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Differences in risk perception factors and behaviours amongst and within professionals and trainees in the aviation engineering domain

In the aviation sector, the variability in the appreciation of safety risk perception factors and responses to risk behaviours has not been sufficiently studied for engineers and technicians. Through a questionnaire survey, this study investigated differences amongst professionals and trainees across eleven risk perception factors and five indicative risk behaviour scenarios. The findings indicated significant differences between the two groups in four factors and three scenarios as well as within groups. Moreover, age, years of work and study and educational level were other factors accounting for such differences within each group of professionals and trainees. The results showing these significant differences are aligned with relevant research about pilots and indicate that the appreciation of risk perception factors by aviation engineers and the development of their risk behaviours deserves more attention. Our findings cannot be generalised due to the small sample and its distribution across the demographic variables. However, the results of this study suggest the need tailoring risk communication and training to address the different degrees to which influences of risk perception factors are comprehended, and risk behaviours emerge in aviation engineering trainees and professionals. Further research could focus on the development of a respective uniform framework and tool for the specific workforce group and could administer surveys to more extensive and more representative samples by including open-ended questions and broader social, organisational and systemic factors.

Skeletal muscle alterations in patients with acute Covid-19 and post-acute sequelae of Covid-19

Skeletal muscle-related symptoms are common in both acute coronavirus disease (Covid)-19 and post-acute sequelae of Covid-19 (PASC). In this narrative review, we discuss cellular and molecular pathways that are affected and consider these in regard to skeletal muscle involvement in other conditions, such as acute respiratory distress syndrome, critical illness myopathy, and post-viral fatigue syndrome. Patients with severe Covid-19 and PASC suffer from skeletal muscle weakness and exercise intolerance. Histological sections present muscle fibre atrophy, metabolic alterations, and immune cell infiltration. Contributing factors to weakness and fatigue in patients with severe Covid-19 include systemic inflammation, disuse, hypoxaemia, and malnutrition. These factors also contribute to post-intensive care unit (ICU) syndrome and ICU-acquired weakness and likely explain a substantial part of Covid-19-acquired weakness. The skeletal muscle weakness and exercise intolerance associated with PASC are more obscure. Direct severe acute respiratory syndrome coronavirus (SARS-CoV)-2 viral infiltration into skeletal muscle or an aberrant immune system likely contribute. Similarities between skeletal muscle alterations in PASC and chronic fatigue syndrome deserve further study. Both SARS-CoV-2-specific factors and generic consequences of acute disease likely underlie the observed skeletal muscle alterations in both acute Covid-19 and PASC.

Goal 13: Climate Action

Oxygen Consumption with High-Flow Nasal Oxygen versus Mechanical Ventilation—An International Multicenter Observational Study in COVID–19 Patients (PROXY–COVID)

The COVID–19 pandemic led to local oxygen shortages worldwide. To gain a better understanding of oxygen consumption with different respiratory supportive therapies, we conducted an international multicenter observational study to determine the precise amount of oxygen consumption with high-flow nasal oxygen (HFNO) and with mechanical ventilation. A retrospective observational study was conducted in three intensive care units (ICUs) in the Netherlands and Spain. Patients were classified as HFNO patients or ventilated patients, according to the mode of oxygen supplementation with which a patient started. The primary endpoint was actual oxygen consumption; secondary endpoints were hourly and total oxygen consumption during the first two full calendar days. Of 275 patients, 147 started with HFNO and 128 with mechanical ventilation. Actual oxygen use was 4.9-fold higher in patients who started with HFNO than in patients who started with ventilation (median 14.2 [8.4–18.4] versus 2.9 [1.8–4.1] L/minute; mean difference 5 11.3 [95% CI 11.0–11.6] L/minute; P, 0.01). Hourly and total oxygen consumption were 4.8-fold (P, 0.01) and 4.8-fold (P, 0.01) higher. Actual oxygen consumption, hourly oxygen consumption, and total oxygen consumption are substantially higher in patients that start with HFNO compared with patients that start with mechanical ventilation. This information may help hospitals and ICUs predicting oxygen needs during high-demand periods and could guide decisions regarding the source of distribution of medical oxygen.

Tolerance to exercise in high-altitude in organ transplant recipients

Op het congres van de Britisch Transplant Society en de Nederlandse Transplantatie Vereniging dat gehouden werd in Bournemouth, Engeland is deze bijgevoegde poster gepresenteerd. De poster beschrijft het onderzoek naar de inspanningstolerantie van mensen na een orgaantransplantatie op grote hoogte, tijdens de beklimming van de Kilimanjaro.

Tolerance of organ transplant recipients to physical activity during a high-altitude expedition

BACKGROUND: It is generally unknown to what extent organ transplant recipients can be physically challenged. During an expedition to Mount Kilimanjaro, the tolerance for strenuous physical activity and high-altitude of organ transplant recipients after various types of transplantation was compared to non-transplanted controls.METHODS: Twelve organ transplant recipients were selected to participate (2 heart-, 2 lung-, 2 kidney-, 4 liver-, 1 allogeneic stem cell- and 1 small bowel-transplantation). Controls comprised the members of the medical team and accompanying family members (n = 14). During the climb, cardiopulmonary parameters and symptoms of acute mountain sickness were recorded twice daily. Capillary blood analyses were performed three times during the climb and once following return.RESULTS: Eleven of the transplant participants and all controls began the final ascent from 4700 meters and reached over 5000 meters. Eight transplant participants (73%) and thirteen controls (93%) reached the summit (5895m). Cardiopulmonary parameters and altitude sickness scores demonstrated no differences between transplant participants and controls. Signs of hyperventilation were more pronounced in transplant participants and adaptation to high-altitude was less effective, which was related to a decreased renal function. This resulted in reduced metabolic compensation.CONCLUSION: Overall, tolerance to strenuous physical activity and feasibility of a high-altitude expedition in carefully selected organ transplant recipients is comparable to non-transplanted controls.