Burnout in doctors and nurses working in neonatal and pediatric intensive care units in a General Hospital

Aim: Health professionals working in intensive care units (ICU) are at high risk of developing the syndrome of professional burnout. The aim of the study was to explore the severity of professional burnout in doctors and nurses of neonatal (NICU) and pediatric ICUs (PICU) while identifying the factors associated with it.Study population and methods: Anonymous questionnaires were distributed to the nurses and doctors working in a NICU and PICU of a General Hospital. We utilized a 22-item questionnaire, the Maslach Burnout Inventory that evaluates three domains of burnout; emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA).Results: The response rate was 58% (52/90). The average (SD) scores were 30.71 (11.5) for EE, 10.11 (5.9) for DP, and 33.37 (8.0) for PA. DP scores were significant higher in PICU than NICU (p = 0.032) and EE and DP scores were higher in nurses than doctors (p 0.013 and p 0.0001 for EE and DP, respectively). Employees who reported health issues had a significantly higher degree of EE (p = 0.044) and appeared less satisfied with their PA (p = 0.046). Multiple regression analysis confirmed that ICU type and professional capacity were independent predictors of burnout. The age, marital status and years of ICU work did not significantly affect the burnout severity.Conclusions: There is a significant degree of burnout in the personnel of Greek PICUs and NICUs which is affected by the professional status, type of ICU, and health issues of the employees involved. The state must implement the necessary interventions that will effectively minimize burnout in ICU personnel in order to prevent the unfavorable consequences on both staff members and inpatients

Prospective Comparison of Multi-Detector Computed Tomographic Angiography with Digital Subtraction Angiography for the Diagnosis of Intracranial Aneurysms in Patients with Acute Non-Traumatic Subarachnoid Hemorrhage

Background Rupture of intracranial aneurysms and malformations are the main causes of spontaneous subarachnoid hemorrhage (SAH). Multi-detector computed tomography angiography (CTA) and intra-arterial digital subtraction angiography (DSA) are used to evaluate cerebrovascular structures and to detect such abnormalities with an intention to treat them. Objective The aim of the present study was to compare CTA and DSA findings in the detection of a cerebral aneurysm in patients with acute non-traumatic SAH and to depict the diagnostic value of CTA. Methods During the last 3 years 52 patients with non-traumatic SAH were prospectively studied. Four patients underwent only 16-slice multi-detector CTA and 48 patients underwent both CTA and DSA in an acute setting. Aneurysm morphologic information on CTA was compared to DSA, which is considered the gold standard imaging technique. Results The sensitivity of CTA per aneurysm was 97.9% (95% confidence intervals-CI 0.83-1), the specificity 100% (CI 0.50-0.99), the positive diagnostic likelihood ratio 0 and the negative diagnostic likelihood ratio 0.02. DSA successfully depicted 47 aneurysms in 40 patients from our study group. One aneurysm was missed on CTA (2 mm) which retrospectively was identified. In 8 patients with SAH no aneurysm was detected by either CTA or DSA. Conclusion 16-slice multi-detector CTA can be successfully used as a first choice imaging tool in the diagnostic algorithm of non-traumatic SAH and efficiently guide the therapeutic strategy

Mycotic Aneurysm of the Abdominal Aorta: Early and Late Computed Tomography Findings

We describe the case of a 60-year-old diabetic man who was admitted to our hospital with keto-acidosis and rapidly developed sepsis and a mycotic abdominal aortic aneurysm (AAA) with branch involvement. Early and late findings on serial computed tomography (CT) examinations are presented. Awareness and recognition of early imaging findings associated with infectious aortitis and serial CT examination in cases of patients with sepsis and predisposing factors are essential for prompt diagnosis and treatment. &nbsp

The Impact of Immune Checkpoint Inhibitors-Induced Skin Toxicity on Patients’ Quality of Life and the Role of Dermatologic Intervention

Introduction: Data regarding quality of life (QoL) of oncologic patients experiencing dermatologic immune-related adverse events (dirAEs)and their course after dermatologic intervention are scarce. Objectives To assess the impact of dirAEs on patients' QoL and to investigate the correlation between dermatologic and oncologic indexes used for estimating QoL. Methods We enrolled oncologic patients with dirAEs managed in two supportive oncodermatology outpatient clinics in Greece. Patient-reported outcomes included DLQI, EORTC-QLQ-C30 and Numerical Rating Scale for pruritus (pNRS). Results Overall, 110 patients were enrolled in the study. Mean(SD) DLQI and pNRS scores were 15.54 (5.44) and7.25 (2.95), correspondingly, while functional, symptom and summary scores of EORTC-C30 were 79.17 (2.11), 17.66 (3.60) and 80.67 (3.08), respectively. After therapeutic interventions, there was a statistically significant decrease in DLQI scores after1st intervention compared to baseline, and 2nd intervention compared to 1st [mean (SD) decrease 4.38 (2.91), p<0.001 and 5.16 (3.99), p<0.001, respectively]. DLQI showed no correlation with global health status/QoLs (rho 0.01, p=0.90) of EORTC-C30. Conclusions dirAEs negatively affect QoL. Dermatologic intervention improves patients’ QoL, facilitating an unimpaired oncologic treatment. Poor correlation between DLQI and EORTC-QLQ-30 highlights the need for adapted QoL measurement tools in the context of ICIs treatment. 

A Novel Glass Fiber Coated with Sol–Gel Poly-Diphenylsiloxane Sorbent for the On-Line Determination of Toxic Metals Using Flow Injection Column Preconcentration Platform Coupled with Flame Atomic Absorption Spectrometry

A novel simple and sensitive, time-based flow injection solid phase extraction system was developed for the automated determination of metals at low concentration. The potential of the proposed scheme, coupled with flame atomic absorption spectrometry (FAAS), was demonstrated for trace lead and chromium(VI) determination in environmental water samples. The method, which was based on a new sorptive extraction system, consisted of a microcolumn packed with glass fiber coated with sol&ndash;gel poly (diphenylsiloxane) (sol&ndash;gel PDPS), which is presented here for the first time. The analytical procedure involves the on-line chelate complex formation of target species with ammonium pyrrolidine dithiocarbamate (APDC), retention onto the hydrophobic sol&ndash;gel sorbent coated surface of glass fibers, and finally elution with methyl isobutyl ketone prior to atomization. All main chemical and hydrodynamic factors, which affect the complex formation, retention, and elution of the metal, were optimized thoroughly. Furthermore, the tolerance to potential interfering ions appearing in environmental samples was also explored. Enhancement factors of 215 and 70, detection limits (3 s) of 1.1 &mu;g&middot;L&minus;1 and 1.2 &mu;g&middot;L&minus;1, and relative standard deviations (RSD) of 3.0% (at 20.0 &mu;g&middot;L&minus;1) and 3.2% (at 20.0 &mu;g&middot;L&minus;1) were obtained for lead and chromium(VI), respec tively, for 120 s preconcentration time. The trueness of the developed method was estimated by analyzing certified reference materials and spiked environmental water samples

Δομική σημασιολογία και σχεδιασμός διαδραστικών εφαρμογών: ενημέρωση για την κατάθλιψη

Narrative structures are sometimes used to make a communication process, such as a documentary or even a news report, more interesting (Ohler, 2008). The need for the systematic study of narrative structures and their interpretation led to the adoption of theories from the field of structural linguistics. A.J. Greimas proposed a model of semantic analysis of texts that studies the codes of the signified, denotative and connotative (Boklund-Lagopoulou, 1983), distinguishing the structural level of narrative discourse, namely the structural organization of the meaning of the text and the manifested text. In this case study, the Greimas’ semantic model is applied in conjunction with multimodality, with the aim of designing an interactive narrative about depression, based on the proposal of Maria-Ilia Katsaridou (2023). According to this proposal, the design of the interactive narrative starts from the level of depth and ends in the textualization. The interactive story is characterized by narrative coherence which contributes to the more effective transmission of information (Katsaridou, 2023), while the mental immersion and social awareness of the viewer is maximized due to the interaction with the gamified environment

Prospective comparison of multi-detector computed tomographic angiography with digital subtraction angiography for the diagnosis of intracranial aneurysms in patients with acute non-traumatic subarachnoid hemorrhage

Objective To compare MDCTA and IA-DSA findings in the detection of a cerebral aneurysm in patients with acute non-traumatic SAH and to depict the diagnostic value of CTA.Background Rupture of intracranial aneurysms and malformations are the main causes of spontaneous subarachnoid hemorrhage (SAH). Multi-detector CT angiography (MDCTA) and Intra-arterial digital subtraction angiography (IA-DSA) are used to evaluate cerebrovascular structures and to detect such abnormalities in an intention to treat.Methods During the last 3 years 52 patients with non-traumatic SAH were prospectively studied. Four patients underwent only CTA and 48 patients underwent both 16-MDCTA and IA- DSA in an acute setting. Aneurysm morphologic information on CTA was compared to DSA, the gold standard.Results The sensitivity of CTA per aneurysm was 97.9% (CI 0.83-1), the specificity 100% (CI 0.50-0.99), the positive diagnostic likelihood ratio 0 and the negative diagnostic likelihood ratio 0.02. DSA successfully depicted 47 aneurysms in 40 patients from our study group. One aneurysm was missed on CTA (2mm) which retrospectively was identified. In 8 patients with SAH an aneurysm wasn’t detected by CTA or DSA. Conclusion 16-MDCTA can be successfully used as a first choice imaging tool in the diagnostic algorithm of non-traumatic SAH and organize efficiently the therapeutic planning.ΣΚΟΠΟΣ: Τα κυριότερα αίτια πρόκλησης μη τραυματικής υπαραχνοειδούς αιμορραγίας είναι η ρήξη των ενδοκρανίων ανευρυσμάτων και των δυσπλασιών. Στη διαγνωστική διερεύνηση των αγγειακών δομών του εγκεφάλου και της παθολογίας τους χρησιμοποιείται τόσο η πολυτομική αξονική αγγειογραφία (MDCTA), όσο και ενδαρτηριακή ψηφιακή αγγειογραφία (IA-DSA). Σκοπός της μελέτης μας είναι η σύγκριση των αποτελεσμάτων των δύο μεθόδων στην απεικόνιση των ενδοκρανίων ανευρυσμάτων σε ασθενείς με οξεία αυτόματη υπαραχνοειδή αιμορραγία και η εκτίμηση της διαγνωστικής αξίας της CTA. ΥΛΙΚΟ ΚΑΙ ΜΕΘΟΔΟΣ: Κατά τη διάρκεια των τριών ετών 52 ασθενείς με μη τραυματική υπαραχνοειδή αιμορραγία συμπεριελήφθησαν στη μελέτη μας. Από αυτούς στους 4 πραγματοποιήθηκε μόνο CTA, ενώ οι υπόλοιποι 48 διερευνήθηκαν και με τις δύο μεθόδους. Ακολούθησε σύγκριση των μορφολογικών χαρακτηριστικών των ανευρυσμάτων που ανευρέθηκαν στην CTA και στην DSA, η οποία θεωρήθηκε στη μελέτη μας μέθοδος αναφοράς. ΑΠΟΤΕΛΕΣΜΑΤΑ: Η ευαισθησία της μεθόδου στην ανάδειξη των ανευρυσμάτων ανήλθε στο 97,9% (CI 0.83-1), η ειδικότητα στο 100% (CI 0.50-0.99), ο θετικός διαγνωστικός δείκτης πιθανότητας στο 0 και ο αρνητικός διαγνωστικός δείκτης πιθανότητας στο 0.02. Με την DSA απεικονίσθηκαν συνολικά 47 ανευρύσματα σε 40 ασθενείς, ενώ με την CTA 46 ανευρύσματα. Δεν απεικονίσθηκε ένα ανεύρυσμα 2mm, το οποίο σε επανεκτίμηση της ιδίας εξέτασης σε δεύτερο χρόνο απεικονίσθηκε. Στους υπόλοιπους 8 ασθενείς δεν σημειώθηκε η παρουσία ανευρύσματος σε καμία από τις δύο μεθόδους. ΣΥΜΠΕΡΑΣΜΑ: Ο πολυτομικός αξονικός τομογράφος 16 τομών μπορεί αξιόπιστα να χρησιμοποιηθεί ως πρώτη επιλογή στον διαγνωστικό αλγόριθμο ασθενών με μη τραυματική υπαραχνοειδή αιμορραγία και με βάση τα αποτελέσματά της να γίνει ο θεραπευτικός σχεδιασμός

Catenary risers

204 σ.Μεταπτυχιακή Διατριβή - - Εθνικό Μετσόβιο Πολυτεχνείο. Σχολή Ναυπηγών Μηχανολόγων Μηχανικών. Διατμηματικό Πρόγραμμα Μεταπτυχιακών Σπουδών "Ναυτική και Θαλάσσια Τεχνολογία και Επιστήμη"Ακραίου μεγέθους καμπτικές ροπές σε λεπτόγραμμες θαλάσσιες κατασκευές (risers) λόγω εφαπτομενικών και πλευρικών κινήσεων εφαρμοζόμενες στην κορυφή.Catenary risersΕλένη Λ. Λαζαρίδο