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1.
《Chronobiology international》2013,30(10):1218-1222
The main goal of the present study was to examine the effects of transition into and out of daylight saving time (DST) on the quality of the sleep/wake cycle, assessed through actigraphy. To this end, 14 healthy university students (mean age: 26.86?±?3.25?yrs) wore an actigraph for 7?d before and 7?d after the transition out of and into DST on fall 2009 and spring 2010, respectively. The following parameters have been compared before and after the transition, separately for autumn and spring changes: bedtime (BT), get-up time (GUT), time in bed (TIB), sleep onset latency (SOL), fragmentation index (FI), sleep efficiency (SE), total sleep time (TST), wake after sleep onset (WASO), mean activity score (MAS), and number of wake bouts (WB). After the autumn transition, a significant advance of the GUT and a decrease of TIB and TST were observed. On the contrary, spring transition led to a delay of the GUT, an increase of TIB, TST, WASO, MAS, and WB, and a decrease of SE. The present results highlight a more strong deterioration of sleep/wake cycle quality after spring compared with autumn transition, confirming that human circadian system more easily adjusts to a phase delay (autumn change) than a phase advance (spring transition).  相似文献   

2.
Cortisol is critical for maintenance of health and homeostasis and factors affecting cortisol levels are of clinical importance. There is conflicting information about the effects of season on morning cortisol and little information on the effects of sunlight on population cortisol assessment. The aim of this study was to assess whether changes in median serum cortisol occurred in a population in conjunction with changing seasons, daylight saving time (DST) or time of sunrise. We analysed serum cortisol results (n?=?27 569) from a single large laboratory over a 13-year period. Subjects with confounding medications or medical conditions were excluded and data analysed in 15-minute intervals. We assessed the influence of traditional seasons, seasons determined by equinox/solstice, DST and time of sunrise on median cortisol. The median time of cortisol collection did not vary significantly between seasons. Using traditional seasons, median cortisol was lowest in summer (386?nmol/L) and spring (384?nmol/L) with higher cortisol in autumn (406?nmol/L) and winter (414?nmol/L). Median cortisol was lowest in the summer solstice quarter with significant comparative increases in the spring equinox quarter (3.1%), the autumn equinox quarter (4.5%) and the winter solstice quarter (8.6%). When cortisol was modelled against time, with adjustment for actual sunrise time on day of collection, for each hour delay in sunrise there was a 4.8% increase in median cortisol (95% CI: 3.9–5.7%). In modelling to explain the variation in cortisol over the morning, sunrise time was better than season in explaining seasonal effects. A subtle cyclic pattern in median cortisol also occurred throughout the months of the year. A 3-year trial of DST allowed comparison of cortisol in DST and non DST periods, when clock time differed by one hour. There was modest evidence of a difference in acrophase between DST and non DST cortisol (p?=?0.038), with DST peak cortisol estimated to occur 58?minutes later than non-DST peak. In summary, we found that time of sunrise and time of cortisol collection were the most important factors influencing median cortisol. For each hour later that the sun rose there was an almost 5% increase in median cortisol. There was significant seasonal variability with lowest cortisol noted in summer coinciding with the earliest sunrise time. This is an important finding which is consistent with the understanding that light is the major zeitgeber in entrainment of the human circadian cortisol rhythm. Our data suggest this rhythm is resistant to the arbitrary changes in clock time with daylight saving.  相似文献   

3.
A comparison between a digestion-sedimentation technique (DST) and the Kato-Katz thick smear technique (KKT) in the detection and quantification of Schistosoma eggs in stool was carried out in 551 subjects. Specimen were collected one or two years after treatment with praziquantel from subjects living in a schistosomiasis endemic area of Mali. One hundred infections missed by the KKT were detected by the DST. Conversely, 35 infections missed by the DST were detected by the KKT (88% were light infections). More subjects were classified as lightly infected by the DST (p < 10(-3)) and more subjects were classified as moderately infected (101-400 epg) by the KKT (p = 0.02). The KKT produced higher counts than the DST among the youngest age group which was also the most infected. The principal advantage of the DST over the KKT was its better sensitivity to detect light infections resulting from a larger amount of stool processed.  相似文献   

4.
A quarter of the world's population is subjected to a 1 hr time change twice a year (daylight saving time, DST). This reflects a change in social clocks, not environmental ones (e.g., dawn). The impact of DST is poorly understood. Circadian clocks use daylight to synchronize (entrain) to the organism's environment. Entrainment is so exact that humans adjust to the east-west progression of dawn within a given time zone. In a large survey (n = 55,000), we show that the timing of sleep on free days follows the seasonal progression of dawn under standard time, but not under DST. In a second study, we analyzed the timing of sleep and activity for 8 weeks around each DST transition in 50 subjects who were chronotyped (analyzed for their individual phase of entrainment). Both parameters readily adjust to the release from DST in autumn but the timing of activity does not adjust to the DST imposition in spring, especially in late chronotypes. Our data indicate that the human circadian system does not adjust to DST and that its seasonal adaptation to the changing photoperiods is disrupted by the introduction of summer time. This disruption may extend to other aspects of seasonal biology in humans.  相似文献   

5.
The financial cost of missed appointments is so great that even a small percentage reduction in Did Not Attend (DNA) rate could save significant sums of money. Previous studies have identified many factors that predict DNA rate, including patient age, gender, and transport options. However, it is not obvious how healthcare providers can use this information to improve attendance, as such factors are not under their control. One factor that is under administrative control is appointment scheduling. Here we asked whether DNA rate could be reduced by altering scheduling policy. In Study 1, we examined attendance records for 4,538,294 outpatient hospital appointments across Scotland between January 1st 2008 and December 31st 2010. DNA rate was highest for Mondays (11%), lowest for Fridays (9.7%), and decreased monotonically over the week (Monday-Friday comparison [χ2(1, N  = 1,585,545)  = 722.33, p<0.0001]; Relative Risk Reduction 11.8%). This weekly decline was present for male and female patient groups of all ages, but was steeper for younger age groups. In Study 2, we examined attendance records for 10,895 appointments at a single GP clinic in Glasgow. Here again, DNA rate was highest for Mondays (6.2%), lowest for Fridays (4.2%), and decreased monotonically over the week (Monday-Friday comparison [χ2(1, N  = 4767)  = 9.20, p<0.01]; Relative Risk Reduction 32.3%). In two very different settings, appointments at the beginning of the week were more likely to be missed than appointments at the end of the week. We suggest that DNA rate could be significantly reduced by preferentially loading appointments onto high-attendance days.  相似文献   

6.
7.
Previous studies indicate that solar clock (daily changes in the Earth’s surface illumination) is a main zeitgeber for human circadian system. It has been shown that human biological clock is weakly adjusted to such changes in social clock as daylight saving time (DST). There are two changes of social clock in Russian Federation: on 25 March 2011, DST has been replaced by permanent DST (DSTp), which was subsequently revoked on 26 October 2014 (non-DSTp). These manipulations with social clock may lead to prolonged disturbances of human circadian system. Our hypothesis is that during period of DSTp, the dissociation between social and biological clocks was greatest as compared with DST and non-DSTp periods. Here, we examine the effects of DSTp on the sleep timing, social jetlag (SJL), academic performance, and winter and summer seasonality of mood and behavior of 10–24-year-old inhabitants of European North of Russia. A cross-sectional retrospective analysis of questionnaire data (n = 7968) was performed using chi squared-test and analysis of covariance. Our findings indicate that SJL (F2,7967 = 31.9; p < 0.0001; η2 = 0.009), and winter pattern of mood seasonality (χ22,7967 = 10.5; p < 0.01) were increased in adolescents during the period of DSTp as compared with DST and non-DSTp periods. The largest increase in SJL was occurred in ages between 10 and 17-year-olds. The finding suggests that increase in SJL can be attributed to a later rise time on free days (F2,7967 = 44.9; p < 0.0001; η2 = 0.012). Similar changes were observed in three subsamples obtained in Syktyvkar, Petrozavodsk, and Vorkuta. Effect sizes of studied relationships were small or very small. The greatest effect sizes (η2 ~ 0.05) were observed in Arctic city of Vorkuta indicating that in polar region, solar clock is still stronger zeitgeber for human circadian system, than the social clock. In conclusion, we have shown for the first time that there is a greatest dissociation between social and biological clocks during the period of DSTp which potentially exerts a negative influence on adolescents’ sleep habits, mood, and behavior. Our data indicate that “non-DSTp” social clock system most suitable for prevention dissociation between social and biological clocks.  相似文献   

8.
BackgroundUnkept outpatient hospital appointments cost the National Health Service £1 billion each year. Given the associated costs and morbidity of unkept appointments, this is an issue requiring urgent attention. We aimed to determine rates of unkept outpatient clinic appointments across hospital trusts in the England. In addition, we aimed to examine the predictors of unkept outpatient clinic appointments across specialties at Imperial College Healthcare NHS Trust (ICHT). Our final aim was to train machine learning models to determine the effectiveness of a potential intervention in reducing unkept appointments.Methods and findingsUK Hospital Episode Statistics outpatient data from 2016 to 2018 were used for this study. Machine learning models were trained to determine predictors of unkept appointments and their relative importance. These models were gradient boosting machines. In 2017–2018 there were approximately 85 million outpatient appointments, with an unkept appointment rate of 5.7%. Within ICHT, there were almost 1 million appointments, with an unkept appointment rate of 11.2%. Hepatology had the highest rate of unkept appointments (17%), and medical oncology had the lowest (6%). The most important predictors of unkept appointments included the recency (25%) and frequency (13%) of previous unkept appointments and age at appointment (10%). A sensitivity of 0.287 was calculated overall for specialties with at least 10,000 appointments in 2016–2017 (after data cleaning). This suggests that 28.7% of patients who do miss their appointment would be successfully targeted if the top 10% least likely to attend received an intervention. As a result, an intervention targeting the top 10% of likely non-attenders, in the full population of patients, would be able to capture 28.7% of unkept appointments if successful. Study limitations include that some unkept appointments may have been missed from the analysis because recording of unkept appointments is not mandatory in England. Furthermore, results here are based on a single trust in England, hence may not be generalisable to other locations.ConclusionsUnkept appointments remain an ongoing concern for healthcare systems internationally. Using machine learning, we can identify those most likely to miss their appointment and implement more targeted interventions to reduce unkept appointment rates.

Sion Phillpott-Morgan and co-workers study occurrence and possible predictors of unkept outpatient appointments in the UK.  相似文献   

9.
ABSTRACT

Most of the processes that occur in the mind and body follow natural rhythms. Those with a cycle length of about one day are called circadian rhythms. These rhythms are driven by a system of self-sustained clocks and are entrained by environmental cues such as light-dark cycles as well as food intake. In mammals, the circadian clock system is hierarchically organized such that the master clock in the suprachiasmatic nuclei of the hypothalamus integrates environmental information and synchronizes the phase of oscillators in peripheral tissues.

The circadian system is responsible for regulating a variety of physiological and behavioral processes, including feeding behavior and energy metabolism. Studies revealed that the circadian clock system consists primarily of a set of clock genes. Several genes control the biological clock, including BMAL1, CLOCK (positive regulators), CRY1, CRY2, PER1, PER2, and PER3 (negative regulators) as indicators of the peripheral clock.

Circadian has increasingly become an important area of medical research, with hundreds of studies pointing to the body’s internal clocks as a factor in both health and disease. Thousands of biochemical processes from sleep and wakefulness to DNA repair are scheduled and dictated by these internal clocks. Cancer is an example of health problems where chronotherapy can be used to improve outcomes and deliver a higher quality of care to patients.

In this article, we will discuss knowledge about molecular mechanisms of the circadian clock and the role of clocks in physiology and pathophysiology of concerns.  相似文献   

10.
11.
未来气候变化对海南橡胶树春季物候期的影响   总被引:1,自引:0,他引:1  
为研究未来气候变化对海南岛橡胶树春季物候期(第一蓬叶展叶期和春花期)的影响,以国内外关于橡胶树物候期量化研究和橡胶树观测试验数据为基础,结合作物生长钟模型,建立橡胶树春季物候期模型,开发成计算机软件RubberSP并进行适宜性评价。在此基础上,通过贝叶斯模型平均法(BMA)结合耦合模式比较计划第五阶段(CMIP5)多模式数据集中的5个大气环流模式(GCMs),分别在RCP2.6、RCP4.5和RCP8.5气候情景下,以1986—2017年为基准时段,预估2020—2099年气候变化对橡胶树春季物候期的可能影响。结果表明:RubberSP的模拟精度较高,模拟值与实测值的决定系数R2为0.73~0.87,均方根误差RMSE为3.26~4.15 d,归一化均方根误差NRMSE为3.4%~7.4%。BMA方法可以有效地处理单一GCMs带来的不确定性问题,较好地反映出气温变化趋势;预估RCP2.6、RCP4.5和RCP8.5情景下,海南岛至21世纪末较基准时段分别升温超过0.3、1.0和2.5 ℃。在未来气候情景下,春季物候期出现日序提前,产胶量提高的可能性变大。日序等值线均向西北方向移动,海南岛橡胶树种植最适宜区有向西北方向扩大的可能。第一蓬叶展叶期的空间差异性变大,春花期则略微变小。橡胶树春季物候期在未来3种情景下提前或推迟的变化幅度随RCP情景下升温的幅度而变化,RCP2.6最平缓,RCP8.5最剧烈。  相似文献   

12.
ABSTRACT

People sleep less in response to setting social clocks earlier relative to the sun clocks. We proposed here a model-based approach for estimating sleep loss as the difference between weekend and weekday risetimes divided on the difference between weekend risetime and weekday bedtime. We compared this approach with a traditional approach to estimating sleep curtailment as the difference in weekly average sleep duration in two conditions. Weekday and weekend sleep times reported for 320 samples provided possibility of testing whether evening types with later weekend sleep times and larger social jetlag differ from morning types with earlier weekend sleep times and smaller social jetlag on amount of sleep lost (1) throughout the week and (2) in response to an advance of weekday wakeups, for instance, after the expected installation of perennial Daylight Saving Time (DST). We found that (1) an amount of sleep lost due to advancing shift of weekday wakeups depends upon neither chronotype nor weekend sleep times nor social jetlag, (2) a very large amount of sleep is usually lost by evening types with later weekend sleep times and larger social jetlag and (3) an essential sleep loss is caused by our usual work/school schedules, even in morning types with early weekend sleep times and small social jetlag. As compared to such permanent sleep losses experienced by any types, an additional loss due to switching from Standard Time (ST) to perennial DST are expected to be relatively small. We also found that the traditional way of calculation of sleep curtailment leads to paradoxical conclusions, such as (1) sleep loss is larger when social jetlag is smaller, not larger, (2) sleep loss is larger when weekend sleep times are earlier, not later, (3) despite 1-h difference between two student samples in weekday wakeups, their sleep losses can be identical.  相似文献   

13.
Clock genes that comprise the circadian clock system control various physiological functions. Delayed sleep-wake phase disorder (DSWPD) and night eating syndrome (NES) are characterized by delayed sleep and meal timing, respectively. We estimated that clock gene expression rhythms in DSWPD patients may be delayed in comparison with the healthy subjects due to delayed melatonin secretion rhythms, producing eveningness chronotype in these individuals. However, it was difficult to estimate which clock gene expression rhythms were delayed or not in NES patients, because previous studies revealed that melatonin secretion rhythm was a little delayed compared with healthy individuals and that chronotype of NES patients depended on the individuals. Therefore, we examined expression rhythms of clock genes such as Period3 (Per3), nuclear receptor subfamily 1, group D, member 1 (Nr1d1) and Nr1d2 in these patients. Further, we expected sleep and meal patterns in DSWPD and NES patients may be more diverse than patterns observed in healthy subjects, and thus analyzed relationships among clock gene expression rhythms, sleep quality, sleep midpoint time, and meal times. We enrolled healthy male participants along with DSWPD and NES male patients, and asked all participants to answer questionnaires and to keep diaries to record information on their sleep and meals. Further, we asked them to collect 5–10 beard follicle samples, 6 times every 4 h. We measured clock gene expression rhythms using total RNA extracted from beard follicle cells. Peak time of clock gene expression in the NES group showed more diversity than the other groups, and that in the DSWPD group was delayed compared with the control group. In addition, the peak time of clock gene expression was negatively correlated with sleep quality and positively correlated with meal time after a long fast. Amplitudes of clock gene expression, especially Per3, positively responded to better mental and physical conditions as well as with better sleep quality. Results of this study suggest that peak times of clock gene expression in NES patients depended on the individuals; some patients with NES showed similar clock gene expression rhythm to healthy subjects, and other patients with NES showed similar to DSWPD patients. Moreover, this study suggests that meal time after a long fast may influence more determination in clock gene expression rhythms than the time of breakfast. Therefore, this study also indicates that Per3 clock gene may be one of the parameters that will help us understand sleep and meal rhythm disturbances.  相似文献   

14.
15.
Summary Proponents of Developmental Systems Theory (DST) argue that it offers an alternative to current research programs in biology that are built on the historic disjunction between evolutionary and developmental biology. In this paper I illustrate how DST can be used to account for the acquisition of an important component of moral agency, conscience. Susan Oyama, a major proponent of DST, has set moral issues outside the compass of DST. Thus, I examine her reasons for restricting DST to non-moral matters, and argue that they are not decisive. On the positive side, I argue that DST not only is compatible with attempts to describe and explain moral agency but also aids us in understanding it. In particular, I show how DST can provide a fruitful perspective for viewing some significant current findings and theories in moral developmental psychology about the acquisition of conscience. The familiar dichotomies resisted by DST, those between genes and environment, inherited and acquired, innate and learned, and biological and cultural, have also plagued human developmental psychology, including moral development. By bringing a DST perspective to the study of moral development, I illustrate how a DST perspective might offer a promising way to reconceive that phenomenon, and provide some insights into how further work in understanding the development of moral agency might proceed. Thus, I hope to contribute to the current efforts of proponents of DST to integrate developmental and evolutionary considerations.  相似文献   

16.
Energetics of interactions occurring in the model ligand-DNA systems constituted from distamycin A (DST), netropsin (NET) and the oligomeric duplexes d(GCAAGTTGCGATATACG)d(CGTATATCGCAACTTGC)=D#1 and d(GCAAGTTGCGAAAAACG)d(CGTTTTTCGCAACTTGC)=D#2 was studied by spectropolarimetry, UV-absorption spectroscopy and isothermal titration calorimetry. Model analysis of the measured signals was applied to describe individual and competitive binding in terms of populations of various species in the solution. Our results reveal several unprecedented ligand-DNA binding features. DST binds to the neighboring 5'-AAGTT-3' and 5'-ATATA-3' sites of D#1 statistically in a 2:1 binding mode. By contrast, its association to D#2 appears to be a 2:1 binding event only at the DST/D#2 molar ratios between 0 and 2 while its further binding to D#2 may be considered as a step-by-step binding to the unoccupied 5'-AAAAA-3' sites resulting first in DST3D#2 and finally in DST4D#2 complex formation. Competition between DST and NET binding shows that for the most part DST displaces NET from its complexes with D#1 and D#2. In contrast to the obligatory 1:1 binding of DST to the ligand-free 5'-AAAAA-3' sites observed at DST/5'-AAAAA-3' <1 the displacement of NET bound to the 5'-AAAAA-3' sites by added DST occurs even at the smallest additions of DST in a 2:1 manner. NET can also displace DST molecules but only those bound monomerically to the 5'-AAAAA-3' sites of DST3D#2. Actually, only half of these molecules can be displaced due to the simultaneous rebinding of the displaced DST to the unreacted 5'-AAAAA-3' sites in DST3D#2. Binding of DST and NET to D#1 and D#2 is an enthalpy driven process accompanied by large unfavorable (DST), small (NET) or large favorable (NET binding to 5'-AAAAA-3') entropy contributions and negative deltaCP degrees that are reasonably close to deltaCP degrees predicted from the calculated changes in solvent-accessible surface areas that accompany complex formation. Although various modes of DST and NET binding within D#1 and D#2 are characterized by significant energetic differences they seem to be governed by the same driving forces; the hydrophobic transfer of ligand from the solution into the duplex binding site and the accompanying specific non-covalent ligand-DNA and ligand-ligand interactions occurring within the DNA minor groove.  相似文献   

17.
Abstract. The acronym Developmental systems theory (DST) has been introduced into the literature on development in at least three different contexts in recent years – twice for DST, and before that, for Dynamical Systems Theory – and in all cases, to designate a new perspective for understanding development. Subtle but significant differences in argument and aims distinguish these uses, and confound the difficulty of saying just what DST is. My aim in this paper is to disambiguate these different terms – both to call attention to the difference of perspectives, and to carve out a conceptual space for the concrete issues at stake.  相似文献   

18.
This study compared the ability of four measures of patient retention in HIV expert care to predict clinical outcomes. This retrospective study examined Veterans Health Administration (VHA) beneficiaries with HIV (ICD-9-CM codes 042 or V08) receiving expert care (defined as HIV-1 RNA viral load and CD4 cell count tests occurring within one week of each other) at VHA facilities from October 1, 2006, to September 30, 2008. Patients were ≥18 years old and continuous VHA users for at least 24 months after entry into expert care. Retention measures included: Annual Appointments (≥2 appointments annually at least 60 days apart), Missed Appointments (missed ≥25% of appointments), Infrequent Appointments (>6 months without an appointment), and Missed or Infrequent Appointments (missed ≥25% of appointments or >6 months without an appointment). Multivariable nominal logistic regression models were used to determine associations between retention measures and outcomes. Overall, 8,845 patients met study criteria. At baseline, 64% of patients were virologically suppressed and 37% had a CD4 cell count >500 cells/mm3. At 24 months, 82% were virologically suppressed and 46% had a CD4 cell count >500 cells/mm3. During follow-up, 13% progressed to AIDS, 48% visited the emergency department (ED), 28% were hospitalized, and 0.3% died. All four retention measures were associated with virologic suppression and antiretroviral therapy initiation at 24 months follow-up. Annual Appointments correlated positively with CD4 cell count >500 cells/mm3. Missed Appointments was predictive of all primary and secondary outcomes, including CD4 cell count ≤500 cells/mm3, progression to AIDS, ED visit, and hospitalization. Missed Appointments was the only measure to predict all primary and secondary outcomes. This finding could be useful to health care providers and public health organizations as they seek ways to optimize the health of HIV patients.  相似文献   

19.
Abstract

Sleep behavior remains one of the most enigmatic areas of life. The unanswered questions range from “why do we sleep?” to “how we can improve sleep in today’s society?” Identification of mutations responsible for altered circadian regulation of human sleep lead to unique opportunities for probing these territories. In this review, we summarize causative circadian mutations found from familial genetic studies to date. We also describe how these mutations mechanistically affect circadian function and lead to altered sleep behaviors, including shifted or shortening of sleep patterns. In addition, we discuss how the investigation of mutations can not only expand our understanding of the molecular mechanisms regulating the circadian clock and sleep duration, but also bridge the pathways between clock/sleep and other human physiological conditions and ailments such as metabolic regulation and migraine headaches.  相似文献   

20.
We examined the effects of nutrient amendments on epilimnetic freshwater bacteria during three distinct periods in the eutrophic Lake Mendota's seasonal cycle (spring overturn, summer stratification and autumn overturn). Microcosm treatments enriched solely with phosphorus containing compounds did not result in a large bacterial community composition (BCC) change or community activity response (assessed via alkaline phosphatase activity, APA) relative to the controls during any season. Treatments enriched with carbon‐ and nitrogen‐containing compounds resulted in a dramatic BCC change and a large APA increase in the autumn and spring seasons, but only treatments receiving carbon, nitrogen and phosphorus (CNP) exhibited similar responses in the summer season. Despite the fact that the amendments created similar CNP concentration conditions across seasons, the BCC following amendment greatly varied among seasons. 16S rRNA gene sequence analysis indicated that many common freshwater bacterial lineages from the Alpha‐ and Betaproteobacteria class and Bacteroidetes phylum were favoured following nutrient (CNP) addition, but individual taxa were generally not favoured across all seasons. Targeted quantitative PCR analysis revealed that the abundance of the Actinobacteria acIB1 cluster decreased in all microcosms during all three seasons, while the Flavobacterium aquatile (spring) and ME‐B0 (summer) clusters of Bacteroidetes increased following CNP addition. These results suggest a particular bacterial group is not universally favoured by increased nutrient loads to a lake; therefore, efforts to predict which bacteria are involved in nutrient cycling during these periods must take into account the seasonality of freshwater bacterial communities.  相似文献   

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