How scientists interpret and address funding criteria: value creation and undesirable side effects.

Scientists and funding bodies are interdependent actors involved in an ongoing two-way signalling interaction; however, we lack insight on the social mechanisms underpinning this interaction. To address this issue, we examine how successfully funded scientists interpret and address criteria set by the funding body to maximise their chances of funding success. We also consider the possible adverse side effects that can arise from scientists' competitive efforts to address these criteria. Our findings identify a portfolio of funding criteria-research feasibility, research alignment and team credentials-that scientists address when preparing grant applications. Effectively addressing these criteria enhances the prospects of funding success and value creation. However, we also find that scientists can over-address funding criteria, which is counterproductive and yields undesirable side effects. Our research therefore makes an important distinction between the possibilities for value creation and the value creation frictions that can unintentionally arise based on how grant-submitting scientists interpret and address the criteria signalled by the funding body. Our research has implications for policymakers, funding bodies and scientists which we also discuss.

Low Pulmonary Artery Pulsatility Index by Echocardiography Is Associated With Increased Mortality in Pulmonary Hypertension.

BACKGROUND: Pulmonary hypertension (PH) is a progressive pulmonary vascular disorder with elevated mortality risk. The pulmonary artery (PA) pulsatility index (PAPi) based on invasively acquired parameters has emerged as a hemodynamic risk predictor. Whether noninvasively derived PAPi (PA pulse pressure divided by right atrial pressure) is valuable is unclear. METHODS: Consecutive patients undergoing transthoracic echocardiography for known or suspected PH were included with conventional echocardiographic measures of PA systolic, PA diastolic, and estimated right atrial pressures. In those patients with PH (mean PA pressure > 20 mm Hg), PAPi was divided into 3 groups: <1.5, 1.5 to 3, and >3. Mortality was assessed over 5 years. RESULTS: Of 1,045 patients enrolled, 64% had PH. Patients with the lowest PAPi had higher N-terminal-pro hormone B-type natriuretic peptide levels, larger right ventricles (RVs), worse RV systolic function, and greater degrees of tricuspid regurgitation. In patients with PH, PAPi was inversely proportional to the risk of death, with PAPi <3 associated with a 1.96-fold increased risk of death (95% CI, 1.45-2.64, P < .0001). At multivariate analysis, RV longitudinal systolic strain (hazard ratio [HR] = 1.45, 1.24-1.71; P < .0001), PAPi <3 (HR = 1.76, 1.31-2.37; P = .0002), and the presence of a pericardial effusion (HR = 1.64, 1.20-2.26 P = .003) were independently associated with increased mortality. In age- and sex-adjusted models, PAPi was incremental to PA compliance. CONCLUSIONS: In patients with PH, low PAPi derived noninvasively by transthoracic echocardiography is associated with markers of right heart failure, RV dysfunction, and worse survival. PAPi could be incorporated into the conventional echo parameters reported in patients with PH and may be a useful predictor of outcome.

Pulmonary artery pulsatility index in patients with tricuspid valve regurgitation: a simple non-invasive tool for risk stratification.

AIMS: Tricuspid valve regurgitation (TR) is a common valvular disease associated with increased mortality. There is a need for tools to assess the interaction between the pulmonary artery (PA) circulation and the right ventricle in patients with TR and to investigate their association with outcomes. The pulmonary artery pulsatility index (PAPi) has emerged as a haemodynamic risk predictor in left heart disease and pulmonary hypertension (PH). Whether PAPi discriminates risk in unselected patients with greater than or equal to moderate TR is unknown. METHODS AND RESULTS: In 5079 patients with greater than or equal to moderate TR (regardless of aetiology) and PA systolic and diastolic pressures measured on their first echocardiogram, we compared all-cause mortality at 5 years based on the presence or absence of PH and PAPi levels. A total of 2741 (54%) patients had PH. The median PAPi was 3.0 (IQR 1.9, 4.4). Both the presence of PH and decreasing levels of PAPi were associated with larger right ventricles, worse right ventricular systolic function, higher NT-pro BNP levels, greater degrees of right heart failure, and worse survival. In a subset of patients who had an echo and right heart catheterization within 24 h, the correlation of non-invasive to invasive PA pressures and PAPi levels was very good (r = 0.76). CONCLUSION: In patients with greater than or equal to moderate TR with and without PH, lower PAPi is associated with right ventricular dysfunction, right heart failure, and worse survival. Incorporating PA pressure and PAPi may help stratify disease severity in patients with greater than or equal to moderate TR regardless of aetiology.

A post-lockdown study of burnout risk amongst New Zealand essential workers.

BACKGROUND AND RATIONALE: Job burnout is an essential topic for researchers and a pressing issue for employers and employees. However, the most popular tool has become widely critiqued, and a new measure of burnout - the Burnout Assessment Tool (BAT) - is used here. The BAT is helpful because it provides a cut-off threshold score representing high burnout risk. This study provides one of the first BAT studies post Covid-19 pandemic and focuses on comparing high burnout risk rates between essential and non-essential workers after the first lockdown in New Zealand (May 2020). METHODS AND RESULTS: Using representative data from 955 employees across a wide range of occupations, sectors, and industries, we calculate an overall burnout risk of 11.1%, with essential workers higher (14%) than non-essential workers (9%). The odds ratios of burnout risk and having high levels of mental health complaints were 10-20 times higher for burnout risk workers. For essential workers, they were significantly higher for high job depression risk (35 times). Building on these results, to develop a deeper understanding of the factors contributing to burnout risk, we report on a qualitative analysis of comments (n = 213) provided by essential workers on their lockdown work experiences. CONCLUSIONS: Findings provide evidence that while a range of (1) health-related concerns (i.e., increased risk of getting and spreading covid) and (2) employee- and employer-specific pressures related to challenging lockdown work practices contribute to essential worker burnout risk, an unwavering sense of pride and purpose in the value of their essential work serves to reduce this risk. We discuss the implications, highlighting the unique issues facing essential workers.