleep disorders and life-style related disease in shift workers].
Chiba, Shigeru
A substantial proportion (-27%) of workers in Japan is engaged in shift work. Many epidemiological studies have shown that the consequences of shift work range from transient and reversible insomnia/sleepiness to major deleterious lifestyle-related disease and cancer pathogenesis. The present paper reviews evidence on sleep disorders and lifestyle-related disease in shift workers and the proposed pathophysiological pathways by which sleep restriction and circadian misalignment may lead to lifestyle-related disease and cancer genesis.
Examining Exposure Assessment in Shift Work Research: A Study on Depression Among Nurses.
Hall, Amy L; Franche, Renée-Louise; Koehoorn, Mieke
Coarse exposure assessment and assignment is a common issue facing epidemiological studies of shift work. Such measures ignore a number of exposure characteristics that may impact on health, increasing the likelihood of biased effect estimates and masked exposure-response relationships. To demonstrate the impacts of exposure assessment precision in shift work research, this study investigated relationships between work schedule and depression in a large survey of Canadian nurses. The Canadian 2005 National Survey of the Work and Health of Nurses provided the analytic sample (n = 11450). Relationships between work schedule and depression were assessed using logistic regression models with high, moderate, and low-precision exposure groupings. The high-precision grouping described shift timing and rotation frequency, the moderate-precision grouping described shift timing, and the low-precision grouping described the presence/absence of shift work. Final model estimates were adjusted for the potential confounding effects of demographic and work variables, and bootstrap weights were used to generate sampling variances that accounted for the survey sample design. The high-precision exposure grouping model showed the strongest relationships between work schedule and depression, with increased odds ratios [ORs] for rapidly rotating (OR = 1.51, 95% confidence interval [CI] = 0.91-2.51) and undefined rotating (OR = 1.67, 95% CI = 0.92-3.02) shift workers, and a decreased OR for depression in slow rotating (OR = 0.79, 95% CI = 0.57-1.08) shift workers. For the low- and moderate-precision exposure grouping models, weak relationships were observed for all work schedule categories (OR range 0.95 to 0.99). Findings from this study support the need to consider and collect the data required for precise and conceptually driven exposure assessment and assignment in future studies of shift work and health. Further research into the effects of shift rotation frequency on depression is
Shift Work in Rats Results in Increased Inflammatory Response after Lipopolysaccharide Administration: A Role for Food Consumption.
Guerrero-Vargas, Natalí N; Guzmán-Ruiz, Mara; Fuentes, Rebeca; García, Joselyn; Salgado-Delgado, Roberto; Basualdo, María del Carmen; Escobar, Carolina; Markus, Regina P; Buijs, Ruud M
The suprachiasmatic nucleus (SCN) drives circadian rhythms in behavioral and physiological variables, including the inflammatory response. Shift work is known to disturb circadian rhythms and is associated with increased susceptibility to develop disease. In rodents, circadian disruption due to shifted light schedules (jet lag) induced increased innate immune responses. To gain more insight into the influence of circadian disruption on the immune response, we characterized the inflammatory response in a model of rodent shift work and demonstrated that circadian disruption affected the inflammatory response to lipopolysaccharide (LPS) both in vivo and in vitro. Since food consumption is a main disturbing element in the shift work schedule, we also evaluated the inflammatory response to LPS in a group of rats that had no access to food during their working hours. Our results demonstrated that the shift work schedule decreased basal TNF-α levels in the liver but not in the circulation. Despite this, we observed that shift work induced increased cytokine response after LPS stimulation in comparison to control rats. Also, Kupffer cells (liver macrophages) isolated from shift work rats produced more TNF-α in response to in vitro LPS stimulation, suggesting important effects of circadian desynchronization on the functionality of this cell type. Importantly, the effects of shift work on the inflammatory response to LPS were prevented when food was not available during the working schedule. Together, these results show that dissociating behavior and food intake from the synchronizing drive of the SCN severely disturbs the immune response. © 2015 The Author(s).
Restless Legs Syndrome in shift workers: A cross sectional study on male assembly workers
Directory of Open Access Journals (Sweden)
Rahimi Mohsen
Full Text Available Abstract Background Restless Legs Syndrome (RLS is a common neurological movement disorder characterized by symptoms that follow a circadian pattern. Night and rotating shift work schedules exert adverse effects on functions of the human body by disturbing circadian rhythms, and they are known to cause sleep disturbances and insomnia. In this paper, we investigate the possible association between shift work and RLS. Methods This cross sectional study was conducted in an automobile manufacturing factory in Tehran, Iran. A total of 780 male assembly workers were recruited in three groups, each with 260 workers: workers on a permanent morning shift (A and two different rotating shift schedules (B and C with morning, afternoon and night shifts. We used the international RLS study group criteria for diagnosis of RLS, and the severity scale for severity assessment in subjects with RLS. Self administered questionnaires were used to gather information on age, smoking, work history, medical condition, and existence and severity of RLS symptoms. Results The prevalence of RLS was significantly higher in rotational shift workers (15% than workers with permanent morning work schedule (8.5%. In workers suffering from RLS, we found greater mean values of age and work experience, higher percentages of drug consumption, smoking, and co-morbid illnesses compared with subjects who did not have RLS, although these differences were statistically significant only for age, work experience and drug consumption. Conclusion Rotational shift work acts as a risk or exacerbating factor for Restless Legs Syndrome.
New MLFQ Scheduling Algorithm for Operating Systems Using Dynamic quantum
Directory of Open Access Journals (Sweden)
Seifedine Kadry
Full Text Available The new design of multilevel feedback queue will depend on usage new technique in computing the quantum to produce (ADQ Auto Detect Quantum which is relied on the burst of each process has enrolled to the system. By summating the burst time of each process has arrived and dividing it by the number of available processes, we can obtained the dynamic quantum in each level of scheduling. The processes are scheduled and shifted down from queue to other according to their remaining bursts time that should be updated periodically. Every queue has a unique auto detected quantum which is gradually increased or decreased from top level to bottom level queues according to the case of arriving processes. Depending on the results of graphical simulating algorithm on cases study, we can discover that a dynamic quantum is very suitable to accommodate low priority processes that still for a long duration to complete their requests, i.e. avoid the starvation of CPU- bounded processes. Although, it stills compatible with high priority processes (I/O-Bounded to provide a fair interactivity with them. In comparison to traditional MLFQ the performance of the new scheduling technique is better and practical according to the applied results. Additional, we developed suitable software to simulate the new design and test it on different cases to prove it.
Heuristic Scheduling Algorithm Oriented Dynamic Tasks for Imaging Satellites
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Maocai Wang
Full Text Available Imaging satellite scheduling is an NP-hard problem with many complex constraints. This paper researches the scheduling problem for dynamic tasks oriented to some emergency cases. After the dynamic properties of satellite scheduling were analyzed, the optimization model is proposed in this paper. Based on the model, two heuristic algorithms are proposed to solve the problem. The first heuristic algorithm arranges new tasks by inserting or deleting them, then inserting them repeatedly according to the priority from low to high, which is named IDI algorithm. The second one called ISDR adopts four steps: insert directly, insert by shifting, insert by deleting, and reinsert the tasks deleted. Moreover, two heuristic factors, congestion degree of a time window and the overlapping degree of a task, are employed to improve the algorithm's performance. Finally, a case is given to test the algorithms. The results show that the IDI algorithm is better than ISDR from the running time point of view while ISDR algorithm with heuristic factors is more effective with regard to algorithm performance. Moreover, the results also show that our method has good performance for the larger size of the dynamic tasks in comparison with the other two methods.
Cumulative exposure to shift work and sickness absence: associations in a five-year historic cohort.
van Drongelen, Alwin; Boot, Cécile R L; Hlobil, Hynek; van der Beek, Allard J; Smid, Tjabe
Exposure to shift work has been associated with negative health consequences, although the association between shift work and sickness absence remains unclear. The aim of this study is to investigate associations between cumulative exposure to shift work and sickness absence among ground staff employees of an airline company. This study used data from the MORE (Monitoring Occupational Health Risks in Employees) cohort, which is a 5-year historic cohort. The population of the present study consisted of 7562 ground staff employees. For each employee, work schedules and sickness absence days between 2005 and 2009 were obtained from company records. For the exposure to different shift schedule types and to the cumulative number of night shifts, the association with long-term sickness absence (>7 consecutive sickness absence days) and the number of sickness absence episodes during 2009, was calculated using logistic and Poisson regression analyses. Socio-demographic variables, work-related variables, job classification variables, and previous sickness absence days were regarded as confounders. After adjusting for previous sickness absence and job classification variables, only the group of employees that switched into working in a three-shift schedule, showed a significantly increased risk for long-term sickness absence (OR = 1.31, 95%CI 1.02-1.69). Night shift exposure was not significantly associated with long-term sickness absence. Exposure to shift work was negatively associated with more sickness absence episodes. Employees who were exposed to more than 46 night shifts also showed a lower risk for more sickness absence episodes. Subgroup analyses showed that single employees and employees without children had an increased risk for long-term sickness absence when exposed to a three-shift schedule, and when they had changed between shift schedule types. Cumulative exposure to shift work proved to be negatively associated with more sickness absence episodes, and
Cumulative exposure to shift work and sickness absence: associations in a five-year historic cohort
Directory of Open Access Journals (Sweden)
Alwin van Drongelen
Full Text Available Abstract Background Exposure to shift work has been associated with negative health consequences, although the association between shift work and sickness absence remains unclear. The aim of this study is to investigate associations between cumulative exposure to shift work and sickness absence among ground staff employees of an airline company. Methods This study used data from the MORE (Monitoring Occupational Health Risks in Employees cohort, which is a 5-year historic cohort. The population of the present study consisted of 7562 ground staff employees. For each employee, work schedules and sickness absence days between 2005 and 2009 were obtained from company records. For the exposure to different shift schedule types and to the cumulative number of night shifts, the association with long-term sickness absence (>7 consecutive sickness absence days and the number of sickness absence episodes during 2009, was calculated using logistic and Poisson regression analyses. Socio-demographic variables, work-related variables, job classification variables, and previous sickness absence days were regarded as confounders. Results After adjusting for previous sickness absence and job classification variables, only the group of employees that switched into working in a three-shift schedule, showed a significantly increased risk for long-term sickness absence (OR = 1.31, 95%CI 1.02–1.69. Night shift exposure was not significantly associated with long-term sickness absence. Exposure to shift work was negatively associated with more sickness absence episodes. Employees who were exposed to more than 46 night shifts also showed a lower risk for more sickness absence episodes. Subgroup analyses showed that single employees and employees without children had an increased risk for long-term sickness absence when exposed to a three-shift schedule, and when they had changed between shift schedule types. Conclusions Cumulative exposure to shift work proved to
Establishing a Policy Framework for the Primary Prevention of Occupational Cancer: A Proposal Based on a Prospective Health Policy Analysis.
Veglia, Amanda; Pahwa, Manisha; Demers, Paul A
Despite our knowledge of the causes of cancer, millions of workers are involuntarily exposed to a wide range of known and suspected carcinogens in the workplace. To address this issue from a policy perspective, we developed a policy framework based on a prospective health policy analysis. Use of the framework was demonstrated for developing policies to prevent cancers associated with diesel engine exhaust (DEE), asbestos, and shift work, three occupational carcinogens with global reach and large cancer impact. An environmental scan of existing prospective health policy analyses was conducted to select and describe our framework parameters. These parameters were augmented by considerations unique to occupational cancer. Policy-related resources, predominantly from Canada, were used to demonstrate how the framework can be applied to cancers associated with DEE, asbestos, and shift work. The parameters of the framework were: problem statement, context, jurisdictional evidence, primary prevention policy options, and key policy players and their attributes. Applying the framework to the three selected carcinogens illustrated multiple avenues for primary prevention, including establishing an occupational exposure limit for DEE, banning asbestos, and improving shift schedules. The framework emphasized the need for leadership by employers and government. To our knowledge, this is the first proposal for a comprehensive policy framework dedicated to the primary prevention of occupational cancer. The framework can be adapted and applied by key policy players in Canada and other countries as a guide of what parameters to consider when developing policies to protect workers' health.
Monitoring of the sleep patterns of shift workers in the automotive industry.
Kawada, Tomoyuki; Shimizu, Takako; Kuratomi, Yushiro; Suto, Sachiko; Kanai, Tomoe; Nishime, Akemi; Nakano, Noriko
The effect of shift schedules on the amount of sleep that workers receive is an important factor in workplace health and safety as well as the employees' overall quality of life. The objective of this study is to compare sleep period among workers engaging in each of the three-shift work. The amount of sleep (sleep period) that male workers with rotating shift schedules received was measured using accelerometers. The mean age of the 16 male workers enrolled in this study was 54.3 years (one standard deviation, 6.7 years). Thirteen participants ranged in age from 51 to 60 years of age, and the other three participants were 32, 48, and 50 years old. Work shifts were rotated on a weekly basis and were categorized into three periods: shift-1 (8:00 to 17:00), shift-2 (15:00 to 23:50), and shift-3 (23:30 to 8:15). Each work week consisted of 5 days. No significant differences were observed in the mean sleep period for each of the three shifts. However, the sleep periods during shift-1 or shift-2 tended to be longer than that obtained during shift-3. No effect of age on the length of the sleep period was observed. Rotating shift-work did not affect the amount of sleep that workers obtained. However, a comparison with previous study results suggests that morning shifts (starting at 6 AM) and day shifts (starting at 8 AM) may have different effects on sleep time.
Shift work and diabetes mellitus: a meta-analysis of observational studies.
Gan, Yong; Yang, Chen; Tong, Xinyue; Sun, Huilian; Cong, Yingjie; Yin, Xiaoxu; Li, Liqing; Cao, Shiyi; Dong, Xiaoxin; Gong, Yanhong; Shi, Oumin; Deng, Jian; Bi, Huashan; Lu, Zuxun
Observational studies suggest that shift work may be associated with diabetes mellitus (DM). However, the results are inconsistent. No systematic reviews have applied quantitative techniques to compute summary risk estimates. To conduct a meta-analysis of observational studies assessing the association between shift work and the risk of DM. Relevant studies were identified by a search of PubMed, Embase, Web of Science and ProQuest Dissertation and Theses databases to April 2014. We also reviewed reference lists from retrieved articles. We included observational studies that reported OR with 95% CIs for the association between shift work and the risk of DM. Two authors independently extracted data and assessed the study quality. Twelve studies with 28 independent reports involving 226 652 participants and 14 595 patients with DM were included. A pooled adjusted OR for the association between ever exposure to shift work and DM risk was 1.09 (95% CI 1.05 to 1.12; p=0.014; I(2)=40.9%). Subgroup analyses suggested a stronger association between shift work and DM for men (OR=1.37, 95% CI 1.20 to 1.56) than for women (OR=1.09, 95% CI 1.04 to 1.14) (p for interaction=0.01). All shift work schedules with the exception of mixed shifts and evening shifts were associated with a statistically higher risk of DM than normal daytime schedules, and the difference among those shift work schedules was significant (p for interaction=0.04). Shift work is associated with an increased risk of DM. The increase was significantly higher among men and the rotating shift group, which warrants further studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Measuring Light at Night and Melatonin Levels in Shift Workers: A Review of the Literature.
Hunter, Claudia M; Figueiro, Mariana G
Shift work, especially that involving rotating and night shifts, is associated with an increased risk of diseases, including cancer. Attempts to explain the association between shift work and cancer in particular have focused on the processes of melatonin production and suppression. One hypothesis postulates that exposure to light at night (LAN) suppresses melatonin, whose production is known to slow the development of cancerous cells, while another proposes that circadian disruption associated with shift work, and not just LAN, increases health risks. This review focuses on six studies that employed quantitative measurement of LAN and melatonin levels to assess cancer risks in shift workers. These studies were identified via searching the PubMed database for peer-reviewed, English-language articles examining the links between shift work, LAN, and disease using the terms light at night, circadian disruption, health, risk, cancer, shift work, or rotating shift. While the results indicate a growing consensus on the relationship between disease risks (particularly cancer) and circadian disruption associated with shift work, the establishment of a direct link between LAN and disease has been impeded by contradictory studies and a lack of consistent, quantitative methods for measuring LAN in the research to date. Better protocols for assessing personal LAN exposure are required, particularly those employing calibrated devices that measure and sample exposure to workplace light conditions, to accurately assess LAN's effects on the circadian system and disease. Other methodologies, such as measuring circadian disruption and melatonin levels in the field, may also help to resolve discrepancies in the findings.
A linear programming based method for the resource constrained multi-project scheduling problem with weighted earliness/tardiness costs
Pamay, Mehmet Berke
This study addresses the Resource Constrained Multi Project Scheduling Problem with Weighted Earliness Tardiness Costs (RCMPSPWET). In multi-project environments, the project portfolio of a company does often change dramatically in time. In this dynamic context, the arrival of a new project requires quoting a due date while keeping the disruptions to the existing plans and schedules to a minimum. The suggested solution method is an adaptation of the well known shifting bottleneck (SB) h...
Sleep Loss and Fatigue in Shift Work and Shift Work Disorder
Åkerstedt, Torbjörn; Wright, Kenneth P
Shift work is highly prevalent in industrialized societies (>20%) but, when it includes night work, it has pronounced negative effects on sleep, subjective and physiological sleepiness, performance, accident risk, as well as on health outcomes such as cardiovascular disease and certain forms of cancer. The reason is the conflict between the day oriented circadian physiology and the requirement for work and sleep at the "wrong" biological time of day. Other factors that negatively impact work ...
Extending the range of linear scheduling in highway construction
Bafna, Tarun
Linear Scheduling Method is a powerful graphical scheduling method which is best suited for scheduling projects involving repetitive activities. Highway construction projects are excellent examples of projects displaying repetitive characteristics. The research explores usefulness of linear scheduling in highway construction. The Linear Scheduling Method (LSM) was implemented in the field to schedule highway projects. Problems encountered during the field experience were studied and res...
The effect of shift work on red blood cell distribution width.
Loprinzi, Paul D
Limited research demonstrates that shift work (e.g., evening shift, night shift, rotating shift) increases the risk of certain health outcomes, such as hypertriglyceridemia and metabolic syndrome. Red blood cell distribution width (RDW), which is commonly assessed and reported by physicians, is a novel biomarker of cardiovascular disease. However, no study has examined the association of shift work on RDW, which was the purpose of this study. Data from the 2005-2010 NHANES were used. RDW was assessed from a blood sample; shift work was assessed from a questionnaire, and various demographic, behavioral/psychological, occupational, and biological parameters were included as covariates. The fully adjusted model showed that the odds of having an elevated RDW for women on rotating shift vs. day shift increased by 46% (OR=1.46; 95% CI: 1.03-2.08). Women on a rotating shift had increased odds of having an elevated RDW, which is concerning as elevated RDW increases the risk of cardiovascular disease and mortality. Health care professionals are encouraged to include questions about organization of work schedules and their tolerance of such schedules during the patient's consultation. Copyright © 2015 Elsevier Inc. All rights reserved.
Optimization of Hierarchically Scheduled Heterogeneous Embedded Systems
DEFF Research Database (Denmark)
Pop, Traian; Pop, Paul; Eles, Petru
We present an approach to the analysis and optimization of heterogeneous distributed embedded systems. The systems are heterogeneous not only in terms of hardware components, but also in terms of communication protocols and scheduling policies. When several scheduling policies share a resource......, they are organized in a hierarchy. In this paper, we address design problems that are characteristic to such hierarchically scheduled systems: assignment of scheduling policies to tasks, mapping of tasks to hardware components, and the scheduling of the activities. We present algorithms for solving these problems....... Our heuristics are able to find schedulable implementations under limited resources, achieving an efficient utilization of the system. The developed algorithms are evaluated using extensive experiments and a real-life example....
Shift work and arteriosclerosis risk in professional bus drivers.
Chen, Chun-Chieh; Shiu, Li-Jie; Li, Yu-Ling; Tung, Kuan-Yeng; Chan, Kwan-Yu; Yeh, Chih-Jung; Chen, Shiuan-Chih; Wong, Ruey-Hong
Professional bus drivers are at increased risk for cardiovascular disease, but the underlying causes are unclear. Professional bus drivers often follow shift schedules. Especially, an association between shift work and early manifestations of cardiovascular disease has not been elucidated. Thus we investigated the links between shift work and arteriosclerosis risk in professional bus drivers. Questionnaires were administered to 184 bus drivers on demographic characteristics, lifestyle, and occupational history from 5 transportation companies in Taiwan. Brachial-ankle pulse wave velocity (baPWV) was measured using a volume-plethysmographic apparatus. Body mass index, waist circumference, biochemical variables, and blood pressure were also measured. Arteriosclerotic risk factors (age, weekly driving hours, systolic blood pressure, diastolic blood pressure, and insulin level) differed in part among different groups of drivers. Long-term shift drivers had higher baPWV compared to regular drivers and short-term shift drivers (1594 cm/s vs. 1497 and 1432, pshift driving. Long-term shift work could increase the risk of arteriosclerosis in professional bus drivers. Larger studies would be necessary to provide further evidence regarding this finding.
Neuroendocrine, immune and oxidative stress in shift workers.
Faraut, Brice; Bayon, Virginie; Léger, Damien
Shift work is commonly associated with disturbed life rhythms, resulting in chronic exposure to circadian desynchronization and sleep restriction. Epidemiological data have shown that shift workers are at an increased risk of cardiovascular disease and breast cancer. In this review, we will explore how observed increases in neuroendocrine stress, non-specific immune responses and pro-oxidative status could act as biological mediators for these damaging health risks in shift workers. To explain these risks, compelling evidence from laboratory studies links circadian misalignment but also sleep restriction to disruptions in the neuroendocrine, immune and oxidative stress systems. Assessment of neuroendocrine, oxidative and immune stress in the shift worker population is still a limited and novel field, which may have considerable clinical relevance. Finally, we will consider the potential benefits of a countermeasure, such as napping, in minimizing the neuroendocrine and immune stress and cardiovascular risk imposed by shift work. Copyright © 2013 Elsevier Ltd. All rights reserved.
On Coding of Scheduling Information in OFDM
Gunnarsson, Fredrik; Moosavi, Reza; Eriksson, Jonas; Larsson, Erik G.; Wiberg, Niklas; Frenger, Pål
Control signaling strategies for scheduling information in cellular OFDM systems are studied. A single-cell multiuser system model is formulated that provides system capacity estimates accounting for the signaling overhead. Different scheduling granularities are considered, including the one used in the specifications for the 3G Long Term Evolution (LTE). A greedy scheduling method is assumed, where each resource is assigned to the user for which it can support the highest number of bits. The...
Crew Scheduling for Netherlands Railways: "destination: customer"
Kroon, Leo; Fischetti, Matteo
textabstract: In this paper we describe the use of a set covering model with additional constraints for scheduling train drivers and conductors for the Dutch railway operator NS Reizigers. The schedules were generated according to new rules originating from the project "Destination: Customer" ("Bestemming: Klant" in Dutch). This project is carried out by NS Reizigers in order to increase the quality and the punctuality of its train services. With respect to the scheduling of drivers and condu...
Religion as Schedule-Induced Behavior
Strand, Paul S
In this article, I argue that a class of religious behaviors exists that is induced, for prepared organisms, by specific stimuli that are experienced according to a response-independent schedule. Like other schedule-induced behaviors, the members of this class serve as minimal units out of which functional behavior may arise. In this way, there exist two classes of religious behavior: nonoperant schedule-induced behaviors and operant behaviors. This dichotomy is consistent with the distinctio...
Distributed Link Scheduling with Constant Overhead
Sanghavi, Sujay; Bui, Loc; Srikant, R.
This paper proposes a new class of simple, distributed algorithms for scheduling in wireless networks. The algorithms generate new schedules in a distributed manner via simple local changes to existing schedules. The class is parameterized by integers $k\\geq 1$. We show that algorithm $k$ of our class achieves $k/(k+2)$ of the capacity region, for every $k\\geq 1$. The algorithms have small and constant worst-case overheads: in particular, algorithm $k$ generates a new schedule using {\\em (a)}...
AVLIS production plant project schedule and milestones
Energy Technology Data Exchange (ETDEWEB)
An AVLIS Production Plant Deployment Schedule for the engineering, procurement, and construction for both the Initial Increment of Production and the fully Activated Plant, has been developed by the project team consisting of Lawrence Livermore National Laboratory, Martin Marietta Energy Systems, Inc. with architect-engineer support from Bechtel National, Inc., Stone and Webster Engineering Corporation, and Westinghouse Corporation. The initial deployment phase consists of six separators modules and the three laser power amplifier modules consistent with the FY84 reference design with a name plate capacity of 5 million separative work units/yr followed by a full plant activation to approximately 13 million separative work units/yr. The AVLIS Production Plant project team's strategy for deployment schedule analysis focused on three schedule options: engineering limited schedule; authorization limited schedule; and funding limited project schedule. The three deployment schedule options developed by AVLIS project team have been classified in ranges such as an optimistic, rapid/moderate, or moderate/pessimistic based on the probability of meeting the individual schedule option's major milestones or program objectives of enriching uranium by the AVLIS process in an effective cost and schedule manner. 47 figures, 7 tables.
A cross-sectional study of shift work, sleep quality and cardiometabolic risk in female hospital employees
Lajoie, P; Aronson, K.J.; Day, A; Tranmer, J
Objectives Investigating the potential pathways linking shift work and cardiovascular diseases (CVD), this study aimed to identify whether sleep disturbances mediate the relationship between shift work and the metabolic syndrome, a cluster of CVD risk factors. Design Cross-sectional study. Setting A tertiary-level, acute care teaching hospital in Southeastern Ontario, Canada. Participants Female hospital employees working a shift schedule of two 12?h days, two 12?h nights, followed by 5?days ...
Sleep loss and circadian disruption in shift work: health burden and management.
Rajaratnam, Shantha M W; Howard, Mark E; Grunstein, Ronald R
About 1.5 million Australians are shift workers. Shift work is associated with adverse health, safety and performance outcomes. Circadian rhythm misalignment, inadequate and poor-quality sleep, and sleep disorders such as sleep apnoea, insomnia and shift work disorder (excessive sleepiness and/or insomnia temporally associated with the work schedule) contribute to these associations. Falling asleep at work at least once a week occurs in 32%-36% of shift workers. Risk of occupational accidents is at least 60% higher for non-day shift workers. Shift workers also have higher rates of cardiometabolic diseases and mood disturbances. Road and workplace accidents related to excessive sleepiness, to which shift work is a significant contributor, are estimated to cost $71-$93 billion per annum in the United States. There is growing evidence that understanding the interindividual variability in sleep-wake responses to shift work will help detect and manage workers vulnerable to the health consequences of shift work. A range of approaches can be used to enhance alertness in shift workers, including screening and treating sleep disorders, melatonin treatment to promote sleep during the daytime, and avoidance of inappropriate use of sedatives and wakefulness-promoters such as modafinil and caffeine. Short naps, which minimise sleep inertia, are generally effective. Shifting the circadian pacemaker with appropriately timed melatonin and/or bright light may be used to facilitate adjustment to a shift work schedule in some situations, such as a long sequence of night work. It is important to manage the health risk of shift workers by minimising vascular risk factors through dietary and other lifestyle approaches.
75 FR 42831 - Proposed Collection; Comment Request for Form 1065, Schedule C, Schedule D, Schedule K-1...
...-3 (Net Income (Loss) Reconciliation for Certain Partnerships)). DATES: Written comments should be... (Loss) per Return (Schedule M-1), Analysis of Partners' Capital Accounts (Schedule M-2), and Net Income... Revenue Code section 6031 requires partnerships to file returns that show gross income items, allowable...
Phase I, dose-escalation trial of the oral cyclin-dependent kinase 4/6 inhibitor PD 0332991, administered using a 21-day schedule in patients with advanced cancer.
Flaherty, Keith T; Lorusso, Patricia M; Demichele, Angela; Abramson, Vandana G; Courtney, Rachel; Randolph, Sophia S; Shaik, M Naveed; Wilner, Keith D; O'Dwyer, Peter J; Schwartz, Gary K
To identify the dose-limiting toxicity (DLT) and maximum tolerated dose (MTD) of the first-in-class, oral CDK4/6 inhibitor PD 0332991 administered once daily for 21 of 28 days (3/1 schedule) in patients with retinoblastoma protein (Rb)-positive advanced solid tumors and to describe pharmacokinetic-pharmacodynamic relationships relative to drug effects. This open-label phase I study (NCT00141297) enrolled patients who received PD 0332991 orally in six dose-escalation cohorts in a standard 3 + 3 design. Forty-one patients were enrolled. DLTs were observed in five patients (12%) overall; at the 75, 125, and 150 mg once daily dose levels. The MTD and recommended phase II dose of PD 0332991 was 125 mg once daily. Neutropenia was the only dose-limiting effect. After cycle 1, grade 3 neutropenia, anemia, and leukopenia occurred in five (12%), three (7%), and one (2%) patient(s), respectively. The most common non-hematologic adverse events included fatigue, nausea, and diarrhea. Thirty-seven patients were evaluable for tumor response; 10 (27%) had stable disease for ≥4 cycles of whom six derived prolonged benefit (≥10 cycles). PD 0332991 was slowly absorbed (median T(max), 5.5 hours), and slowly eliminated (mean half-life was 25.9 hours) with a large volume of distribution (mean, 2,793 L). The area under the concentration-time curve increased linearly with dose. Using an E(max) model, neutropenia was shown to be proportional to exposure. PD 0332991 warrants phase II testing at 125 mg once daily, at which dose neutropenia was the sole significant toxicity. ©2011 AACR.
Ups and Downs Associated with Implementing Shift Schedules on a Southern Harvesting Operation
D. Mitchell
Extended working hours can increase the number of hours that equipment is available to perform work, but how effective are workers during those additional evening/night hours? A study was conducted in Alabama to compare daytime and nighttime production rates of a feller-buncher. The study was installed in a first thinning of a single-aged loblolly pine (Pinus taeda)...
Quantized beam shifts in graphene
Energy Technology Data Exchange (ETDEWEB)
de Melo Kort-Kamp, Wilton Junior [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Sinitsyn, Nikolai [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Dalvit, Diego Alejandro Roberto [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)
We predict the existence of quantized Imbert-Fedorov, Goos-Hanchen, and photonic spin Hall shifts for light beams impinging on a graphene-on-substrate system in an external magnetic field. In the quantum Hall regime the Imbert-Fedorov and photonic spin Hall shifts are quantized in integer multiples of the fine structure constant α, while the Goos-Hanchen ones in multiples of α2. We investigate the influence on these shifts of magnetic field, temperature, and material dispersion and dissipation. An experimental demonstration of quantized beam shifts could be achieved at terahertz frequencies for moderate values of the magnetic field.
Designing cyclic appointment schedules for outpatient clinics with scheduled and unscheduled patient arrivals
Kortbeek, Nikky; Zonderland, Maartje Elisabeth; Braaksma, Aleida; Vliegen, Ingrid; Boucherie, Richardus J.; Litvak, Nelli; Hans, Elias W.
We present a methodology to design appointment systems for outpatient clinics and diagnostic facilities that offer both walk-in and scheduled service. The developed blueprint for the appointment schedule prescribes the number of appointments to plan per day and the moment on the day to schedule the
Designing cyclic appointment schedules for outpatient clinics with scheduled and unscheduled patient arrivals
Kortbeek, Nikky; Zonderland, Maartje Elisabeth; Boucherie, Richardus J.; Litvak, Nelli; Hans, Elias W.
We present a methodology to design appointment systems for outpatient clinics and diagnostic facilities that offer both walk-in and scheduled service. The developed blueprint for the appointment schedule prescribes the number of appointments to plan per day and the moment on the day to schedule the
29 CFR 1952.173 - Developmental schedule.
... 29 Labor 9 2010-07-01 2010-07-01 false Developmental schedule. 1952.173 Section 1952.173 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... schedule. (a) Within 1 year following plan approval, legislation will be enacted authorizing complete...
Lightweight EDF Scheduling with Deadline Inheritance
Jansen, P.G.; Mullender, Sape J.; Scholten, Johan; Havinga, Paul J.M.
EDFI is a lightweight real-time scheduling protocol that combines EDF with deadline inheritance over shared resources. We will show that EDFI is flexible during a tasks admission control, efficient with scheduling and dispatching, and straightforward in feasibility analysis. The application
Special cases of online parallel job scheduling
Hurink, Johann L.; Paulus, J.J.
In this paper we consider the online scheduling of jobs, which require processing on a number of machines simultaneously. These jobs are presented to a decision maker one by one, where the next job becomes known as soon as the current job is scheduled. The objective is to minimize the makespan. For
15 CFR 700.14 - Preferential scheduling.
... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Preferential scheduling. 700.14...) BUREAU OF INDUSTRY AND SECURITY, DEPARTMENT OF COMMERCE NATIONAL SECURITY INDUSTRIAL BASE REGULATIONS DEFENSE PRIORITIES AND ALLOCATIONS SYSTEM Industrial Priorities § 700.14 Preferential scheduling. (a) A...
5 CFR 950.801 - Campaign schedule.
... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Campaign schedule. 950.801 Section 950... VOLUNTARY ORGANIZATIONS CFC Timetable § 950.801 Campaign schedule. (a) The Combined Federal Campaign will be.../International and International parts of the Charity List to all local campaigns by a date to be determined by...
Clustering and scheduling maintenance tasks over time
Kreuger, Per
We report results on a maintenance scheduling problem. The problem consists of allocating maintenance task instances to and scheduling the performances of a suitable number of maintenance packages. The number of maintenance packages is not fixed, nor is, in general, the dates or durations of their performances. A constraint programming (CP) model and solver for the problem is presented together with preliminary computational results.
African Journals Online (AJOL)
shortest processing time rule (SPT), longest processing time rule (LPT), and monetary value of completed order rule (MO); and possibly ascertain whether any of these rules offers a better schedule than the FIFO schedule currently used by the shop. This comparison is carried out on the basis of the combined objective.
Robust scheduling in an uncertain environment
Wilson, M.
This thesis presents research on scheduling in an uncertain environment, which forms a part of the rolling stock life cycle logistics applied research and development program funded by Dutch railway industry companies. The focus therefore lies on scheduling of maintenance operations on rolling stock
Scheduling identical jobs on uniform parallel machines
M.I. Dessouky; B.J. Lageweg; J.K. Lenstra (Jan Karel); S.L. van de Velde
textabstractWe address the problem of scheduling n identical jobs on m uniform parallel machines to optimize scheduling criteria that are nondecreasing in the job completion times. It is well known that this can be formulated as a linear assignment problem, and subsequently solved in O(n3) time. We
Religion as Schedule-Induced Behavior
Strand, Paul S.
In this article, I argue that a class of religious behaviors exists that is induced, for prepared organisms, by specific stimuli that are experienced according to a response-independent schedule. Like other schedule-induced behaviors, the members of this class serve as minimal units out of which functional behavior may arise. In this way, there…
Sensitivity Analysis of List Scheduling Heuristics
A.W.J. Kolen; A.H.G. Rinnooy Kan (Alexander); C.P.M. van Hoesel; A.P.M. Wagelmans (Albert)
textabstractWhen jobs have to be processed on a set of identical parallel machines so as to minimize the makespan of the schedule, list scheduling rules form a popular class of heuristics. The order in which jobs appear on the list is assumed here to be determined by the relative size of their
A computational approach to optimized appointment scheduling
Kuiper, A.; Kemper, B.; Mandjes, M.
Appointment scheduling is prevalent in various healthcare settings. Generally, the objective is to determine a schedule (i.e., the sequence of epochs at which the individual patients are asked to appear) that appropriately balances the interests of the patients (low waiting times) and the medical
21 CFR 1308.13 - Schedule III.
... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Schedule III. 1308.13 Section 1308.13 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE SCHEDULES OF CONTROLLED SUBSTANCES... 2316 (iii) Pentobarbital 2271 or any salt of any of these drugs and approved by the Food and Drug...
Optimal online-list batch scheduling
Paulus, J.J.; Ye, Deshi; Zhang, Guochuan
We consider the online-list batch scheduling problem. Jobs arrive one by one and have to be assigned upon arrival to a scheduled batch such that the makespan is minimized. Each batch can accommodate up to B jobs. We give a complete classification of the tractability of this online problem.
Unrelated Machine Scheduling with Stochastic Processing Times
Skutella, Martin; Sviridenko, Maxim; Uetz, Marc Jochen
Two important characteristics encountered in many real-world scheduling problems are heterogeneous processors and a certain degree of uncertainty about the processing times of jobs. In this paper we address both, and study for the first time a scheduling problem that combines the classical unrelated
Machine scheduling with resource dependent processing times
Grigoriev, A.; Sviridenko, M.; Uetz, Marc Jochen
We consider machine scheduling on unrelated parallel machines with the objective to minimize the schedule makespan. We assume that, in addition to its machine dependence, the processing time of any job is dependent on the usage of a discrete renewable resource, e.g. workers. A given amount of that
76 FR 18262 - January 2011 Pay Schedules
... members covered by a certified SES performance appraisal system and $165,300 (level III of the Executive Schedule) for SES members covered by an SES performance appraisal system that has not been certified. The... (level II of the Executive Schedule) for SL or ST employees covered by a certified SL/ST performance...
Schedule-extended synchronous dataflow graphs
Damavandpeyma, M.; Stuijk, S.; Basten, T.; Geilen, M.; Corporaal, H.
Synchronous dataflow graphs (SDFGs) are used extensively to model streaming applications. An SDFG can be extended with scheduling decisions, allowing SDFG analysis to obtain properties, such as throughput or buffer sizes for the scheduled graphs. Analysis times depend strongly on the size of the
A Heuristic Approach to Scheduling University Timetables.
Loo, E. H.; And Others
Categories of facilities utilization and scheduling requirements to be considered when using a heuristic approach to timetabling are described together with a nine-step algorithm and the computerized timetabling system, Timetable Schedules System (TTS); TTS utilizes heuristic approach. An example demonstrating use of TTS and a program flowchart…
A Program Master Schedule Can Improve Results
A Program Master Schedule Can Improve Results Patrick K. Barker "There cannot be a crisis today; my schedule is already full." — Henry Kissinger...briefings, so PMOs often rely on static pictures and Gantt charts available on presentation software such as Microsoft PowerPoint. That's fine—and
Improved MLWDF scheduler for LTE downlink transmission
Obinna Nnamani, Christantus; Anioke, Chidera Linda; Ikechukwu Ani, Cosmas
In long-term evolution (LTE) downlink transmission, modified least weighted delay first (MLWDF) scheduler is a quality of service (QoS) aware scheduling scheme for real-time (RT) services. Nevertheless, MLWDF performs below optimal among the trade-off between strict delay and loss restraints of RT and non-RT traffic flows, respectively. This is further worsened with the implementation of hybrid automatic retransmission request (HARQ). As these restraints grow unabated with increasing number of user demands, the performance of MLWDF further reduces. In order to ameliorate this situation, there is a need to directly incorporate the variations in user demands and HARQ implementation as parameters to the MLWDF scheduler. In this work, an improvement to the MLWDF scheduler is proposed. The improvement entails adding two novel parameters that characterise user demand and HARQ implementation. The scheduler was tested using varying three classes of service in QoS class identifiers (QCIs) table standardised by Third Generation Partnership Project for LTE network to characterise different services. It was also tested on the basis of packet prioritisation. The proposed scheduler was simulated with LTE-SIM simulator and compared with the MLWDF and proportional fairness schedulers. In terms of delay, throughput and packet loss ratio; the proposed scheduler increased overall system performance.
Does age affect the relationship between control at work and sleep disturbance for shift workers?
Loudoun, Rebecca Jane; Muurlink, Olav; Peetz, David; Murray, Georgina
Among miners, shift work, aging and lack of control at work may be factors leading to increased sleep problems. Such risk factors may also operate in interaction, resulting in an even increased harm for sleep disruption. The present study aims at evaluating these relationships drawing on a sample of Australian mine and energy workers and their partners. The workers were mainly men. All performed shift work that included either nights (95%) or multiple shifts (92%), usually both (87%), while 36% were aged 50 years or above. The results show that low latitude over work activities is associated with higher sleep disturbances across the sample, though the effects are clearer amongst younger workers. By contrast, for younger workers, control over shift scheduling is not associated with sleep disturbances but for workers aged 50 or more, low control results in more sleep disturbance. Misalignment between shift workers and partner work schedules, and partner dissatisfaction with shift worker's employment and shift worker's work-life balance, are also associated with more sleep disturbances amongst shift workers.
A. Ball
Introduction Since the lowering of YB0 in February, less spectacular but nonetheless crucial progress has been made along the critical path to CMS completion. The YB0 has been aligned with the beamline to a fraction of a mm, and the HCAL has been fully installed. Cabling scaffolding for YB0 services has been built and one half (-z end) of the ECAL barrel has been installed. The YB0 services installation has begun, with two of the major technical challenges delaying bulk installation, namely PP1 detailed design, manufacture and installation plus Tracker cooling pipe insulation, now apparently solved. Significant difficulties in detailed design, integration and procurement of cable ducts remain. Despite this, the design of the +end is close to complete, and Tracker power cable installation on two sectors of the +end is well advanced. A new master schedule, v36.0, is being prepared to account for the updated actual situation at point 5 and for the revised LHC machine planning. Safety The enormous amount of...
A. Ball
Introduction Despite the holiday season affecting available manpower, many key internal milestones have been passed over the summer, thanks to the dedication and commitment of the team at point 5. In particular, the installation on, and within, YB0 has progressed steadily through several potentially difficult phases. The v36 planning contingency of lowering YB-1 and YB-1 wheels on schedule in October, before Tracker installation, will be executed in order to give more time to complete YB0 services work, whilst still being consistent with completion of heavy lowering by the end of 2007. Safety In the underground areas the peak level of activity and parallel work has been reached and this will continue for the coming months. Utmost vigilance is required of everybody working underground and this must be maintained. However, it is encouraging to note that the compliance with safety rules is, in general, good. More and more work will be carried out from scaffolding and mobile access platforms. (cherry-picke...
A. Ball
Introduction and Schedule After nearly seven months of concentrated effort, the installation of services on YB0 moved off the CMS critical path in late November. In line with v36 planning provisions, the additional time needed to finish this challeng¬ing task was accommodated by reducing sequential dependencies between assembly tasks, putting more tasks (especially heavy logistic movements) in parallel with activities on, or within, the central wheel. Thus the lowering of wheels YB-1 and YB -2 and of disk YE-3 is already complete, the latter made possible, in the shadow of YB0 work, by inverting the order of the 3 endcap disks in the surface building. Weather conditions permitting, the Tracker will be transported to point 5 during CMS week for insertion in EB before CERN closes. The lowering of the last two disks will take place mid- and end-of January, respectively. Thus central beampipe installation can be confidently planned to start in February as foreseen, allowing closure of CMS in time for CRA...
Development of an Irrigation Scheduling Model
Directory of Open Access Journals (Sweden)
Full Text Available This paper presents an irrigation scheduling software named ?Mehran Model? which computes reference evapotranspiration (ETo using FAO-56 Penman Monteith method and crop evapotranspiration (ETc by dual crop coefficients. The model can develop irrigation schedules for sixty-six crop types using soil and water balance approach. The model distinguishes soil texture classes, irrigation methods, and designs real time irrigation schedule for a crop using daily weather data of a reference site. The Mehran Model also includes planning on demand basis as well as rotational (warabandi irrigation schedules, and synchronizes both systems as well. The model has been field tested and validated on planning and management of irrigation schedules for cotton and wheat crops in Lower Indus Basin of Pakistan. Statistical analysis showed that the model at an average overestimated seasonal ETc of cotton and wheat crop by 2.41% and 4.31% respectively.
Production scheduling with ant colony optimization
Chernigovskiy, A. S.; Kapulin, D. V.; Noskova, E. E.; Yamskikh, T. N.; Tsarev, R. Yu
The optimum solution of the production scheduling problem for manufacturing processes at an enterprise is crucial as it allows one to obtain the required amount of production within a specified time frame. Optimum production schedule can be found using a variety of optimization algorithms or scheduling algorithms. Ant colony optimization is one of well-known techniques to solve the global multi-objective optimization problem. In the article, the authors present a solution of the production scheduling problem by means of an ant colony optimization algorithm. A case study of the algorithm efficiency estimated against some others production scheduling algorithms is presented. Advantages of the ant colony optimization algorithm and its beneficial effect on the manufacturing process are provided.
Real-time Tumor Oxygenation Changes After Single High-dose Radiation Therapy in Orthotopic and Subcutaneous Lung Cancer in Mice: Clinical Implication for Stereotactic Ablative Radiation Therapy Schedule Optimization
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Song, Changhoon [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Hong, Beom-Ju; Bok, Seoyeon; Lee, Chan-Ju; Kim, Young-Eun [Division of Integrative Biosciences and Biotechnology, Pohang University of Science and Technology, Pohang, Gyeongbuk (Korea, Republic of); Jeon, Sang-Rok [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Cancer Research Institute, Seoul National University College of Medicine, Seoul (Korea, Republic of); Wu, Hong-Gyun [Department of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Cancer Research Institute, Seoul National University College of Medicine, Seoul (Korea, Republic of); Institute of Radiation Medicine, Medical Research Center, Seoul National University College of Medicine, Seoul (Korea, Republic of); Lee, Yun-Sang [Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul (Korea, Republic of); Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University College of Medicine, Seoul (Korea, Republic of); Cheon, Gi Jeong; Paeng, Jin Chul [Cancer Research Institute, Seoul National University College of Medicine, Seoul (Korea, Republic of); Institute of Radiation Medicine, Medical Research Center, Seoul National University College of Medicine, Seoul (Korea, Republic of); Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul (Korea, Republic of); Carlson, David J. [Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut (United States); and others
Purpose: To investigate the serial changes of tumor hypoxia in response to single high-dose irradiation by various clinical and preclinical methods to propose an optimal fractionation schedule for stereotactic ablative radiation therapy. Methods and Materials: Syngeneic Lewis lung carcinomas were grown either orthotopically or subcutaneously in C57BL/6 mice and irradiated with a single dose of 15 Gy to mimic stereotactic ablative radiation therapy used in the clinic. Serial [{sup 18}F]-misonidazole (F-MISO) positron emission tomography (PET) imaging, pimonidazole fluorescence-activated cell sorting analyses, hypoxia-responsive element-driven bioluminescence, and Hoechst 33342 perfusion were performed before irradiation (day −1), at 6 hours (day 0), and 2 (day 2) and 6 (day 6) days after irradiation for both subcutaneous and orthotopic lung tumors. For F-MISO, the tumor/brain ratio was analyzed. Results: Hypoxic signals were too low to quantitate for orthotopic tumors using F-MISO PET or hypoxia-responsive element-driven bioluminescence imaging. In subcutaneous tumors, the maximum tumor/brain ratio was 2.87 ± 0.483 at day −1, 1.67 ± 0.116 at day 0, 2.92 ± 0.334 at day 2, and 2.13 ± 0.385 at day 6, indicating that tumor hypoxia was decreased immediately after irradiation and had returned to the pretreatment levels at day 2, followed by a slight decrease by day 6 after radiation. Pimonidazole analysis also revealed similar patterns. Using Hoechst 33342 vascular perfusion dye, CD31, and cleaved caspase 3 co-immunostaining, we found a rapid and transient vascular collapse, which might have resulted in poor intratumor perfusion of F-MISO PET tracer or pimonidazole delivered at day 0, leading to decreased hypoxic signals at day 0 by PET or pimonidazole analyses. Conclusions: We found tumor hypoxia levels decreased immediately after delivery of a single dose of 15 Gy and had returned to the pretreatment levels 2 days after irradiation and had decreased
Management process invaded Ames as the Center shifted from NACA to NASA oversight. Ames constructed
Management process invaded Ames as the Center shifted from NACA to NASA oversight. Ames constructed a review room in its headquarters building where, in the graphical style that prevailed in the 1960's, Ames leadership could review progress against schedule, budget and performance measures. Shown, in October 1965 is Merrill Mead chief of Ames' program and resources office. (for H Julian Allen Retirement album)
Implications of Shift Work for Parent-Adolescent Relationships in Dual-Earner Families
Davis, Kelly D.; Crouter, Ann C.; McHale, Susan M.
This investigation examined the implications of shift work for parent-adolescent relationship quality--intimacy, conflict, parental knowledge, and involvement--in a sample of 376 dual-earner families. The findings suggested that mothers' relationships with their adolescents were not negatively impacted by their working nonstandard schedules but…
Work shifts in Emergency Medicine
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Roberto Recupero
Full Text Available Emergency Medicine is known as a high stress specialty. The adverse effect of constantly rotating shifts is the single most important reason given for premature attrition from the field. In this work problems tied with night shift work will be taken into account and some solutions to reduce the impact of night work on the emergency physicians will be proposed.
Night shift work and levels of 6-sulfatoxymelatonin and cortisol in men.
Mirick, Dana K; Bhatti, Parveen; Chen, Chu; Nordt, Frank; Stanczyk, Frank Z; Davis, Scott
Night shift work is associated with cancer among men, but the biologic mechanism is unclear. We investigated whether male night shift workers showed changes in levels of melatonin and cortisol, potential biomarkers of cancer risk. Urine was collected from 185 night shift and 158 day shift-working male healthcare providers, aged 22 to 55 years, throughout work and sleep periods, and assayed for 6-sulfatoxymelatonin and cortisol. Morning serum was collected within 90 minutes of completing the night and assayed for cortisol. Night shift workers had significantly lower 6-sulfatoxymelatonin levels during daytime sleep, nighttime work, and nighttime sleep on off-nights (57%, 62%, and 40% lower, respectively), relative to the day shift workers during nighttime sleep (P cortisol in night shift workers was 16% higher during daytime sleep and 13% lower during nighttime sleep on off-nights (P cortisol post-work and post-sleep in night shift workers were 24% and 43% lower, respectively, than post-sleep levels among day shift workers (P melatonin levels and significantly higher urinary cortisol levels during daytime sleep and nighttime work, relative to nighttime sleep (P cortisol levels post-work were lower than those post-sleep. Night shift workers have substantially lower 6-sulfatoxymelatonin during night work and daytime sleep, and levels remain low when night shift workers sleep at night. Chronic reduction in melatonin among night shift workers may be an important carcinogenic mechanism. Cortisol secretion patterns may be impacted by night shift work, which could affect cancer risk. Shift work could be an important risk factor for many types of cancer.
Paradigm shift in head and neck oncology patient management
van den Heuvell, Chiquit van Linden; van Zuuren, Florence; Wells, Mary; van der Laan, Geert; Reintsema, Harry
Objective: This article describes a paradigm shift in what is considered to be good care for patients living with and after (head and neck) cancer. HNO patients often experience severe and difficult physical and psychosocial problems due to the nature and location of the disease. Many disciplines
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SHIFT: server for hidden stops analysis in frame-shifted translation.
Gupta, Arun; Singh, Tiratha Raj
Frameshift is one of the three classes of recoding. Frame-shifts lead to waste of energy, resources and activity of the biosynthetic machinery. In addition, some peptides synthesized after frame-shifts are probably cytotoxic which serve as plausible cause for innumerable number of diseases and disorders such as muscular dystrophies, lysosomal storage disorders, and cancer. Hidden stop codons occur naturally in coding sequences among all organisms. These codons are associated with the early termination of translation for incorrect reading frame selection and help to reduce the metabolic cost related to the frameshift events. Researchers have identified several consequences of hidden stop codons and their association with myriad disorders. However the wealth of information available is speckled and not effortlessly acquiescent to data-mining. To reduce this gap, this work describes an algorithmic web based tool to study hidden stops in frameshifted translation for all the lineages through respective genetic code systems. This paper describes SHIFT, an algorithmic web application tool that provides a user-friendly interface for identifying and analyzing hidden stops in frameshifted translation of genomic sequences for all available genetic code systems. We have calculated the correlation between codon usage frequencies and the plausible contribution of codons towards hidden stops in an off-frame context. Markovian chains of various order have been used to model hidden stops in frameshifted peptides and their evolutionary association with naturally occurring hidden stops. In order to obtain reliable and persuasive estimates for the naturally occurring and predicted hidden stops statistical measures have been implemented. This paper presented SHIFT, an algorithmic tool that allows user-friendly exploration, analysis, and visualization of hidden stop codons in frameshifted translations. It is expected that this web based tool would serve as a useful complement for
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Ladislav Rosocha
Full Text Available Purpose: The efficiency of medical staff is a fundamental feature of healthcare facilities quality. Therefore the better implementation of their preferences into the scheduling problem might not only rise the work-life balance of doctors and nurses, but also may result into better patient care. This paper focuses on optimization of medical staff preferences considering the scheduling problem.Methodology/Approach: We propose a medical staff scheduling algorithm based on simulated annealing, a well-known method from statistical thermodynamics. We define hard constraints, which are linked to legal and working regulations, and minimize the violations of soft constraints, which are related to the quality of work, psychic, and work-life balance of staff.Findings: On a sample of 60 physicians and nurses from gynecology department we generated monthly schedules and optimized their preferences in terms of soft constraints. Our results indicate that the final value of objective function optimized by proposed algorithm is more than 18-times better in violations of soft constraints than initially generated random schedule that satisfied hard constraints.Research Limitation/implication: Even though the global optimality of final outcome is not guaranteed, desirable solutionwas obtained in reasonable time. Originality/Value of paper: We show that designed algorithm is able to successfully generate schedules regarding hard and soft constraints. Moreover, presented method is significantly faster than standard schedule generation and is able to effectively reschedule due to the local neighborhood search characteristics of simulated annealing.
Mission Operations Planning and Scheduling System (MOPSS)
Wood, Terri; Hempel, Paul
MOPSS is a generic framework that can be configured on the fly to support a wide range of planning and scheduling applications. It is currently used to support seven missions at Goddard Space Flight Center (GSFC) in roles that include science planning, mission planning, and real-time control. Prior to MOPSS, each spacecraft project built its own planning and scheduling capability to plan satellite activities and communications and to create the commands to be uplinked to the spacecraft. This approach required creating a data repository for storing planning and scheduling information, building user interfaces to display data, generating needed scheduling algorithms, and implementing customized external interfaces. Complex scheduling problems that involved reacting to multiple variable situations were analyzed manually. Operators then used the results to add commands to the schedule. Each architecture was unique to specific satellite requirements. MOPSS is an expert system that automates mission operations and frees the flight operations team to concentrate on critical activities. It is easily reconfigured by the flight operations team as the mission evolves. The heart of the system is a custom object-oriented data layer mapped onto an Oracle relational database. The combination of these two technologies allows a user or system engineer to capture any type of scheduling or planning data in the system's generic data storage via a GUI.
Downlink Scheduling for Multiclass Traffic in LTE
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Madan Ritesh
Full Text Available We present a design of a complete and practical scheduler for the 3GPP Long Term Evolution (LTE downlink by integrating recent results on resource allocation, fast computational algorithms, and scheduling. Our scheduler has low computational complexity. We define the computational architecture and describe the exact computations that need to be done at each time step (1 milliseconds. Our computational framework is very general, and can be used to implement a wide variety of scheduling rules. For LTE, we provide quantitative performance results for our scheduler for full buffer, streaming video (with loose delay constraints, and live video (with tight delay constraints. Simulations are performed by selectively abstracting the PHY layer, accurately modeling the MAC layer, and following established network evaluation methods. The numerical results demonstrate that queue- and channel-aware QoS schedulers can and should be used in an LTE downlink to offer QoS to a diverse mix of traffic, including delay-sensitive flows. Through these results and via theoretical analysis, we illustrate the various design tradeoffs that need to be made in the selection of a specific queue-and-channel-aware scheduling policy. Moreover, the numerical results show that in many scenarios strict prioritization across traffic classes is suboptimal.
NRC comprehensive records disposition schedule. Revision 3
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Title 44 US Code, ``Public Printing and Documents,`` regulations issued by the General Service Administration (GSA) in 41 CFR Chapter 101, Subchapter B, ``Management and Use of Information and Records,`` and regulations issued by the National Archives and Records Administration (NARA) in 36 CFR Chapter 12, Subchapter B, ``Records Management,`` require each agency to prepare and issue a comprehensive records disposition schedule that contains the NARA approved records disposition schedules for records unique to the agency and contains the NARA`s General Records Schedules for records common to several or all agencies. The approved records disposition schedules specify the appropriate duration of retention and the final disposition for records created or maintained by the NRC. NUREG-0910, Rev. 3, contains ``NRC`s Comprehensive Records Disposition Schedule,`` and the original authorized approved citation numbers issued by NARA. Rev. 3 incorporates NARA approved changes and additions to the NRC schedules that have been implemented since the last revision dated March, 1992, reflects recent organizational changes implemented at the NRC, and includes the latest version of NARA`s General Records Schedule (dated August 1995).
Associations Among Work and Family Health Climate, Health Behaviors, Work Schedule, and Body Weight.
Buden, Jennifer C; Dugan, Alicia G; Faghri, Pouran D; Huedo-Medina, Tania B; Namazi, Sara; Cherniack, Martin G
Correctional employees exhibit elevated obesity rates. This study examines interrelations among health behaviors, health climate, body mass index (BMI), and work schedule. Using survey results from correctional supervisors (n = 157), mediation and moderated-mediation analyses were performed to examine how health behaviors explain relationships between obesity, work health climate (WHC) and family health climate (FHC), and work schedule. Over 85% of the sample was overweight/obese (mean BMI = 30.20). Higher WHC and FHC were associated with lower BMI, mediated by nutrition, and physical activity. The interaction effect between health behavior and work schedule revealed a protective effect on BMI. Overtime shift work may share a relationship with BMI. Findings may have implications for reexamining organizational policies on maximum weekly overtime in corrections. They provide direction for targeted obesity interventions that encourage a supportive FHC and promote healthy behaviors among supervisors working overtime.
A Modified Biogeography-Based Optimization for the Flexible Job Shop Scheduling Problem
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Yuzhen Yang
Full Text Available The flexible job shop scheduling problem (FJSSP is a practical extension of classical job shop scheduling problem that is known to be NP-hard. In this paper, an effective modified biogeography-based optimization (MBBO algorithm with machine-based shifting is proposed to solve FJSSP with makespan minimization. The MBBO attaches great importance to the balance between exploration and exploitation. At the initialization stage, different strategies which correspond to two-vector representation are proposed to generate the initial habitats. At global phase, different migration and mutation operators are properly designed. At local phase, a machine-based shifting decoding strategy and a local search based on insertion to the habitat with best makespan are introduced to enhance the exploitation ability. A series of experiments on two well-known benchmark instances are performed. The comparisons between MBBO and other famous algorithms as well as BBO variants prove the effectiveness and efficiency of MBBO in solving FJSSP.
Simultaneous scheduling of machines and mobile robots
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Dang, Vinh Quang; Nielsen, Izabela Ewa
in terms of their advanced ability to perform tasks at machines by using their manipulation arms. The mobile robots thus have to be scheduled in relation to scheduling of machines so as to increase the efficiency of the overall system. The performance criterion is to minimize time required to complete all......This paper deals with the problem of simultaneously scheduling machines and a number of autonomous mobile robots in a flexible manufacturing system (FMS). Besides capability of transporting materials between machines, the considered mobile robots are different from other material handling devices...
Scheduling Network Traffic for Grid Purposes
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Gamst, Mette
This thesis concerns scheduling of network traffic in grid context. Grid computing consists of a number of geographically distributed computers, which work together for solving large problems. The computers are connected through a network. When scheduling job execution in grid computing, data...... transmission has so far not been taken into account. This causes stability problems, because data transmission takes time and thus causes delays to the execution plan. This thesis proposes the integration of job scheduling and network routing. The scientific contribution is based on methods from operations...
Stress shift in rhythmical speech
Quené, Hugo; Port, Robert
In phrases like thirteen men, stress in thirteen is often shifted forward from its canonical final position. Presumably, the occurrence of this optional stress shift may be partly controlled by the rhythm of speech. Work on rhythmic speech production has demonstrated that given a repetition cycle, T, its harmonic fractions like T/2 attract stressed vowel onsets. Comparing phrases like ceMENT thirTEEN and GALaxy thirTEEN, differing in the number of weak syllables between strong ones, it was predicted that, during rhythmic production, the harmonic locations would attract shifted stress. Since shifting stress results in more even distribution of syllables through the cycle, we expected that faster repetition rates would also result in more stress shift. Dependent variables were the relative stress in the second word of each pair, and the location of onset of the nuclear vowel of the stressed syllable. Results confirmed the predictions, first, that with more intermediate unstressed syllables, stress was shifted forward more often (thereby locating the stressed vowel onset closer to T/2) and, second, that stress shifted forward more often at faster speaking rates. [Work supported by Fulbright Visiting Scholar program and by Utrecht University, The Netherlands.
Very Long (> 48 hours) Shifts and Cardiovascular Strain in Firefighters: a Theoretical Framework
Shift work and overtime have been implicated as important work-related risk factors for cardiovascular disease (CVD). Many firefighters who contractually work on a 24-hr work schedule, often do overtime (additional 24-hr shifts) which can result in working multiple, consecutive 24-hr shifts. Very little research has been conducted on firefighters at work that examines the impact of performing consecutive 24-hr shifts on cardiovascular physiology. Also, there have been no standard field methods for assessing in firefighters the cardiovascular changes that result from 24-hr shifts, what we call "cardiovascular strain". The objective of this study, as the first step toward elucidating the role of very long (> 48 hrs) shifts in the development of CVD in firefighters, is to develop and describe a theoretical framework for studying cardiovascular strain in firefighters on very long shifts (i.e., > 2 consecutive 24-hr shifts). The developed theoretical framework was built on an extensive literature review, our recently completed studies with firefighters in Southern California, e-mail and discussions with several firefighters on their experiences of consecutive shifts, and our recently conducted feasibility study in a small group of firefighters of several ambulatory cardiovascular strain biomarkers (heart rate, heart rate variability, blood pressure, salivary cortisol, and salivary C-reactive protein). The theoretical framework developed in this study will facilitate future field studies on consecutive 24-hr shifts and cardiovascular health in firefighters. Also it will increase our understanding of the mechanisms by which shift work or long work hours can affect CVD, particularly through CVD biological risk factors, and thereby inform policy about sustainable work and rest schedules for firefighters. PMID:24602344