49 research outputs found
Comparison of cardiac, hepatic, and renal effects of arginine vasopressin and noradrenaline during porcine fecal peritonitis: a randomized controlled trial
INTRODUCTION: Infusing arginine vasopressin (AVP) in vasodilatory shock usually decreases cardiac output and thus systemic oxygen transport. It is still a matter of debate whether this vasoconstriction impedes visceral organ blood flow and thereby causes organ dysfunction and injury. Therefore, we tested the hypothesis whether low-dose AVP is safe with respect to liver, kidney, and heart function and organ injury during resuscitated septic shock. METHODS: After intraperitoneal inoculation of autologous feces, 24 anesthetized, mechanically ventilated, and instrumented pigs were randomly assigned to noradrenaline alone (increments of 0.05 microg/kg/min until maximal heart rate of 160 beats/min; n = 12) or AVP (1 to 5 ng/kg/min; supplemented by noradrenaline if the maximal AVP dosage failed to maintain mean blood pressure; n = 12) to treat sepsis-associated hypotension. Parameters of systemic and regional hemodynamics (ultrasound flow probes on the portal vein and hepatic artery), oxygen transport, metabolism (endogenous glucose production and whole body glucose oxidation derived from blood glucose isotope and expiratory 13CO2/12CO2 enrichment during 1,2,3,4,5,6-13C6-glucose infusion), visceral organ function (blood transaminase activities, bilirubin and creatinine concentrations, creatinine clearance, fractional Na+ excretion), nitric oxide (exhaled NO and blood nitrate + nitrite levels) and cytokine production (interleukin-6 and tumor necrosis factor-alpha blood levels), and myocardial function (left ventricular dp/dtmax and dp/dtmin) and injury (troponin I blood levels) were measured before and 12, 18, and 24 hours after peritonitis induction. Immediate post mortem liver and kidney biopsies were analysed for histomorphology (hematoxylin eosin staining) and apoptosis (TUNEL staining). RESULTS: AVP decreased heart rate and cardiac output without otherwise affecting heart function and significantly decreased troponin I blood levels. AVP increased the rate of direct, aerobic glucose oxidation and reduced hyperlactatemia, which coincided with less severe kidney dysfunction and liver injury, attenuated systemic inflammation, and decreased kidney tubular apoptosis. CONCLUSIONS: During well-resuscitated septic shock low-dose AVP appears to be safe with respect to myocardial function and heart injury and reduces kidney and liver damage. It remains to be elucidated whether this is due to the treatment per se and/or to the decreased exogenous catecholamine requirements
Austrian Research and Technology Report 2023
Der Forschungs- und Technologiebericht ist der Lagebericht ĂŒber die aus Bundesmitteln geförderte Forschung, Technologie und Innovation in Ăsterreich und wird im Auftrag des Bundesministeriums fĂŒr Bildung, Wissenschaft und Forschung (BMBWF) in Einvernehmen mit dem Bundesministerium fĂŒr Klimaschutz, Umwelt, Energie, MobilitĂ€t, Innovation und Technologie (BMK) sowie dem Bundesministerium fĂŒr Arbeit und Wirtschaft (BMAW) erstellt.
Der vorliegende Bericht steht im Zeichen eines komplexen Wandels auf unterschiedlichen Ebenen, einerseits getrieben durch multiple Krisen, die nicht nur das Innovationsverhalten von Unternehmen und wissenschaftlichen Akteurinnen und Akteuren verĂ€ndern, sondern auch verĂ€nderte Rahmenbedingungen mit sich bringen. Die Twin Transition ist allgegenwĂ€rtig. Im vorliegenden Bericht wird mit dem Schwerpunktthema der Fokus auf die GrĂŒne Transformation in Forschung und Wirtschaft gelegt.
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Ăsterreichischer Forschungs- und Technologiebericht 2023
Der Forschungs- und Technologiebericht ist der LageberichtÂ ĂŒber die aus Bundesmitteln geförderte Forschung, Technologie und Innovation in Ăsterreich und wird im Auftrag des Bundesministeriums fĂŒr Bildung, Wissenschaft und Forschung (BMBWF) in Einvernehmen mit dem Bundesministerium fĂŒr Klimaschutz, Umwelt, Energie, MobilitĂ€t, Innovation und Technologie (BMK) sowie dem Bundesministerium fĂŒr Arbeit und Wirtschaft (BMAW) erstellt.
Der vorliegende Bericht steht im Zeichen eines komplexen Wandels auf unterschiedlichen Ebenen, einerseits getrieben durch multiple Krisen, die nicht nur das Innovationsverhalten von Unternehmen und wissenschaftlichen Akteurinnen und Akteuren verĂ€ndern, sondern auch verĂ€nderte Rahmenbedingungen mit sich bringen. Die Twin Transition ist allgegenwĂ€rtig. Im vorliegenden Bericht wird mit dem Schwerpunktthema der Fokus auf die GrĂŒne Transformation in Forschung und Wirtschaft gelegt
Defining an Adequate Sample of Earlywood Vessels for Retrospective Injury Detection in Diffuse-Porous Species
Vessels of broad-leaved trees have been analyzed to study how trees deal with various environmental factors. Cambial injury, in particular, has been reported to induce the formation of narrower conduits. Yet, little or no effort has been devoted to the elaboration of vessel sampling strategies for retrospective injury detection based on vessel lumen size reduction. To fill this methodological gap, four wounded individuals each of grey alder (Alnus incana (L.) Moench) and downy birch (Betula pubescens Ehrh.) were harvested in an avalanche path. Earlywood vessel lumina were measured and compared for each tree between the injury ring built during the growing season following wounding and the control ring laid down the previous year. Measurements were performed along a 10 mm wide radial strip, located directly next to the injury. Specifically, this study aimed at (i) investigating the intra-annual duration and local extension of vessel narrowing close to the wound margin and (ii) identifying an adequate sample of earlywood vessels (number and intra-ring location of cells) attesting to cambial injury. Based on the results of this study, we recommend analyzing at least 30 vessels in each ring. Within the 10 mm wide segment of the injury ring, wound-induced reduction in vessel lumen size did not fade with increasing radial and tangential distances, but we nevertheless advise favoring early earlywood vessels located closest to the injury. These findings, derived from two species widespread across subarctic, mountainous, and temperate regions, will assist retrospective injury detection in Alnus, Betula, and other diffuse-porous species as well as future related research on hydraulic implications after wounding
Austrian Research and Technology Report 2022
Der Forschungs-und Technologiebericht 2022 gibt einen Ăberblick ĂŒber die aus Bundesmitteln geförderte Forschung, Technologie und Innovation (FTI) in Ăsterreich. Neben der Darstellung aktueller forschungspolitischer Entwicklungen, die den Stand der Umsetzung der mit Ende 2020 verabschiedeten FTI-Strategie 2030, forschungsrelevante Teilstrategien und neueste Entwicklungen im Hochschulbereich behandelt, werden auf Grundlage rezenter Daten aus diversen internationalen Rankings, aus der F&E (Forschung & Entwicklung)-Erhebung 2019 und der GlobalschĂ€tzung 2022 Analysen zur nationalen und internationalen FTI-Performance Ăsterreichs erstellt
Randomized controlled trial of an internet-based self-guided hand exercise program to improve hand function in people with systemic sclerosis: the Scleroderma Patient-centered Intervention Network Hand Exercise Program (SPIN-HAND) trial
BACKGROUND:
Systemic sclerosis (scleroderma; SSc) is a rare autoimmune connective tissue disease. Functional impairment of hands is common. The Scleroderma Patient-centered Intervention Network (SPIN)-HAND trial compared effects of offering access to an online self-guided hand exercise program to usual care on hand function (primary) and functional health outcomes (secondary) in people with SSc with at least mild hand function limitations.
METHODS:
The pragmatic, two-arm, parallel-group cohort multiple randomized controlled trial was embedded in the SPIN Cohort. Cohort participants with Cochin Hand Function Scale (CHFS) scoresââ„â3 and who indicated interest in using the SPIN-HAND Program were randomized (3:2 ratio) to an offer of program access or to usual care (targeted Nâ=â586). The SPIN-HAND program consists of 4 modules that address (1) thumb flexibility and strength; (2) finger bending; (3) finger extension; and (4) wrist flexibility and strength. The primary outcome analysis compared CHFS scores 3 months post-randomization between participants offered versus not offered the program. Secondary outcomes were CHFS scores 6 months post-randomization and functional health outcomes (Patient-Reported Outcomes Measurement Information System profile version 2.0 domain scores) 3 and 6 months post-randomization.
RESULTS:
In total, 466 participants were randomized to intervention offer (Nâ=â280) or usual care (Nâ=â186). Of 280 participants offered the intervention, 170 (61%) consented to access the program. Of these, 117 (69%) viewed at least one hand exercise instruction video and 77 (45%) logged into the program website at least 3 times. In intent-to-treat analyses, CHFS scores were 1.2 points lower (95% CIâââ2.8 to 0.3) for intervention compared to usual care 3 months post-randomization and 0.1 points lower (95% CIâââ1.8 to 1.6 points) 6 months post-randomization. There were no statistically significant differences in other outcomes.
CONCLUSION:
The offer to use the SPIN-HAND Program did not improve hand function. Low offer uptake, program access, and minimal usage among those who accessed the program limited our ability to determine if using the program would improve function. To improve engagement, the program could be tested in a group format or as a resource to support care provided by a physical or occupational therapist.
TRIAL REGISTRATION:
NCT03419208. Registered on February 1, 2018
Patterns of patient-reported symptoms and association with sociodemographic and systemic sclerosis disease characteristics: a scleroderma Patient-centered Intervention Network (SPIN) Cohort cross-sectional study
Background: Systemic sclerosis is a heterogenous disease in which little is known about patterns of patient-reported symptom clusters. We aimed to identify classes of individuals with similar anxiety, depression, fatigue, sleep disturbance, and pain symptoms and to evaluate associated sociodemographic and disease-related characteristics.
Methods: This multi-centre cross-sectional study used baseline data from Scleroderma Patient-centered Intervention Network Cohort participants enrolled from 2014 to 2020. Eligible participants completed the PROMIS-29 v2.0 measure. Latent profile analysis was used to identify homogeneous classes of participants based on patterns of anxiety, depression, fatigue, sleep disturbance, and pain scores. Sociodemographic and disease-related characteristics were compared across classes.
Findings: Among 2212 participants, we identified five classes, including four classes with âLowâ (565 participants, 26%), âNormalâ (651 participants, 29%), âHighâ (569 participants, 26%), or âVery Highâ (193 participants, 9%) symptom levels across all symptoms. Participants in a fifth class, âHigh Fatigue/Sleep/Pain and Low Anxiety/Depressionâ (234 participants, 11%) had similar levels of fatigue, sleep disturbance, and pain as in the âHighâ class but low anxiety and depression symptoms. There were significant and substantive trends in sociodemographic characteristics (age, education, race or ethnicity, marital or partner status) and increasing disease severity (diffuse disease, tendon friction rubs, joint contractures, gastrointestinal symptoms) across severity-based classes. Disease severity and sociodemographic characteristics of âHigh Fatigue/Sleep/Pain and Low Anxiety/Depressionâ class participants were similar to the âHighâ severity class.
Interpretation: Most people with systemic sclerosis can be classified by levels of patient-reported symptoms, which are consistent across symptoms and highly associated with sociodemographic and disease-related variables, except for one group which reports low mental health symptoms despite high levels of other symptoms and substantial disease burden. Studies are needed to better understand resilience in systemic sclerosis and to identify and facilitate implementation of cognitive and behavioural strategies to improve coping and overall quality of life.
Funding: National Institute of Nursing Research (F31NR019007), Canadian Institutes of Health Research, Arthritis Society Canada, the Lady Davis Institute for Medical Research, the Jewish General Hospital Foundation, McGill University, Scleroderma Society of Ontario, Scleroderma Canada, Sclérodermie Québec, Scleroderma Manitoba, Scleroderma Atlantic, Scleroderma Association of BC, Scleroderma SASK, Scleroderma Australia, Scleroderma New South Wales, Scleroderma Victoria, and Scleroderma Queensland
Evaluation of Measurement Properties and Differential Item Functioning in the English and French Versions of the University of California, Los Angeles, Loneliness Scale-6: A Scleroderma Patient-Centered Intervention Network (SPIN) Study
Objective: Loneliness has been associated with poorer health-related quality of life but has not been studied in patients with systemic sclerosis (SSc). The current study was undertaken to examine and compare the psychometric properties of the English and French versions of the University of California, Los Angeles, Loneliness Scale-6 (ULS-6) in patients with SSc during the COVID-19 pandemic. Methods: This study used baseline cross-sectional data from 775 adults enrolled in the Scleroderma Patient-Centered Intervention Network (SPIN) COVID-19 Cohort. Reliability and validity of ULS-6 scores overall and between languages were evaluated using confirmatory factor analysis (CFA), differential item functioning (DIF) through the multiple-indicator multiple-cause (MIMIC) model, omega/alpha calculation, and correlations of hypothesized convergent relationships. Results: CFA for the total sample supported the single-factor structure (comparative fit index [CFI] 0.96, standardized root mean residual [SRMR] 0.03), and all standardized factor loadings for items were large (0.60â0.86). The overall MIMIC model with language as a covariate fit well (CFI 0.94, SRMR 0.04, root mean square error of approximation 0.11). Statistically significant DIF was found for 3 items across language (ÎČitem2Â =Â 0.14, P < 0.001; ÎČitem4Â =Â â0.07, PÂ =Â 0.01; ÎČitem6Â =Â 0.13, P < 0.001), but these small differences were without practical measurement implications. Analyses demonstrated high internal consistency with no language-based convergent validity differences. Conclusion: Analyses demonstrated evidence of acceptable reliability and validity of ULS-6 scores in English- and French-speaking adults with SSc. DIF analysis supported use of the ULS-6 to examine comparative experiences of loneliness without adjusting for language
Pain levels and associated factors in the Scleroderma Patient-centered Intervention Network (SPIN) cohort: a multicentre cross-sectional study
Background: Pain is an important and detrimental feature of systemic sclerosis but is often overlooked or deprioritised in research and clinical care. Raynaud's phenomenon, arthritis, and cutaneous ulcers are among the commonly reported disease manifestations of systemic sclerosis that could be associated with pain. We aimed to assess levels of pain intensity and interference and to evaluate disease factors associated with pain intensity and interference. Methods: In this multicentre cross-sectional study, participants from the Scleroderma Patient-centered Intervention Network cohort who completed pain intensity and interference measures (Patient Reported Outcomes Information System-29 profile, version 2·0) as part of baseline assessments were included. Patients were recruited from 46 centres in Australia, Canada, France, Mexico, Spain, the UK, and the USA between April 15, 2014, and Jan 7, 2020. Eligible patients included those aged 18 years or older who met the criteria for systemic sclerosis devised by the American College of Rheumatology and the European League Against Rheumatism. Associations of pain intensity and pain interference with systemic sclerosis-related variables and overlap syndromes, controlling for sociodemographic variables, were assessed with multiple linear regression. Continuous independent variables were standardised. Findings: Among 2157 participants with systemic sclerosis (268 [12%] males and 1889 [88%] females), 1870 (87%) reported mild, moderate, or severe pain (defined as â„1 on a 0 to 10 scale), and 815 (38%) reported moderate or severe pain (defined as â„5). Moreover, 757 (35%) participants reported moderate or severe pain interference. Greater pain intensity was independently associated with female sex (0·58 points [95% CI 0·26â0·90]), non-White race or ethnicity (0·50 points [0·21â0·79]), fewer years in formal education (0·30 points per SD [0·19â0·41]), country (reference: USA; Canada: 0·29 points [0·01â0·57] and UK: 0·58 points [0·21â0·95]), greater body-mass index (0·35 points per SD [0·24â0·45]); joint contractures (0·67 points [0·39â0·94]), digital ulcers (0·33 points [0·10â0·55]), gastrointestinal involvement (0·66 points [0·33â0·98]), skin involvement (measured using modified Rodnan skin score; 0·22 points per SD [0·10â0·35]), rheumatoid arthritis (0·96 points [0·50â1·43]), and Sjögren's syndrome (0·42 points [0·01â0·83]). Pain interference results were similar. Interpretation: Pain is common among people with systemic sclerosis. Controlling for sociodemographic variables, greater pain was associated with multiple systemic sclerosis-related manifestations, including joint contractures, digital ulcers, gastrointestinal involvement, skin involvement, and the presence of overlap syndromes. Health-care providers should work with patients to address pain, including identifying and addressing systemic sclerosis manifestations associated with their pain, and supporting behavioural approaches to minimise impact on function and quality of life. Funding: Canadian Institutes of Health Research, Arthritis Society, The Lady Davis Institute for Medical Research of the Jewish General Hospital, Jewish General Hospital Foundation, McGill University, Scleroderma Society of Ontario, Scleroderma Canada, SclĂ©rodermie QuĂ©bec, Scleroderma Manitoba, Scleroderma Atlantic, Scleroderma Association of BC, Scleroderma SASK, Scleroderma Australia, Scleroderma New South Wales, Scleroderma Victoria, and Scleroderma Queensland