Editorial Thoracic duct decompression (TDD) is an idea first proposed and applied as a novel therapeutic strategy by lymphologists in the 1960's. TDD is recently being reexamined and, in selected ...patients with portal hypertension from hepatic cirrhosis or with central venous hypertension from isolated right-sided heart failure, undertaken using advanced surgical and image-guided interventional radiologic approaches.
Burnout in Belgian physicians and nurses Vandenbroeck, S; Van Gerven, E; De Witte, H ...
Occupational medicine (Oxford),
2017-Oct-01, 2017-10-01, Letnik:
67, Številka:
7
Journal Article
Recenzirano
Odprti dostop
Burnout in healthcare is a worldwide problem. However, most studies focus narrowly on work-related factors and outcomes in one health profession or speciality.
To investigate the prevalence of ...burnout and its association with job demands, job resources, individual well-being, work-related attitudes and behaviour in physicians and nurses across different specialties.
Multi-centre cross-sectional study of physicians and nurses working in Belgian hospitals. An electronic questionnaire was used to assess job demands (e.g. workload), job resources (e.g. autonomy) and indicators of well-being, work-related attitudes and behaviours. Structural equation modelling was used to examine interrelationships between explanatory variables and outcomes.
1169 physicians and 4531 nurses participated; response rate 26%. High scores (>75th percentile in reference group of Dutch health care workers) were seen in 6% of the sample on three burnout dimensions (i.e. emotional exhaustion, depersonalization and personal competence) and in 13% for at least two dimensions. In contrast to the other dimensions, emotional exhaustion strongly related to almost all variables examined in the model. Positive associations were seen with workload, role conflicts, emotional burden and work-home interference and negative associations with learning and development opportunities and co-worker support. Emotional exhaustion correlated negatively with well-being, turnover intention, being prepared and able to work until retirement age, medication use, absenteeism and presenteeism.
Work-related factors were critical correlates of emotional exhaustion, which strongly related to poor health and turnover intention. Randomized controlled trials are suggested to underpin the effectiveness of interventions tackling job stressors and promoting job resources.
Multiple organs cooperate to regulate appetite, metabolism, and glucose and fatty acid homeostasis. Here, we identified and characterized lymphatic vasculature dysfunction as a cause of adult-onset ...obesity. We found that functional inactivation of a single allele of the homeobox gene Prox1 led to adult-onset obesity due to abnormal lymph leakage from mispatterned and ruptured lymphatic vessels. Prox1 heterozygous mice are a new model for adult-onset obesity and lymphatic vascular disease.
Intraluminal valves are required for the proper function of lymphatic collecting vessels and large lymphatic trunks like the thoracic duct. Despite recent progress in the study of lymphvasculogenesis ...and lymphangiogenesis, the molecular mechanisms controlling the morphogenesis of lymphatic valves remain poorly understood. Here, we report that gap junction proteins, or connexins (Cxs), are required for lymphatic valvulogenesis. Cx37 and Cx43 are expressed early in mouse lymphatic development in the jugular lymph sacs, and later in development these Cxs become enriched and differentially expressed by lymphatic endothelial cells on the upstream and downstream sides of the valves. Specific deficiencies of Cx37 and Cx43 alone or in combination result in defective valve formation in lymphatic collecting vessels, lymphedema, and chylothorax. We also show that Cx37 regulates jugular lymph sac size and that both Cx37 and Cx43 are required for normal thoracic duct development, including valve formation. Another Cx family member, Cx47, whose human analog is mutated in some families with lymphedema, is also highly enriched in a subset of endothelial cells in lymphatic valves. Mechanistically, we present data from Foxc2−/− embryos suggesting that Cx37 may be a target of regulation by Foxc2, a transcription factor that is mutated in human lymphedema–distichiasis syndrome. These results show that at least three Cxs are expressed in the developing lymphatic vasculature and, when defective, are associated with clinically manifest lymphatic disorders in mice and man.
► Cx37, Cx43, and Cx47 are expressed in lymphatic endothelial cells. ► Cxs differentially expressed in lymphatic valves and required for valvulogenesis. ► Cxs contribute to development of jugular lymph sac and thoracic duct. ► Cx deficiencies in mice result in lymph reflux, lymphedema and chylothorax. ► Cx37 may be a target of regulation by the transcription factor Foxc2.
The Arctic Ocean ecosystem is particularly vulnerable to ocean acidification (OA) related alterations due to the relatively high CO2 solubility and low carbonate saturation states of its cold surface ...waters. Thus far, however, there is only little known about the consequences of OA on the base of the food web. In a mesocosm CO2 -enrichment experiment (overall CO2 levels ranged from ~ 180 to 1100 μatm) in Kongsfjorden off Svalbard, we studied the consequences of OA on a natural pelagic microbial community. OA distinctly affected the composition and growth of the Arctic phytoplankton community, i.e. the picoeukaryotic photoautotrophs and to a lesser extent the nanophytoplankton thrived. A shift towards the smallest phytoplankton as a result of OA will have direct consequences for the structure and functioning of the pelagic food web and thus for the biogeochemical cycles. Besides being grazed, the dominant pico- and nanophytoplankton groups were found prone to viral lysis, thereby shunting the carbon accumulation in living organisms into the dissolved pools of organic carbon and subsequently affecting the efficiency of the biological pump in these Arctic waters.
The Brookhaven National Laboratory (BNL) has been chosen to host the Electron-Ion Collider (EIC). The interaction region (IR) poses several challenges, including cross-talk between the hadron and the ...electron beam. A previous work 1 proposed a feasible magnet design with sufficient quench margin at 2 K using cutouts in the iron yoke and sharing the gradient between the low beta quadrupole magnets Q1ApF and Q1BpF in the IR. The present paper focuses on other aspects of the cross-talk issues, such as the contribution of both the contribution of hysteresis and persistent current during the injection phase.
We describe a method for generating primary cultures of human brain microvascular endothelial cells (HBMVECs). HBMVECs are derived from microvessels isolated from temporal tissue removed during ...operative treatment of epilepsy. The tissue is mechanically fragmented and size filtered using polyester meshes. The resulting microvessel fragments are placed onto type I collagen-coated flasks to allow HBMVECs to migrate and proliferate. The overall process takes less than 3 h and does not require specialized equipment or enzymatic processes. HBMVECs are typically cultured for approximately 1 month until confluent. Cultures are highly pure ( approximately 97% endothelial cells; approximately 3% pericytes), are reproducible, and show characteristic brain endothelial markers (von Willebrand factor, glucose transporter-1) and robust expression of tight and adherens junction proteins as well as caveolin-1 and efflux protein P-glycoprotein. Monolayers of HBMVECs show characteristically high transendothelial electric resistance and have proven useful in multiple functional studies for in vitro modeling of the human blood-brain barrier.
Editorial Lymphatic vessels and lymph are a missing link in SARS-CoV-2/COVID-19 pathophysiology and therapeutic strategies. Based on well-established principles of lymphatic function and dysfunction ...and a neglected literature, this article highlights promising directions for future research and clinical exploration.
Time-variant coherence analysis between the heart rate variability (HRV) and the channel-related envelopes of adaptively selected EEG components was used as an indicator for the occurrence of ...(correlative) couplings between the central autonomic network (CAN) and the epileptic network before, during and after epileptic seizures. Two groups of patients were investigated, a group with left and a group with right hemispheric temporal lobe epilepsy. The individual EEG components were extracted by a signal-adaptive approach, the multivariate empirical mode decomposition, and the envelopes of each resulting intrinsic mode function (IMF) were computed by using Hilbert transform. Two IMFs, whose envelopes were strongly correlated with the HRV's low-frequency oscillation (HRV-LF; 0.1 Hz) before and after the seizure were identified. The frequency ranges of these IMFs correspond to the EEG delta-band. The time-variant coherence was statistically quantified and tensor decomposition of the time-frequency coherence maps was applied to explore the topography-time-frequency characteristics of the coherence analysis. Results allow the hypothesis that couplings between the CAN, which controls the cardiovascular-cardiorespiratory system, and the 'epileptic neural network' exist. Additionally, our results confirm the hypothesis of a right hemispheric lateralization of sympathetic cardiac control of the HRV-LF.
Measurement of peak vertical ground reaction force (GRFz) from multiple limbs simultaneously during high-speed, over-ground locomotion would enhance our understanding of the locomotor mechanics of ...cursorial animals. Here, we evaluate the accuracy of predicting peak GRFz from duty factor (the proportion of the stride for which the limb is in contact with the ground). Foot-mounted uniaxial accelerometers, combined with UHF FM telemetry, are shown to be practical and accurate for the field measurement of stride timing variables, including duty factor. Direct comparison with the force plate produces a mean error of 2.3 ms and 3.5 ms for the timing of foot on and foot off, respectively, across all gaits. Predictions of peak GRFz from duty factor show mean errors (with positive values indicating an overestimate) of 0.8+/-0.04 N kg(-1) (13%; N=42; mean +/- S.E.M.) at walk, -0.3+/-0.06 N kg(-1) (3%; N=75) at trot, -2.3+/-0.27 N kg(-1) (16%; N=18) for the non-lead limb at canter and +2.1+/-0.7 N kg(-1) (19%; N=9) for the lead limb at canter. The substantial over- and underestimate seen at canter, in the lead and non-lead limbs, respectively, is attributed to the different functions performed by the two limbs in the asymmetrical gaits. The difference in load experienced by the lead and non-lead limbs decreased with increasing speed.
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