The student version of the Burnout assessement tool (BAT): psychometric properties and evidence regarding measurement validity on a romanian sample.

The objective of the present research was to investigate the psychometric properties and the validity of the student version of the Burnout Assessment Tool (BAT) in a Romanian undergraduate student sample. A sample of undergraduate students (N = 399, 60,70% female) from a Romanian university completed the BAT and other measures used for assessing measurement validity. Confirmatory factor analyses supported the original factor structure of the BAT, and all scales showed good internal consistency. The validity of the BAT scales was supported by their strong associations with measures of depression, anxiety, stress, psychosomatic symptoms, prospective appraisal of future tasks, and coping strategies. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-023-04232-w.

Choosing between the red and the blue pill. How do people decide when they face uncertainty regarding different treatment alternatives?

BACKGROUND: When we are faced with health challenges, we have to choose a treatment from several alternatives. Most of the time, we must make a choice even though some information regarding the options is missing. Previous research found that missing information systematically impacts our choices. AIM: The present study investigated if context-related variables (type of information: advantages or costs, the label of the alternatives) and individual differences (moral purity, thinking style) have an impact on the way people make these kinds of choices. Methods: One hundred twenty-three students (52% males) had to make 27 decisions regarding their preferred alternative for treating various medical conditions. We manipulated the type of comparable information (i.e., regarding advantages, disadvantages, or costs), and the label of the treatment alternatives (i.e., abstract vs. recognizabletreatments). Additionally, we measured the participants' moral purity endorsement and thinking style via self-report questionnaires. RESULTS: The results showed that context variables like the type of comparable information and the label of the alternatives are significant predictors of people's medical treatment choices. At the same time, self-reported measures were unrelated to the way people choose medical treatment. CONCLUSION: The results highlight the importance of discussing the issue of missing information with healthcare consumers and patients.

[Catheter-directed thrombolysis in iliofemoral thrombosis and aplasia of the inferior vena cava]. / Kateter-napravlennyi trombolizis pri iliofemoral'nom tromboze i aplazii nizhnei poloi veny.

Demonstrated in the article are the results of catheter-directed thrombolysis in a male patient presenting with bilateral acute iliofemoral venous thrombosis on the background of aplasia of the inferior vena cava. The incidence rate of this pathology is specified, with an emphasis on no recommendations on choosing optimal therapeutic strategy in this cohort of patients. The main causes and complications of the disease are described. The realized policy of revascularization demonstrated its safety and efficacy. The chosen method of correction resulted in a successful outcome of treatment, preventing phlegmasia cerulea dolens. This policy can be recommended as most preferred for patients with acute iliofemoral venous thrombosis on the background of aplasia of the inferior venal cava.

[Bypass grafting in patients with infected vascular grafts]. / Obkhodnoe shuntirovanie pri infitsirovanii sosudistogo proteza.

Analysed herein are the results of treating a total of 17 patients presenting with pathology of the aorta and lower-limb arteries, who from 2010 to 2018 required redo interventions due to infection of a previously implanted synthetic vascular graft. At admission, 3 patients were diagnosed as having an open infected wound, 11 were found to have a fistula, 2 had a false aneurysm in the area of the distal anastomosis of the branch of the bifurcation aortofemoral prosthesis, and 1 had thrombosis of the branch of the prosthesis with evidence of infection. As redo surgery, 4 patients underwent subclavian-femoral bypass grafting, 2 were subjected to crossover iliac-femoral bypass grafting, 8 to unilateral iliac-femoral bypass grafting, 3 to loop endarterectomy. In the majority of cases (14 of the 17) we used bypass grafting with creation of the tunnel through the muscular lacuna. Lethal outcomes were registered in 35% (n=6) of cases in the early postoperative period. Death was caused by acute renal failure in 6% (n=1), by acute mesenteric thrombosis in 12% (n=2), by gastrointestinal haemorrhage in 6% (n=1), and by multiple organ failure in 12% (n=2). Long-term mortality amounted to 33% (n=3) within 12 months. The main causes of death were increasing renal failure in 10% (n=1) and cardiovascular insufficiency on the background of heart diseases in 10% (n=1), as well as respiratory insufficiency in 10% (n=1). Reinfection in the remote period was diagnosed in 1 patient. A conclusion was drawn that bypass grafting is traumatic, however, it may be the only way to save the limb or patient's life in a complicated clinical situation. Using the superficial femoral vein as a shunt demonstrated good long-term results as to patency and resistance to surgical infection. Using a flap of the greater omentum, retroperitoneal fat, as well as wrapping of the prosthesis with a muscular flap ensured good tolerance of the zone of bypass grafting to reinfection.

Not All Forms of Independence Are Created Equal: Only Being Independent the "Right Way" Is Associated With Self-Esteem and Life Satisfaction.

Past research has found a strong and positive association between the independent self-construal and life satisfaction, mediated through self-esteem, in both individualistic and collectivistic cultures. In Study 1, we collected data from four countries (the United States, Japan, Romania, and Hungary; N = 736) and replicated these findings in cultures which have received little attention in past research. In Study 2, we treated independence as a multifaceted construct and further examined its relationship with self-esteem and life satisfaction using samples from the United States and Romania (N = 370). Different ways of being independent are associated with self-esteem and life satisfaction in the two cultures, suggesting that it is not independence as a global concept that predicts self-esteem and life satisfaction, but rather, feeling independent in culturally appropriate ways is a signal that one's way of being fits in and is valued in one's context.

[Open surgical treatment of aneurysms and dissection of the thoracic and thoracoabdominal aorta]. / Otkrytoe khirurgicheskoe lechenie anevrizm i rassloeniia grudnoi i torakoabdominal'noi aorty.

Presented herein is experience in treating a total of 56 patients with pathology of the arch, descending and thoracoabdominal aorta from 1997 to 2017. Of these, 6 (11%) patients were diagnosed with a Crawford type I-II thoracoabdominal aortic aneurysm (TAAA), 20 (35%) patients with Crawford type III-IV TAAA, 18 (32%) were diagnosed as having an aortic arch aneurysm (AAA) and descending thoracic aortic aneurysm (DTAA), 12 (22%) had DeBakey type I and IIIb aortic dissection. To protect the visceral organs and spinal cord from ischaemia in 28 (50%) cases we used a temporal bypass from a synthetic vascular graft with zero porosity and measuring from 15 to 20 cm in diameter. RESULTS: Mortality within 30 days amounted to 14.3% (n=8), that after 30 days amounted to 10.7% (n=6): in elective operations - 12% (n=5) and 5.4% (n=3), in emergency operations - 21% (n=3) and 21.4% (n=3), respectively. The total in-hospital mortality amounted to 25% (n=14), equalling 19% (n=8) and 43% (n=6) for elective and emergency operations, respectively. Mortality in using temporal bypass in elective operation amounted to 9.5% (n=2) during 30 days and that without using this method to 14.3% (n=3), after 30 days being 9.5% (n=2) and 4.7% (n=1), respectively. Mortality for emergency cases with a temporal shunt during 30 days was 28.6% (n=2), without - 14.3% (n=1), after 30 days - 28.6% (n=2), without - 14.3% (n=1). In type I-II TAAA mortality within 30 days was 16.6% (n=1), after 30 days - 50% (n=2); type III-IV TAAA - 10% (n=2) and 15% (n=1); DTAA - 22.2% (n=4) and 33.3% (n=2); aortic dissection - 8.3% (n=1) and 16.6% (n=1). Acute renal failure (ARF) occurred in 6 (10.7%) patients and was more often observed in the group without temporal shunting. Events of spinal cord ischaemia with the development of spinal stroke occurred in 6 (10.7%) cases. Five-year survival amounted to 61%. CONCLUSION: Temporal bypass in surgery of the thoracic and thoracoabdominal aorta may be used for prevention of ischaemia of visceral organs, kidneys and spinal cord in operations accompanied by cross-clamping of the descending thoracic aorta.

[Treatment of an aortic arch aneurysm ruptured into the lung]. / Lechenie razryva anevrizmy dugi aorty s proryvom v legkoe.

Described herein is a clinical case report concerning treatment of a 32-year-old female patient with rupture of an aneurysm of the arch and descending portion of the thoracic aorta, with the bleeding having penetrated the upper lobe of the left lung. The woman was admitted to the Department of Vascular Surgery of Municipal Multimodality Hospital No 2 of Saint Petersburg, presenting with a clinical pattern of aneurysmal rupture previously diagnosed by computed tomography performed at one of the local hospitals. Studying her case history revealed that, when a child, she had endured an operation for a defect of the interventricular septum and aortic coarctation with aortoplasty using a Dacron synthetic patch. On admission, she was treated as an emergency to immediately undergo temporal ascending-descending bypass grafting of the aorta and left common carotid artery without use of a heart-lung machine. After resection of the aneurysm of the arch and descending portion of the thoracic aorta and removal of the upper lobe of the left lung, a decision was made to leave the temporal shunt as permanent. In the early postoperative period the woman developed acute cerebral circulation impairment with minimal neurological deficit which was later on relieved. After 22 days, due to persisting atelectasis of the lower lobe of the left lung, the presence of an incompetent stump of the upper bronchus and air in the left pleural cavity, as well as high risk of infection of the vascular graft, we performed final bilateral pneumonectomy with omentopexy, i. e., suturing of the greater omentum to a portion of the thoracic graft. The woman was discharged on postoperative day 34 in a satisfactory condition. She then successfully gave birth to a child. She is currently presenting neither complaints nor evidence of respiratory insufficiency. The duration of follow up amounted to 8 years.

Successful management of automatic dysfunctional thoughts in the context of negative emotions.

BACKGROUND AND OBJECTIVES: Cognitive and affective overloads trigger automatic dysfunctional thoughts and undermine their voluntary management [ADTs; Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York: Meridian; Wegner, D. M. (1994). Ironic processes of mental control. Psychology Review, 101(1), 34-52]. Taking into account intense negative emotions as triggers for the ADTs, we explored whether context (i.e., social context) and emotional experience (i.e., emotional intensity) predict the successful management of ADTs. We also examine the moderating role of difficulties in emotional regulation strategies. METHOD: Thirty-eight participants wrote in a personal online diary of at least 10 times in 40 weeks. We analyzed the conditions for managing ADTs by means of multilevel in stages models. RESULTS: Emotional intensity negatively predicted successful management of ADTs. Attempts to control ADTs and work context positively predicted successful management of ADTs. The negative relation between the emotional intensity and the management of ADTs was stronger as individuals were less aware of their own emotions, and was weaker as they had less clear representations of their own emotions. Superior access to emotion regulation strategies explained a stronger relationship between the work context and the successful management of ADTs. CONCLUSIONS: We discuss theoretical and practical implications of the results.

[Hybrid surgical treatment of a multilevel lesion of lower-limb arteries]. / Gibridnoe khirurgicheskoe lechenie mnogourovnevogo porazheniia arterii nizhnikh konechnostei.

The study was aimed at assessing immediate postoperative and remote results of hybrid surgical treatment of patients with a multilevel lesion of lower-limb arteries. Described herein is the authors' experience with simultaneous hybrid surgical management of 48 patients, including 43 subjects with a multilevel lesion of arteries of the lower extremities. There were 40 men and 8 women, with the average age amounting to 65.8±7.9 years. Of these, 30 patients suffered from stage II-b chronic arterial insufficiency (CAI), 11 had stage III CAI and 7 had stage IV CAI according to A.V. Pokrovsky classification. While planning the hybrid operation on the arteries of lower limbs we assessed the type of the lesion to the aortofemoral and femoropopliteal segments according to TASC II. All patients were subdivided into 3 groups, depending on the type of hybrid operations: Group I (n=17) - aortofemoral segment, Group II (n=5) - femoropopliteal segment, and Group III (n=26) reconstruction of both above-mentioned segments. The technical success amounted to 93.7% in revascularization of all types of lesions of the arteries of lower limbs with the use of hybrid vascular reconstructions. The mean duration of the operation was 231.8±90.7 min, including that of the open stage amounting to 126.4±72.8 min and that of the endovascular stage to 105.4±62.9 min. In the immediate postoperative period there were 2 complications requiring repeat reconstructive operation. The ankle-brachial index (ABI) after the intervention increased from 0.43±0.17 to 0.85±0.12. The duration of follow-up averaged 23.4±15.1 months (range 1.9-45.2 mos). Primary patency at 6 months was 94%, at 12 months 94%, at 24 months - 85% and at 36 months - 79% in all groups studied. Four patients during the follow-up period were subjected to amputation. The limb salvage rates were as follows: during 36 months in all patients - 91.6%, in those with stage II-b CAI - 93.3% and in those with critical lower-limb ischaemia - 88.8%. The overall survival rate was 95.8%. The use of a hybrid method in treatment of a multilevel lesion of lower-limb arteries with revascularization of the aortofemoral and femoropopliteal segments proved efficient both in the immediate and remote periods.

The effectiveness of regional anaesthesia before and after the introduction of a dedicated regional anaesthesia service incorporating a block room.

Dedicated regional anaesthesia services incorporating block rooms and/or block teams may facilitate theatre efficiency and improve training in regional anaesthesia. Currently, it is unknown if a dedicated regional anaesthesia service improves the effectiveness of regional anaesthesia. In November 2013, the Royal Brisbane and Women's Hospital established a dedicated regional anaesthesia service comprising a block team and a block room. Pre-intervention (conventional model of care) registry data was retrospectively compared with post-intervention (dedicated regional anaesthesia service) audit data, with regard to pain and opioid requirement in the post-anaesthesia care unit (PACU). The primary outcome was inadequate analgesia, defined as a numerical rating scale (NRS; 0, no pain; 10, worst pain imaginable) for pain >5 in the PACU. Pre- and post-intervention, 43.7% and 27.7% of patients respectively reported a NRS >5 (P <0.001). A difference in the type of blocks and surgery performed may have accounted for the improved outcome seen post-intervention. After adjustment for American Society of Anesthesiologists physical status, block type and surgery type, the odds ratio of having inadequate analgesia (NRS >5) was 0.54 (95% confidence interval 0.39 to 0.76) for post-intervention compared to pre-intervention. Secondary outcomes examined pre- and post-intervention were the absence of pain (39.3% and 55.1% of patients, respectively, P <0.001), systemic opioid analgesia requirement (48.6% and 30.5% of patients respectively, P <0.001) and median maximum NRS (4 [interquartile range (IQR) 0 to 8] and 0 [IQR 0 to 6] respectively, P <0.001). A dedicated regional anaesthesia service was associated with improved effectiveness of regional anaesthesia.

[Operation for a giant pseudoaneurysm of the aortic arch without artificial circulation]. / Operatsiia pri gigantskoi lozhnoi anevrizme dugi aorty bez ispol'zovaniia iskusstvennogo krovoobrashcheniia.

Presented herein is a variant of surgical management of a patient with a giant false aneurysm of the aortic arch in the posterior mediastinum. Using the technique of temporary bypass or temporary "debranching" made it possible to carry out a reconstructive intervention without the use of an artificial circulation apparatus. This technique also decreases the necessity of using heparin, thus diminishing the risk of blood loss both during the operation and in the postoperative period. The described variant of the operation for a false aneurysm of the aortic arch extends and supplements the surgeon's capabilities of performing interventions on the aortic arch in the absence of a possibility of using an artificial circulation apparatus both in a scheduled and emergency situation.

[FEATURES OF CLINICAL COURSE OF INFECTIOUS MONONUCLEOSIS IN CHILDREN DEPENDENT ON ETIOLOGY].

The article highlights the clinical features of infectious mononucleosis in children (based on the analysis of the data for children of different ages treated in Odessa clinical hospital of infectious diseases in connection with infectious mononucleosis) based on etiological factors.

[The detection of occurrence rate of genes coding capability to form pili binding in auto-strains of Escherichia coli].

E. coli is a commensal of intestine of the vertebrata. The exchange of genetic material of different types of bacteria between themselves and with other representatives of family of Enterobacteriaceae in intestinal ecosystem results in development of types of normal colibacillus with genetic characteristics of pathogenicity that can serve as a theoretical substantiation to attribute such strains to pathobionts. The entero-pathogenic colibacillus continues be an important cause of diarrhea in children in developing countries. The gene responsible for formation of pili binding is a necessary condition for virulence of entero-pathogenic colibacillus. The polymerase chain reaction was applied to examine 316 strains of different types of E. coli (normal, with weak enzyme activity and hemolytic activity) isolated from healthy children and children with functional disorders of gastro-intestinal tract for presence of genes coding capability to form pill binding. The presence of this gene in different biochemical types of E. coli permits to establish the fact of formation of reservoir of pathogenicity in indigent microbiota of intestinal biocenosis.

[The distinctive features of EMG-activity in early age children with movement disorders].

The purpose of this work was the study of neuromuscular characteristics of healthy infants and infants with movement disorders by method of surface electromyography. 76 children at the age from 6 months till 3 years participated in the investigation: 61 with movement disorders (13--with ataxic form of cerebral palsy (CP), 48--with spastic form of CP) and 15 without movement disorders. Passive flexing and extending of knee and hip joints was conducted to the child in a recumbent position, EMG activity of the basic muscles groups of a hip and a shin was recorded. Characteristic properties of electromyographic activity were assessed with wavelet transform and subsequent analysis of obtained time dependencies. As a result of work the parameters connected with diagnosis of infants with movement disorders were revealed.

[Determination of molecular glioblastoma subclasses on the basis of analysis of gene expression].

Two glioblastoma groups, which are distinguished from each other by expression level of 416 genes (P < 0.05), were determined using a mathematical model of linear Boolean programming on the basis of gene expression data, obtained by microarray analysis of the glioblastomas and available in Gene Expression Omnibus (GEO) data base. The expression level of 15 genes was more than two-fold higher in the first group of glioblastoma (80 samples) in comparison with the second group (144 samples) and 401 genes and--more than two-fold lower as compared to the second group. 10 of 15 genes, which expression level prevailed in the first group, encode the proteins involved in cell cycle regulation and cell proliferation. A significant percentage of 401 genes are the genes that encode proteins involved in the functioning of neural cells and participating in the processes such as synaptic transmission, neurogenesis, the formation of myelin sheath, axon formation. Kohonen map, built on the basis of the data of 15 genes with prevailed expression in the first group and 60 (of4 01) genes, whose expression level elevated in the second group, confirmed the existence of two glioblastoma groups with specific gene expression profiles. Distribution of the glioblastomas into two groups may reflect two pathways of astrocytic glioma development, one of which leads to the formation of tumors with higher levels of gene expression, which protein products are involved in cell cycle regulation and proliferation. On the other hand, the existence of two molecular variants may reflect different states of glioblastoma progression.

[Response of HeLa cells to mitomycine C. III. The analysis of nucleoli of mother and daughter cells].

The comparative analysis of the number of nucleoli in cells of the established HeLa-M line was carried out before and after exposure to mitomycin C in a concentration of 10 µg/ml for 2 h. Using time-lapse microscopy, nucleoli in mother and their respective daughter cells were computed. It has been shown that the average number of nucleoli per cell is generally higher in daughter cells than in mother cells, and a standard deviation, on the contrary, decreases. An average number of nucleoli in daughter cells, whose mother cells had been treated with mitomycin C, was higher than in corresponding cells of control group. The separate analysis has been performed for the cells having from 1 to 4 nucleoli. Nonrandom complete coincidence of the number of nucleoli in mather and daughter cells has been typicaly shown for about 1/7 of the total cell population. Mitomycin C reduces this value of about 1.5 times.

[Colocalization of nucleoli in cell nuclei of HeLa line].

The pattern of localization of nucleoli relative to each other and to cell nucleus was studied in M-HeLa cell line. For this puspose, the following morphometric parameters were introduced. For the two-nucleolar cells: 1) the ratio of the nucleus long axis to the length of a segment between the centers of the nucleoli, and 2) the angle between the segment connecting the centers of the nucleoli and a longitudinal axis of cell nucleus. For the three-nucleolar cells: the ratio perimeter of the nucleus to perimeter of a triangle with vertexes in the centre of nucleoli. We have shown that the values of these parameters are individual for each cell but their values remain constant for the cell in spite of the changes in cell shape. These results allow us to conclude that, on the one hand, the nucleoli colocalization is individual for each cell, and, on the other hand, location of nucleoli in relation to nucleus is not changed during interphase. Thereby, the distance between nucleoli increases proportionally with nucleus growth.

[Catecholamine content in the adrenal gland of rat offspring in the model of prenatal hyperhomocysteinemia].

Catecholamine content has been studied in the adrenal gland of rat females whose pregnant mothers were loaded daily with L-methionine administered per os during all the pregnancy period, on the first day of postnatal life, and in one and two months after birth. The animal model of hyperhomocysteinemia used in the experiment has been shown to result in the catecholamine content decreasing in the adrenal gland of both newly born rat offspring with high serum level of homocysteine and one-month old offspring with their homocysteine level decreased to the normal values. It was found that nitrotyrosine level increased significantly in the blood serum of the offspring aged one and two months. The data obtained may testify to oxidative stress development.

[Effect of flavonoids on the composition of surface glycopolymers in Azospirillum lipoferum Sp59b].

Cultivation of the type strain Azospirillum lipoferum Sp59b in the presence of the flavonoid quercetin induced modification of the structure of the bacterial lipopolysaccharide. Cultivation in the presence of the flavonoid was shown to result in altered serological characteristics of the bacteria, increased heterogeneity of the outer membrane lipopolysaccharide pool, as well as in modified composition and fatty acid ratio of lipid A. The flavonoid was shown to induce the synthesis of the O-specific polysaccharide with the repeating structure represented by a tetrasaccharide consisting of a linear trisaccharide fragment of α-L-Rhap residues in the main chain and the terminal ß-D-Glcp residue. The structure of this O-specific polysaccharide was identical to the previously determined structure of the capsular polysaccharide of these bacteria grown without quercetin. Modifications in the structural composition of the capsular polysaccharide induced by cultivation in the presence of quercetin were revealed.