Nurses who work rotating shifts consume more energy,macronutrients and calcium when they work the night shift versus day shift

Background: Shift work has been associated with increased body mass index (BMI), metabolic disruption and increased chronic disease risk. Typically, these reports compare individuals who work the day shift to those who work the night shift. Because shift assignment is not random, differences may reflect other, unmeasured characteristics that account for outcome differences.

Objective: To compare dietary intake on days on which the participant worked the night shift to days on which she worked the day shift in a population of female nurses who work rotating shifts at a hospital.

Methods: This cross-sectional study recruited 132 female registered nurses who work rotating shifts in surgical or internal medicine departments. Dietary intake was ascertained using food diaries and analyzed on Tzameret Nutrition Analysis Software (Israel Ministry of Health). Demographic and anthropometric variables were also recorded.

Results: Compared to dietary intake on a day the nurse worked the day shift, intake of the following nutrients increased significantly on the day she worked the night shift: energy; protein; carbohydrates; total fat; saturated fat; and calcium.

Discussion: A significant increase in calorie, macronutrient and calcium intake on days the night shift was worked compared to days the day shift was worked among female nurses who work rotating shifts was demonstrated. These findings could be extended to other professionals who work rotating shifts, including physicians and allied healthcare personnel. It appears that the difference detected may be influenced by the food supplied by the hospital as well as by increased food intake in general.     

Circadian gene methylation in rotating-shift nurses: a cross-sectional study

Investigating the methylation status of the circadian genes may contribute to a better understanding of the shift work-related circadian disruption in individuals exposed to artificial light at night. In the present study, we determined the methylation status of the circadian genes associated with a shift work pattern among nurses and midwives participating in a cross-sectional study in Lodz, Poland.

Quantitative methylation polymerase chain reaction assays were used to assess promoter CpG methylation in PER1, PER2, PER3, CRY1, CRY2, BMAL1, CLOCK, and NPAS2 in genomic DNA from whole blood of 347 women having a rotating-shift work schedule and 363 women working days only. The percentage of methylated reference (PMR) was assessed using fluorescent probes for PER1, PER2, PER3, CRY1, and NPAS2, and the percentage of gene methylation, as the methylation index (MI), using two sets of primers for BMAL1, CLOCK, and CRY2.

We tested the possible association between current and lifetime rotating night-shift work characteristics and circadian gene methylation by using proportional odds regression model with blood DNA methylation, categorized into tertiles, and adjusted for age, current smoking status, folate intake and blood collection time. The findings indicated that CpG methylation in PER2 promoter was significantly decreased (P < 0.004) among nurses and midwives currently working rotating shifts, as compared with day-working nurses and midwives. The lower percentage of PER2 methylation was associated with a higher monthly frequency of current night duties (2–7 night shifts, and eight or more night shifts per month) (P = 0.012) and was associated at borderline significance (P = 0.092) with the lifetime duration of shift work (>10 ≤ 20 years and >20 ≤ 43 years of rotating-shift work) among nurses and midwives (N = 710). Moreover, women with a longer lifetime duration of shift work presented a lower status of PER1 methylation (P = 0.040) than did the women with up to 10 years of rotating-shift work. Long lifetime duration of shift work (> 10 years) among current rotating night-shift workers (N = 347) was associated with BMAL1 hypomethylation (P = 0.013).

Among eight of the investigated circadian genes, only PER1, PER2, and BMAL1 showed differential methylation attributable to the rotating-shift work of nurses and midwives. The findings on blood-based DNA methylation in the circadian genes may provide a better insight into the mechanistic principles underlying the possible health effects of night-shift work but these should be verified in further studies recruiting larger populations of shift workers.     

Effects of night shift on the cognitive load of physicians and urinary steroid hormone profiles – a randomized crossover trial

Mental and physical stress is common in physicians during night shifts. Neurocognitive effects of sleep deprivation as well as alterations in hormonal and metabolic parameters have previously been described. The aim of this crossover study was to evaluate the effects of night-shift work with partial sleep deprivation on steroid hormone excretion and possible associations with mood, sleep characteristics and cognitive functions in physicians.

In total, 34 physicians (mean age 42 ± 8.5 years, 76.5% male) from different departments of the General Hospital of Vienna, Austria, were randomly assigned to two conditions: a regular day shift (8 h on duty, condition 1) and a continuous day-night shift (24 h on duty, condition 2). In both conditions, physicians collected a 24 h urine sample for steroid hormone concentration analysis and further completed psychological tests, including the sleep questionnaire (SF-A), the questionnaire for mental state (MDBF) and the computer-assisted visual memory test (FVW) before and at the end of their shifts, respectively.

Although mean sleep deprivation during night shift was relatively small (~1.5 h) the impairment in participants’ mental state was high in all three dimensions (mood, vigilance and agitation, p ≤ 0.001). Sleep quality (SQ), feeling of being recovered after sleep and mental balance decreased (p ≤ 0.001), whereas mental exhaustion increased (p < 0.05). Moreover, we could show a nearly linear relationship between most of these self-rating items. Testing visual memory participants made significantly more mistakes after night shift (p = 0.011), however, mostly in incorrectly identified items and not in correctly identified ones (FVW). SQ and false identified items were negatively correlated, whereas SQ and time of reaction were positively associated. It is assumed that after night shift, a tendency exists to make faster wrong decisions. SQ did not influence correctly identified items in FVW. In contrast to previous investigations, we found that only excretion rates for pregnanetriol and androsterone/etiocholanolone ratios (p < 0.05, respectively) were slightly reduced in 24-h urine samples after night shift. A considerable stimulation of the adrenocortical axis could not be affirmed. In general, dehydroepiandrosteron (DHEA) was negatively associated with the sense of recreation after sleep and with the time of reaction and positively correlated with correctly identified items in the FVW test.

These results, on the one hand, are in line with previous findings indicating that stress and sleep deprivation suppress gonadal steroids, but, on the other hand, do not imply significant adrenocortical-axis stimulation (e.g. an increase of cortisol) during the day-night shift.     

Landscape effects on nest site selection and nest success of Northern Lapwing Vanellus vanellus in lowland wet grasslands

Capsule: Northern Lapwing Vanellus vanellus avoid nesting close to small woodland patches but nest predation rates do not vary with distance to woodland patches, either because risky areas are avoided or perceived nest predation risk does not reflect actual risk.

Aims: To explore the effects of woodland patches in wet grassland landscapes on nest distribution and success of Lapwings.

Methods: We quantified the effect of woodland patches on the distribution and outcome of Lapwing nests across four wet grassland sites by mapping nest distribution and monitoring nest outcomes.

Results: Lapwing nested significantly further from woods than expected by chance. Neither nest predation rates nor the probability of predation occurring at night (thus primarily mammalian predators) or day (primarily avian predators) varied in relation to distance from woodland patches.

Conclusions: High levels of nest and chick predation in wet grassland landscapes limit the capacity for breeding wader populations to be self-sustaining. Consequently, identifying manageable landscape features that influence predation rates is an important focus of conservation research. Lapwing avoid breeding close to woodland but, as nest predation rates do not vary with distance from woodland patches, their removal may increase the area of suitable nesting habitat but is unlikely to substantially influence productivity.     

Improved reliability of the urine lactate concentration under controlled hydration after maximal exercise

Context: Urine lactate may be a novel biomarker of lactate production capacity but its reliability has been unsatisfactory so far.

Objective: To compare the reliability of urine lactate between controlled hydration and no hydration after maximal exercise.

Material and methods: Athletes performed swimming exercise four times: two followed by consumption of 1?L of water and two followed by no water intake. Blood and urine lactate was measured.

Results: The reliability of urine lactate was good and similar to that in blood only after controlled hydration. Blood and urine lactate were correlated under both hydration conditions.

Discussion and conclusion: Controlled hydration after exercise provides satisfactory reliability of urine lactate.     

Brood sex ratio in expansive and non-expansive tern species in east-central Poland

Capsule Evidence from two tern species does not support the theory that species in expansion should bias their brood sex ratios towards the more dispersing sex.

Aims Sex ratio theory predicts that when a species is in expansion, the sex ratio should be biased towards the more dispersing sex. We compared the sex ratio of nestlings in two closely related species of terns, characterized by different expansion rates: the White-winged Tern Chlidonias leucopterus (an expansive species) and the Black Tern Chlidonias niger (a non-expansive species).

Methods The fieldwork was carried out in the valleys of the Rivers Bug and Narew in east-central Poland, from 2008 to 2014, during which time eight White-winged Tern colonies and ten Black Tern colonies were monitored. Nest inspections began around 15–20 May, when the first eggs were laid, and continued until mid-July, when the last nestlings were 7–20 days old.

Results The nestling sex ratios were similar in both species, and the differences between number of females and males were not significant (White-winged Tern: 56.6% females vs. 43.4% males; Black Tern: 57.4% females vs. 42.6% males).

Conclusions The lack of differences in nestling sex ratio in these species may be due to the cessation of the White-winged Tern's expansion in this area or because the sex ratio is characteristic of Sternidae species, as similar results have been reported for other tern species.     

Circulating adiponectin as a biomarker in renal cell carcinoma: a systematic review and meta-analysis

Context: Metabolic imbalance in renal cell carcinoma (RCC) can lead to abnormal adiponectin levels.

Objective: To evaluate circulating adiponectin as a detection or predictive marker for RCC.

Methods: A comprehensive literature search and meta-analysis was performed on studies reporting circulating adiponectin levels and RCC. The meta-analysis was performed using RevMan.

Results: Seven studies compared the circulating adiponection levels between RCC cases and controls. Adiponectin level was significantly lower in RCC cases compared to controls at pre-diagnosis and pre-operative time-points. RCC stage, grade and subtype did not affect adiponectin levels.

Conclusion: Low circulating adiponectin could be a predictive or risk factor for RCC.     

Propeptide big-endothelin,N-terminal-pro brain natriuretic peptide and mortality. The Ludwigshafen risk and cardiovascular health (LURIC) study

Context: The endothelin system (Big-ET-1) is a key regulator in cardiovascular (CV) disease and congestive heart failure (CHF).

Objectives: We have examined the incremental value of Big-ET-1 in predicting total and CV mortality next to the well-established CV risk marker N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP).

Methods: Big-ET-1 and NT-proBNP were determined in 2829 participants referred for coronary angiography (follow-up 9.9 years).

Results: Big-ET-1 is an independent predictor of total, CV mortality and death due to CHF.

Discussion: The conjunct use of Big-ET-1 and NT-proBNP improves the risk stratification of patients with intermediate to high risk of CV death and CHF.

Conclusions: Big-ET-1improves risk stratification in patients referred for coronary angiography.     

Kleptoparasitism in gulls Laridae at an urban and a coastal foraging environment: an assessment of ecological predictors

Capsule: Kleptoparasitism in gulls occurred at a greater rate at an urban compared with a coastal site. Population density and prey size predicted the rate of kleptoparasitism at the urban site.

Aims: To investigate and assess the ecological variables associated with kleptoparasitism among gulls at urban and rural sites.

Methods: Field observations were conducted at Brancaster (coastal rural) and Billingsgate Market (urban) to examine differences in the rate of kleptoparasitism in mixed-species flocks of gulls. Four key variables (prey size, population density, season and species) were assessed as predictors of kleptoparasitism.

Results: Generalized linear models revealed significant effects on kleptoparasitism rate of site, population density and prey size, and two-way interactions between these main terms. Population density and prey size differed significantly between sites, but population density appeared to predict the rate of kleptoparasitism.

Conclusion: Kleptoparasitism may well aid invasion and increase the range of environments a gull can tolerate by helping them meet their energy needs in novel environments where normal foraging behaviours are difficult to implement.     

When should Common Cuckoos Cuculus canorus lay their eggs in host nests?

Capsule Brood parasitic Common Cuckoo Cuculus canorus chicks hatch earlier than the nestlings of their Great Reed Warbler Acrocephalus arundinaceus hosts, but hatching priority is less consistent when Cuckoo eggs are laid after the onset of host incubation.

Aim To reveal by field observations what the optimal stage is for Cuckoos to lay their eggs in relation to the host laying cycle to ensure prior hatching of the parasitic chicks.

Methods We monitored the hatching of Cuckoo chicks in relation to the hosts’ laying stage at which the Cuckoo eggs appeared and also monitored host incubation behaviour.

Results Great Reed Warblers incubated more on day 5 after the host's onset of laying relative to day 3. All Cuckoo eggs hatched earlier than hosts when they were laid prior to the onset of host incubation (day 4). Cuckoo eggs also maintained hatching priority in about 2/3 of the nests when laid on days 5–6.

Conclusions Most Cuckoo eggs are laid prior to the onset of host incubation and this, together with other adaptive mechanisms, ensures the prior hatching of Cuckoo eggs. Cuckoo eggs laid after the onset of incubation lose the advantage of prior hatching in approximately 30% of nests.     

Kallistatin levels in HIV-infected patients and effects of statin therapy

Background: Kallistatin, a serine proteinase inhibitor, has vasodilatory and anti-inflammatory properties and is increased in other inflammatory conditions. We measured kallistatin in HIV for the first time, examined its relationship with inflammation, and determined if statin therapy affected levels.

Methods: Kallistatin levels were measured in subjects from a randomized, double-blinded, placebo-controlled trial.

Results: One hundred and thirty-five HIV-infected subjects were included. Kallistatin levels were 28.4?μg/mL at baseline and not affected by rosuvastatin. Levels were correlated with high-sensitivity C-reactive protein (hsCRP), interleukin-6, fibrinogen and insulin resistance.

Conclusions: Kallistatin levels were correlated with some markers of systemic inflammation and should be further explored in the HIV population.     

Heparanase is a predictive marker for high thrombus burden in patients with ST-segment elevation myocardial infarction

Objective: Heparanase (HPA) is an endo-β-D-glucuronidase capable of degrading heparin sulphate (HS) and heparin side chains. HPA plays a role in tumour growth, angiogenesis, cell invasion and in activation of the coagulation system. We aimed to investigate the relationship between HPA and thrombus burden (TB) in patients with ST-Segment Elevation Myocardial Infarction (STEMI).

Methods: This prospective study enrolled 187 patients with STEMI who were treated with primary percutaneous coronary intervention (pPCI). Blood samples were taken to determine serum HPA levels prior to coronary angiography and heparin administration. Serum HPA analysis was performed with a commercially available Human Elisa kit.

Results: Patients were divided into two groups: high TB (n:58) and low TB (n:129) group. Serum HPA levels were significantly higher in patients with high TB than low TB [250.1 (188.5–338.1) vs. 173.6 (134.3–219.8) pg/mL] (p?<?0.001). Serum HPA levels were higher in patients with no-reflow phenomenon compared with others [(409.3 (375.6–512.5) pg/mL vs. 186.2 (144.2–247.4) pg/mL, p?<?0.001]. In multiple logistic regression analysis HPA was a predictor of high TB.

Conclusion: Elevated HPA level in patients with STEMI is related to high TB. Furthermore, increased HPA level may be associated with thrombotic complications such as no-reflow phenomenon in patients with STEMI.     

Fuel load,fuel deposition rate and stopover duration of the Common Sandpiper Actitis hypoleucos during the autumn migration

Capsule: Common sandpipers stopping over in a tidal marsh in northern Iberia during the autumn migration period showed a moderate mean fuel load and low fuel deposition rate, but relatively long stopover periods, suggesting a ‘hopping’ strategy of migration.

Aims: The main objectives of this paper were to analyse the stopover ecology of migrant Common Sandpipers at Txingudi coastal marshes, northern Iberia, in autumn.

Methods: Common sandpipers were captured during the autumn migration of 2007–2013 at the Txingudi marshlands (province of Gipuzkoa, northern Iberia). Data were obtained from a constant effort ringing station working on a daily basis.

Results: We observed a moderate fuel load and fuel deposition rate and long stopovers.

Conclusion: Our results suggest overall a ‘hopping’ migration strategy. When moving along the coast of northern Iberia, Common Sandpipers may not use key wetlands to gain much fuel, as found in other waders or in some wetlands of inland Iberia, but all coastal marshes seem to be potentially used in the same way.     

Soluble CD40 ligand in haemodialysis patients: survival impact and cardiovascular prognostic role

Context: Soluble CD40 ligand (sCD40l) can predict cardiovascular events (CVE) and mortality in haemodialysis (HD) patients (short-, medium-term follow-up studies).

Objective: To evaluate the relationship between sCD40l and survival, CVE and mortality in HD patients on long-term follow-up.

Methods: We registered 46?HD patients’ baseline characteristics, mortality and CVE for 108 months.

Results: SCD40l correlated positively with C-reactive protein, was higher in survivors, but had no impact on survival and was not predictive for CVE or CV mortality.

Conclusion: The levels of sCD40l have no influence on survival or CVE and mortality in HD patients in a long-term follow-up.     

Riboflavin as an independent and accurate biomarker for adherence in a randomized double-blind and placebo-controlled clinical trial

Background: Medication adherence is critical for success of clinical trials.

Objective: To assess oral riboflavin is an adherence marker.

Methods: Riboflavin was incorporated into active treatment and placebo pills for a clinical trial lasting for 2 years.

Results: The accuracy (area under the receiver operating curve) of urinary riboflavin was 0.91 as a binary classifier of adherence, and was similar or better than for two active study ingredients daidzein (0.92) and genistein (0.87) (all p?<?0.0001). Decreased adherence over time was similar in the two study groups.

Conclusion: Riboflavin is an accurate and useful biomarker for study pill ingestion.     

Differential expression of circulating vascular cell adhesion molecule-1 in subjects with coronary artery disease and cardiac syndrome X without known diabetes mellitus

Context: Inflammation is one of the mechanisms underlying cardiac syndrome X (CSX).

Objectives: Few studies have compared the expression of inflammatory or adhesion molecules between coronary artery disease (CAD) versus CSX.

Materials and methods: Ninety-two CSX and 145 CAD subjects without known diabetes mellitus underwent coronary angiogram for angina.

Results: Vascular cell adhesion molecule (VCAM)-1 (median, 507 versus 431?ng/ml, p?=?0.001) was significantly higher in the CAD group. In the binary regression, VCAM-1 was a significant differential factor for CAD versus CSX.

Discussion and conclusion: Adhesion molecules might be implicated in the differential expression of macro versus microvascular coronary disease.

Trial registration number: NCT01198730 at https://clinicaltrials.gov     

Blood markers of inflammation and endothelial dysfunction in cardioembolic stroke: systematic review and meta-analysis

Context: Various processes including inflammation and endothelial dysfunction have been implicated in the pathogenesis of cardioembolic (CE) strokes.

Objective: To review the evidence and investigate the association between immune-inflammatory biomarkers and CE strokes versus other stroke subtypes.

Methods: We systematically reviewed the literature (sources: MEDLINE, web-based register http://stroke-biomarkers.com, reference lists) with quality assessment and meta-analysis of selected articles.

Results: The most consistent association was found between C-reactive protein (CRP) and CE strokes when compared to other stroke subtypes (standardized mean difference 0.223 (0.116, 0.343); p?<?0.001)

Conclusions: Our findings confirm a possible association between selected inflammatory biomarkers and CE stroke.     

Water-induced stress influences the relative investment in cleistogamous and chasmogamous flowers of an invasive grass,Microstegium vimineum (Poaceae)

Background: Global climate change has the potential to shape evolutionary trajectories of invasive species via many routes, including through changes in mating systems. Many cleistogamous (CL) plants adjust investment in CL (selfed) vs. chasmogamous (CH, potentially outcrossed) progeny across environmental gradients. However, the details of such adjustments are lacking for highly invasive plant species.

Aims: We used a highly invasive grass, Microstegium vimineum, as a model for understanding how changes in water-induced stress (including potential associated changes in soil nutrient availability) might affect mating systems and thus evolutionary change in invasive species. We predicted that plants would respond to increased water-induced stress through a relative reduction in investment in CL vs. CH reproduction (i.e., a decrease in the CL:CH ratio).

Methods: Under greenhouse conditions, we measured fecundity (number of inflorescences and florets per plant) as well as relative investment in CL vs. CH florets (CL:CH ratios for number of inflorescences, florets per inflorescence, overall florets) in response to three watering treatments approximating mesic (low) to inundated (high) conditions.

Results: Plant biomass was significantly lower in high-watering treatment relative to intermediate and low treatments, indicating that the high-water condition was stressful. Contrary to expectations, stressed plants significantly increased relative investment in CL reproduction, a pattern associated with decreased inflorescence number and increased numbers of CL florets per inflorescence.

Conclusions: We conclude that changes in water-induced stress could strongly influence realised rates of outcrossing in this invasive plant, leading to mating system evolution, and altered invasiveness.     

Tawny Owl Strix aluco response to call-broadcasting and implications for survey design

Capsule: The use of call-broadcasting significantly increases the number of Tawny Owls Strix aluco detected in winter point counts, but requires careful survey design to avoid introducing potential sources of bias into population estimates.

Aims: To examine Tawny Owl response to call-broadcasting to aid survey design in national monitoring efforts.

Methods: A nocturnal survey was undertaken at 36 survey points over three nights in winter in Thetford Forest, England. Each survey consisted of four consecutive five-minute segments: a passive count, followed by three counts with the use of call-broadcasting.

Results: Few (4%) Tawny Owls were recorded during passive surveys, whereas the greatest response was during the first and second call-broadcast segments (49% and 36%, respectively). New detections declined to 11% in the final segment. Response was fastest at dusk, although time of night did not significantly affect the number of individuals detected. Male owls accounted for 79% of detections.

Conclusion: Our results show that ten minutes of call-broadcast surveying will detect 85% of responsive Tawny Owls, thus vastly improving detection compared to passive listening alone. However, simultaneous counts of geographically separated detections should be used to provide a minimum count and reduce potential double-counting of mobile individuals.