Proactive Management of Intraoperative Hypotension Reduces Biomarkers of Organ Injury and Oxidative Stress during Elective Non-Cardiac Surgery: A Pilot Randomized Controlled Trial

Background: Intraoperative hypotension is associated with increased postoperative morbidity and mortality. Methods: We randomly assigned patients undergoing major general surgery to early warning system (EWS) and hemodynamic algorithm (intervention group, n = 20) or standard care (n = 20). The primary outcome was the difference in hypotension (defined as mean arterial pressure < 65 mmHg) and as secondary outcome surrogate markers of organ injury and oxidative stress. Results: The median number of hypotensive episodes was lower in the intervention group (−5.0 (95% CI: −9.0, −0.5); p < 0.001), with lower time spent in hypotension (−12.8 min (95% CI: −38.0, −2.3 min); p = 0.048), correspondent to −4.8% of total surgery time (95% CI: −12.7, 0.01%; p = 0.048).The median time-weighted average of hypotension was 0.12 mmHg (0.35) in the intervention group and 0.37 mmHg (1.11) in the control group, with a median difference of −0.25 mmHg (95% CI: −0.85, −0.01; p = 0.025). Neutrophil Gelatinase-Associated Lipocalin (NGAL) correlated with time-weighted average of hypotension (R = 0.32; p = 0.038) and S100B with number of hypotensive episodes, absolute time of hypotension, relative time of hypotension and time-weighted average of hypotension (p < 0.001 for all). The intervention group showed lower Neuronal Specific Enolase (NSE) and higher reduced glutathione when compared to the control group. Conclusions: The use of an EWS coupled with a hemodynamic algorithm resulted in reduced intraoperative hypotension, reduced NSE and oxidative stress.

Mapping the Knowledge

In this chapter, the author examines the possibility of applying the servant leadership concept's critical components in the innovation management process. The author, based on his own experience as a top manager of a prominent Russian public company, reveals the importance of a proactive approach to managing innovative projects. The chapter's objective is to develop the rules for the proactive management of innovative project portfolios and, based upon these rules, to lead the team of key personnel. The author concludes that while following the five rules of proactive management of innovative projects, the manager becomes a team's servant-leader. The manager is not suppressing the team's initiative, not depriving them of the right to independently understand current events, and arming them with self-immersion tools in the project's details. The author is confident that the presented approach may be of interest to other practicing innovative managers.

COUNTERING CLIMATE CHANGE BY PROTECTING THE ATMOSPHERE FROM ANTHROPOGENIC GASES AND CREATING ARTIFICIAL SOURCES OF FRESH WATER

The activities of mankind in the past at least 70 years have led to the disruption of the planet's ecosystem with the prospect of serious consequences for life on Earth. To start at least slow down their action, only global scientific and technical solutions with very short periods of their implementation are needed. The article proposes to carry out the separation of fumes before their emission into the atmosphere, during which, to carry out the selection of greenhouse and toxic components of fumes, with the aim of their further utilization or neutralization. Protecting the atmosphere from smoke and eliminating the shortage of freshwater are purely technical areas that will not create unsolvable problems for the modern scientific and technical potential of mankind. All that is needed is a proactive management, ideologically aimed at solving these technical problems in an emergency mode.

Development of Model of Proactive Management of Refineries' Equipment Restoration

The article considers the topic of maintenance of equipment in a working condition in the activities of oil producing enterprises. The exploitation of the means of labor takes place in difficult mining, geological and climatic conditions. Ensuring the reliability and efficiency of the surface and underground equipment operation is a priority task for the oil producing enterprises of the Russian Federation. In modern economic conditions, there is a need to improve the efficiency of work on the restoration of equipment.

Considerations on Young People's Choices and Behaviors in the Postmodern Society: Fitness, Nutrition and Healthy Lifestyle

In postmodern society, many of the perceptions that people had about them, their lives, the values ​​that define them and the strategies that they can use to achieve their ideals have changed. Specifically, today we can talk about new paradigms, such as health, lifestyle focused on personal well-being, obtained through fitness (physical activity, balanced diet and recovery) and wellness, respectively wellbeing that adds the spiritual component, in an holistic interdependence (Larson, 1999). An important role in the changes we are talking about has been played by the media, which promote living standards built on hedonistic principles, specific to the consumer society. The consequence is that more and more teenagers and young people want to look good and feel good, but only a small part of them reach the specialists, who are best able to provide individualized guidance, support, and programs to prevent any negative consequences of uninspired choices or poorly dosed enthusiasm The stakes of choice are high, because a healthy lifestyle, which should not be limited to body aesthetics, but also aims to develop the spiritual side, can support a more effective adaptation to the dynamics of changes in society (economic changes influencing developments in social life supported by political decisions). The last year, marked by a new challenge, the pandemic, has fully demonstrated the need to assume on a personal level a balanced and responsible lifestyle, which offers new values ​​of quality of life, as well as complementing proactive management with that managed by specialists.

Think human, act digital: activating data-driven orientation in innovative start-ups

PurposeThe study queries the drivers of innovation management in contemporary data-driven organizations/companies. It is argued that data-driven organizations that integrate a strategic orientation grounded in data, human abilities and proactive management are more effective in triggering innovation.Design/methodology/approachResearch reported in this paper employs constructivist grounded theory, Gioia methodology, and the abductive approach. The data collected through semi-structured interviews administered to 20 Italian start-up founders are then examined.FindingsThe paper identifies the key enablers of innovation development in data-driven companies and reveals that data-driven companies may generate different innovation patterns depending on the kind of capabilities activated.Originality/valueThe study provides evidence of how the combination of data-driven culture, skills' enhancement and the promotion of human resources may boost the emergence of innovation.