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The article analyses studies on the impact of the COVID-19 pandemic on outpatient services in a large hospital, aiming to provide insights for resource management amidst disruptive events. The objectives include identifying challenges and proposing solutions to optimize service delivery and address spatial constraints using discrete-event simulation. Utilizing a case study approach, the research employs simulation as a key methodology to analyse outpatient service scenarios. Scenarios are generated by combining different probabilities of patient return to check-in with various team parameterizations. The researchers analysed historical data and key performance indicators from the simulation. The study focuses on a collaborative approach with the hospital team to ensure the relevance and applicability of proposed solutions. The research identifies bottlenecks induced by social distancing measures, particularly in patient reception and check-in areas. Uneven service distribution throughout the day leads to a misallocation of resources and reduction of available physical space. Telemedicine emerges as a significant response, effectively addressing both service optimization and physicians’ workload despite spatial constraints. Additionally, the study underscores the role of simulation in crisis decision-making for hospital operations management. Practical applications emanating from the study emphasize the need for healthcare institutions to adopt adaptable strategies and leverage simulation tools for effective resource management during disruptive events. Hospital administrators can draw insights to inform resource reallocation and workflow optimization, with a focus on negotiating flexible scheduling and exploring telemedicine to enhance service delivery.

Background/Objectives Studies in rodents indicate that disruptions in both cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) signaling pathways are involved in the development of hyperactive behavior. We examined whether vinpocetine, a phosphodiesterase type 1 inhibitor that enhances brain cAMP and cGMP levels, could mitigate locomotor hyperactivity in mice exposed to lead during early development. Methods Swiss mice were exposed to 90 ppm of lead in their drinking water throughout gestation and the first ten postnatal days. At postnatal day 10 (PN10), blood lead levels (BLLs) were about 30 µg/dL. At PN30, animals either received vinpocetine (20 mg/kg, i.p.) or a vehicle 4 h before the evaluation of locomotor activity in the open field. Results Lead-exposed males did not display differences in locomotor activity compared to controls, while lead-exposed females showed a significant increase in locomotion. Vinpocetine treatment significantly reversed the lead-induced hyperactivity in females. Conclusions These findings suggest that the cAMP and cGMP signaling pathways play a role in the hyperactivity induced by lead exposure. [ABSTRACT FROM AUTHOR]

In this work, a novel optimisation-simulation based on the Recursive Optimisation-Simulation Approach (ROSA) methodology is developed to provide effective decision-support for integrated production planning and scheduling. The proposed iterative approach optimises production plans while satisfying complex scheduling constraints, such as robots' allocation in collaborative tasks. The plans are determined through a two-level MILP model and are iteratively evaluated by a detailed discrete-event simulation model to guarantee capacity-feasible solutions at the scheduling level. Through an industrial case study of a multistage assembly line design collaboratively operated by humans and mobile shared robots, near-optimal solutions comprise lot-sizing decisions, the release schedule of production orders, the allocation of tasks to humans or robots, and the number of robots per period. Moreover, by addressing a set of propositions to assess the methodology, the results highlight the advantages of the hybrid approach to converge into optimised operational decisions and analyse the process dynamics. [ABSTRACT FROM AUTHOR]

Many cross-sectional studies have shown that circadian rhythms change with age, but such age-related modifications are gradual and may be insufficiently described by cross-sectional studies. In this case study, circadian activity rhythm (CAR) was evaluated longitudinally, in both LD (12:12) and LL conditions, on two occasions in a single male marmoset: when ‘adult’ (3 y.o.) and when ‘old’ (9 y.o.). When adult, the CAR synchronized with positive phase angles for the onset and offset of activity. In LL, the rhythm free-ran with? < 24 h. When old, the animal showed a significant phase delay of its activity rhythm with respect to the LD cycle (t-test,p < 0.01) and a reduction on total daily activity (t-test,p < 0.01), with signs of lesser stability, greater fragmentation and some loss of photic synchronization. In LL, the period free-ran with? > 24 h. We conclude that aging is associated with attenuation of photic synchronization and expression of CAR in LL in the marmoset. Further studies with a larger number of individuals are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

The article discusses research which was conducted to investigate the physiological responses and activity profiles of small sided football games. Researchers evaluated 10 players who played on teams with between two and five members. They found that players on each type of team had different measurements of maximum heart rate, body load, rating of perceived exertion and number of sprints.

Natural daylight exposures in arctic regions vary substantially across seasons. Negative consequences have been observed in self-reports of sleep and daytime functions during the winter but have rarely been studied in detail. The focus of the present study set out to investigate sleep seasonality among indoor workers using objective and subjective measures. Sleep seasonality among daytime office workers ( n = 32) in Kiruna (Sweden, 67.86° N, 20.23° E) was studied by comparing the same group of workers in a winter and summer week, including work and days off at the weekend, using actigraphs (motion loggers) and subjective ratings of alertness and mood. Actigraph analyses showed delayed sleep onset of 39 min in winter compared to the corresponding summer week ( p < 0.0001) and shorter weekly sleep duration by 12 min ( p = 0.0154). A delay of mid-sleep was present in winter at workdays (25 min, p < 0.0001) and more strongly delayed during days off (46 min, p < 0.0001). Sleepiness levels were higher in winter compared to summer ( p < 0.05). Increased morning light exposure was associated with earlier mid-sleep ( p < 0.001), while increased evening light exposure was associated with delay ( p < 0.01). This study confirms earlier work that suggests that lack of natural daylight delays the sleep/wake cycle in a group of indoor workers, despite having access to electric lighting. Photic stimuli resulted in a general advanced sleep/wake rhythm during summer and increased alertness levels., Competing Interests: Conflicts of InterestThe authors declare no conflict of interest., (© 2018 by the authors.)

In marmosets, social synchrony between circadian profiles of activity is stronger in animals that cohabit in a family. The activity of three breeding pairs was recorded by actiwatches to investigate the mechanisms involved in the synchrony between the circadian activity profiles during cohabitation in marmoset reproductive pairs. The dyads were submitted to LD 12:12 (21 days) and LL: 1) cohabitation (24 days), 2) removal of the cage mate (20 days), 3) reintroduction of the mate into the cage of the 1 st situation (30 days) and 4) removal of the cage mate (7 days). Next, they were rejoined and maintained in LD 12:12 (11 days). In conditions involving cohabitation of pair, the general and maximum correlation indexes between circadian profiles were higher in cage mates compared to animals of the same or different sex with which they maintain only acoustic and olfactive contact. This strong synchrony between rhythms was accompanied by a stable phase relationship at the activity onset and offset, with identical circadian periods between mates. When the pairs were separated, there was a break in stability in the phase relationships between activity profiles with different circadian periods and a greater phase angle difference between rhythms of cage mates. During separation, two females and one male progressively anticipated the activity onset and offset in a phase similar to that in previous conditions, expressing entrainment to the mate. During the first reintroduction, two pairs exhibited signs of masking in rhythm. Although modulation in the rhythm of some animals has been observed through acoustic cues from animals outside the colony, we suggest that cohabitation favors strong synchrony between the circadian activity profiles of marmoset reproductive pairs involving synchronization by entrainment and masking. Further studies in the absence of external social cues are necessary to clarify the role of these mechanisms on social synchronization in marmosets.

Among the most co-occurring conditions in autism spectrum disorders (ASD), there are sleep disorders which may exacerbate associated behavioral disorders and lead to intensification of existing autistic symptoms. Several studies investigating the use of melatonin in the treatment of sleep disorders in ASD have shown comparative efficiency in sleep with little or no side effects. Here we report a case of ASD with non-24-hour rhythm and the effect of melatonin in circadian parameters by actigraphy. Visual analysis of the first 10 days recorded and the periodogram suggest that this patient showed a non-24-hour rhythm. This ASD subject showed before melatonin administration an activity/rest rhythm lower than 24 hours. The results show that melatonin increased approximately 4.7 times the regularity of circadian activity rhythm and resting staying on average between 00:00 and 06:00 and showed positive effects in improving the quality of sleep and behavior. So, the actigraphy showed an ASD subject with a non-24-hour activity/rest rhythm which changed this rhythm to a 24-hour rhythm after melatonin administration. This result reinforces the prospect of therapy with melatonin for synchronization (increased regularity) of endogenous rhythms and improve sleep quality and hence behavior and indicates the actigraphy as a choice tool to characterize several parameters of the activity/rest rhythm of ASD individuals.

In marmosets, a phase advance was observed in activity onset in pubertal animals living in captivity under semi-natural conditions which had stronger correlation with the times of sunrise over the course of the year than the age of the animal. In order to evaluate the effect of puberty on the circadian activity rhythm in male and female marmosets living in family groups in controlled lighting conditions, the activity of 5 dyads of twins (4 ♀/♂ and 1 ♂/♂) and their respective parents was continuously monitored by actiwatches between the 4th and 12th months of age. The families were kept under LD 12:12 h with constant humidity and temperature. The onset of puberty was identified by monitoring fecal steroids. Juveniles showed higher totals of daily activity and differences in the daily distribution of activity in relation to parents, in which the bimodal profile was characterized by higher levels in evening activity in relation to morning activity. Regarding the phase, the activity onset and offset, occurred later in relation to parents. After entering puberty, the activity onset and offset occurred later and there was an increase in total daily activity. On the other hand, when assessing the effect of sex, only females showed a delay in the activity offset and an increase in total daily activity. Therefore, the circadian activity rhythm in marmosets has peculiar characteristics in the juvenile stage in relation to the total of daily activity, the onset and offset of the active phase, and the distribution of activity during this phase. Besides, the entering puberty was associated with a phase delay and increase on total daily activity, with differences between sexes, possibly due to hormonal influences and/or social modulation on rhythm.

Circadian rhythmicity in humans has been well studied using actigraphy, a method of measuring gross motor movement. As actigraphic technology continues to evolve, it is important for data analysis to keep pace with new variables and features. Our objective is to study the behavior of two variables, interdaily stability and intradaily variability, to describe rest activity rhythm. Simulated data and actigraphy data of humans, rats, and marmosets were used in this study. We modified the method of calculation for IV and IS by modifying the time intervals of analysis. For each variable, we calculated the average value (IVm and ISm) results for each time interval. Simulated data showed that (1) synchronization analysis depends on sample size, and (2) fragmentation is independent of the amplitude of the generated noise. We were able to obtain a significant difference in the fragmentation patterns of stroke patients using an IVm variable, while the variable IV60 was not identified. Rhythmic synchronization of activity and rest was significantly higher in young than adults with Parkinson׳s when using the ISM variable; however, this difference was not seen using IS60. We propose an updated format to calculate rhythmic fragmentation, including two additional optional variables. These alternative methods of nonparametric analysis aim to more precisely detect sleep-wake cycle fragmentation and synchronization.