Multiple variation of right renal and gonadal vascularization: report of two cases.

We present two cases of multiple anatomical variations of the renal and gonadal vessels. The first case presented duplication of the renal vein and the presence of an accessory renal artery. However, the most interesting fact, in this case, was that the right gonadal vein emptied into the inferior right renal vein instead of ending in the inferior vena cava as would typically be the case. In the second case, we also found an accessory renal artery and the right gonadal vein emptied at the exact junction between the right renal vein and the inferior vena cava. Clinicians and surgeons should be familiar with anatomical variations to provide an accurate diagnosis during preoperative studies and to avoid surprises in abdominal surgical procedures.

Este estudo apresenta dois casos de variação anatômica múltipla de vasos renais e gonadais. O primeiro caso apresentou uma duplicação da veia renal e a presença de uma artéria renal acessória. Porém, o fato mais interessante nesse caso foi a veia gonadal direita desembocar na veia renal direita inferior em vez de terminar na veia cava inferior, como seria o normal. No segundo caso, além de também encontrarmos uma artéria renal acessória, a veia gonadal direita desembocava no exato ponto de junção entre a veia renal direita e a veia cava inferior. Clínicos e cirurgiões devem estar familiarizados com a presença de possíveis variações dos vasos renais e gonadais, sendo um conhecimento imprescindível para obter um diagnóstico mais preciso e para evitar surpresas em procedimentos cirúrgicos abdominais.

Occupational safety in homecare organizations: the design and implementation of a train-the-trainer program.

Homecare workers face significant occupational risks, necessitating effective safety training programs. This paper presents a comprehensive Train-the-Trainer (TTT) program developed to enhance occupational safety in homecare organizations. Through an analysis of 229 reported safety events, the frequency and type of incidents, such as injuries during handling, road crashes, slips, trips, and falls, were identified and primarily attributed to human errors and violations. Based on the results, a TTT program was designed and implemented. The TTT successfully engaged Health, Safety, and Environment managers, fostering collaborative activities, knowledge sharing, and resource discussions. The program modules address critical areas, including distractions and inattentions, fatigue, time pressure, frustration and aggressiveness, and safety behaviors. This innovative approach provides valuable insights for organizations seeking to improve homecare workers' safety. The findings add to the broader comprehension of occupational safety in the homecare sector, proposing a pragmatic framework for future interventions.

Multiple variation of right renal and gonadal vascularization: report of two cases / Variação múltipla da vascularização renal e gonadal direita: relato de dois casos

Abstract We present two cases of multiple anatomical variations of the renal and gonadal vessels. The first case presented duplication of the renal vein and the presence of an accessory renal artery. However, the most interesting fact, in this case, was that the right gonadal vein emptied into the inferior right renal vein instead of ending in the inferior vena cava as would typically be the case. In the second case, we also found an accessory renal artery and the right gonadal vein emptied at the exact junction between the right renal vein and the inferior vena cava. Clinicians and surgeons should be familiar with anatomical variations to provide an accurate diagnosis during preoperative studies and to avoid surprises in abdominal surgical procedures.

Resumo Este estudo apresenta dois casos de variação anatômica múltipla de vasos renais e gonadais. O primeiro caso apresentou uma duplicação da veia renal e a presença de uma artéria renal acessória. Porém, o fato mais interessante nesse caso foi a veia gonadal direita desembocar na veia renal direita inferior em vez de terminar na veia cava inferior, como seria o normal. No segundo caso, além de também encontrarmos uma artéria renal acessória, a veia gonadal direita desembocava no exato ponto de junção entre a veia renal direita e a veia cava inferior. Clínicos e cirurgiões devem estar familiarizados com a presença de possíveis variações dos vasos renais e gonadais, sendo um conhecimento imprescindível para obter um diagnóstico mais preciso e para evitar surpresas em procedimentos cirúrgicos abdominais.

Does Organizational Commitment to Mental Health Affect Team Processes? A Longitudinal Study.

Purpose: Team processes, such as reflexivity and participation, are critical for organizational sustainability, especially in high-reliability professions such as healthcare. However, little is known about health-related predictors of team processes. Basing our hypotheses on the Input-Process-Output (IPO) model, this study investigates the influence of perceived organizational commitment to mental health (OCMH) on healthcare workers' team reflexivity and participation via mental health-specific leadership (MHsL) and team autonomy. Patients and Methods: The study involved 82 participants (ie, physicians, nurses, healthcare assistants, healthcare technicians, and physiotherapists) working in the Medicine, Emergency, and Neurological Departments at a large public healthcare organization in Italy. Data was gathered at 2-time points, 14 months apart. Results: The results suggest that healthcare workers' perception of their organization's support for mental health at T1 significantly impacts team participation at T2 through MHsL and team autonomy. Likewise, the indirect effect of OCMH through MHsL and team autonomy was also significant in the model predicting team reflexivity. However, in both models, no direct relationship of OCMH on the dependent variables was found. Conclusion: The findings highlight the importance of a mental health-supportive environment and leadership to foster team autonomy and, subsequentially, team processes, which are fundamental for performance and patient care.

The Impact of Nordic Walking Pole Length on Gait Kinematic Parameters.

Nordic walking (NW) is a popular physical activity used to manage chronic diseases and maintain overall health and fitness status. This study aimed to compare NW to ordinary walking (W) with regard to pole length and to identify kinematic differences associated with different poles' length (55%, 65% and 75% of the subject's height, respectively). Twelve male volunteers (21.1 ± 0.7 years; 1.74 ± 0.05 m; 68.9 ± 6.1 kg) were tested in four conditions (W, NW55, NW65 and NW75) at three different speeds (4-5-6 km∗h-1). Each subject performed a total of twelve tests in a random order. Three-dimensional kinematics of upper and lower body were measured for both W and NW, while oxygen consumption levels (VO2) and rating of perceived exertion (RPE) were measured only for NW trials with different poles' length. NW showed a higher step length, lower elbow motion and higher trunk motion (p < 0.05) compared to W. Additionally, NW65 did not show any kinematic or RPE differences compared to NW55 and NW75. Only NW75 showed a higher elbow joint (p < 0.05) and lower pole (p < 0.05) range of motion compared to NW55 and a higher VO2 (p < 0.05) compared to NW55 and NW65 at 6 km∗h-1. In conclusion, the use of the poles affects the motion of the upper and lower body during gait. Poles with shorter or longer length do not produce particular changes in NW kinematics. However, increasing the length of the pole can be a smart variation in NW to increase exercise metabolic demand without significantly affecting the kinematics and the RPE.

Spatio-temporal distribution pattern of COVID-19 in the Northern Italy during the first-wave scenario: The role of the highway network.

Background: The rapid outbreak of Coronavirus disease 2019 (COVID-19) has posed several challenges to the scientific community. The goal of this paper is to investigate the spread of COVID-19 in Northern Italy during the so-called first wave scenario and to provide a qualitative comparison with the local highway net. Methods: Fixed a grid of days from February 27, 2020, the cumulative numbers of infections in each considered province have been compared to sequences of thresholds. As a consequence, a time-evolving classification of the state of danger in terms of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, in view of the smallest threshold overtaken by this comparison, has been obtained for each considered province. The provinces with a significant amount of cases have then been collected into matrices containing only the ones featuring a significant amount of cases. Results: The time evolution of the classification has then been qualitatively compared to the highway network, to identify similarities and thus linking the rapid spreading of COVID-19 and the highway connections. Conclusions: The obtained results demonstrate how the proposed model properly fits with the spread of COVID-19 along with the Italian highway transport network and could be implemented to analyze qualitatively other disease transmissions in different contexts and time periods.

"We All Held Our Own": Job Demands and Resources at Individual, Leader, Group, and Organizational Levels During COVID-19 Outbreak in Health Care. A Multi-Source Qualitative Study.

BACKGROUND: Interventions tackling COVID-19 impact on health care workers' mental health would benefit from being informed by validated and integrated assessment frameworks. This study aimed to explore the fitness of integrating the Job Demands-Resources (JD-R) model and the Individual-Group-Leader-Organization (IGLO) framework to investigate the pandemic's impact on health care workers' mental health. METHODS: Qualitative data were collected via 21 semi-structured interviews with senior and middle managers and four focus groups with employees (doctors, nurses, health care assistants) from three areas (Department of Emergency, Department of Medicine, Research Institute of Neuroscience) of a large health care institution facing the first wave of COVID-19. NVivo deductive content analysis of text data was performed. FINDINGS: Several COVID-19-related job demands and resources were found at IGLO levels. Individual-level demands included emotional load, while resources included resilience and motivation. Group-level demands included social distancing, while resources included team support and cohesion. Leader-level demands included managers' workload, while resources included leader support. Organizational-level demands included work reorganization, while resources included mental health initiatives. CONCLUSIONS/APPLICATION TO PRACTICE: Integrating JD-R and IGLO proved feasible, as job demands and resources could be categorized according to the individual, group, leader, and organization framework. The findings expand previous studies by filling the lack of knowledge on how job demands and resources might unfold at different workplace levels during a pandemic. Results provide unit-level evidence for designing and implementing multilevel interventions to manage health care workers' mental health during COVID-19 and future pandemics. Our findings offer occupational health practitioners a suitable approach to perform workplace mental health assessment activities.

Job Insecurity and Job Performance: A Serial Mediated Relationship and the Buffering Effect of Organizational Justice.

The study aimed to extend the current knowledge of the relationship between job insecurity and performance. In line with traditional stress theories, work-family and burnout were hypothesized as serial mediators of the negative link between job insecurity and job performance. Also, the current study hypothesized that the association between job insecurity and the mediators [i.e., Work-family conflict (WFC) and burnout] could be buffered by perceived organizational justice among employees. Therefore, we empirically tested a moderated serial mediation model. Participants were 370 employees of an Italian multiservice social cooperative. Data were collected using a self-report questionnaire in the aftermath of the COVID-19 pandemic outbreak. The obtained results indicated that WFC and burnout mediated the association between job insecurity and job performance. Furthermore, perceived organizational justice buffered the relationship between job insecurity and WFC. Concerning job burnout, the association with job insecurity was moderated only among employees perceiving medium and high levels of organizational justice. The moderated serial mediation index provided support to the role of organizational justice in decreasing the association between job insecurity and job performance. This study delves deeper into the variables explaining the relationship between job insecurity and job performance by testing a serial process mechanism that involved WFC and burnout. Additionally, the obtained results provide suggestions to organizations and managers regarding the protective role of organizational justice to sustain employees' mental health and performance. Practical implications at the organizational and managerial level are provided, along with a focus on the actual impact of the pandemic.

A Cluster Analysis of University Commuters: Attitudes, Personal Norms and Constraints, and Travel Satisfaction.

Higher education institutions are recognised as settings where the community's awareness of sustainable mobility can be strengthened or reshaped. The first objective of the present study was to identify groups of commuters based on their modal choice in a large higher education institution in Italy. The second objective was to compare the groups on socio-demographic and psychosocial variables, specifically attitudes, personal norms, personal constraints, and travel satisfaction. The cluster analysis revealed five different types of commuters: car-oriented, two-wheeled urban users, pedestrians, long-distance commuters, and regular bus users. Attitudes, personal constraints and norms, and satisfaction differed in the five groups of commuters. The present study provides insights for behavioural change programmes and organizational policies on sustainable mobility.

Correction: Is no test better than a bad test: Impact of diagnostic uncertainty on the spread of COVID-19.

[This corrects the article DOI: 10.1371/journal.pone.0240775.].

H-WORK Project: Multilevel Interventions to Promote Mental Health in SMEs and Public Workplaces.

The paper describes the study design, research questions and methods of a large, international intervention project aimed at improving employee mental health and well-being in SMEs and public organisations. The study is innovative in multiple ways. First, it goes beyond the current debate on whether individual- or organisational-level interventions are most effective in improving employee health and well-being and tests the cumulative effects of multilevel interventions, that is, interventions addressing individual, group, leader and organisational levels. Second, it tailors its interventions to address the aftermaths of the Covid-19 pandemic and develop suitable multilevel interventions for dealing with new ways of working. Third, it uses realist evaluation to explore and identify the working ingredients of and the conditions required for each level of intervention, and their outcomes. Finally, an economic evaluation will assess both the cost-effectiveness analysis and the affordability of the interventions from the employer perspective. The study integrates the training transfer and the organisational process evaluation literature to develop toolkits helping end-users to promote mental health and well-being in the workplace.

Is "no test is better than a bad test"? Impact of diagnostic uncertainty in mass testing on the spread of COVID-19.

Testing is viewed as a critical aspect of any strategy to tackle epidemics. Much of the dialogue around testing has concentrated on how countries can scale up capacity, but the uncertainty in testing has not received nearly as much attention beyond asking if a test is accurate enough to be used. Even for highly accurate tests, false positives and false negatives will accumulate as mass testing strategies are employed under pressure, and these misdiagnoses could have major implications on the ability of governments to suppress the virus. The present analysis uses a modified SIR model to understand the implication and magnitude of misdiagnosis in the context of ending lockdown measures. The results indicate that increased testing capacity alone will not provide a solution to lockdown measures. The progression of the epidemic and peak infections is shown to depend heavily on test characteristics, test targeting, and prevalence of the infection. Antibody based immunity passports are rejected as a solution to ending lockdown, as they can put the population at risk if poorly targeted. Similarly, mass screening for active viral infection may only be beneficial if it can be sufficiently well targeted, otherwise reliance on this approach for protection of the population can again put them at risk. A well targeted active viral test combined with a slow release rate is a viable strategy for continuous suppression of the virus.

Efficient training of interval Neural Networks for imprecise training data.

This paper describes a robust and computationally feasible method to train and quantify the uncertainty of Neural Networks. Specifically, we propose a back propagation algorithm for Neural Networks with interval predictions. In order to maintain numerical stability we propose minimising the maximum of the batch of errors at each step. Our approach can accommodate incertitude in the training data, and therefore adversarial examples from a commonly used attack model can be trivially accounted for. We present results on a test function example, and a more realistic engineering test case. The reliability of the predictions of these networks is guaranteed by the non-convex Scenario approach to chance constrained optimisation, which takes place following training, and is hence robust to the performance of the optimiser. A key result is that, by using minibatches of size M, the complexity of the proposed approach scales as O(M⋅Niter), and does not depend upon the number of training data points as with other Interval Predictor Model methods. In addition, troublesome penalty function methods are avoided. To the authors' knowledge this contribution presents the first computationally feasible approach for dealing with convex set based epistemic uncertainty in huge datasets.

Gender differences in cyclists' crashes: an analysis of routinely recorded crash data.

Previous research on gender differences in road crashes has focussed uniquely on car drivers and there has been little research examining such differences among cyclists. In this study, we investigated gender differences in bicycle crashes, using routinely recorded crash data. The present paper focussed on characteristics related to the type of crashes (type of collision and opponent vehicle), the infrastructure (road type and type of road segment), the environmental (season, road surface condition and weather) and time period (time of the day and day of the week). Results revealed that, compared to women cyclists, men cyclists were more likely to be involved in a crash regardless the cyclists' age. Moreover, we found gender differences in terms of type of road segment, type of opponent vehicle, type of manoeuvre of the opponent vehicle and of the cyclists, type of collision, time of the day, day of the week and season.

Green wave for cyclists: Users' perception and preferences.

Several innovative measures in traffic control applied in Europe have successfully improved the comfort and safety of cycling, among which is the green waves for cyclists. Consecutive traffic lights are synchronised to create a green wave, increasing comfort and decreasing waiting times and related deliberate red-light running. This study focused on exploring the user acceptance of green wave systems and the user evaluation of six distinct interface designs (i.e. numeric-based countdown, dot-based vertical countdown, dot-based clockwise countdown, LED line, LED road surface, on-bike speed indicator). Results indicate a preference for three systems: numeric-based countdown, LED line and LED road surface. Results also show a significant influence of nationality on the evaluation of the interfaces. Based on our findings, we argue that the numeric-based countdown represents the most promising option for future adaptive green wave implementations. The outcomes of the present study represent a useful evidence and guidance for researchers, designers and decision makers in the field of green waves, mobility and traffic safety.

Unsafe cycling behaviours and near crashes among Italian cyclists.

This study investigates the direct and indirect effect of three types of unsafe behaviours (i.e. errors, generic violations and smartphone-specific violations) on the likelihood of near crashes and actual crashes among Italian cyclists. We considered smartphone-specific violations as a different unsafe behaviour subtype that enhances the probability of committing errors, thus increasing the likelihood of being involved in near crashes. Furthermore, we hypothesized that near crashes will predict actual crashes. Results revealed that errors predicted near crashes, whereas generic and smartphone-specific violations did not. Near crashes mediated the effect of errors on crashes. Moreover, smartphone-specific violations predicted crashes throughout its consecutive effects on errors and near crashes. These findings contribute to deepen our understanding of the relationship between cyclists' unsafe behaviours, near crashes and actual crashes. To our knowledge, the present study is the first that links errors to near crashes among cyclists.

Characteristics of cyclist crashes in Italy using latent class analysis and association rule mining.

The factors associated with severity of the bicycle crashes may differ across different bicycle crash patterns. Therefore, it is important to identify distinct bicycle crash patterns with homogeneous attributes. The current study aimed at identifying subgroups of bicycle crashes in Italy and analyzing separately the different bicycle crash types. The present study focused on bicycle crashes that occurred in Italy during the period between 2011 and 2013. We analyzed categorical indicators corresponding to the characteristics of infrastructure (road type, road signage, and location type), road user (i.e., opponent vehicle and cyclist's maneuver, type of collision, age and gender of the cyclist), vehicle (type of opponent vehicle), and the environmental and time period variables (time of the day, day of the week, season, pavement condition, and weather). To identify homogenous subgroups of bicycle crashes, we used latent class analysis. Using latent class analysis, the bicycle crash data set was segmented into 19 classes, which represents 19 different bicycle crash types. Logistic regression analysis was used to identify the association between class membership and severity of the bicycle crashes. Finally, association rules were conducted for each of the latent classes to uncover the factors associated with an increased likelihood of severity. Association rules highlighted different crash characteristics associated with an increased likelihood of severity for each of the 19 bicycle crash types.

Cyclists' Anger As Determinant of Near Misses Involving Different Road Users.

Road anger constitutes one of the determinant factors related to safety outcomes (e.g., accidents, near misses). Although cyclists are considered vulnerable road users due to their relatively high rate of fatalities in traffic, previous research has solely focused on car drivers, and no study has yet investigated the effect of anger on cyclists' safety outcomes. The present research aims to investigate, for the first time, the effects of cycling anger toward different types of road users on near misses involving such road users and near misses in general. Using a daily diary web-based questionnaire, we collected data about daily trips, bicycle use, near misses experienced, cyclist's anger and demographic information from 254 Spanish cyclists. Poisson regression was used to assess the association of cycling anger with near misses, which is a count variable. No relationship was found between general cycling anger and near misses occurrence. Anger toward specific road users had different effects on the probability of near misses with different road users. Anger toward the interaction with car drivers increased the probability of near misses involving cyclists and pedestrians. Anger toward interaction with pedestrians was associated with higher probability of near misses with pedestrians. Anger toward cyclists exerted no effect on the probability of near misses with any road user (i.e., car drivers, cyclists or pedestrians), whereas anger toward the interactions with the police had a diminishing effect on the occurrence of near misses' involving all types of road users. The present study demonstrated that the effect of road anger on safety outcomes among cyclists is different from that of motorists. Moreover, the target of anger played an important role on safety both for the cyclist and the specific road users. Possible explanations for these differences are based on the difference in status and power with motorists, as well as on the potential displaced aggression produced by the fear of retaliation by motorized vehicle users.