[Use of thoracic and lung ultrasound in general anesthesia]. / A mellkas és a tüdo ultrahangvizsgálatának szerepe az általános érzéstelenítés során.

The use of ultrasound became an essential tool in the everyday practice of anesthesiology and intensive care as an indispensable prerequisite for the precise guidance of invasive procedures and also as a point-of-care diagnostic method. Despite the limitations of imaging the lung and thoracic structures, the COVID-19 pandemic and recent advances made this technology an evolving field. The intensive therapy applies these methods with important experience for differential diagnosis and assessment of disease severity or prognosis. Minor modifications of these results make the method beneficial for anesthesia and perioperative medicine. In the present review, the authors accentuate the most important imaging artefacts of lung ultrasonography and the principles of lung ultrasound diagnostic steps. Methods and artefacts of high importance supported by evidence for the assessment of airway management, attuning of intraoperative mechanical ventilation, respiratory disorders during surgery, and postoperative prognosis are articulated. This review intends to focus on evolving subfields in which technological or scientific novelties are expected. Orv Hetil. 2023; 164(22): 864-870.

Reliability and clinical correlations of semi-quantitative lung ultrasound on BLUE points in COVID-19 mechanically ventilated patients: The 'BLUE-LUSS'-A feasibility clinical study.

INTRODUCTION: Bedside lung ultrasound has gained a key role in each segment of the treatment chain during the COVID-19 pandemic. During the diagnostic assessment of the critically ill patients in ICUs, it is highly important to maximize the amount and quality of gathered information while minimizing unnecessary interventions (e.g. moving/rotating the patient). Another major factor is to reduce the risk of infection and the workload of the staff. OBJECTIVES: To serve these significant issues we constructed a feasibility study, in which we used a single-operator technique without moving the patient, only assessing the easily achievable lung regions at conventional BLUE points. We hypothesized that calculating this 'BLUE lung ultrasound score' (BLUE-LUSS) is a reasonable clinical tool. Furthermore, we used both longitudinal and transverse scans to measure their reliability and assessed the interobserver variability as well. METHODS: University Intensive Care Unit based, single-center, prospective, observational study was performed on 24 consecutive SARS-CoV2 RT-PCR positive, mechanically ventilated critically ill patients. Altogether 400 loops were recorded, rated and assessed off-line by 4 independent intensive care specialists (each 7+ years of LUS experience). RESULTS: Intraclass correlation values indicated good reliability for transversal and longitudinal qLUSS scores, while we detected excellent interrater agreement of both cLUSS calculation methods. All of our LUS scores correlated inversely and significantly to the P/F values. Best correlation was achieved in the case of longitudinal qLUSS (r = -0.55, p = 0.0119). CONCLUSION: Summarized score of BLUE-LUSS can be an important, easy-to-perform adjunct tool for assessing and quantifying lung pathology in critically ill ventilated patients at bedside, especially for the P/F ratio. The best agreement for the P/F ratio can be achieved with the longitudinal scans. Regarding these findings, assessing BLUE-points can be extended with the BLUE-LUSS for daily routine using both transverse and longitudinal views.

Factor structure, reliability and criterion-related validity of the English version of the Problematic Series Watching Scale.

BACKGROUND: Psychological research in the past decade has investigated the psychosocial implications of problematic use of on-demand online video streaming services, particularly series watching. Yet, a psychometric measure of problematic series watching in English is not available. AIMS: The present study aimed to test the factor structure, reliability and criterion-related validity of the English version of the Problematic Series Watching Scale, a six-item self-report assessing problematic series watching, based on the biopsychosocial components model of addiction. METHOD: Participants were recruited from two UK university student samples. Study 1 (n = 333) comprised confirmatory factor analysis, reliability tests and item response theory analyses to test the original unidimensional model and investigate each item's levels of discrimination and information. Study 2 (n = 209) comprised correlation analyses to test the criterion-related validity of the scale. RESULTS: There was a good fit of the theoretical model of the scale to the data (Comparative Fit Index = 0.998, Root Mean Square Error of Approximation = 0.024 [90% CI 0.000-0.093], Standardised Root Mean square Residual = 0.048), satisfactory reliability (ω = 0.79) and item levels of discrimination and information. The scale positively correlated with time spent watching series (rs = 0.26, P < 0.001) and negative affect (rs = 0.43, P < 0.001), and correlated negatively with positive affect (rs = -0.12, P > 0.05), mental well-being (rs = -0.25, P < 0.001) and sleep quality (rs = -0.14, P < 0.05). CONCLUSIONS: Results are discussed in relation to the ongoing debate on binge watching and series watching in the context of positive reinforcement versus problematic behaviour.

Nepotistic Hiring and Poverty From Cultural, Social Class, and Situational Perspectives.

Being poor can influence how one makes ethical decisions in various fields. Nepotism is one such area, emerging as kinship-based favoritism in the job market. People can be poor on at least three levels: one can live in a poor country (cross-cultural poverty), be poor compared to others around them (socio-economic poverty), or feel poor in their given situation (situational poverty). We assumed that these levels can simultaneously influence nepotistic hiring decisions among Hungarian (N = 191) and US participants (N = 176). Prior cross-cultural, non-experimental studies demonstrated that nepotism is more prevalent in poorer countries such as Hungary than in richer countries such as the United States. However, contrary to our expectations, in our non-representative, preliminary study, US participants showed stronger nepotistic behavioral tendencies than Hungarians (cross-cultural level). Furthermore, people with lower socioeconomic status had less nepotistic intentions than richer people (socio-economic level). When participants were asked to imagine themselves as a poor person (situational level), they tended to be more nepotistic than had they imagined themselves to be rich. Finally, nepotistic hiring intentions were in general stronger than non-nepotistic hiring intentions. These seemingly paradoxical results were interpreted in the light of the COVID-19 job market context and were explained by the mechanisms described by research on wealth and immoral behaviors, as well as the presence of risk aversion.

Safety-Critical Control of Active Interventions for COVID-19 Mitigation.

The world has recently undergone the most ambitious mitigation effort in a century, consisting of wide-spread quarantines aimed at preventing the spread of COVID-19. The use of influential epidemiological models of COVID-19 helped to encourage decision makers to take drastic non-pharmaceutical interventions. Yet, inherent in these models are often assumptions that the active interventions are static, e.g., that social distancing is enforced until infections are minimized, which can lead to inaccurate predictions that are ever evolving as new data is assimilated. We present a methodology to dynamically guide the active intervention by shifting the focus from viewing epidemiological models as systems that evolve in autonomous fashion to control systems with an "input" that can be varied in time in order to change the evolution of the system. We show that a safety-critical control approach to COVID-19 mitigation gives active intervention policies that formally guarantee the safe evolution of compartmental epidemiological models. This perspective is applied to current US data on cases while taking into account reduction of mobility, and we find that it accurately describes the current trends when time delays associated with incubation and testing are incorporated. Optimal active intervention policies are synthesized to determine future mitigations necessary to bound infections, hospitalizations, and death, both at national and state levels. We therefore provide means in which to model and modulate active interventions with a view toward the phased reopenings that are currently beginning across the US and the world in a decentralized fashion. This framework can be converted into public policies, accounting for the fractured landscape of COVID-19 mitigation in a safety-critical fashion.

Identity Leadership, Employee Burnout and the Mediating Role of Team Identification: Evidence from the Global Identity Leadership Development Project.

Do leaders who build a sense of shared social identity in their teams thereby protect them from the adverse effects of workplace stress? This is a question that the present paper explores by testing the hypothesis that identity leadership contributes to stronger team identification among employees and, through this, is associated with reduced burnout. We tested this model with unique datasets from the Global Identity Leadership Development (GILD) project with participants from all inhabited continents. We compared two datasets from 2016/2017 (n = 5290; 20 countries) and 2020/2021 (n = 7294; 28 countries) and found very similar levels of identity leadership, team identification and burnout across the five years. An inspection of the 2020/2021 data at the onset of and later in the COVID-19 pandemic showed stable identity leadership levels and slightly higher levels of both burnout and team identification. Supporting our hypotheses, we found almost identical indirect effects (2016/2017, b = -0.132; 2020/2021, b = -0.133) across the five-year span in both datasets. Using a subset of n = 111 German participants surveyed over two waves, we found the indirect effect confirmed over time with identity leadership (at T1) predicting team identification and, in turn, burnout, three months later. Finally, we explored whether there could be a "too-much-of-a-good-thing" effect for identity leadership. Speaking against this, we found a u-shaped quadratic effect whereby ratings of identity leadership at the upper end of the distribution were related to even stronger team identification and a stronger indirect effect on reduced burnout.