The development of sleep disorders, and specifically insomnia, has been linked to the exposure to different stressors. In this line, Coronavirus disease 2019 (COVID-19) outbreak caused by the new ...coronavirus SARS-CoV-2, has caused a huge impact on our environment, and has exposed healthcare workers to an unprecedented threat. In this study, we try to assess sleep quality and the development of sleep disorders in health personnel directly dedicated to the care of COVID-19 patients at the height of the pandemic, compared to the general population.
A cross-sectional, anonymized, self-reported questionnaire survey was carried out at the “12 de Octubre” Hospital, in Madrid, Spain, during the outbreak of COVID-19, from March 1st to April 30th 2020. We compared two groups, healthcare workers who have treated directly COVID-19 patients versus non-healthcare workers. The questionnaire included demographic data, sleep related aspects, Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI) and 17-items Hamilton Rating Scale (HRS).
In total 170 participants completed the questionnaire successfully, 100 healthcare workers and 70 non-healthcare workers. Self-reported insomnia, nightmares, sleepwalking, sleep terrors and PSQI>6 were more frequent in the healthcare group (p < 0,05). Shift work was associated to greater risk when performing multiple logistic regression analysis.
We observed that, during the outbreak of COVID-19, healthcare workers on the front line developed more sleep disturbances than non-healthcare professionals, and they had worse quality of sleep. Special attention should be paid to shift workers. Concrete protection and prevention measures for particularly exposed population should be considered in pandemic situations.
•Health care workers dealing with COVID-19 patients show poorer sleep quality and higher incidence of self-reported insomnia.•Higher incidence of nightmares, sleepwalking and sleep terrors, is also shown in this group.•Shift work may encourage the emergence of these symptoms.•Special protection measures for particularly exposed groups should be considered in health threatening circumstances.
Este estudio tuvo por propósito determinar los factores que se asocian con el no consumo de drogas. Para ello se administró, además de una diversidad de instrumentos, una escala de resiliencia que ...permitió determinar factores de riesgo y de protectores en dos muestras seleccionadas intencionalmente en la Gran Área Metropolitana (gam), con el fin de establecer si el no consumo de sustancias se asociaba con mayores o menores valores de resiliencia. La aplicación de modelos de regresión logística y análisis factorial permitieron establecer la ausencia de relaciones significativas entre niveles de resiliencia y la abstinencia o la ingestión de diversas drogas.
The luteinizing hormone receptor (LHR) is a glycoprotein member of the G protein-coupled receptors superfamily. It participates in corpus luteum formation and ovulation in females and acts in ...testosterone synthesis and spermatogenesis in males. In this study, we extracted RNA from sheep testicles and synthetized the cDNA to amplify the gene lhr-bed. This gene consists of 762 bp and encodes 273 amino acids of the extracellular domain of LHR. The lhr-bed was cloned into pJET1.2/blunt, then subcloned into pCOLD II, and finally, transformed in E. coli BL21 (DE3) cells. Because the induced rLHR-Bed protein was found in the insoluble fraction, we followed a modified purification protocol involving induction at 25 °C, subjection to denaturing conditions, and on-column refolding to increase solubility. We confirmed rLHR-Bed expression by means of Western blot and mass spectrometry analysis. It is currently known that the structure stem-loop 5′UTR on pCOLD II vector is stable at 15 °C. We predicted and obtained RNAfold stability at 25 °C. We successfully obtained the recombinant LHR extracellular domain, with protein yields of 0.2 mg/L, and purity levels of approximately 90%, by means of a single chromatographic purification step. The method described here may be used to obtain large quantities of rLHR-Bed in the future.
Urban Expansion of Havana: El Cerro 1925–1960
As part of the valuable urban history of Havana in the 20th century, the territory of El Cerro treasures a mixed urban fabric, with developments and ...layouts from different historical periods. With the advance of the century, it progressively extended its paths beyond its historic nucleus, with urbanisations of diverse character that welcomed from proletarian groups to small merchants and a thriving middle class of professionals. However, these areas have not been sufficiently studied, so their values are unknown and increase their vulnerability to inappropriate actions that endanger their identity. The research set out to document this urban development experienced between 1925 and 1960 from the analysis of archival documentary sources supplemented with fieldwork. The results show a wide and diverse universe of urban networks that left an important mark on the expansion and consolidation of the city, as part of Cuban cultural history.
Guanabacoa, Término Municipal de La Gran Habana [1948-1959] Ruslan Muñoz Hernández; Alexis Jesús Rouco Méndez; Pupo, Susana Cordovés
Bitácora urbano Territorial/Bitácora Urbano Territorial,
01/2023, Volume:
33, Issue:
2
Journal Article
Open access
El antiguo Término Municipal de Guanabacoa (TMG) constituyó el tercer municipio en importancia dentro de la ciudad de La Habana durante el periodo republicano, debido a una rápida expansión urbana ...experimentada entre 1940 y 1960. Por medio de la revisión de fuentes documentales de diverso carácter y con el empleo de métodos de análisis mixtos, apoyado por el trabajo de campo y el análisis histórico-lógico, el artículo busca exponer y precisar los antecedentes y factores que condicionaron su desarrollo urbano entre 1948 y 1959, y su relación con el crecimiento de la ciudad de La Habana, con el propósito de obtener una visión más amplia e integral de esta evolución. Se concluye que la materialización del amplio Plan de Obras Públicas impulsado por el gobierno de Ramón Grau San Martín, fue el motor dinamizador que abrió el camino del municipio a la modernidad, propició la expansión industrial y el surgimiento de nuevos desarrollos residenciales, amparados en un amplio marco legislativo que favoreció el crecimiento y condujo a la conurbación con la marcha urbana metropolitana.
El Movimiento Moderno renovó forma y espacio, basado en la razón, los avances tecnológicos y el valor social de la arquitectura y el urbanismo. Su internacionalización condujo a versiones regionales, ...con aportes particulares válidos. En La Habana, su consolidación coincidió con la expansión acelerada de la urbe en un entramado heterogéneo de parcelaciones residenciales. A la luz de hoy, se detecta la existencia de respuestas de diseño urbano-arquitectónico con criterios de sustentabilidad, referentes para la creación de nuevos entornos. El artículo muestra los valores del legado del MoMo, en cuatro urbanizaciones del municipio Cerro, que responden a criterios actuales de sustentabilidad, y cuya aplicación resulta posible en el contexto cubano contemporáneo. Se emplearon métodos teóricos y empíricos de investigación, entre los que se destacan el trabajo de campo y la búsqueda de archivo, y los resultados se insertan en una investigación macro sobre el MoMo habanero.
Este artículo tiene como objetivo validar la importancia de un adecuado involucramiento parental en la prevención del consumo de drogas, así como en la disminución de los niveles de prevalencia de ...consumo, mediante un análisis correlacional de variables. La investigación se realiza a partir de una muestra de 5863 estudiantes de secundaria, como parte de la “IV Encuesta nacional sobre consumo de drogas en población de educación secundaria”, la cual se aplicó durante el 2015 a un grupo representativo de estudiantes de 50 colegios de todo Costa Rica. El instrumento utilizado contó con 109 preguntas distribuidas en siete secciones distintas, desde información personal y académica básica, a conductas de riesgo, bajo los efectos de sustancias psicoactivas. Entre los principales resultados se encuentra que aproximadamente 6 de cada 10 estudiantes reportan un mayor involucramiento por parte de sus padres, además, se rescatan mayores niveles de prevalencia en consumo de alcohol, tabaco y marihuana entre los jóvenes con menor involucramiento parental; de igual forma, aquellos jóvenes con una mejor relación con sus padres presentan una percepción de alto riesgo mayor sobre conductas de consumo. Se encontraron también relaciones estadísticamente significativas entre el consumo de padres y su nivel de involucramiento, evidenciando que aquellos que consumen en menor medida presentan un mayor nivel de involucramiento.
Home respiratory polygraphy may be a simpler alternative to in-laboratory polysomnography for the management of more symptomatic patients with obstructive sleep apnea, but its effectiveness has not ...been evaluated across a broad clinical spectrum.
To compare the long-term effectiveness (6 mo) of home respiratory polygraphy and polysomnography management protocols in patients with intermediate-to-high sleep apnea suspicion (most patients requiring a sleep study).
A multicentric, noninferiority, randomized controlled trial with two open parallel arms and a cost-effectiveness analysis was performed in 12 tertiary hospitals in Spain. Sequentially screened patients with sleep apnea suspicion were randomized to respiratory polygraphy or polysomnography protocols. Moreover, both arms received standardized therapeutic decision-making, continuous positive airway pressure (CPAP) treatment or a healthy habit assessment, auto-CPAP titration (for CPAP indication), health-related quality-of-life questionnaires, 24-hour blood pressure monitoring, and polysomnography at the end of follow-up. The main outcome was the Epworth Sleepiness Scale measurement. The noninferiority criterion was -2 points on the Epworth scale.
In total, 430 patients were randomized. The respiratory polygraphy protocol was noninferior to the polysomnography protocol based on the Epworth scale. Quality of life, blood pressure, and polysomnography were similar between protocols. Respiratory polygraphy was the most cost-effective protocol, with a lower per-patient cost of 416.7€.
Home respiratory polygraphy management is similarly effective to polysomnography, with a substantially lower cost. Therefore, polysomnography is not necessary for most patients with suspected sleep apnea. This finding could change established clinical practice, with a clear economic benefit. Clinical trial registered with www.clinicaltrials.gov (NCT 01752556).
Obesity hypoventilation syndrome (OHS) has been associated with cardiac dysfunction. However, randomized trials assessing the impact of long-term noninvasive ventilation (NIV) or continuous positive ...airway pressure (CPAP) on cardiac structure and function assessed by echocardiography are lacking.
In a prespecified secondary analysis of the largest multicenter randomized controlled trial of OHS (Pickwick Project;
= 221 patients with OHS and coexistent severe obstructive sleep apnea), we compared the effectiveness of three years of NIV and CPAP on structural and functional echocardiographic changes.
At baseline and annually during three sequential years, patients underwent transthoracic two-dimensional and Doppler echocardiography. Echocardiographers at each site were blinded to the treatment allocation. Statistical analysis was performed using a linear mixed-effects model with a treatment group and repeated measures interaction to determine the differential effect between CPAP and NIV.
A total of 196 patients were analyzed: 102 were treated with CPAP and 94 were treated with NIV. Systolic pulmonary artery pressure decreased from 40.5 ± 1.47 mm Hg at baseline to 35.3 ± 1.33 mm Hg at three years with CPAP, and from 41.5 ± 1.56 mm Hg to 35.5 ± 1.42 with NIV (
< 0.0001 for longitudinal intragroup changes for both treatment arms). However, there were no significant differences between groups. NIV and CPAP therapies similarly improved left ventricular diastolic dysfunction and reduced left atrial diameter. Both NIV and CPAP improved respiratory function and dyspnea.
In patients with OHS who have concomitant severe obstructive sleep apnea, long-term treatment with NIV and CPAP led to similar degrees of improvement in pulmonary hypertension and left ventricular diastolic dysfunction.Clinical trial registered with www.clinicaltrials.gov (NCT01405976).
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