BackgroundSleep restriction, leading to deprivation of sleep, is common in modern 24-h societies and is associated with the development of health problems including cardiovascular diseases. Our objective was to investigate the immunological effects of prolonged sleep restriction and subsequent recovery sleep, by simulating a working week and following recovery weekend in a laboratory environment.Methods and FindingsAfter 2 baseline nights of 8 hours time in bed (TIB), 13 healthy young men had only 4 hours TIB per night for 5 nights, followed by 2 recovery nights with 8 hours TIB. 6 control subjects had 8 hours TIB per night throughout the experiment. Heart rate, blood pressure, salivary cortisol and serum C-reactive protein (CRP) were measured after the baseline (BL), sleep restriction (SR) and recovery (REC) period. Peripheral blood mononuclear cells (PBMC) were collected at these time points, counted and stimulated with PHA. Cell proliferation was analyzed by thymidine incorporation and cytokine production by ELISA and RT-PCR. CRP was increased after SR (145% of BL; p<0.05), and continued to increase after REC (231% of BL; p<0.05). Heart rate was increased after REC (108% of BL; p<0.05). The amount of circulating NK-cells decreased (65% of BL; p<0.005) and the amount of B-cells increased (121% of BL; p<0.005) after SR, but these cell numbers recovered almost completely during REC. Proliferation of stimulated PBMC increased after SR (233% of BL; p<0.05), accompanied by increased production of IL-1β (137% of BL; p<0.05), IL-6 (163% of BL; p<0.05) and IL-17 (138% of BL; p<0.05) at mRNA level. After REC, IL-17 was still increased at the protein level (119% of BL; p<0.05).Conclusions5 nights of sleep restriction increased lymphocyte activation and the production of proinflammatory cytokines including IL-1β IL-6 and IL-17; they remained elevated after 2 nights of recovery sleep, accompanied by increased heart rate and serum CRP, 2 important risk factors for cardiovascular diseases. Therefore, long-term sleep restriction may lead to persistent changes in the immune system and the increased production of IL-17 together with CRP may increase the risk of developing cardiovascular diseases.

Nordic walking intervention seems to decrease chemerin and leptin levels, and subjects in this intervention group achieved the most beneficial effects on components of MeS.

Objective-To assess whether monthly treatment with intravenous methylprednisolone enhances or accelerates the effect of disease modifying drugs in patients with rheumatoid arthritis. Design-A 12 month double blind, placebo controlled, multicentre trial in which patients with active

IntroductionNursing personnel have high risk for incidence of low back pain (LBP) followed by development of chronic pain and disability. Multiple risk factors such as patient handling, night shift work and lack of supporting work culture have been identified. In subacute LBP, high-fear avoidance is prognostic for more pain, disability and not returning to work. Lack of leisure-time physical activity predicts long-term sickness absence. The purpose of this study is to compare effectiveness of 6-month neuromuscular exercise and counselling in treating back pain in female nursing personnel with recurrent non-specific LBP pain compared with either (exercise or counselling) alone and a non-treatment control group.Methods and analysisThe design is of a double-blinded four-arm randomised controlled trial with cost-effectiveness evaluation at 12 and 24 months. The study is conducted in 3 consecutive substudies. The main eligibility criteria are experience of LBP during the past 4 weeks with intensity of at least 2 (Numeric Rating Scale 0–10) and engagement in patient handling. Sample size was estimated for the primary outcome of pain intensity (visual analogue scale). Study measurements are outlined according to the model of International Classification of Functioning, Disability and Health, which incorporates the biopsychosocial processes assessed.Ethics and disseminationThis study is carried out conforming to the guidelines of good scientific practice and provisions of the declaration of Helsinki. Increasing physical and mental capacity with interventions taking place immediately after working hours near the worksite may reduce development of chronic LBP and work disability in female nursing personnel with recurrent non-specific LBP.Trial registration numberNCT04165698.

The purpose of this study is to perform a multiparametric analysis on the environmental factors, the physiological stress reactions in the body, the measured alertness, and the subjective symptoms during simulated office work. Volunteer male subjects were monitored during three 4-hr work meetings in an office room, both in a ventilated and a non-ventilated environment. The environmental parameters measured included CO(2), temperature, and relative humidity. The physiological test battery consisted of measuring autonomic nervous system functions, salivary stress hormones, blood's CO(2)- content and oxygen saturation, skin temperatures, thermal sensations, vigilance, and sleepiness. The study shows that we can see physiological changes caused by high CO(2) concentration. The findings support the view that low or moderate level increases in concentration of CO(2) in indoor air might cause elevation in the blood's transcutaneously assessed CO(2). The observed findings are higher CO(2) concentrations in tissues, changes in heart rate variation, and an increase of peripheral blood circulation during exposure to elevated CO(2) concentration. The subjective parameters and symptoms support the physiological findings. This study shows that a high concentration of CO(2) in indoor air seem to be one parameter causing physiological effects, which can decrease the facility user's functional ability. The correct amount of ventilation with relation to the number of people using the facility, functional air distribution, and regular breaks can counteract the decrease in functional ability. The findings of the study suggest that merely increasing ventilation is not necessarily a rational solution from a technical-economical viewpoint. Instead or in addition, more comprehensive, anthropocentric planning of space is needed as well as instructions and new kinds of reference values for the design and realization of office environments.