Good outcomes of living donor liver transplant in primary sclerosing cholangitis: an experience from North India.

BACKGROUND: Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease. In the absence of effective medical therapy, liver transplant is the definitive treatment for advanced stage. However, recurrence of PSC after liver transplant is of concern which can lead to graft failure and may require retransplant. There are limited data on outcomes of living donor liver transplant (LDLT) in PSC. Also, in LDLT as donors are genetically related there can be an increased risk of recurrence. We conducted this retrospective study to analyze the outcomes of LDLT in PSC at a tertiary liver transplant center in north India. METHODS: We conducted a retrospective analysis of 3213 transplant recipients who underwent LDLT from January 2006 to May 2021. Of these 26 (0.80%) patients had PSC as indication for liver transplantation (PSC = 24, PSC-AIH overlap = 2). Data analysis was done to look for baseline demographics, clinical details, transplant outcomes, PSC recurrence, and survival. RESULTS: Mean age of study group was 42 (± 13.8) years and 19 patients (73.1%) were males. All patients had decompensated cirrhosis at the time of transplant. Mean CTP score and MELD score were 9.5 (± 1.8) and 18.9 (± 7.1), respectively. Sixteen patients received modified right lobe graft, seven extended right lobe graft and five patients received left lateral graft. Median graft weight and mean graft to recipient weight ratio (GRWR) were 633.5 (IQR 473.5-633.5) grams and 1.23 (± 0.42), respectively. Most common biliary anastomosis was hepaticojejunostomy, done in 19 (73.1%) while duct to duct anastomosis was performed in 7 (26.9%) patients. Median follow-up was 96 (36-123) months. One patient had ulcerative colitis and none had cholangiocarcinoma. Two (7.7%) patients had bile leak during early post-transplant period. Three (11.1%) patients developed graft rejection and were managed successfully with steroid pulses. Three patients died during early post-transplant period while seven deaths occurred during long-term follow-up including one death due to COVID-19. Five (21.73%) patients had recurrence of PSC of which two patients had graft loss including one after retransplantation. The one year graft and patient survival rate was 88.5%. CONCLUSION: LDLT can be performed in PSC with good long-term outcomes with a risk of PSC recurrence in about one-fifth patients.

Decision Criteria for Partial Nationalization of Pharmaceutical Supply Chain: A Scoping Review

(1) Background: Any disturbance in the pharmaceutical supply chain (PSC) can disrupt the supply of medicines and affect the efficiency of health systems. Due to shortages in the global pharma supply chain over the past few years and the complex nature of free trade and its limitations when confronted by a major global health and humanitarian crisis, many countries have taken steps to mitigate the risks of disruption, including, for example, recommending the adoption of a plus one diversification approach, increasing safety stock, and nationalizing the medical supply chains. (2) Objective: To scope findings in the academic literature related to decision criteria to guide national policy decisions for the "Partial Nationalization of Pharmaceutical Supply Chain” (PNPSC) from the viewpoints of the three main stakeholders: industry, payers (government and health insurance), and patients. (3) Methods: These consist of a scoping review of the peer-reviewed literature. (4) Results: A total of 115 studies were included. For local manufacturing decisions, five criteria and 15 sub-criteria were identified. Weighting, decision-making, risk assessment, and forecasting were the main data analysis tools applied;(5) Conclusions: The findings could serve as a baseline for constructing PNPSC frameworks after careful adaptation to the local context.

How Psychosocial Safety Climate Helped Alleviate Work Intensification Effects on Presenteeism during the COVID-19 Crisis? A Moderated Mediation Model.

Healthcare sector organizations have long been facing the issue of productivity loss due to presenteeism which is affected by psychosocial safety climate (PSC) and work intensification. Presenteeism has visibly increased among nurses during COVID-19 pandemic period. Grounded in COR theory and sensemaking theory, the current study aimed to examine the role PSC plays as driver or moderator to reduce presenteeism by lessening work intensification over time and the impact of work intensification over time on presenteeism during the COVID-19 pandemic. Adopting a time-lagged research design, this study gathered data from randomly selected registered nurses, practicing in Québec, Canada in two phases, i.e., 800 at Time 1 and 344 at Time 2 through email surveys. The study results showed that (1) PSC reduces presenteeism over time by reducing work intensification at time 1; (2) PSC moderates the relationship between work intensification at time 1 and work intensification at time 2; and (3) PSC as moderator also lessens the detrimental effect of work intensification at time 2 on presenteeism at time 2. Presenteeism among nurses affects their health and psychological well-being. We find that PSC is likely an effective organizational tool particularly in crises situations, by providing an organizational mechanism to assist nurses cope (through a resource caravan, management support) with managing intensified work.

"I Was Given Three Marks and Told to Buy a Porsche"-Supervisors' Experiences of Leading Psychosocial Safety Climate and Team Psychological Safety in a Remote Academic Setting.

This study examines leading psychosocial safety climate (PSC) within the organization and psychological safety in teams in remote work conditions caused by the COVID-19 pandemic. These topical working life phenomena have an essential role in health, well-being and productivity in today's working life, but they have rarely been studied in remote work context. A total of 26 supervisors and leaders at three Finnish universities participated in semi-structured interviews. The data were analyzed using qualitative content analysis, resulting in four main categories: supportive and challenging aspects of leading psychological safety and well-being, supportive and challenging aspects of organizational psychosocial safety climate leadership, support for working as a supervisor, and characteristics specific to working in academia. The results indicate that leading psychological safety remotely requires more time, deliberation and intentionality than when working face to face, and that the role of remote interaction is underlined in it. As to PSC, it is important to improve the cohesion in leading psychological safety and health in academic organizations. How PSC is led in the organizations affects not only the general psychosocial working conditions, but also the possibilities for good leadership of psychological safety in smaller units in the organization. The study makes a novel contribution especially in understanding (1) leadership of PSC and psychological safety in remote work conditions, and (2) the reciprocal relations between leading psychological safety and well-being at the organizational level and the team level.

Is port state control influenced by the COVID-19? Evidence from inspection data.

Maritime transport plays a key role in global trade. The safeguard of maritime transport is the Port State Control (PSC) inspection implemented all over the world. The outbreak of the Coronavirus disease (COVID-19) in 2020 presents new and unprecedented impacts on global supply chains and the ports as well as the entire shipping industry. Various measures were adopted by the countries and regions to halt the spread of the pandemic, mainly by reducing face-to-face interactions. As PSC inspections involve getting onboard vessels and in-person communications between the inspectors and the crew, its procedure and results are highly likely to be influenced by the COVID-19. This study aims to explore whether, how, and why the global and regional PSC inspection statuses are influenced by the pandemic through analyzing real inspection data. Specifically, three general indicators, namely inspection number, average deficiency number per inspection, and detention rate, are considered. Moreover, a detailed and comprehensive analysis of the inspection data at the Hong Kong port is conducted, including the number of inspections conducted, the average deficiency number and detention rate, the types of inspections conducted and ships inspected, the detailed deficiency and detention conditions, the relationship between the local pandemic situation and the PSC inspection status, and regression analysis on the influencing factors on inspection outcome. It is found that the COVID-19 pandemic indeed has an impact on PSC. Meanwhile, pragmatic and flexible measures are adopted by the port states, and the PSC has always been acting as a 'safety net' to guarantee maritime safety, promote the marine environment, and protect the seafarers' rights even under the difficult times during the COVID-19 pandemic.

Heart in a Dish: From Traditional 2D Differentiation Protocols to Cardiac Organoids.

Human pluripotent stem cells (hPSCs) constitute a valuable model to study the complexity of early human cardiac development and investigate the molecular mechanisms involved in heart diseases. The differentiation of hPSCs into cardiac lineages in vitro can be achieved by traditional two-dimensional (2D) monolayer approaches or by adopting innovative three-dimensional (3D) cardiac organoid protocols. Human cardiac organoids (hCOs) are complex multicellular aggregates that faithfully recapitulate the cardiac tissue's transcriptional, functional, and morphological features. In recent years, significant advances in the field have dramatically improved the robustness and efficiency of hCOs derivation and have promoted the application of hCOs for drug screening and heart disease modeling. This review surveys the current differentiation protocols, focusing on the most advanced 3D methods for deriving hCOs from hPSCs. Furthermore, we describe the potential applications of hCOs in the pharmaceutical and tissue bioengineering fields, including their usage to investigate the consequences of Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV2) infection in the heart.

Short Form of the Pediatric Symptom Checklist-Youth Self-Report (PSC-17-Y): Spanish Validation Study.

BACKGROUND: The short form, 17-item version of the Pediatric Symptom Checklist-Youth Self-Report (PSC-17-Y) is a validated measure that assesses psychosocial problems overall (OVR) and in 3 major psychopathological domains (internalizing, externalizing, and attention-deficit/hyperactivity disorder), taking 5-10 min to complete. Prior research has established sound psychometric properties of the PSC-17-Y for English speakers. OBJECTIVE: This study extends psychometric evidence for the acceptability of the PSC-17-Y in a large sample of Spanish adolescents, providing proof of its reliability and structure, convergent and discriminant validity, and longitudinal and gender invariance. METHODS: Data were collected on 5430 adolescents, aged 12-18 years, who filled out the PSC-17-Y twice during 2018-2019 (7-month interval). We calculated the Cronbach alpha and the McDonald omega coefficients to test reliability, the Pearson correlation for convergent (distress) and criterion validity (well-being, quality of life, and socioemotional skills), confirmatory factor analysis (CFA) for structure validity, and multigroup and longitudinal measurement invariance analysis for longitudinal and gender stability. RESULTS: Within structural analysis for the PSC-17-Y, CFA supported a correlated 3-factor solution, which was also invariant longitudinally and across gender. All 3 subscales showed evidence of reliability, with coefficients near or above .70. Moreover, scores of PSC-17-Y subscales were positively related with convergent measures and negatively related with criterion measures. Normative data for the PSC-17-Y are presented in the form of percentiles (75th and 90th). CONCLUSIONS: This work provides the first evidence of the reliability and validity of the Spanish version of the PSC-17-Y administered over the internet to assess mental health problems among adolescents, maintaining the same domains as the long version.

How does psychosocial safety climate affect burnout among malaysian educators during the covid-19 pandemic?

Nowadays, the COVID-19 pandemic has led Malaysian educators to experience more significant burnout due to job demands. This paper is an effort to examine the reasons that caused burnout among Malaysian educators. A total of 413 Malaysian educators participated in the study. This study’s findings revealed that PSC has a significant negative relationship with hindrance demands and burnout, whereas both challenge and hindrance demands have insignificant positive relationships with burnout. Furthermore, the study showed that two variables—challenge demands and hindrance demands—played significant mediators in the relationship between PSC and burnout. As a result, it is concluded that PSC can reduce the unfavorable characteristics of hindrance demands and burnout among Malaysian educators. This paper’s findings are valuable to academics and experts who wish to minimize the burnout pervasiveness among Malaysian educators. © 2021 by De La Salle University.

Teleworking While Sick: A Three-Wave Study of Psychosocial Safety Climate, Psychological Demands, and Presenteeism.

Introduction: The COVID-19 pandemic has led to a significant increase in the proportion of employees for whom teleworking became mandatory. Presenteeism, or the behavior of working while ill, has hardly been studied in the context of telework. The pandemic forced millions of workers to abruptly transition to working from home for a prolonged period of time, leaving employers often unaware of their health status or work capacity of the workers. This change also eroded the work experience itself, the workplace, and their protective impact on both individual health and work outcomes. This study focused on the longitudinal relationships among psychosocial safety climate (PSC), a lead indicator of workplace conditions, psychological demands, an indicator of quality of work, and presenteeism among a representative sample of teleworkers. PSC was expected to have an indirect impact on presenteeism with psychological demands as a mediator of this impact. Method: We collected the data from a representative sample of teleworkers in the first months (T1: April, T2: June, and T3: December 2020) of the pandemic using a three-wave online survey (n = 275). We tested a model of PSC as a determinant of presenteeism in teleworkers with psychological demands as a mediator. A cross-lagged panel model was estimated to test cross-sectional and longitudinal relationships. Findings: As expected, psychological demands increased over time. Contrary to expectations, the prevalence of presenteeism remained unchanged while PSC increased over time. The data fully supported the mediating effect of psychological demands such that a higher evaluation of PSC at T1 led to lower psychological demands at T2, which led to reduced presenteeism at T3. We also found a reciprocal relationship, with higher psychological demands at T2 leading to decreased evaluation of PSC at T3. These results show that the perception of teleworkers on their organization as giving a high priority to their psychological health is an important determinant of their work experience, ultimately influencing their decision to work while ill. The context of the pandemic has highlighted the importance of a positive workplace climate and working conditions for reducing the behaviors that can be harmful to health and productivity. Implications for theory and practice, beyond the pandemic, are discussed.

Post Traumatic Growth for Gestational Diabetic Patients During COVID-19: Role of Partner Supportive Communication and Family Environment.

PURPOSE: Leading a normal life and managing daily psychological or physical stress is hard for everybody but when a person is diagnosed with gestational diabetes mellitus (GDM) during a widespread pandemic, the battle is inescapable. This research aimed to explore some positive dimensions that can lessen the adversities of these women. DESIGN AND METHODS: We assessed all 200 cases of GDM who were registered in the maternity wards of the government and private hospitals of South Punjab, Pakistan. Respondents were diagnosed with GDM during the first wave of COVID-19. Post-traumatic growth (PTG) inventory, Family environment scale, and Partner supportive communication (PSC) scale were used. SEM and moderation analysis was conducted to test the hypothesized relationship among the variables. RESULTS: Result showed that elicitation of thoughts and feelings (ß = 0.109, t-value = 3.501, p = 0.001), effective listening (ß = -0.144, t-value = 1.928, p = 0.054), and communication towards partner (ß = -0.209, t-value = 4.850, p = 0.005) significantly moderated the relationship between family environment and post traumatic growth. PRACTICAL IMPLICATIONS: This research is beneficial for health practitioners because the trauma of being diagnosed with such a disease can be alleviated by the role of family environment and PSC.

Incidence, characteristics, and outcome of COVID-19 in patients on liver transplant program: a retrospective study in the north of Iran.

The risk of severe coronavirus disease-2019 (COVID-19) disease seems to be higher in individuals with solid organ transplantation. Therefore, the purpose of the present research is to investigate the incidence of COVID-19 and laboratory data and epidemiologic factors in liver transplant recipients and the patients on the waiting list for liver transplantation. In this study, we evaluated the records of patients on the waiting list for liver transplantation and of recipients of a liver transplant. Demographic data, underlying disease, history of drug use and participants' outcomes were collected. The diagnosis of SARS-CoV-2 infection for all patients was confirmed using a nasopharyngeal swab specimen with real-time RT-PCR. During the study period, 172 patients were enrolled, among whom 85 patients (49.4%) were on the waiting list for liver transplantation, and 87 patients (50.6%) were recipients of a liver transplant. Out of them, 10 (5.8%) had a positive result for SARS-CoV-2. Of these patients, 7.05% (6/85) and 4.6% (4/87) of patients on the waiting list and recipients of liver transplants were positive for SARS-CoV-2, respectively. Patients on the waiting list with COVID-19 infection had a higher median of albumin, ALT, AST, TBIL, DBIL, HDL and LDL value. In summary, the incidence of COVID-19 in liver transplant patients was slightly higher. The existence of underlying liver diseases should be well known as one of the poor predictive factors for worse outcomes in patients with COVID-19. So, comparative studies are recommended to identify risk factors for COVID-19 in patients with liver injury.

Rethinking Remdesivir: Synthesis, Antiviral Activity, and Pharmacokinetics of Oral Lipid Prodrugs.

Remdesivir (RDV; GS-5734) is currently the only FDA-approved antiviral drug for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The drug is approved for use in adults or children 12 years or older who are hospitalized for the treatment of COVID-19 on the basis of an acceleration of clinical recovery for inpatients with this disease. Unfortunately, the drug must be administered intravenously, restricting its use to those requiring hospitalization for relatively advanced disease. RDV is also unstable in plasma and has a complex activation pathway which may contribute to its highly variable antiviral efficacy in SARS-CoV-2-infected cells. Potent orally bioavailable antiviral drugs for early treatment of SARS-CoV-2 infection are urgently needed, and several, including molnupiravir and PF-07321332, are currently in clinical development. We focused on making simple, orally bioavailable lipid analogs of remdesivir nucleoside (RVn; GS-441524) that are processed to RVn monophosphate, the precursor of the active RVn triphosphate, by a single-step intracellular cleavage. In addition to high oral bioavailability, stability in plasma, and simpler metabolic activation, new oral lipid prodrugs of RVn had submicromolar anti-SARS-CoV-2 activity in a variety of cell types, including Vero E6, Calu-3, Caco-2, human pluripotent stem cell (PSC)-derived lung cells, and Huh7.5 cells. In Syrian hamsters, oral treatment with 1-O-octadecyl-2-O-benzyl-glycero-3-phosphate RVn (ODBG-P-RVn) was well tolerated and achieved therapeutic levels in plasma above the 90% effective concentration (EC90) for SARS-CoV-2. The results suggest further evaluation as an early oral treatment for SARS-CoV-2 infection to minimize severe disease and reduce hospitalizations.

Can servant leadership prevent hotel employee depression during the COVID-19 pandemic? A mediating and multigroup analysis.

The hospitality industry has been severely hit by the COVID-19 pandemic, with changes that have harmed employees' psychological well-being. However, having supervisors who are servant may make a difference. With a focus on serving others and the care taken to ensure their employees' highest priority needs are served, these leaders could help employees feel less depressed in these complicated times. By instilling servant behaviors in followers that help them become people that others can trust or with whom they can develop friendships, leaders could help these employees earn greater levels of personal social capital (PSC) through which to more successfully address pandemic times, especially if furloughed. Using structural equation modeling to analyze a sample of 205 hotel employees in Spain, we found that servant leadership directly decreases depression, and that PSC mediates this relationship. Our multigroup analyses (MGA) findings also reveal that when these employees are furloughed, the negative effect of PSC and the mediating role of PSC in this relationship is stronger. New light is thus shed on how servant leadership is effective in reducing employee depressive symptoms in times of severe changes such as those produced by the COVID-19 pandemic.