Takotsubo cardiomyopathy: A case report.

Takotsubo Cardiomyopathy is a cardiac syndrome of rare type involving apical akinesis of the left ventricle. Symptoms of acute myocardial infarction, i.e. chest pain, S-T changes, and positive cardiac enzymes, are observed in patients with Takotsubo Cardiomyopathy. Cardiac angiography of Takotsubo Cardiomyopathy patients manifest left ventricular apical ballooning with no remarkable coronary artery stenosis. Mostly the cases are managed on the lines of treatment for Acute Coronary Syndrome. We present a case of Takotsubo Cardiomyopathy in a teenage girl from Karachi, Pakistan. The prevalence of Takotsubo Cardiomyopathy in Pakistan is yet to be mapped due to its rarity.

Students are at risk? Elucidating the impact of health risks of COVID-19 on emotional exhaustion and academic performance: role of mindfulness and online interaction quality.

Although previous online learning studies have looked at how student outcomes are influenced in different settings, this study is unique in that it looks at the role of COVID-19 as a particular stressor. This study discussed how students' perceptions of health risks of COVID-19 (PHRC) influenced their academic performance through emotional exhaustion. This study also looked at how mindfulness and online interaction quality (OIQ) affected PHRC's direct effects on exhaustion, as well as PHRC's indirect effects on academic performance via exhaustion. The data for the current study were collected from 336 students in three waves who were studying online during COVID-19. The results through structural equation modeling (SEM) revealed that PHRC influenced academic performance. The results further revealed that mindfulness and OIQ attenuated the direct effects of PHRC on emotional exhaustion as well as indirect effects on academic performance through emotional exhaustion. This study provides some novel implications for practice and research.

Misinformation and work-related outcomes of healthcare community: Sequential mediation role of COVID-19 threat and psychological distress.

By applying coping theory, this study develops and tests a process model investigating the sequential mediating roles of perceived COVID-19 threat and psychological distress on the relationships between social media misinformation and turnover intentions, and in-role performance. Hypothesized model for Study 1 was fully supported, showing that the association between social media misinformation and turnover intentions are each mediated sequentially, first by perceived COVID-19 threat and then by psychological distress. Additional support was found for the sequential mediation model when predicting turnover intentions and in-role performance in Study 2, using time-lagged data. Besides, this study found that resilience moderated social media misinformation's sequential indirect effect on turnover intentions and in-role performance. Implications and future research directions have been discussed.

The role of food crop production, agriculture value added, electricity consumption, forest covered area, and forest production on CO2 emissions: insights from a developing economy.

Several studies have quantified the carbon dioxide (CO2) emissions associated with energy consumption, agriculture value added, food crop production, forest covered area, and forest production in various countries. However, past studies have ignored the long-term and short-term effects of these factors on CO2. This study used data from 1980 to 2018 and applied the autoregressive distributed lag model (ARDL) technique to test long-run and short-run effects of these factors on CO2 emission in the Pakistani context. The results revealed that in short-run food crop production, forest covered area and forest production have capacity to reduce CO2 emission. However, in long run, energy consumption and agriculture value added along with food crop production, forest covered area, and forest production are negatively and significantly related to CO2 emission which shows that these sectors, in long run, have capacity to mitigate emissions. Additionally, results also show that food crop production and forest covered area are more effective to reduce CO2 emission as compared to other sectors. The robustness of the results was supported by using additional models and tests. This study provides scholars with valuable insights and also helps government authorities and policymakers to develop comprehensive strategies to reduce carbon emissions.

A diary study of psychological effects of misinformation and COVID-19 Threat on work engagement of working from home employees.

Since the COVID -19 pandemic, the open literature presents plenty of discussions on how individuals have adopted being forced to work from home (WFH). Nevertheless, there hasn't been much information on how individuals perceive WFM is affecting their daily work routine in the pandemic. By applying the stressors-strain-outcome (SSO) framework, the current study develops and tests a model that explains how misinformation and COVID-19 threat triggered the anxiety and social media fatigue of WFH employees and affected their work-related response. This study collected diary data for ten consecutive days from 56 WFH employees. Results widely supported the hypothesized model. Specifically, findings revealed that misinformation and COVID-19 threat increase anxiety and social media fatigue among these employees, resulting in a lower level of work engagement. This study also found that resilience as a coping mechanism reduces the adverse effects of anxiety on work engagement. The results have significant, timely implications for policy and research.

The Nexus Between High-Involvement Work Practices and Employees' Proactive Behavior in Public Service Organizations: A Time-Lagged Moderated-Mediation Model.

Purpose: Public service organizations may improve the quality of services they offer citizens by instilling proactive behavior in their employees. This study aimed to provide insights on how high-involvement work practices may indirectly facilitate proactive behavior in frontline government employees via employee commitment. Methods: A time-lagged approach was used to collect data from 542 frontline employees in three waves at 3-week intervals. We tested the hypothesized moderated mediation model using a PROCESS macro bootstrap approach. Results: A moderated-meditation model was applied in which public service motivation was theorized to increase the mediating effect of employee commitment on the relationship between high-involvement work practices and employee proactive behavior. As predicted, the findings show that supervisor' deviant behavior attenuated the mediating effect of employee commitment on the relationship between high-involvement work practices and employee proactive behavior. Conclusion: The findings of this research contribute to the emerging literature on public management and have implications for public sector organizations seeking to improve the quality of services they offer citizens.

Investigating the Impacts of Information Overload on Psychological Well-being of Healthcare Professionals: Role of COVID-19 Stressor.

While past research has focused on the benefits of social media during pandemics, this study emphasizes the possible negative effects of social media use among healthcare professionals. It has been stated that healthcare professionals are exposed to COVID-19 and its impacts on the mental health of these workers. Even though recognizing the importance of healthcare professionals during the pandemic, the impacts of COVID-19 on the mental health of healthcare professionals have been rarely considered for investigation by researchers. By applying differential susceptibility to the media effects model (DSMM), the current article investigated the effect of COVID-19 information overload (CIO) on psychological and mental well-being and underline mechanisms. Time-wave technique was applied to collect the data. This study tested moderated mediation model by collecting data from 314 healthcare professionals. The findings stated that COVID-19 information overload impacted COVID-19 fatalism and COVID-19 exhaustion directly. Likewise, COVID-19 fatalism mediated the association between CIO and COVID-19 exhaustion. Moreover, the COVID-19 stressor moderated this mediating relationship. This study proposes several practical recommendations for healthcare professionals, social media platform providers, health authorities, organizations, and institutions on how to use social media effectively and sustainably during the global COVID-19 epidemic.

Beyond pro-environmental consumerism: role of social exclusion and green self-identity in green product consumption intentions.

In the context of social exclusion and pro-social or pro-environmental behaviors, past research has yielded inconclusive results. This study extended the theory of planned behavior (TPB) by including green self-identity (GSI) as a boundary condition to check the impact of social exclusion on green product consumption intentions through TPB's components. This study collected data from 476 respondents through online questionnaires. Structural equation modeling (SEM) technique was applied to test the proposed model. Green product attitudes, subjective norms about green products, and perceived behavioral control (PBC) were significantly predicted by social exclusion. Our results also reveal that TPB's components play an interceding role between social exclusion and green product consumption intentions. Moreover, regarding boundary conditions of GSI, the interaction between social exclusion and GSI was significant for green product attitudes and subjective norms about green products; however, it was not significant for PBC. Furthermore, the results of moderated mediation revealed that green self-identity moderated the indirect effects of social exclusion on green product consumption intentions through green product attitude and social norms about green products. Moreover, these effects were not significant in the case of PBC. This study has several implications for organizations and policymakers in the context of social exclusion and green product consumption.

Elucidating the effects of organisational practices on innovative work behavior in UAE public sector organisations: The mediating role of employees' wellbeing.

In the context of the transitioning economy of the United Arab Emirates, which demands inculcating innovative behavior in public employees, this study investigates the relationship between high-involvement work practices and leaders' collaborative nature with employees' innovative behavior. Drawing on the social exchange and ability-motivation-opportunity theories, this research expounds the mediating effect of employees' wellbeing to examine the mechanisms through which high-involvement work practices and public leaders' collaborative nature affect employees' innovative behavior in public organisations. Using three-wave data from 207 individuals in public service organisations, this study tests the effects of employees' perceptions of high-involvement work practices and leaders' collaborative nature on their wellbeing and innovative work behaviors. Our findings have theoretical and practical implications for research on innovative work behavior in the milieu of public organisations.

The impacts of economic and environmental factors on sustainable mega project development: role of community satisfaction and social media.

This study examines the impacts of different economic, environmental, and social factors on sustainable China-Pakistan Economic Corridor (CPEC) development in the context of the CPEC, a multi-billion-dollar mega project. By applying the social exchange theory, this study tested the relationship between economic and environmental impacts through community satisfaction on sustainable CPEC development. This study used social media use as moderator in the relationship between community satisfaction and sustainable CPEC development. The quantitative methods were applied in this study. The data were collected through an online survey from 254 residents along the CPEC route in Pakistan, and structural equation modeling (SEM) technique was applied for analysis. Results suggested that economic benefits are positively related with community satisfaction which is related with sustainable CPEC development; however, environmental impacts were not significant. Furthermore, social media use related to CPEC development moderated the relationship between community satisfaction and sustainable CPEC development. Findings of this study suggest how economic benefits and community satisfaction can enhance the reputation of sustainable CPEC development resulting in a positive image of this mega project in the minds of local population. Furthermore, positive impact of this mega project can be created by using effective social media policies.

Comparison of various steady state surrogate insulin resistance indices in diagnosing metabolic syndrome.

BACKGROUND: Insulin resistance is core cause of metabolic syndrome. Determining insulin resistance is one of the foremost requirements imperative to understanding the pathophysiology of disease. The gold standard "Euglycaemic clamp test" is cumbersome, long and non-feasible in routine clinical setups to diagnose metabolic syndrome. Various continuous and steady state insulin resistance indices are now available in literature. We plan to evaluate commonly utilized steady state insulin resistance indices directly and Homeostasis Model Assessment for Insulin Resistance (HOMAIR) with added triglyceride (HOMA-TG index). METHODS: The cross-sectional study was carried from Jan-2016 to Dec-2018 at PNS HAFEEZ and department of chemical pathology, AFIP with following objectives: (1) To evaluate steady state insulin resistance markers for diagnosing metabolic syndrome as per IDF defined criteria by ROC curve analysis, (2) to measure Kendal Concordance between various insulin resistance indices and (3) to correlate steady state insulin resistance markers with anthropometric and lipid indices. After several exclusions we selected 224 subjects based upon "non-probability convenience sampling" for inclusion in study. Clinical history, anthropometric measures were calculated and sampling was done for insulin, glucose and other biochemical parameters. Metabolic syndrome was diagnosed as per IDF criteria, while HbA1c was utilized to diagnose diabetes mellitus. Pearson correlation was used to correlate various steady state insulin resistance indices including HOMAIR, HOMA2 index, QUICKI, G/I ratio, HOMA-TG index and serum insulin. AUC was calculated by ROC analysis for all surrogate insulin measures in diagnosis of metabolic syndrome. RESULTS: "HOMA-TG index" has shown the highest AUC for diagnosing metabolic syndrome along with higher correlation with lipid markers and anthropometric indices in comparison to other steady-state insulin resistance markers. Furthermore, QUICKI and G/I ratio showed the lowest AUC for detection of metabolic syndrome. CONCLUSION: "HOMA-TG index" has shown highest AUC for metabolic syndrome diagnosis. However, QUICKI and G/I ration showed the lowest AUC for detection of metabolic syndrome. It is hoped that the potential "HOMA-TG index" may provide better diagnostic efficiency for diagnosing metabolic syndrome.

Transthoracic needle aspiration in solitary pulmonary nodule.

With improved awareness of public health and the recent advances in various imaging technologies, the detection rate of solitary pulmonary nodules (SPN) is continuously increasing. Transthoracic needle aspiration (TTNA) has represented a major approach for the diagnosis and differential diagnosis of pulmonary masses, owing to its simplicity and minimal invasiveness. This paper demonstrates the role of TTNA in SPN.

Pictorial essay of radiological features of benign intrathoracic masses.

With increased exposure of patients to routine imaging, incidental benign intrathoracic masses are frequently recognized. Most have classical imaging features, which are pathognomonic for their benignity. The aim of this pictorial review is to educate the reader of radiological features of several types of intrathoracic masses. The masses are categorized based on their location/origin and are grouped into parenchymal, pleural, mediastinal, or bronchial. Thoracic wall masses that invade the thorax such as neurofibromas and lipomas are included as they may mimic intrathoracic masses. All examples are illustrated and include pulmonary hamartoma, pleural fibroma, sarcoidosis, bronchial carcinoid, and bronchoceles together with a variety of mediastinal cysts on plain radiographs, computed tomography (CT) and magnetic resonance imaging (MRI). Sometimes a multimodality approach would be needed to confirm the diagnosis in atypical cases. The study would include the incorporation of radionuclide studies and relevant discussion in a multidisciplinary setting.

Pictorial review of intrathoracic manifestations of progressive systemic sclerosis.

Intra-thoracic manifestations of progressive systemic sclerosis (PSS) are not well known particularly the imaging features, which forms the basis of accurate and timely diagnosis. The aim of this study is to familiarize the physicians and radiologists with these features. The diagnosis can remain elusive because of the non-specific nature of symptoms which mimic many common conditions. Thus, the diagnosis of PSS can be missed leading to continuous morbidity if the correct imaging is not pursued. The authors examined the records of rheumatology patient referrals of over a 5 year period. A hundred and seventy patients with systemic sclerosis and mixed connective tissue disorders were chosen for detailed study of the imaging available, which form the basis of this review. The images included conventional chest radiographs, digital radiographs computed radiography (CT) and high resolution computed tomography (HRCT). Where applicable computed pulmonary angiography (CTPA) and radionuclide scans were also interrogated.

Value of delayed 18F-FDG PET in the diagnosis of solitary pulmonary nodule.

Performing dual point 18F-FDG PET scans of solitary pulmonary nodules at an initial SUV (max) <2.5 is a useful technique. However, prolonging second image acquisition from 120 to 180 min does not appear to improve accuracy. Dual time 18F-FDG PET is not useful in differentiating benign and malignant pulmonary nodules with an initial mean SUV ≤2.5 in parts of the world where granulomatous disease is prevalent. Prolonged imaging on PET scanners is expensive particularly where availability if these scanners is limited. Further prospective research is required to define the potential benefits of dual time point 18F-FDG PET imaging, before recommending routine use of the technique.

Atypical radiological manifestations of thoracic sarcoidosis: A review and pictorial essay.

Thoracic sarcoidosis is a common disease, with well-described and recognizable radiographic features. Nevertheless, most physicians are not familiar with the rare atypical often-confusing manifestations of thoracic sarcoid. Although these findings have been previously reviewed, but more recent advances in imaging and laboratory science, need to be incorporated. We present a review of literature and illustrate the review with unpublished data, intended to provide a more recent single comprehensive reference to assist with the diagnosis when atypical radiographic findings of thoracic sarcoidosis are encountered. Thoracic involvement accounts for most of morbidity and mortality associated with sarcoidosis. An accurate timely identification is required to minimize morbidity and mortality. It is essential to recognize atypical imaging findings and relate these to clinical manifestations and histology.

Guidelines for the role of FDG-PET/CT in lung cancer management.

Fluoro-2-deoxy-d-glucose (FDG)-positron emission tomography (PET) and PET/computed tomography (FDG-PET/CT) is regarded as a standard of care in the management of non-small-cell lung carcinoma (NSCLC) and is a useful adjunct in the characterization of indeterminate solitary lung nodules (SLN), and pre-treatment staging of NSCLC, notably mediastinal nodal staging and detection of remote metastases. FDG-PET/CT has the ability to assess locoregional lymph node spread more precisely than CT, to detect metastatic lesions that would have been missed on conventional imaging or are located in difficult areas, and to help in the differentiation of lesions that are equivocal after conventional imaging. Increasingly FDG-PET/CT is employed in radiotherapy planning, prediction of prognosis in terms of tumor response to neo-adjuvant, radiation and chemotherapy treatment. Evidence is accumulating of usefulness of PET/CT in small cell lung cancer.

Imaging review of procedural and periprocedural complications of central venous lines, percutaneous intrathoracic drains, and nasogastric tubes.

Placements of central venous lines (CVC), percutaneous intrathoracic drains (ITDs), and nasogastric tubes (NGTs) are some of the most common interventional procedures performed on patients that are unconscious and in almost all intensive care/high dependency patients in one form or the other. These are standard procedures within the remit of physicians, and other trained health professionals. Procedural complications may occur in 7%-15% of patients depending upon the intervention and experience of the operator. Most complications are minor, but other serious complications may add significantly to morbidity and even mortality of already compromised patients. Imaging findings are the key to the detection of misplaced lines, and tubes and their prompt recognition are vital to avoid harm to the patient. It is, therefore, pertinent that healthcare professionals who perform these procedures are familiar with imaging complications of these procedures. Here, we present the imaging characteristics of procedural complications.

Pulmonary vascular complications of chronic liver disease: Pathophysiology, imaging, and treatment.

To review the pathogenesis of pulmonary vascular complications of liver disease, we discuss their clinical implications, and therapeutic considerations, with emphasis on potential reversibility of the hepatopulmonary syndrome after liver transplantation. In this review, we also discuss the role of imaging in pulmonary vascular complications associated with liver disease.