Exercise Pressor Reflex in Type 1 Diabetic Rats is Not Different Between Sexes

Diabetes is a major risk factor for cardiovascular disease and is associated with complications such as autonomic and peripheral neuropathy. The pathophysiology and prevalence of cardiovascular disease differ between sexes. Diabetic patients have an exaggerated pressor and sympathetic response to exercise compared to healthy individuals, which may increase the risk of myocardial infarction and stroke during physical activity. PURPOSE: The purpose of this study was to determine whether the cardioaccelerator and pressor responses to static contraction and tendon stretch differ between sexes in type 1 diabetic (T1DM) rats. METHODS: We injected 50 mg/kg Streptozotocin (STZ) or the vehicle (CTL) i.p in fasted female and male Sprague Dawley rats and waited 10.5±2.5 days (female CTL: BW=274±5 g, glucose=195±12 mg/dL, HbA1C=4.4±0.07%; male CTL: BW=384±4 g, glucose=189±3 mg/dL, HbA1C=4.7±0.1%; female STZ: BW=259±9 g, glucose=485±20 mg/dL, HbA1C=7.3±0.4%; male STZ: BW=294±10 g, glucose=458±17 mg/dL, HbA1C=9.6±0.6%) before performing experiments. All experiments were performed on unanaesthetized, decerebrated rats. We either statically contracted the hind limb muscles or stretched the Achilles tendon for 30 s and measured changes in mean arterial pressure (MAP) and heart rate (HR). RESULTS: We found that the pressor (female CTL: ΔMAP=15±1 mmHg, n=8; male CTL: ΔMAP=16±1 mmHg, n=9; female STZ: ΔMAP=29±6 mmHg, n=8; male STZ: ΔMAP=25±3 mmHg, n=9, p=0.62) and cardioaccelerator (female CTL: ΔHR=17±2 bpm, n=8; male CTL: ΔHR=12±1 bpm, n=9; female STZ: ΔHR=13±5 bpm, n=8; male STZ: ΔHR=24±5 bpm, n=9, p=0.051) responses to static contraction were not significantly different between sexes in T1DM rats. Likewise, the pressor (female CTL: ΔMAP=21±6 mmHg, n=8; male CTL: ΔMAP=33±2 mmHg, n=9; female STZ: ΔMAP=37±8 mmHg, n=10; male STZ: ΔMAP=31±5 mmHg, n=12, p=0.11) and cardioaccelerator (female CTL: ΔHR=9±2 bpm, n=8; male CTL: ΔHR=12±1 bpm, n=9; female STZ: ΔHR=12±4 bpm, n=10; male STZ: ΔHR=14±3 bpm, n=12, p=0.33) responses to tendon stretch were not different between sexes in T1DM rats. The developed tensions from contraction or tendon stretch were similar within each comparison (p\u3e0.05). CONCLUSION: We conclude that the pressor and cardioaccelerator responses to static contraction and tendon stretch are not different between female and male T1DM rats

Individualized quality of life in patients with low back pain: reliability and validity of the Patient Generated Index

Objective: To evaluate the reliability and validity of the improved version of the Patient Generated Index (PGI) in patients with low back pain. Methods: The PGI was administered to 90 patients attending care in 1 of 6 institutions in Norway and evaluated for reliability and validity. The questionnaire was given out to 61 patients for re-test purposes. Results: The PGI was completed correctly by 80 (88.9%) patients and, of the 61 patients responding to the re-test, 50 (82.0%) completed both surveys correctly. PGI scores were approximately normally distributed, with a median of 40 (range 80), where 100 is the best possible quality of life. There were no floor or ceiling effects. The 5 most frequently listed areas affecting quality of life were pain, sleep, stiffness, socializing and housework. The test-retest intraclass correlation coefficient was 0.73. The smallest detectable changes for individual and group purposes were 32.8 and 4.6, respectively. The correlations between PGI scores and other instrument scores followed a priori hypotheses of low to moderate correlations. Discussion: The PGI has evidence for reliability and validity in Norwegian patients with low back pain at the group level and may be considered for application in intervention studies when a comprehensive evaluation of quality of life is important. However, the smallest detectable change, of approximately 30 points, may be considered too large for individual purposes in clinical application

Predicting outcome in acute low back pain using different models of patient profiling

This is a non-final version of an article published in final form in Spine, 34(18), 1970 - 1975, 2009. Copyright © 2009 Lippincott Williams & Wilkins, Inc.Study Design. Prospective observational study of prognostic indicators, using data from a randomized, controlled trial of physiotherapy care of acute low back pain (ALBP) with follow-up at 6 weeks, 3 months, and 6 months. Objective. To evaluate which patient profile offers the most useful guide to long-term outcome in ALBP. Summary of Background Data. The evidence used to inform prognostic decision-making is derived largely from studies where baseline data are used to predict future status. Clinicians often see patients on multiple occasions so may profile patients in a variety of ways. It is worth considering if better prognostic decisions can be made from alternative profiles. Methods. Clinical, psychological, and demographic data were collected from a sample of 54 ALBP patients. Three clinical profiles were developed from information collected at baseline, information collected at 6 weeks, and the change in status between these 2 time points. A series of regression models were used to determine the independent and relative contributions of these profiles to the prediction of chronic pain and disability. Results. The baseline profile predicted long-term pain only. The 6-week profile predicted both long-term pain and disability. The change profile only predicted long-term disability (P 0.05). A similar result was obtained when the order of entry was reversed. When predicting long-term disability, after the 6-week profile was entered at the first step, the change profile was not significant when forced in at the second step. However, when the change profile was entered at the first step and the 6-week clinical profile was forced in at the second step, a significant contribution of the 6-week profile was found. Conclusion. The profile derived from information collected at 6 weeks provided the best guide to long-term pain and disability. The baseline profile and change in status offered less predictive value

Assistive devices, hip precautions, environmental modifications and training to prevent dislocation and improve function after hip arthroplasty

This is the protocol for a review and there is no abstract. The objectives are as follows: The aim of this review is to assess the effects of provision of assistive devices, education on hip precautions, environmental modifications and training in ADL and EADL for people undergoing hip arthroplasty

Multidimensional screening for predicting pain problems in adults : a systematic review of screening tools and validation studies

Screening tools allowing to predict poor pain outcomes are widely used. Often these screening tools contain psychosocial risk factors. This review (1) identifies multidimensional screening tools that include psychosocial risk factors for the development or maintenance of pain, pain-related distress, and pain-related disability across pain problems in adults, (2) evaluates the quality of the validation studies using Prediction model Risk Of Bias ASsessment Tool (PROBAST), and (3) synthesizes methodological concerns. We identified 32 articles, across 42 study samples, validating 7 screening tools. All tools were developed in the context of musculoskeletal pain, most often back pain, and aimed to predict the maintenance of pain or pain-related disability, not pain-related distress. Although more recent studies design, conduct, analyze, and report according to best practices in prognosis research, risk of bias was most often moderate. Common methodological concerns were identified, related to participant selection (eg, mixed populations), predictors (eg, predictors were administered differently to predictors in the development study), outcomes (eg, overlap between predictors and outcomes), sample size and participant flow (eg, unknown or inappropriate handling of missing data), and analysis (eg, wide variety of performance measures). Recommendations for future research are provided

Thermodynamic Response Enhanced by Sloshing in Marine LNG Fuel Tanks: Experimental Work and Numerical Modelling

This thesis presents studies of sloshing and how it influences thermodynamic conditions in liquefied natural gas (LNG) fuel tanks. Liquid in a moving tank mixes more efficiently with the gas, which condenses and is followed by a drop in pressure. This issue is relevant for the operation of LNG-fuelled vessels, where the system pressure may drop rapidly under severe motion. To compensate for the pressure loss, it may become necessary to derate the engines, or, in the worst case, perform a complete shutdown of the gas-fuel system. The long-term objective of the research is to improve the operational reliability of LNG-fuelled vessels by performing design improvements or operational measures. LNG has become increasingly popular as a marine fuel due to its low emissions compared to those from conventional fuels like heavy fuel oil (HFO) and marine diesel oil (MDO). Low-pressure LNG fuel systems are designed similarly to landbased storage facilities. The storage tanks are vacuum-insulated and pressurized such that heat ingress is minimal. But when the tank is pressurised, the liquid may be significantly colder relative to the saturated condition. The thermal equilibrium is controlled in the short term by the liquid due to its large mass. The sloshing enhances the internal energy transfer, and the final state corresponds to a state that is closer to the initial liquid temperature. This research is based on experimental work, analysis, modelling, and simulations. An experimental facility was designed and constructed, experimental tests were conducted separately, with a transparent tank for hydrodynamic studies and a pressurised steel tank for analysis of the thermodynamic response. Hydrodynamic sloshing tests were conducted with both rectangular and cylindrical tanks. Computational fluid dynamics (CFD) simulations of sloshing hydrodynamics were carried out with both tank geometries with the aim of replacing the hydrodynamic experiments to investigate any tank shape, inner structure, or motion. The resulting sloshing regimes were categorized and used systematically when preparing tests involving the thermodynamic response. Experiments with a pressurized steel tank were conducted using both liquid nitrogen (LIN) and water. A theoretical framework was developed and implemented into a lumped capacity model. The model provides a good starting point for development of correlations between motion parameters and the enhanced heat transfer. It can also be combined with other submodels into a system model. CFD simulations were found to represent sloshing with acceptable accuracy. New sloshing characteristics inside LNG fuel tanks are described. The thermodynamic response is influenced significantly by the severity of the sloshing. The final state depends on the initial liquid temperature and tank pressure, but the time to reach the final state depends on the sloshing intensity. The largest pressure drop rate occurs close to the primary resonance, f/f1,0 = 1. The PBU power needed to maintain the pressure was estimated from the measured pressure. It corresponds well with the PBU power used in the experiments. An existing CFD solver was modified to take into account the transport of thermal energy. The pressure drop was predicted with this model, and the result was found to correspond well with the experimental results for resonant sloshing. A case study is presented in which anticipated motion of a full-scale ship were used to simulate sloshing inside the LNG fuel tank. The L/D ratio is found to have a prominent effect on the sloshing, even at low frequencies

Comparison of the SF6D, the EQ5D, and the oswestry disability index in patients with chronic low back pain and degenerative disc disease

Background The need for cost effectiveness analyses in randomized controlled trials that compare treatment options is increasing. The selection of the optimal utility measure is important, and a central question is whether the two most commonly used indexes - the EuroQuol 5D (EQ5D) and the Short Form 6D (SF6D) – can be used interchangeably. The aim of the present study was to compare change scores of the EQ5D and SF6D utility indexes in terms of some important measurement properties. The psychometric properties of the two utility indexes were compared to a disease-specific instrument, the Oswestry Disability Index (ODI), in the setting of a randomized controlled trial for degenerative disc disease. Methods In a randomized controlled multicentre trial, 172 patients who had experienced low back pain for an average of 6 years were randomized to either treatment with an intensive back rehabilitation program or surgery to insert disc prostheses. Patients filled out the ODI, EQ5D, and SF-36 at baseline and two-year follow up. The utility indexes was compared with respect to measurement error, structural validity, criterion validity, responsiveness, and interpretability according to the COSMIN taxonomy. Results At follow up, 113 patients had change score values for all three instruments. The SF6D had better similarity with the disease-specific instrument (ODI) regarding sensitivity, specificity, and responsiveness. Measurement error was lower for the SF6D (0.056) compared to the EQ5D (0.155). The minimal important change score value was 0.031 for SF6D and 0.173 for EQ5D. The minimal detectable change score value at a 95% confidence level were 0.157 for SF6D and 0.429 for EQ5D, and the difference in mean change score values (SD) between them was 0.23 (0.29) and so exceeded the clinical significant change score value for both instruments. Analysis of psychometric properties indicated that the indexes are unidimensional when considered separately, but that they do not exactly measure the same underlying construct. Conclusions This study indicates that the difference in important measurement properties between EQ5D and SF6D is too large to consider them interchangeable. Since the similarity with the “gold standard” (the disease-specific instrument) was quite different, this could indicate that the choice of index should be determined by the diagnosis

Endgame: Alex Jones’ Nye Verdensorden som konspirationsteori og alternativ sandhed

Artiklen undersøger fremstillingen af en alternativ virkelighed i konspirationsdokumentaren Endgame (2007) med særlig fokus på historiebrug. Fortællingen konstrueres først og fremmest med konspirationsteorier, særligt Den Nye Verdensorden, der hævder, at en global magtelite i århundreder har undertrykt den øvrige befolkning og nu planlægger at gøre dem til slaver. Denne fortælling skal dels læses i forhold til amerikansk konspirationskultur og vægtige skrifter om Den Nye Verdensorden gennem tiden, dels som en højreorienteret forklaringsmodel på en kompleks verden, samt frygten for dens forfald