Role of Cardiac Magnetic Resonance Imaging in the Evaluation of Athletes with Premature Ventricular Beats

Premature ventricular beats (PVBs) in athletes are not rare. The risk of PVBs depends on the presence of an underlying pathological myocardial substrate predisposing the subject to sudden cardiac death. The standard diagnostic work-up of athletes with PVBs includes an examination of family and personal history, resting electrocardiogram (ECG), 24 h ambulatory ECG (possibly with a 12-lead configuration and including a training session), maximal exercise testing and echocardiography. Despite its fundamental role in the diagnostic assessment of athletes with PVBs, echocardiography has very limited sensitivity in detecting the presence of non-ischemic left ventricular scars, which can be revealed only through more in-depth studies, particularly with the use of contrast-enhanced cardiac magnetic resonance (CMR) imaging. The morphology, complexity and exercise inducibility of PVBs can help estimate the probability of an underlying heart disease. Based on these features, CMR imaging may be indicated even when echocardiography is normal. This review focuses on interpreting PVBs, and on the indication and role of CMR imaging in the diagnostic evaluation of athletes, with a special focus on non-ischemic left ventricular scars that are an emerging substrate of cardiac arrest during sport.

Comparison of delirium detection tools in acute care

Background Delirium is a frequent psychopathological syndrome in geriatric patients. It is sometimes the only symptom of acute illness and bears a high risk for complications. Therefore, feasible assessments are needed for delirium detection. Objective and methods Rapid review of available delirium assessments based on a current Medline search and cross-reference check with a special focus on those implemented in acute care hospital settings. Results A total of 75 delirium detection tools were identified. Many focused on inattention as well as acute onset and/or fluctuating course of cognitive changes as key features for delirium. A range of assessments are based on the confusion assessment method (CAM) that has been adapted for various clinical settings. The need for a collateral history, time resources and staff training are major challenges in delirium assessment. Latest tests address these through a two-step approach, such as the ultrabrief (UB) CAM or by optional assessment of temporal aspects of cognitive changes (4 As test, 4AT). Most delirium screening assessments are validated for patient interviews, some are suitable for monitoring delirium symptoms over time or diagnosing delirium based on collateral history only. Conclusion Besides the CAM the 4AT has become well-established in acute care because of its good psychometric properties and practicability. There are several other instruments extending and improving the possibilities of delirium detection in different clinical settings.

Recruiting on the Net: insights for employers from prospective employees

PurposeDrawing on the signaling theory and technology acceptance model, the main purpose of this study was to predict prospective employees' intentions to apply for jobs in a firm, with a special focus on the mediating role of attitudes toward corporate websites and the moderating role of perceived value fit.Design/methodology/approachCollecting data from a convenient sample of 318 prospective job candidates, the research hypotheses were tested using structural equation modeling (SEM) with AMOS (version 24) and SPSS Process Macro (version 3.4).FindingsThe test results revealed that prospective employees' attitudes toward corporate websites partially mediate the association of corporate reputations, perceived ease of use and perceived usefulness with their intentions to apply for jobs in an organization. Noticeably, perceived value fit moderated the perceived usefulness–application intentions link in such a way that the impact of perceived usefulness on intentions to apply appears higher for individuals with a low level (than a high level) of perceived value fit.Research limitations/implicationsConsistent with the research findings, a notable theoretical contribution and practical implications for HR professionals have been discussed. This paper ends with outlining some limitations and future research directions.Originality/valueDespite having the salient buffering effects of perceived value fit on the applicant attraction process, empirical study on this theoretical phenomenon is still sparse in a pre-employment context. This may be the first study that demonstrates under what circumstances prospective employees' job pursuit intentions could be optimized in respect of their perceived value fit within a single framework comprised of two theories.

Biscayne National Park colonial nesting birds monitoring protocol—Version 1.1

Breeding colonies of wading birds (orders Ciconiiformes, Pelecaniformes) and seabirds (orders Suliformes, Pelecaniformes) serve as important indicators of aquatic ecosystem health, as they respond to changes in food abundance and quality, contaminants, invasive species, and disturbance. The Comprehensive Everglades Restoration Plan, Restoration Coordination & Verification program (CERP-RECOVER) has identified wading-bird colonies as an important ecosystem restoration indicator. The National Park Service South Florida/Caribbean Inventory & Monitoring Network (SFCN) ranked colonial nesting birds eighth out of 44 vital signs of park natural resource conditions for ecological significance and feasibility. However, while large-scale monitoring efforts are occurring in the rest of the Greater Everglades Ecosystem, only minimal historic data collection and no extensive ongoing monitoring of wading bird and seabird nesting have occurred in Biscayne National Park. Consequently, due to their high importance as biological indicators and because they are a gap occurring in regional monitoring efforts, the network has initiated a monitoring program of colonial nesting birds in Biscayne National Park. This protocol provides the rationale, approach, and detailed Standard Operating Procedures for annual colonial bird monitoring within and close to Biscayne National Park and conforms to the Oakley et al. (2003) guidelines for National Park Service long-term monitoring protocols. The specific objectives of this monitoring program are to determine status and long-term trends in: Numbers and locations of active colonies of colonial nesting birds with a special focus on Double-crested Cormorants, Great Egrets, Great White Herons, Great Blue Herons, White Ibises, and Roseate Spoonbills. Annual peak active nest counts of colonial nesting birds in Biscayne National Park with a special focus on the species mentioned above. An annual nesting index (i.e., sum of monthly nest counts) with a special focus on the species mentioned above. Timing of peak nest counts for the focal species.

Computational Modeling Intervertebral Disc Pathophysiology: A Review

Lower back pain is a medical condition of epidemic proportion, and the degeneration of the intervertebral disc has been identified as a major contributor. The etiology of intervertebral disc (IVD) degeneration is multifactorial, depending on age, cell-mediated molecular degradation processes and genetics, which is accelerated by traumatic or gradual mechanical factors. The complexity of such intertwined biochemical and mechanical processes leading to degeneration makes it difficult to quantitatively identify cause–effect relationships through experiments. Computational modeling of the IVD is a powerful investigative tool since it offers the opportunity to vary, observe and isolate the effects of a wide range of phenomena involved in the degenerative process of discs. This review aims at discussing the main findings of finite element models of IVD pathophysiology with a special focus on the different factors contributing to physical changes typical of degenerative phenomena. Models presented are subdivided into those addressing role of nutritional supply, progressive biochemical alterations stemming from an imbalance between anabolic and catabolic processes, aging and those considering mechanical factors as the primary source that induces morphological change within the disc. Limitations of the current models, as well as opportunities for future computational modeling work are also discussed.

Irreversible and Self-Healing Electrically Conductive Hydrogels Made of Bio-Based Polymers

Electrically conductive materials that are fabricated based on natural polymers have seen significant interest in numerous applications, especially when advanced properties such as self-healing are introduced. In this article review, the hydrogels that are based on natural polymers containing electrically conductive medium were covered, while both irreversible and reversible cross-links are presented. Among the conductive media, a special focus was put on conductive polymers, such as polyaniline, polypyrrole, polyacetylene, and polythiophenes, which can be potentially synthesized from renewable resources. Preparation methods of the conductive irreversible hydrogels that are based on these conductive polymers were reported observing their electrical conductivity values by Siemens per centimeter (S/cm). Additionally, the self-healing systems that were already applied or applicable in electrically conductive hydrogels that are based on natural polymers were presented and classified based on non-covalent or covalent cross-links. The real-time healing, mechanical stability, and electrically conductive values were highlighted.

Hydrogen Energy Demand Growth Prediction and Assessment (2021–2050) Using a System Thinking and System Dynamics Approach

Adoption of hydrogen energy as an alternative to fossil fuels could be a major step towards decarbonising and fulfilling the needs of the energy sector. Hydrogen can be an ideal alternative for many fields compared with other alternatives. However, there are many potential environmental challenges that are not limited to production and distribution systems, but they also focus on how hydrogen is used through fuel cells and combustion pathways. The use of hydrogen has received little attention in research and policy, which may explain the widely claimed belief that nothing but water is released as a by-product when hydrogen energy is used. We adopt systems thinking and system dynamics approaches to construct a conceptual model for hydrogen energy, with a special focus on the pathways of hydrogen use, to assess the potential unintended consequences, and possible interventions; to highlight the possible growth of hydrogen energy by 2050. The results indicate that the combustion pathway may increase the risk of the adoption of hydrogen as a combustion fuel, as it produces NOx, which is a key air pollutant that causes environmental deterioration, which may limit the application of a combustion pathway if no intervention is made. The results indicate that the potential range of global hydrogen demand is rising, ranging from 73 to 158 Mt in 2030, 73 to 300 Mt in 2040, and 73 to 568 Mt in 2050, depending on the scenario presented.

Collapsing Focal Segmental Glomerulosclerosis in Viral Infections

Collapsing glomerulopathy represents a special variant of the proteinuric kidney disease focal segmental glomerulosclerosis (FSGS). Histologically, the collapsing form of FSGS (cFSGS) is characterized by segmental or global condensation and obliteration of glomerular capillaries, the appearance of hyperplastic and hypertrophic podocytes and severe tubulointerstitial damage. Clinically, cFSGS patients present with acute kidney injury, nephrotic-range proteinuria and are at a high risk of rapid progression to irreversible kidney failure. cFSGS can be attributed to numerous etiologies, namely, viral infections like HIV, cytomegalovirus, Epstein–Barr-Virus, and parvovirus B19 and also drugs and severe ischemia. Risk variants of the APOL1 gene, predominantly found in people of African descent, increase the risk of developing cFSGS. Patients infected with the new Corona-Virus SARS-CoV-2 display an increased rate of acute kidney injury (AKI) in severe cases of COVID-19. Besides hemodynamic instability, cytokine mediated injury and direct viral entry and infection of renal epithelial cells contributing to AKI, there are emerging reports of cFSGS associated with SARS-CoV-2 infection in patients of mainly African ethnicity. The pathogenesis of cFSGS is proposed to be linked with direct viral infection of podocytes, as described for HIV-associated glomerulopathy. Nevertheless, there is growing evidence that the systemic inflammatory cascade, activated in acute viral infections like COVID-19, is a major contributor to the impairment of basic cellular functions in podocytes. This mini review will summarize the current knowledge on cFSGS associated with viral infections with a special focus on the influence of systemic immune responses and potential mechanisms propagating the development of cFSGS.