Neurally adjusted ventilatory assist in patients with critical illness-associated polyneuromyopathy

Purpose: Diaphragmatic electrical activity (EAdi), reflecting respiratory drive, and its feedback control might be impaired in critical illness-associated polyneuromyopathy (CIPM). We aimed to evaluate whether titration and prolonged application of neurally adjusted ventilatory assist (NAVA), which delivers pressure (P aw) in proportion to EAdi, is feasible in CIPM patients. Methods: Peripheral and phrenic nerve electrophysiology studies were performed in 15 patients with clinically suspected CIPM and in 14 healthy volunteers. In patients, an adequate NAVA level (NAVAal) was titrated daily and was implemented for a maximum of 72h. Changes in tidal volume (V t) generation per unit of EAdi (V t/EAdi) were assessed daily during standardized tests of neuro-ventilatory efficiency (NVET). Results: In patients (median [range], 66 [44-80]years), peripheral electrophysiology studies confirmed CIPM. Phrenic nerve latency (PNL) was prolonged and diaphragm compound muscle action potential (CMAP) was reduced compared with healthy volunteers (p<0.05 for both). NAVAal could be titrated in all but two patients. During implementation of NAVAal for 61 (37-64)h, the EAdi amplitude was 9.0 (4.4-15.2)μV, and the V t was 6.5 (3.7-14.3)ml/kg predicted body weight. V t, respiratory rate, EAdi, PaCO2, and hemodynamic parameters remained unchanged, while PaO2/FiO2 increased from 238 (121-337) to 282 (150-440)mmHg (p=0.007) during NAVAal. V t/EAdi changed by −10 (−46; +31)% during the first NVET and by −0.1 (−26; +77)% during the last NVET (p=0.048). Conclusion: In most patients with CIPM, EAdi and its feedback control are sufficiently preserved to titrate and implement NAVA for up to 3days. Whether monitoring neuro-ventilatory efficiency helps inform the weaning process warrants further evaluatio

FUmanoid team description 2009

Abstract. This document describes hardware and software of the robots developed by the &quot;FUmanoid&quot; Team for the RoboCup competitions to be held in Graz, Austria 2009. The robot has 22 actuated degrees of freedom based on Dynamixel RX28, and RX64 servos. Central Processing, including Machine vision, Planning and control is performed using a Gumstix Verdex 6LP which is an ARM based 600MHz platform. Planning algorithms are organized in a new structure called Concurrent Scenario based Planning (CSBP). This paper explains the software and hardware used for the robot as well as control and stabilization methods developed by our team

Intrauterine Growth Retarded Progeny of Pregnant Sows Fed High Protein:Low Carbohydrate Diet Is Related to Metabolic Energy Deficit

High and low protein diets fed to pregnant adolescent sows led to intrauterine growth retardation (IUGR). To explore underlying mechanisms, sow plasma metabolite and hormone concentrations were analyzed during different pregnancy stages and correlated with litter weight (LW) at birth, sow body weight and back fat thickness. Sows were fed diets with low (6.5%, LP), adequate (12.1%, AP), and high (30%, HP) protein levels, made isoenergetic by adjusted carbohydrate content. At −5, 24, 66, and 108 days post coitum (dpc) fasted blood was collected. At 92 dpc, diurnal metabolic profiles were determined. Fasted serum urea and plasma glucagon were higher due to the HP diet. High density lipoprotein cholesterol (HDLC), %HDLC and cortisol were reduced in HP compared with AP sows. Lowest concentrations were observed for serum urea and protein, plasma insulin-like growth factor-I, low density lipoprotein cholesterol, and progesterone in LP compared with AP and HP sows. Fasted plasma glucose, insulin and leptin concentrations were unchanged. Diurnal metabolic profiles showed lower glucose in HP sows whereas non-esterified fatty acids (NEFA) concentrations were higher in HP compared with AP and LP sows. In HP and LP sows, urea concentrations were 300% and 60% of AP sows, respectively. Plasma total cholesterol was higher in LP than in AP and HP sows. In AP sows, LW correlated positively with insulin and insulin/glucose and negatively with glucagon/insulin at 66 dpc, whereas in HP sows LW associated positively with NEFA. In conclusion, IUGR in sows fed high protein∶low carbohydrate diet was probably due to glucose and energy deficit whereas in sows with low protein∶high carbohydrate diet it was possibly a response to a deficit of indispensable amino acids which impaired lipoprotein metabolism and favored maternal lipid disposal

Year in review in Intensive Care Medicine 2011: III. ARDS and ECMO, weaning, mechanical ventilation, noninvasive ventilation, pediatrics and miscellanea

SCOPUS: re.jinfo:eu-repo/semantics/publishe

Epigenetics and developmental programming of welfare and production traits in farm animals

The concept that postnatal health and development can be influenced by events that occur in utero originated from epidemiological studies in humans supported by numerous mechanistic (including epigenetic) studies in a variety of model species. Referred to as the ‘developmental origins of health and disease’ or ‘DOHaD’ hypothesis, the primary focus of large-animal studies until quite recently had been biomedical. Attention has since turned towards traits of commercial importance in farm animals. Herein we review the evidence that prenatal risk factors, including suboptimal parental nutrition, gestational stress, exposure to environmental chemicals and advanced breeding technologies, can determine traits such as postnatal growth, feed efficiency, milk yield, carcass composition, animal welfare and reproductive potential. We consider the role of epigenetic and cytoplasmic mechanisms of inheritance, and discuss implications for livestock production and future research endeavours. We conclude that although the concept is proven for several traits, issues relating to effect size, and hence commercial importance, remain. Studies have also invariably been conducted under controlled experimental conditions, frequently assessing single risk factors, thereby limiting their translational value for livestock production. We propose concerted international research efforts that consider multiple, concurrent stressors to better represent effects of contemporary animal production systems

Physiologic response to changing positive end-expiratory pressure during neurally adjusted ventilatory assist in sedated, critically ill adults

Neurally adjusted ventilatory assist (NAVA) delivers airway pressure (Paw) in proportion to neural inspiratory drive as reflected by electrical activity of the diaphragm (EAdi). Changing positive end-expiratory pressure (PEEP) impacts respiratory muscle load and function and, hence, EAdi. We aimed to evaluate how PEEP affects the breathing pattern and neuroventilatory efficiency during NAVA

Neurally adjusted ventilatory assist in patients with critical illness-associated polyneuromyopathy

Diaphragmatic electrical activity (EA(di)), reflecting respiratory drive, and its feedback control might be impaired in critical illness-associated polyneuromyopathy (CIPM). We aimed to evaluate whether titration and prolonged application of neurally adjusted ventilatory assist (NAVA), which delivers pressure (P (aw)) in proportion to EA(di), is feasible in CIPM patients

Surface grafting onto template-assembled synthetic protein scaffolds in molecular recognition

A review with 35 refs. Creating functional biol. mols. de novo requires a detailed understanding of the intimate relationship between primary sequence, folding mechanism, and packing topol., and remains up to now a most challenging goal in protein design and mimicry. As a consequence, the use of well-defined robust macromols. as scaffolds for the introduction of function by grafting surface residues has become a major objective in protein engineering and de novo design. In this article, the concept of scaffolds is demonstrated on some selected examples, illustrating that novel types of functional mols. can be generated. Re-engineered proteins and, most notably, de novo designed peptide scaffolds exhibiting mol. function, are ideal tools for structure-function studies and as leads in drug design. [on SciFinder (R)

The dual role of functional pseudo-prolines for the design of novel SH3 ligands

Pseudo-proline building blocks exert a dual functionality in enhancing and stabilizing the relevant polyproline II (PPII) conformation and increasing and optimizing van der Waals contacts and hydrogen bonding to the receptor mols. thus modifying affinity and specificity. They are highly useful in studying ligand recognition mediated by Src homol. 3 domains essential in cellular regulation and protein-protein interactions. The 2-C substituents promote the induction of the required PPII helix and allow for optimal complementation of the SH3 topog. [on SciFinder (R)