FMRP inhibits translation elongation independent of mRNA G-quadruplexes

Loss of functional fragile X mental retardation protein (FMRP) causes fragile X syndrome, the leading form of inherited intellectual disability and the most common monogenic cause of autism spectrum disorders. FMRP is an RNA-binding protein that controls neuronal mRNA localization and translation. Notably, FMRP is thought to inhibit translation elongation after being recruited to target transcripts via binding RNA G-quadruplexes (G4s) within the coding sequence. Here we directly tested this model and report that FMRP inhibits translation elongation independent of mRNA G4s. Furthermore, we found that the RGG box motif together with its natural C-terminal domain forms a non-canonical RNA-binding domain (ncRBD) that binds reporter mRNA and all four polymeric RNA sequences. The ncRBD is essential for FMRP to inhibit translation. Transcripts that are bound by FMRP through the ncRBD co-sediment with heavy polysomes, which is consistent with stalling elongating ribosomes and a subsequent accumulation of slowed polysomes. Together, this work shifts our understanding of how FMRP inhibits translation elongation and supports a model where repression is driven by local FMRP and mRNA concentrations rather than target mRNA sequence.

PENGARUH SHIFT KERJA TERHADAP KELELAHAN KERJA PERAWAT DI UNIT RAWAT COVID-19 RSUD dr. DJASAMEN SARAGIH

Work weakness is portion of the common probelms that are regulary experienced within the work constrain, wearness can significantly affect the health of the workforce and can reduce productivity, including the nurse workforce. Fatigue is often caused by inappropriate working hours. Shift workers tend to be more prone to work burnout. Impactof work shift on nurse's work weakness in the unit covid-19 roomRSUD dr. Djasamen Saragih. The study used quantitative research with observational methods on 34 respondents. Univariat analysis showed that the majority of respondents experienced work fatigue, namely 20 people (58.8%) and not tired of work, namely 14 people (41.2%). From the results of the Bivariate analysis between work shifts and work weakness using the Chi-Square test, the p-value is 0.005. With p-value (0.005)<(0.05). This H0 is rejected and H1 is accepted. There’s an effect of work shifts on the work fatigue of nurses in the Covid-19 Inpatient room at dr. Djasamen Saragih in 2021.

Influence of medical trainee sleep pattern (chronotype) on burn-out and satisfaction with work schedules: a multicentre observational study

BackgroundMedical trainees’ work schedule is designed to cover duties without consideration of differences in circadian rhythms during a 24-hour period (chronotype).ObjectiveTo explore chronotype variation among medical trainees and understand its association with burn-out and schedule satisfaction.MethodsIn a multicentre observational study, we conducted two surveys between 1 October 2018 and 1 April 2019. Trainees from nine centres across the USA participated. We measured burn-out using Maslach Burnout Inventory (MBI), and trainee chronotype using the Morningness-Eveningness Questionnaire (MEQ).Results324 (32%) out of 1012 responded to our survey. Participants were 51% female and had a mean age of 30.8 years. Most participants had an intermediate MEQ type (65%). A large proportion of participants had burn-out on at least one of three tested MBI scales (62%); 5% of participants had burn-out on all three MBI scales. More participants with evening MEQ type had burn-out (66%) compared with morning MEQ type (55%), however, the results were not statically significant (p=0.294). Overall satisfaction with work shifts was 6.5 (95% CI 6.3 to 6.7), with higher satisfaction with day shift 7.7 (95% CI 7.5 to 7.9) and lowest satisfaction with overnight 24-hour call 3.5 (95% CI 3.2 to 3.9). Satisfaction was lower in trainees with burn-out 6.0 (95% CI 5.7 to 6.4), (p<0.001). In the follow-up survey, burn-out was present in at least one scale in 64% compared with 60% of respondents in the initial survey.ConclusionBurn-out is prevalent among medical trainees. Improving alignment between trainee preferences may improve performance, reduce human errors and burn-out.

ANALISIS KESELAMATAN KESEHATAN KERJA (K3) TERHADAP RISIKO BAHAYA LINGKUNGAN FISIK DENGAN METODE “HIRARC” DI RUMAH POTONG HEWAN KOTA PEKANBARU TAHUN 2020

ABSTRAK Rumah Potong Hewan merupakan suatu bangunan yang memiliki desain dan konstruksi khusus digunakan sebagai tempat pemotongan hewan. Aktivitas kerja di RPH memiliki potensi bahaya yang dapat mengancam keselamatan dan kesehatan kerja. Berdasarkan observasi awal, RPH Kota Pekanbaru ini tidak memiliki laporan bulanan maupun tahunan mengenai data kecelakaan, dan juga belum pernah melakukan identifikasi, dan penilaian terhadap bahaya yang ada. Adapun tujuan penelitian ini yaitu untuk menganalisis keselamatan kesehatan kerja (K3) terhadap risiko bahaya lingkungan fisik di tempat kerja dengan metode “HIRARC” (Hazard Identification, Risk Assessment, and Risk Control). Jenis penelitian ini adalah kualitatif analitik. Lokasi penenlitian dilakukan di rumah potong hewan Kota Pekanbaru, penelitian dilakukan pada bulan Juli-Agustus 2020. Informan dalam penelitian ini sebanyak 6 orang, sebagai informan utama yaitu Kepala UPTD, 2 orang informan pendukung yaitu koordinator lapangan dan dokter hewan, dan informan kunci yaitu pekerja, metode yang digunakan peneliti yaitu wawancara mendalam dan observasi langsung. Berdasarkan hasil penelitian yang dilakukan potensi bahaya tingkatan risiko “Ekstrim” seperti diseruduk sapi pada proses penggiringan sapi menuju killing box, tertimpa katrol dan sapi pada proses penggantungan dan pemindahan sapi menggunakan katrol. Rumah Potong Hewan belum pernah melakukan identifikasi bahaya, penilaian risiko akan tetapi untuk pengendalian risiko sudah dilakukan beberapa upaya di rumah potong hewan, seperti SOP, Shift kerja, dan juga APD. Rekomendasi yang diberikan yaitu diharapkan sebaiknya RPH memiliki fasilitas yang berhubungan dengan kesehatan pekerja. Perlu adanya upaya pengendalian risiko secara engineering control, contohnya, membuat kerangkeng sapi. administrative control, seperti, memberikan sosialisasi, maintenance, housekeeping dan inspeksi, terhadap alat, mesin dan pekerja. ABSTRACTSlaughterhouse is a building having the design and construction specifically used as animal slaughterhouse. Slaughterhouse’s work activities have potential of hazards which can cause harm to workers’ safety and health. Based on pre observation, the slaughterhouse in Pekanbaru does not have any monthly and annual report about the data of accident. This livestock production also has no doing identification and assessment of hazard. The purposes of this study are to analyze occupational health and safety toward risk of danger physical environment at work, this study uses Hazard Identification, Risk Assessment, and Risk Control “HIRARC” method which using likelihood and severity level of each hazard as references to define a risk value. There are 6 informants the maininfromants is a UPTD head, 2 supporting informants are the field coordinator and venetarian, and the key informant is a worker, The methode that use in this study is interview And observation. The study shows that the most extreme are getting hit by a cow in cattle herding to killing box, falling of a cow hoist material from conveyor railing in shackling and hoisting process. Slaughterhouse has never done hazard identification and risk assessment. However, for risk control have done several attempts in slaughterhouse, such as Standard Operating Procedures, work shifts, and Personal Protective Equipment. Recommendation is given that the slaughterhouse should has facilities related to health of workers. It needs an effort to risk control through engineering control such as making cow cages, administrative control, such as giving socialization, maintenance, housekeeping and inspection of tools, machines and workersKeywords : Slaughterhouse, Hazard, Risk, Physical Environtmen, HIRARC.

44. Impact of Nursing Home (NH) Universal Decolonization and COVID Prevention Training on COVID-19 Burden During the 2020-2021 Winter Surge in Orange County (OC), California (CA)

Background OC is the 6th largest U.S. county with 70 NHs. Universal decolonization (chlorhexidine for routine bathing, and twice daily nasal iodophor Mon-Fri every other week) was adopted in 24 NHs prior to the COVID-19 pandemic, and 12 NHs (11 of those adopting decolonization) participated in a COVID prevention training program with a rolling launch from July-Sept 2020. We evaluated the impact of these initiatives on staff and resident COVID cases. Methods We conducted a quasi-experimental study of the impact of decolonization and COVID prevention training on staff and resident COVID cases during the CA winter surge (11/16/20-1/31/21), when compared to non-participating NHs. Decolonization NHs received weekly visits for encouraging adherence during the pandemic, and NHs in the COVID training program received 3 in-person training sessions for all work shifts plus weekly feedback about adherence to hand hygiene, masking, and breakroom safety using video monitoring. We calculated incident 1) staff COVID cases, 2) resident COVID cases, and 3) resident COVID deaths adjusting for NH average daily census. We assessed impact of initiatives on these outcomes using linear mixed effects models testing the interaction between any training participation and calendar date when clustering by NH. Because of the overlap of the two initiatives, we evaluated ‘any training’ vs ‘no training.’ Results 63 NHs had available data. 24 adopted universal decolonization, 12 received COVID training (11 of which participated in decolonization), and 38 were not enrolled in either. During the winter surge, the 63 NHs experienced 1867 staff COVID cases, 2186 resident COVID cases, and 251 resident deaths due to COVID, corresponding to 29.6, 34.7, and 4.0 events per NH, respectively. In NHs participating in either initiative, staff COVID cases were reduced by 31% (OR=0.69 (0.52, 0.92), P=0.01), resident COVID cases were reduced by 43% (OR=0.57 (0.39, 0.82), P=0.003), and resident deaths were reduced (non-significantly) by 26% (OR=0.74 (0.46, 1.21), P=0.23). The grey box represents the California COVID-19 winter surge (11/16/20-1/31/21). Incident and cumulative COVID-19 cases and deaths for each nursing home were divided by the nursing home’s average daily census and multiplied by 100, representing events per 100 beds, which were aggregated across groups. Conclusion NHs are vulnerable to COVID-19 outbreaks. A universal decolonization and COVID prevention training initiative in OC, CA significantly reduced staff and resident COVID cases in this high-risk care setting. Disclosures Gabrielle Gussin, MS, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Stryker (Sage) (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic products)Xttrium (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic products) Raveena Singh, MA, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Stryker (Sage) (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic products)Xttrium (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic products) Shruti K. Gohil, MD, MPH, Medline (Other Financial or Material Support, Co-Investigator in studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Molnycke (Other Financial or Material Support, Co-Investigator in studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Stryker (Sage) (Other Financial or Material Support, Co-Investigator in studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products) Raheeb Saavedra, AS, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Stryker (Sage) (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic products)Xttrium (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic products) Robert Pedroza, BS, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products) Chase Berman, BS, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products) Susan S. Huang, MD, MPH, Medline (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Molnlycke (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Stryker (Sage) (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)Xttrium (Other Financial or Material Support, Conducted studies in which participating hospitals and nursing homes received contributed antiseptic and cleaning products)

A new two-stage nurse scheduling approach based on occupational justice considering assurance attendance in works shifts by using Z-number method: A real case study

In this paper, a new binary integer programming mathematical model for scheduling nurses' problems in the emergency department of Kamkar Hospital in Qom province is developed. The manual arrangement of nurses by the head nurse and its time-consuming, occasional absences during the period and protests against injustices in the arrangement of nurses' work shifts were among the emergency department's challenges before implementing the model. Most relevant studies aimed to enhance nurses' satisfaction by creating a general balance considering occupational preferences. Thus, the present study pursued justice through considering preferences based on the results from periodical evaluations of each nurse's performance with the ultimate goal of improving nurses' satisfaction. Moreover, the lack of clarity in selecting shifts, which may cause irregular attendance, was improved using the Z-number method. After the run of the model, the rate of nurses' absences decreased by 40%, the rate of complaints about the performance of the nursing unit decreased by 50%. Also, nurses' satisfaction increased by 30% after the implementation of the model.

Generation of infectious waste during the COVID-19 pandemic: The case of a Brazilian hospital

Coronavirus-19 disease (COVID-19) acquired pandemic status in March 2020. The new virus has caused serious implications in the healthcare services management, including several sectors, among them the generation of waste. Healthcare wastes (HCW) generation increased along pandemic representing a health problem due to potentially infected ones. From this perspective, the study sought to analyse the challenges and changes imposed by COVID-19 in the HCW management in a large public hospital from Brazil. For this purpose, data about the Contingency Plan prepared by the hospital and HCW generation from 2017 to 2020 were used, analysed by statistical methods. When dealing with the Contingency Plan, the Brazilian hospital adopted measures similar to other hospitals around the world as described by the literature, such as: adoption of new protocols, specific team assigned to manage actions and training of professionals and suspension of elective surgeries. Regarding the generation of HCW, there was a significant increase in the mass of biological waste with a high risk of infection. The waste of this group increased from March 2020, coinciding with the start of care for the patients infected by COVID-19. The contribution of this type of waste to total generation jumped from approximately 0.2% in previous years to almost 5% in 2020. In addition, a reduction in the average of total waste generated in kilogrammes per bed per day from 2017 to 2019 was indicated compared to the 2020. COVID-19 pandemic led to major challenges for hospitals that had to care for patients infected with the SARS-CoV-2 virus, including new protocols, changing the work shifts and training the teams in the new procedures. The biological waste with a high risk of infectiousness also increased 30 times.