Predicting Role of Resilience and Meaning in Life in Perceived Stress of Frontline Health Care Workers during COVID-19 Outbreak

This paper investigates the predicting role of resilience and meaning in life on perceived stress of frontline health care workers treating patients with COVID-19. To measure the variables, a set of online questionnaires including Perceived Stress Questionnaire (PSS), Meaning of Life Questionnaire (MLQ), and Resilience Questionnaire (CD_RISC) was prepared. Presence of meaning, search for meaning, notion of personal competence, tolerance and trust in intuition, acceptance and secure relationships, control, and spiritual influences were examined as predictors of perceived stress. Several frontline health care workers were included in the final study. To analyze the data, regression analysis method was used with SPSS-20 software. The results showed that: 1) the regression model of resilience and the presence of meaning in the life of health care workers on their perceived stress was significant (F (6,229)=45.14, p<0.0001); 2) the predictive variables, in total, could explain 53% of the variance of perceived stress; 3) perceived stress correlated negatively with presence of meaning (β = −0.380, p<0.05), with acceptance and secure relationships (β = −0.620, p< 0.05), with control (β = −0.609, p<0.05), and positively correlated with spiritual influences (β = 0.465, p<0.05). Finding and maintaining meaning in life and improving acceptance, secure relationships, and sense of control would reduce perceived stress of frontline health care workers.

Predictive Role of the D-Dimer Level in Acute Kidney Injury in Living Donor Liver Transplantation: A Retrospective Observational Cohort Study

This study aimed to determine the association between serum D-dimer levels and the risk of acute kidney injury (AKI) in patients undergoing living donor liver transplantation (LDLT). Clinical data of 675 patients undergoing LDLT were retrospectively analyzed. The exclusion criteria included a history of kidney dysfunction, emergency cases, and missing data. The final study population of 617 patients was divided into the normal and high D-dimer groups (cutoff: 0.5 mg/L). After LDLT, 145 patients (23.5%) developed AKI. A high D-dimer level (>0.5 mg/L) was an independent predictor of postoperative development of AKI in the multivariate analysis when combined with diabetes mellitus [DM], platelet count, and hourly urine output. AKI was significantly higher in the high D-dimer group than in the normal D-dimer group (odds ratio [OR], 2.792; 95% confidence interval [CI], 1.227–6.353). Patients with a high D-dimer exhibited a higher incidence of early allograft dysfunction, longer intensive care unit stay, and a higher mortality rate. These results could improve the risk stratification of postoperative AKI development by encouraging the determination of preoperative D-dimer levels in patients undergoing LDLT.

Perfusion-Diffusion Ratio: A New IVIM Approach in Differentiating Solid Benign and Malignant Primary Lesions of the Liver

Introduction. In order to improve the efficacy of intravoxel incoherent motion (IVIM) parameters in characterising specific tissues, a new concept is introduced: the perfusion–diffusion ratio (PDR), which expresses the relationship between the signal S b decline rate as a result of IVIM and the rate of signal S b decline due to diffusion. The aim of this study was to investigate this novel approach in the differentiation of solid primary liver lesions. Material and Methods. Eighty-three patients referred for liver MRI between August 2017 and January 2020 with a suspected liver tumour were prospectively examined with the standard liver MRI protocol extended by DWI-IVIM sequence. Patients with no liver lesions, haemangiomas, or metastases were excluded. The final study population consisted of 34 patients with primary solid liver masses, 9 with FNH, 4 with regenerative nodules, 10 with HCC, and 11 with CCC. The PDR coefficient was introduced, defined as the ratio of the rate of signal S b decrease due to the IVIM effect to the rate of signal S b decrease due to the diffusion process, for b = 0 . Results. No significant differences were found between benign and malignant lesions in the case of IVIM parameters ( f , D , or D ∗ ) and ADC. Significant differences were observed only for PDR, with lower values for malignant lesions ( p = 0.03 ). The ROC analysis yielded an AUC value for PDR equal to 0.74, with a cut-off value of 5.06, sensitivity of 81%, specificity of 77%, and accuracy of 79%. Conclusion. PDR proved to be more effective than IVIM parameters and ADC in the differentiation of solid benign and malignant primary liver lesions.

Bedside detection of intracranial midline shift using portable magnetic resonance imaging

Neuroimaging is crucial for assessing mass effect in brain-injured patients. Transport to an imaging suite, however, is challenging for critically ill patients. We evaluated the use of a low magnetic field, portable MRI (pMRI) for assessing midline shift (MLS). In this observational study, 0.064 T pMRI exams were performed on stroke patients admitted to the neuroscience intensive care unit at Yale New Haven Hospital. Dichotomous (present or absent) and continuous MLS measurements were obtained on pMRI exams and locally available and accessible standard-of-care imaging exams (CT or MRI). We evaluated the agreement between pMRI and standard-of-care measurements. Additionally, we assessed the relationship between pMRI-based MLS and functional outcome (modified Rankin Scale). A total of 102 patients were included in the final study (48 ischemic stroke; 54 intracranial hemorrhage). There was significant concordance between pMRI and standard-of-care measurements (dichotomous, κ = 0.87; continuous, ICC = 0.94). Low-field pMRI identified MLS with a sensitivity of 0.93 and specificity of 0.96. Moreover, pMRI MLS assessments predicted poor clinical outcome at discharge (dichotomous: adjusted OR 7.98, 95% CI 2.07–40.04, p = 0.005; continuous: adjusted OR 1.59, 95% CI 1.11–2.49, p = 0.021). Low-field pMRI may serve as a valuable bedside tool for detecting mass effect.

Environmental Knowledge of Participants’ Outdoor and Indoor Physical Education Lessons as an Example of Implementing Sustainable Development Strategies

(1) Background: The purpose of the study was to assess the impact of physical activity outdoors in nature as part of physical education in schools on the level of knowledge and ecological attitudes. (2) Material and methods: A total of 220 students took part in the study, with 103 of them in the treatment group, which usually practiced outdoor physical education classes, and 117 in the control group, which practiced mainly indoor. The project lasted 21 months, covering the last two years of primary school. The authors used the Children’s Environmental Attitude and Knowledge Scale CHEAKS in this study. The authors sought for an answer to the question of whether bringing a young person closer to nature by participating in a greater number of outdoor physical education lessons results in in-depth environmental knowledge. (3) Results: The appearance of seven statistically significant differences in ecological knowledge in the final study in favor of the group having outdoor physical education lessons proves the cognitively and visually stimulating role of a natural environment for physically active people. The location of physical education lessons turned out to be a much stronger condition for in-depth knowledge than gender, place of residence, parents’ education level, and subjective assessment of the financial satisfaction level. (4) Conclusion: These results are an incentive to further developing the young generation’s contact with nature through outdoor physical education lessons.

Factors associated with transitions between frailty states among older persons in Brazil, 2006-2010

Background Frailty is considered one of the major conditions faced by ageing societies. Little has been reported about the transitions between the different frailty states in developing countries. Objective This study aimed to identify the factors associated with transitions between frailty states between 2006 and 2010 among older adults in Brazil. Method The present investigation is part of the SABE study (Health, Well-being and Ageing). Frailty state was classified according to the Fried’s criteria (nonfrail, prefrail, and frail). The final study sample was composed of 1,399 individuals representing 1,019,243 older adults in the city of Sao Paulo, Brazil. Multiple logistic regression was used to identify factors associated with changes in frailty states. Results Women were more likely to present a decline in frailty states. In the prefrail-to-nonfrail model, level of education was the most strongly associated factor. Advanced age and difficulty in performing at least one basic activity of daily living reduced in 9 and 64% the risk of becoming nonfrail, respectively. Conclusion Addressing the factors associated with transition between frailty states among older adults is essential. Adequate interventions are important to reduce vulnerability and improve the health and well-being of older persons.

Supraventricular Tachycardia Ablation and Effects on Anxiety Medications

Background: Patients with true paroxysmal supraventricular tachycardia (SVT) are frequently misdiagnosed with panic or anxiety disorders due to similar symptoms of palpitations, light-headedness, dyspnea, or chest discomfort. Unrecognized SVT can lead to unnecessary management with anxiety medications. Treatment of SVT with catheter ablation may lead to reduction in anxiety medications. Methods: A total of 175 patients underwent successful SVT ablation between January 1, 2010 and December 31, 2020. We examined symptoms at presentation, psychiatric medications prior to SVT ablation, comorbidities, and psychiatric medications at 3 months post-ablation. Results: 15% of patients who underwent successful SVT ablation were being treated with psychiatric medications and were included in the final study population. The most common symptoms were palpitations (80.77%), followed by dizziness (42.31%), and shortness of breath (34.62%). The average number of medications prior to ablation was 1.42 and decreased down to 1.08 at 3 months post-ablation (p = 0.04). The average number of SSRIs, SNRIs, and other anxiolytics were also decreased but were not statistically significant. Conclusion: In patients with anxiety and paroxysmal supraventricular tachycardia, catheter ablation is associated with reduced average number of psychiatric medications.

Co-opetition, corporate responsibility and sustainability: why multi-dimensional constructs matter

Purpose This study aims to set out to develop and validate a new instrument to measure the multi-dimensional nature of co-opetition in corporate responsibility and sustainability (CRS). It is anticipated that this instrument will prove useful to firms wanting to adopt measures that support relevant sustainability strategies. Design/methodology/approach The scale development concerns three separate components, namely, item generation through expert interviews; a pilot study conducted for scale purification; and a final study for scale confirmation and validation, respectively. The final study comprises 215 firms across 11 sectors in Australia that engage in co-opetitive alliances for CRS activities. Findings This study empirically validates the distinctiveness of three dimensions (commonality-driven, competition-driven and collaboration-driven) of co-opetition in relation to CRS resulting in a 15-item multi-dimensional scale. The three dimensions were found to be important aspects both in terms of scale validity and organisational consideration. Research limitations/implications This study proposes a new research area regarding the proposed framework, as well as practical strategies for practitioners when considering co-opetition and their firm’s engagement in CRS activities. Originality/value Prior studies in similar areas have mainly comprised conceptual or qualitative approaches and do not tend to focus on all three aspects of co-opetition, corporate social responsibility and sustainability.

Grid Operation Assessment under a Specific EV Chargers Deployment Plan in the City of Heraklion

The development of electric vehicles (EVs) as part of the electrification of the transportation sector plays a significant role in energy transition to a low-carbon and highly renewable society. The use of EVs has been promoted through the development of inclusive strategies for electromobility in the recent years. Apart from actions directed and funded by the European Union, national strategies have also been employed to support electromobility. Such a strategic plan has already been enacted by the Hellenic Ministry of Environment and Energy, funding municipalities to prepare siting and sizing plans for electric vehicle chargers. In this paper, the final study of this strategic plan for the municipality of Heraklion in Crete is used as a case study to investigate the effect of EV chargers on the operation of the Cretan power system. Their selected siting points are evaluated by performing a power flow analysis at the level of 150 kV. Thus, they are aggregated in each 20 kV/150 kV distribution substation of the electrical grid with the aim of investigating their effect on substation loading and transmission line losses. Generally, extensive fast charging should be avoided to minimize the risk of sudden stress of the existing cities’ grids and control strategies should be implemented to mitigate the need for upscale substation equipment or even postpone reinforcements.

Evaluation of Iodine Supplementation in Women With Pregnancy Associated With Gestational Diabetes. IODIAB Study

Iodine supplementation is indicated by the French High Authority for Health (HAS) and by the World Health Organization (WHO) during pregnancy. We want to know if this supplementation is prescribed in a manner consistent with the HAS and WHO recommenations in women diagnosed with gestational diabetes mellitus.Results: Recruitment for the study will start August 2021 and will be ended in October 2021, with the final study results scheduled for December 2021Conclusion The objective of the Iododiab study is to assess whether practitioners caring for women with gestational diabetes mellitus prescribe iodine supplementation according to the recommendations of the French High Authority for Health and by the World Health Organization.