Exploratory factor analysis (EFA) can link the levels of ontology in critical realism together as described in Summers (2020). To demonstrate how components of the actual can be defined by linking potential factors in the empirical to the theorised generative mechanisms in the real. This article describes one part of a three-part sequential mixed-methods study that used EFA to describe how components of the actual were linked using factors in the empirical to the generative mechanisms in the real. The author theorised three generative mechanisms the perceived impact of continuing professional development (CPD) on patient care, the motivations for undertaking CPD and the perceived barriers to CPD. He used EFA to test factors from the empirical against these generative mechanisms to identify linking components in the actual. This article shows how components of the actual can be defined using EFA. These components are multifactorial and many factors in the empirical are influenced by different generative mechanisms. Being able to articulate and link the different aspects of ontology enables researchers to define theorised generative mechanisms and link theory to practice. Being able to articulate and link the different aspects of ontology enables researchers to define theorised generative mechanisms and link theory to practice.There is scarce literature on point-of-care ultrasound (POCUS) assessment characteristics in coronavirus disease 2019 (COVID-19) pneumonia with hypoxic respiratory failure. This study was an observational, prospective, single-center study, including adults suspected to have COVID-19 who were transferred to the intensive care unit (ICU). An intensivist in critical care ultrasound performed lung ultrasound (LUS) and echocardiology within 12 hours of patients' admission to the ICU. We calculated the trans mitral E/A ratio, E/e', left ventricular ejection fraction (EF), inferior vena cava (IVC) diameter, right ventricle (RV) size and systolic function. In the group of patients with confirmed COVID-19 pneumonia, echocardiographic findings revealed normal E/e', deceleration time (DT), and transmittal E/A ratio compared to those in the non-COVID-19 patients (p = 0.001, 0.0001, and 0.0001, respectively). IVC diameter was < 2 cm with > 50% collapsibility in 62 (81%) patients with COVID-19 pneumonia; a diameter of > 2 cm and < 50% collapsibility was detected among those with non-COVID-19 pneumonia (p-value of 0.001). In patients with COVID-19 pneumonia, there were 3 cases of myocarditis (3.9%) with poor EF, severe RV systolic dysfunction was seen in 9 cases (11.6%), and 3 cases exhibited RV thrombus. Lung US revealed 4 signs suggestive of COVID-19 pneumonia in 77 patients (98.6%) (sensitivity 96.9%; confidence interval, 85%-99.5%) when compared with reverse transcriptase-polymerase chain reaction results. POCUS plays an important role in the bedside diagnosis, hemodynamic assessment and management of patients with acute hypoxic respiratory and circulatory failure with COVID-19 pneumonia. POCUS plays an important role in the bedside diagnosis, hemodynamic assessment and management of patients with acute hypoxic respiratory and circulatory failure with COVID-19 pneumonia.Left ventricular false tendons (LVFT) are common structures visualized on transthoracic echocardiography (TTE). The present study tested the hypothesis that LVFT, via a possible 'constraint' mechanism, attenuate left ventricular (LV) remodeling and secondary mitral regurgitation after acute myocardial infarction. Seventy-one patients admitted to the Coronary Care Unit following an ST-elevation (n = 63) or non-ST-elevation (n = 8) myocardial infarction were analyzed; 29 (41%) had LVFT, and 42 (59%) did not (no-LVFT). All had a TTE and at least 1 follow-up study after revascularization. The χ² analysis, Student's t-test, and Mann Whitney U test were used for the statistical analyses. The mean age (64 vs. 66 years), left ventricular ejection fraction (LVEF) (41% vs. 39%), left ventricular end-diastolic diameter (LVEDd) index (23 mm/m² for both), and prevalence of ≥ moderate secondary/functional mitral regurgitation (MR) (17% vs. 14%) were similar between the LVFT and no-LVFT groups. At 1-year follow-up, there was no significant difference in chamber remodeling amongst the LVFT versus no-LVFT group when assessed by 1) ≥ 10% decrease in the relative LVEF (24% vs. 26%; p = 0.83); 2) ≥ 10% increase in the LVEDd index (41% vs. 38%, p = 0.98); and, 3) ≥ 10% increase in the LV mass index (48% vs. 41%, p = 0.68). There was no difference in the prevalence of ≥ moderate secondary/functional MR (17% vs. https://www.selleckchem.com/products/Gefitinib.html 12%, p = 0.77). Outcomes remained similar when stratifying by LVFT morphology or ischemic territory. In patients with mild to moderate LV dysfunction and normal chamber size, LVFT do not affect the development of LV remodeling or secondary/functional MR post-myocardial infarction. In patients with mild to moderate LV dysfunction and normal chamber size, LVFT do not affect the development of LV remodeling or secondary/functional MR post-myocardial infarction.Assessment of diastolic dysfunction (DD) and left ventricular filling pressures (LVFP) by echocardiography is complex in patients with preserved ejection fraction (EF). The American Society of Echocardiography and the European Association of Cardiovascular Imaging (ASE/EACVI) jointly published recommendations in 2016 to simplify the diagnosis and classification of DD and the assessment of LVFP. We aimed to study the impact of the updated 2016 ASE/EACVI guidelines vis-à-vis the 2009 ASE recommendations on prevalence of DD and LVFP in patients with preserved EF. Five hundred patients referred to the echocardiography laboratory from March 2020 to May 2020 were analyzed. Patients with left ventricular ejection fraction (LVEF) < 50% were excluded. All patients underwent comprehensive transthoracic echocardiography. DD and LVFP were assessed by the 2016 ASE/EACVI and 2009 ASE recommendations. The concordance between the guidelines was analyzed by kappa coefficient and overall proportion of agreement. Mean age was 53 ± 13 years and 63.

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