Perceived stress and team performance during a simulated resuscitation

Purpose: Barriers to optimal performance of cardiopulmonary resuscitation may partly relate to human factors, such as stress and specific emotions. The aim of this study was to investigate whether mental stress and different perceived emotions have a negative impact on the performance of rescuers. Methods: This prospective, observational study was conducted at the Simulator Center of the University Hospital Basel, Switzerland. A total of 120 medical students (70% female) participated in teams of three. They reported levels of perceived stress, feeling overwhelmed, motivation and specific emotions before, during, and after a simulated resuscitation. The association of stress/overload (index of stress and feeling overwhelmed), motivation, and specific emotions with resuscitation performance defined as hands-on time during the first 180s after cardiac arrest was investigated. Results: During resuscitation, levels of stress/overload, motivation, and negative emotions were significantly higher as compared to the periods before and after resuscitation. In contrast, positive emotions were highest before and after resuscitation and significantly lower during resuscitation. In general, females reported higher stress/overload and negative emotions, whereas males reported more positive emotions. A multivariate linear regression model showed negative associations of stress/overload (regression coefficient −18.12, 95% CI −30.73, −5.51, p=0.006) and positive associations of motivation (regression coefficient 13.45, 95% CI 0.95, 25.95, p=0.036) with resuscitation performance. Conclusion: A simulated cardiac arrest caused substantial perceived stress/overload and negative emotions, particularly in female students, which adversely impacted resuscitation performance. Further studies are required to expand our findings to more experienced medical professionals and investigate whether stress coping strategies improve resuscitation performanc

The effects of authentic leadership, six areas of worklife, and occupational coping self-efficacy on new graduate nurses’ burnout and mental health. A cross-sectional study

Background: New nurse burnout has personal and organizational costs. The combined effect of authentic leadership, person-job fit within areas of worklife, and occupational coping self-efficacy on new nurses’ burnout and emotional wellbeing has not been investigated. Objectives: This study tested a model linking authentic leadership, areas of worklife, occupational coping self-efficacy, burnout, and mental health among new graduate nurses. We also tested the validity of the concept of interpersonal strain at work as a facet of burnout. Design: A cross-sectional national survey of Canadian new graduate nurses was conducted. Participants: Registered nurses working in direct patient care in acute care settings with less than 3 years of experience were selected from provincial registry databases of 10 Canadian provinces. A total of 1009 of 3743 surveyed new graduate nurses were included in the final sample (useable response rate 27%). Methods: Participants received a mail survey package that included a letter of information, study questionnaire, and a $2 coffee voucher. To optimize response rates non-respondersreceived a reminder letter four weeks after the initial mailing, followed by a second survey package four weeks after that. Ethics approval was obtained from the university ethics board prior to starting the study. Descriptive statistics and scale reliabilities were analyzed. Structural equation modelling with maximum likelihood estimation was used to test the fit between the data and the hypothesized model and to assess the factor structure of the expanded burnout measure. Results: The hypothesized model was an acceptable fit for the data (x2 (164) = 1221.38; x2 ratio = 7.447; CFI = .921; IFI = .921; RMSEA = .08). All hypothesized paths were significant. Authentic leadership had a positive effect on areas of worklife, which in turn had a positive effect on occupational coping self-efficacy, resulting in lower burnout, which was associated with poor mental health

Perceived stress and team performance during a simulated resuscitation

Barriers to optimal performance of cardiopulmonary resuscitation may partly relate to human factors, such as stress and specific emotions. The aim of this study was to investigate whether mental stress and different perceived emotions have a negative impact on the performance of rescuers

The impact of the Pliensbachian–Toarcian crisis on belemnite assemblages and size distribution

The second-order Pliensbachian–Toarcian crisis affected major groups of marine organisms. While its impact has been intensively studied for ammonites, the response of belemnites is only currently emerging through quantitative studies. Novel overall and regional diversity analyses suggest that belemnite richness in the NW-Tethys drops at the Pliensbachian–Toarcian boundary, while overall diversity slightly increases in NW-Tethys assemblages during the Toarcian Oceanic Anoxic event (T-OAE), mostly driven by NW European assemblages (e.g., Yorkshire). The T-OAE coincides with marked taxonomic turnover within individual basins, which is associated with an increase in median rostrum size of specimens in taxa at most localities. The changes in median body size across the Pliensbachian–Toarcian boundary are less consistent and driven by changes in body size within individual lineages crossing the boundary. However, our analyses also illustrate differences in sampling across the Pliensbachian–Toarcian crisis, which needs to be considered in further studies. © 2021, The Author(s).Open Access funding enabled and organized by Projekt DEAL. KDB, PN and PR were supported by the DFG (Ba 5148/1-1, Ba 5148/1-2 to KDB). This research benefitted from a Synthesys Grant to Patricia Rita

Reduced mitochondrial resilience enables non-canonical induction of apoptosis after TNF receptor signaling in virus-infected hepatocytes

Background & Aims: Selective elimination of virus-infected hepatocytes occurs through virus-specific CD8 T cells recognizing peptide-loaded MHC molecules. Herein, we report that virus-infected hepatocytes are also selectively eliminated through a cell-autonomous mechanism. Methods: We generated recombinant adenoviruses and genetically modified mouse models to identify the molecular mechanisms determining TNF-induced hepatocyte apoptosis in vivo and used in vivo bioluminescence imaging, immunohistochemistry, immunoblot analysis, RNAseq/proteome/phosphoproteome analyses, bioinformatic analyses, mitochondrial function tests. Results: We found that TNF precisely eliminated only virus-infected hepatocytes independently of local inflammation and activation of immune sensory receptors. TNF receptor I was equally relevant for NF-kB activation in healthy and infected hepatocytes, but selectively mediated apoptosis in infected hepatocytes. Caspase 8 activation downstream of TNF receptor signaling was dispensable for apoptosis in virus-infected hepatocytes, indicating an unknown non-canonical cell-intrinsic pathway promoting apoptosis in hepatocytes. We identified a unique state of mitochondrial vulnerability in virus-infected hepatocytes as the cause for this non-canonical induction of apoptosis through TNF. Mitochondria from virus-infected hepatocytes showed normal biophysical and bioenergetic functions but were characterized by reduced resilience to calcium challenge. In the presence of unchanged TNF-induced signaling, reactive oxygen species-mediated calcium release from the endoplasmic reticulum caused mitochondrial permeability transition and apoptosis, which identified a link between extrinsic death receptor signaling and cell-intrinsic mitochondrial-mediated caspase activation. Conclusion: Our findings reveal a novel concept in immune surveillance by identifying a cell-autonomous defense mechanism that selectively eliminates virus-infected hepatocytes through mitochondrial permeability transition. Lay summary: The liver is known for its unique immune functions. Herein, we identify a novel mechanism by which virus-infected hepatocytes can selectively eliminate themselves through reduced mitochondrial resilience to calcium challenge. (C) 2020 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved