The relationship between mitral regurgitant severity, symptoms, and exercise capacity in primary degenerative mitral regurgitation.

Although it is assumed that more severe MR is associated with a greater burden of symptoms and lower exercise capacity, the relationship between symptoms, exercise capacity, and mitral regurgitant severity has not been well studied. We prospectively studied 67 (63 ± 11 years, 72% male) patients with at least mild degenerative MR and left ventricular ejection fraction ≥ 50% who underwent stress echocardiography, CMR, and evaluation with the Kansas City Cardiomyopathy questionnaire (KCCQ). Symptoms and exercise capacity were evaluated in the context of MR severity. Patients reporting dyspnea had lower KCCQ symptom scores (79 ± 23 vs. 96 ± 9, p = 0.01) and achieved lower percentage of age and gender predicted METs (114 ± 37 vs. 152 ± 43%, p < 0.001) compared to those without dyspnea. There was no significant difference in MR volume between those with vs. without dyspnea by CMR (43 ± 26 ml vs. 51 ± 28 ml, p = 0.3) or echocardiography (64 ± 28 vs. 73 ± 41ml, p = 0.4). Those with severe MR by CMR had similar KCCQ symptom scores (96 ± 10 vs. 89 ± 17, p = 0.04) and percentage of age and gender predicted METs (148 ± 42 vs. 133 ± 47%, p = 0.2) to those without severe MR. Those with severe MR by echocardiography had similar KCCQ symptom score (93 ± 15 vs. 89 ± 16, p = 0.3) and percentage of age and gender predicted METs (138 ± 43 vs. 153 ± 46%, p = 0.2) to those without severe MR. Patients with degenerative MR assessed by CMR and stress echocardiography, there was no relationship between MR severity and either symptoms or exercise capacity. These findings highlight the disconnect between symptoms and the severity of MR and challenge the assumption that correcting MR can be counted on to improve symptom status in patients with degenerative MR.

Evaluating workplace safety in the oil and gas industry during the COVID-19 pandemic using occupational health and safety Vulnerability Measure and partial least square Structural Equation Modelling.

The study aims to apply the Partial Least Squares Structural Equation Modeling (PLS-SEM) to model workplace safety in the Oil and Gas Industry (OGI) during the COVID-19 pandemic. The five areas of the Occupational Health and Safety (OHS) Vulnerability Measure (e.g., Exposure to Workplace Hazards, Policies and Procedures in the Workplace, Perception on Health & Safety Culture in the Workplace, Self-Awareness in Health & Safety Procedures and Responsibilities, and Preventive Measure for Prevention of the Transmission of COVID-19 at Workplace) were considered as the constructs to be evaluated. Fifty workers from the oil and gas industry worldwide participated in the online survey, and the data were analyzed using the SmartPLS software. The results revealed that only Perception on Health & Safety Culture was a significant factor influencing the perceived workplace safety in the OGI during the COVID-19 pandemic (ß = 0.603; t-value = 3.323; p-value = 0.001). The study suggested that the oil and gas companies should maintain a positive perception of health and safety culture to improve workplace safety even during the pandemic.