The effect of wind turbine noise on polysomnographically-measured and self-reported sleep latency in wind turbine noise naïve participants

SLEEP ◽  
2021 ◽  
Author(s):  
Tessa Liebich ◽  
Leon Lack ◽  
Gorica Micic ◽  
Kristy Hansen ◽  
Branko Zajamsek ◽  
...  

Abstract Study Objectives Wind turbine noise exposure could potentially interfere with the initiation of sleep. However, effects on objectively assessed sleep latency are largely unknown. This study sought to assess the impact of wind turbine noise on polysomnographically-measured and sleep diary-determined sleep latency compared to control background noise alone in healthy good sleepers without habitual prior wind turbine noise exposure. Methods Twenty-three wind turbine noise naïve urban residents (mean±standard deviation age: 21.7±2.1 years, range 18-29, 13 females) attended the sleep laboratory for two polysomnography studies, one week apart. Participants were blind to noise conditions and only informed that they may or may not hear noise during each night. During the sleep onset period, participants were exposed to counterbalanced nights of wind turbine noise at 33 dB(A), the upper end of expected indoor values; or background noise alone as the control condition (23 dB(A)). Results Linear mixed model analysis revealed no differences in log10 normalized objective or subjective sleep latency between the wind turbine noise versus control nights (median [interquartile range] objective 16.5 [11.0 to 18.5] versus 16.5 [10.5 to 29.0] minutes, p = 0.401; subjective 20.0 [15.0 to 25.0] versus 15.0 [10.0 to 30.0] minutes, p = 0.907). Conclusions Although undetected small effects cannot be ruled out, these results do not support that wind turbine noise extends sleep latency in young urban dwelling individuals without prior wind turbine noise exposure.

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A1-A2
Author(s):  
T Liebich ◽  
L Lack ◽  
G Micic ◽  
K Hansen ◽  
B Zajamsek ◽  
...  

Abstract Introduction Well-controlled studies of wind farm noise (WFN) on sleep are lacking despite complaints and known effects of other noise types on sleep. This laboratory-based study investigated the impact of continuous full-night WFN exposure replicated from field recordings on polysomnography-measured (objective) and sleep diary-determined (subjective) sleep efficiency compared to a quiet control night. Methods Based on residential location and self-report data, 50 participants were categorised into three groups (14 living <10km from a wind farm and self-reporting sleep disturbance; 19 living <10km from a wind farm and self-reporting no sleep disturbance and 18 controls living in a quiet rural area). Participants underwent full in-laboratory polysomnography during exposure to continuous WFN (25 dB(A)) throughout the night and a quiet control night (background noise 19 dB(A)) in random order. Group and noise condition effects were examined via linear mixed model analysis. Results Participants (30 females) were aged (mean±SD) 54.9±17.6 range: 18–80 years. Sleep efficiency in the control condition was (median [interquartile range]) objective: 85.5 [77.4 to 91.2]%; subjective: 85.7 [69.2 to 92.7]%) versus the WFN condition (objective: 86.1 [78.6 to 91.7]% subjective: 85.8 [66.2 to 93.8]%) with no significant main or interaction effects of group or noise condition (all p’s >0.05). Conclusion These results do not support that WFN at 25 dB(A) significantly impacts objective or subjective sleep efficiency in participants with or without prior WFN exposure or self-reported WFN-related sleep disturbance. Further analyses to investigate potential sleep micro-structural changes remain warranted.


Author(s):  
Judith Rösler ◽  
Stefan Georgiev ◽  
Anna L. Roethe ◽  
Denny Chakkalakal ◽  
Güliz Acker ◽  
...  

AbstractExoscopic surgery promises alleviation of physical strain, improved intraoperative visualization and facilitation of the clinical workflow. In this prospective observational study, we investigate the clinical usability of a novel 3D4K-exoscope in routine neurosurgical interventions. Questionnaires on the use of the exoscope were carried out. Exemplary cases were additionally video-documented. All participating neurosurgeons (n = 10) received initial device training. Changing to a conventional microscope was possible at all times. A linear mixed model was used to analyse the impact of time on the switchover rate. For further analysis, we dichotomized the surgeons in a frequent (n = 1) and an infrequent (n = 9) user group. A one-sample Wilcoxon signed rank test was used to evaluate, if the number of surgeries differed between the two groups. Thirty-nine operations were included. No intraoperative complications occurred. In 69.2% of the procedures, the surgeon switched to the conventional microscope. While during the first half of the study the conversion rate was 90%, it decreased to 52.6% in the second half (p = 0.003). The number of interventions between the frequent and the infrequent user group differed significantly (p = 0.007). Main reasons for switching to ocular-based surgery were impaired hand–eye coordination and poor depth perception. The exoscope investigated in this study can be easily integrated in established neurosurgical workflows. Surgical ergonomics improved compared to standard microsurgical setups. Excellent image quality and precise control of the camera added to overall user satisfaction. For experienced surgeons, the incentive to switch from ocular-based to exoscopic surgery greatly varies.


Author(s):  
Amy L Petry ◽  
Nichole F Huntley ◽  
Michael R Bedford ◽  
John F Patience

Abstract In theory, supplementing xylanase in corn-based swine diets should improve nutrient and energy digestibility and fiber fermentability, but its efficacy is inconsistent. The experimental objective was to investigate the impact of xylanase on energy and nutrient digestibility, digesta viscosity, and fermentation when pigs are fed a diet high in insoluble fiber (>20% neutral detergent fiber; NDF) and given a 46-d dietary adaptation period. Three replicates of 20 growing gilts were blocked by initial body weight, individually housed, and assigned to 1 of 4 dietary treatments: a low-fiber control (LF) with 7.5% NDF, a 30% corn bran high-fiber control (HF; 21.9% NDF), HF+100 mg xylanase/kg [HF+XY, (Econase XT 25P; AB Vista, Marlborough, UK)] providing 16,000 birch xylan units/kg; and HF+50 mg arabinoxylan-oligosaccharide (AXOS) product/kg [HF+AX, (XOS 35A; Shandong Longlive Biotechnology, Shandong, China)] providing AXOS with 3-7 degrees of polymerization. Gilts were allowed ad libitum access to fed for 36-d. On d 36, pigs were housed in metabolism crates for a 10-d period, limit fed, and feces were collected. On d 46, pigs were euthanized and ileal, cecal, and colonic digesta were collected. Data were analyzed as a linear mixed model with block and replication as random effects, and treatment as a fixed effect. Compared with LF, HF reduced the apparent ileal digestibility (AID), apparent cecal digestibility (ACED), apparent colonic digestibility (ACOD), and apparent total tract digestibility (ATTD) of dry matter (DM), gross energy (GE), crude protein (CP), acid detergent fiber (ADF), NDF, and hemicellulose (P<0.01). Relative to HF, HF+XY improved the AID of GE, CP, and NDF (P<0.05), and improved the ACED, ACOD, and ATTD of DM, GE, CP, NDF, ADF, and hemicellulose (P<0.05). Among treatments, pigs fed HF had increased hindgut DM disappearance (P=0.031). Relative to HF, HF+XY improved cecal disappearance of DM (162 vs. 98g; P=0.008) and NDF (44 vs. 13g; P<0.01). Pigs fed xylanase had a greater proportion of acetate in cecal digesta and butyrate in colonic digesta among treatments (P<0.05). Compared with LF, HF increased ileal, cecal, and colonic viscosity, but HF+XY decreased ileal viscosity compared with HF (P<0.001). In conclusion, increased insoluble corn-based fiber decreases digestibility, reduces cecal fermentation, and increases digesta viscosity, but supplementing xylanase partially mitigated that effect.


2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Nicolaas P. Pronk ◽  
A. Lauren Crain ◽  
Jeffrey J. VanWormer ◽  
Brian C. Martinson ◽  
Jackie L. Boucher ◽  
...  

Objective.To determine the accuracy of self-reported body weight prior to and following a weight loss intervention including daily self-weighing among obese employees.Methods.As part of a 6-month randomized controlled trial including a no-treatment control group, an intervention group received a series of coaching calls, daily self-weighing, and interactive telemonitoring. The primary outcome variable was the absolute discrepancy between self-reported and measured body weight at baseline and at 6 months. We used general linear mixed model regression to estimate changes and differences between study groups over time.Results.At baseline, study participants underreported their weight by an average of 2.06 (se=0.33) lbs. The intervention group self-reported a smaller absolute body weight discrepancy at followup than the control group.Conclusions.The discrepancy between self-reported and measured body weight appears to be relatively small, may be improved through daily self-monitoring using immediate-feedback telehealth technology, and negligibly impacts change in body weight.


2018 ◽  
Vol 4 (1) ◽  
pp. 16-23
Author(s):  
Fitri Haryanti ◽  
Mohammad Hakimi ◽  
Yati Sunarto ◽  
Yayi S Prabandari

Background: Although the WHO strategy integrated management of childhood illness (IMCI) for primary care has been implemented in over 100 countries, there is less global experience with hospital-based IMCI training. Until recently, no training had been done in Indonesia, and globally there has been limited experience of the role of IMCI in rebuilding health systems after complex emergencies.Objective: We aimed to examine the effect of hospital-based IMCI training on pedicatric nurse competency and explore the perception of Indonesian doctors, nurse managers and paediatricians about IMCI training and its development in West Aceh, a region that was severely affected by the South-Asian tsunami in December 2004.Methods: This study used stepped wedge design. Training was conducted for 39 nurses staff, 13 midwifes, 6 Head nurses, 5 manager of nurses, 5 doctors, 1 paediatricians, and 3 support facilities  (nutritionist, pharmacist, laboratory) in Cut Nyak Dien (CND) Hospital in Meulaboh, West Aceh, Indonesia. The IMCI training was developed based on the WHO Pocketbook of Hospital Care for Children. A nurses competency questionnaire was used based on the guideline of assessment of the quality of child health services at the first level reference hospitals in districts / municipalities issued by the Ministry of Health in 2007. A linear mixed model was used for data analysis.Results: The hospital based IMCI training improved the competences of nurses paediatric in assessing emergency signs of the sick children, management of cough and difficulty breathing, diarrhoea, fever, nutritional problems, supportive care, monitoring, discharge planning and follow up.  The assessment highlighted several problems in adaptation process of material training, training process and implementation in an environment soon after a major disaster.Conclusion: Hospital based IMCI training can be implemented in a setting after major disasters or internal conflict as part of a rebuilding process.  The program requires strong management support and the emergency phase to be subsided.  Other pre-requisites include the existence of standard operating procedures, adequate physical facilities and support for staff morale and well-being.  Improving the quality of paediatric care requires more than just training and clinical guidelines; internal motivation and health worker support are essential.


2021 ◽  
Author(s):  
David J Pascall ◽  
Guy Mollett ◽  
Rachel Blacow ◽  
Naomi Bulteel ◽  
Robyn Campbell ◽  
...  

Background The Alpha (B.1.1.7) SARS-CoV-2 variant of concern has been associated with increased transmission and increased 28-day mortality. We aimed to investigate the impact of infection on clinical severity of illness, including the need for oxygen or ventilation in a national cohort study. Methods In this prospective clinical cohort study, 1475 SARS-CoV-2 sequences were obtained from patients infected in Scotland, UK between the 1st November 2020 and 30th January 2021 and matched to clinical outcomes as the lineage became dominant in Scotland. We modelled the association between B.1.1.7 infection and severe disease using a cumulative generalised linear mixed model employing a 4-point scale of maximum severity based on requirement of respiratory support at 28 days. We also estimated the growth rate of B.1.1.7-associated infections as it emerged in Scotland using a phylogenetic exponential growth rate population model. Results The B.1.1.7 lineage was responsible for a third wave of SARS-CoV-2 infection in Scotland in association with a transmission rate 5-fold higher than the preceding second wave B.1.177 lineage. Of 1475 patients, 364 were infected with B.1.1.7, 1030 with B.1.177 and 81 with other lineages. Our analysis found a positive association between increased clinical severity and lineage (B.1.1.7 versus non-B.1.1.7; cumulative odds ratio: 1.40, 95% CI: 1.02, 1.93). Viral load was higher in B.1.1.7 samples than in non-B.1.1.7 samples, as measured by cycle threshold (Ct) value (mean Ct change: -2.46, 95% CI: -4.22, -0.70). Conclusions The B.1.1.7 lineage was associated with more severe clinical disease in Scottish patients than co-circulating lineages.


2021 ◽  
Author(s):  
Yvonne Kutzer ◽  
Lisa Whitehead ◽  
Eimear Quigley ◽  
Shih Ching Fu ◽  
Mandy Stanley

BACKGROUND The current Covid-19 pandemic has brought about a marked interest in sleep health, as well as an increased demand for telehealth services, such as online Cognitive Behavioral Therapy for insomnia (CBT-I). Older adults in particular report a high rate of sleep problems. Recent studies have suggested that dysfunctional sleep beliefs could contribute to the high rates of self-reported insomnia in this age group. In addition, older adults have an increased rate of uncoupled sleep, e.g. displaying an insomnia complaint in the absence of objectively measured poor sleep. It is essential to determine the prevalence of coupled and uncoupled sleep in older adults and to examine the efficacy of online CBT-I to improve sleep outcomes. OBJECTIVE This study aims to assess objective and subjective sleep quality and dysfunctional sleep beliefs in a sample of community-dwelling older adults aged 60-80 years with and without uncoupled sleep in Western Australia following digitally delivered CBT-I. METHODS Objective sleep was measured using wrist actigraphy, and subjective sleep quality via sleep diaries and the Pittsburgh Sleep Quality Index (PSQI). Dysfunctional sleep beliefs were assessed by the Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS-16) prior to and following a four-week online CBT-I programme. Linear mixed model and generalised linear mixed model analyses were conducted to examine objective and subjective sleep onset latency, total sleep time, wake after sleep onset and number of awakenings as well as PSQI and DBAS16 scores, respectively. RESULTS 62 participants (55 females; 88.7%) completed the study. CBT-I effectively reduced dysfunctional sleep beliefs and PSQI scores across all sleep classifications, even in good sleepers without a sleep complaint. Objective and self-reported changes in sleep parameters were mainly demonstrated in complaining poor sleepers. Complaining good sleepers reported a decrease in the number of subjective sleep awakenings only. CONCLUSIONS Online CBT-I was effective in improving the sleep outcomes of individuals who had both subjective and objective poor sleep. However, as the online CBT-I reduced dysfunctional sleep beliefs in all sleep groups, further examination of dysfunctional sleep beliefs and whether they mediate the outcomes of digital CBT-I in older adults will need to be conducted. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN 12619001509156; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378451 INTERNATIONAL REGISTERED REPORT RR2-32705


2019 ◽  
Vol 41 (4) ◽  
pp. 214-221
Author(s):  
Anny P. Castilla-Earls ◽  
Brittany Harvey ◽  
Katrina Fulcher-Rood ◽  
Christopher D. Barr

The purpose of this study was to examine the impact of clinical review bias on the coding of grammaticality in child language. Seventy-four native-English students studying communication disorders and sciences made judgments about the grammaticality of 250 utterances presented in five language samples. Each language sample included grammatical, ungrammatical, and ambiguous utterances. Participants were randomly assigned to a blind or nonblind group. The nonblind group was presented with diagnostic information, whereas the blind group was not. We employed a generalized linear mixed model to examine the binary data. Our results suggest that both blind and nonblind participants were accurate in judging grammatical and ungrammatical utterances. However, nonblind participants were slightly more likely to judge ambiguous utterances as ungrammatical when the language sample identified the child as having a language impairment, suggesting that there was an effect of clinical review bias in this study. This effect, although statistically significant, was small.


2020 ◽  
Vol 58 (5) ◽  
pp. 915-922
Author(s):  
Ting-Tse Lin ◽  
Ming-Hsien Lin ◽  
Cho-Kai Wu ◽  
Lian-Yu Lin ◽  
Jou-Wei Lin ◽  
...  

Abstract OBJECTIVES Serial lactate (clearance) data are commonly used for risk stratification in patients receiving veno-arterial extracorporeal life support (ECLS). METHODS We retrospectively analysed 855 patients who had undergone ECLS due to cardiac (n = 578) and non-cardiac (n = 277) aetiologies between 2002 and 2013 at National Taiwan University Hospital. Serial lactate (clearance) data were collected before ECLS and at 8, 16, 24, 48 and 72 h after ECLS. To investigate the impact of lactate (clearance) levels on 180-day survival, we performed linear mixed model and joint model analyses using the Bayesian approach. RESULTS Among the 855 patients, 564 (65.9%) patients died within 180 days after ECLS cannulation. The joint model showed that the effect of lactate on survival was null in both the reduced model and the fully adjusted model. However, an effect of lactate clearance on survival was observed in the reduced model [estimate 0.004; 95% confidence interval (CI) 0.002–0.006] and the fully adjusted model (estimate 0.003; 95% CI 0.001–0.005). In a further secondary analysis, lactate clearance (hazard ratio 0.861; 95% CI 0.813–0.931) at 16 h after ECLS cannulation was determined to be a risk factor for mortality. According to a receiver operating characteristic curve analysis, the SAVE score combined with lactate clearance (area under curve = 0.881) showed good outcome discrimination. CONCLUSIONS Incorporating lactate clearance at 16 h after ECLS cannulation into the SAVE system improved the predictive value for mortality in patients receiving ECLS.


Author(s):  
Julia Ageborg Morsing ◽  
Michael Smith ◽  
Mikael Ögren ◽  
Pontus Thorsson ◽  
Eja Pedersen ◽  
...  

The number of onshore wind turbines in Europe has greatly increased over recent years, a trend which can be expected to continue. However, the effects of wind turbine noise on long-term health outcomes for residents living near wind farms is largely unknown, although sleep disturbance may be a cause for particular concern. Presented here are two pilot studies with the aim of examining the acoustical properties of wind turbine noise that might be of special relevance regarding effects on sleep. In both pilots, six participants spent five consecutive nights in a sound environment laboratory. During three of the nights, participants were exposed to wind turbine noise with variations in sound pressure level, amplitude modulation strength and frequency, spectral content, turbine rotational frequency and beating behaviour. The impact of noise on sleep was measured using polysomnography and questionnaires. During nights with wind turbine noise there was more frequent awakening, less deep sleep, less continuous N2 sleep and increased subjective disturbance compared to control nights. The findings indicated that amplitude modulation strength, spectral frequency and the presence of strong beats might be of particular importance for adverse sleep effects. The findings will be used in the development of experimental exposures for use in future, larger studies.


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