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Influence of lung volume on the interaction between cardiac output and cerebrovascular regulation during extreme apnoea
(2017-10-01) Stembridge, Mike; Hoiland, Ryan L.; Bain, Anthony R.; Barak, Otto F.; Drvis, Ivan; MacLeod, David B.; MacLeod, Douglas M.; Madden, Dennis; Batinic, Tonci; O'Donoghue, Peter; Shave, Rob; Dujic, Zeljko; Ainslie, Philip N.; Department of Sport Science
New Findings: What is the central question of this study? Does the reduction in cardiac output observed during extreme voluntary apnoea, secondary to high lung volume, result in a reduction in cerebral blood flow, perfusion pressure and oxygen delivery in a group of elite free divers? What is the main finding and its importance? High lung volumes reduce cardiac output and ventricular filling during extreme apnoea, but changes in cerebral blood flow are observed only transiently during the early stages of apnoea. This reveals that whilst cardiac output is important in regulating cerebral haemodynamics, the role of mean arterial pressure in restoring cerebral perfusion pressure is of greater significance to the regulation of cerebral blood flow. We investigated the role of lung volume-induced changes in cardiac output (Q) on cerebrovascular regulation during prolonged apnoea. Fifteen elite apnoea divers (one female; 185 ± 7 cm, 82 ± 12 kg, 29 ± 7 years old) attended the laboratory on two separate occasions and completed maximal breath-holds at total lung capacity (TLC) and functional residual capacity (FRC) to elicit disparate cardiovascular responses. Mean arterial pressure (MAP), internal jugular venous pressure and arterial blood gases were measured via cannulation. Global cerebral blood flow was quantified by ultrasound and cardiac output was quantified by via photoplethysmography. At FRC, stroke volume and Q did not change from baseline (P > 0.05). In contrast, during the TLC trial stroke volume and Q were decreased until 80 and 40% of apnoea, respectively (P < 0.05). During the TLC trial, global cerebral blood flow was significantly lower at 20%, but subsequently increased so that cerebral oxygen delivery was comparable to that during the FRC trial. Internal jugular venous pressure was significantly higher throughout the TLC trial in comparison to FRC. The MAP increased progressively in both trials but to a greater extent at TLC, resulting in a comparable cerebral perfusion pressure between trials by the end of apnoea. In summary, although lung volume has a profound effect on Q during prolonged breath-holding, these changes do not translate to the cerebrovasculature owing to the greater sensitivity of cerebral blood flow to arterial blood gases and MAP; regulatory mechanisms that facilitate the maintenance of cerebral oxygen delivery.
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Changing Categorical Work in Healthcare : the Use of Patient-Generated Health Data in Cancer Rehabilitation
(2020) Cerna, Katerina; Grisot, Miria; Islind, Anna Sigridur; Lindroth, Tomas; Lundin, Johan; Steineck, Gunnar; Department of Computer Science
Categorical work in chronic care is increasingly dependent on digital technologies for remote patient care. However, remote care takes many forms and while various types of digital technologies are currently being used, we lack a nuanced understanding of how to design such technologies for specific novel usages. In this paper, we focus on digital technologies for patient-generated health data and how their use changes categorical work in chronic care. Our aim is to understand how categorical work changes, which novel forms of categorical work emerge and what the implications are for the care relation. This paper is based on an ethnographic study of healthcare professionals’ work at a pelvic cancer rehabilitation clinic and their interactions with patients. In this setting, supportive talks between patients and nurses are central. To understand the complexities of categorical work in chronic care when patient-generated health data are introduced, we contrast the traditional supportive talks with supportive talks where the nurses had access to the patients’ patient-generated health data. We identify and analyze challenges connected to novel forms of categorical work. Specifically, we focus on categorical work and how it can undergo changes. Our empirical findings show how changes occur in the way patients’ lived experience of the chronic disease aligns with the categories from chronic care, as well as in the way the nurse works with clinical categories during the talk. These insights help us further understand the implications of patient generated-data use in supportive talks. We contribute to an improved understanding of the use of patient-generated health data in clinical practice and based on this, we identify design implications for how to make categorical work more collaborative.
Verk
Post-meeting report of the 2022 On-site Padua Days on Muscle and Mobility Medicine, March 30 - April 3, 2022, Padua, Italy
(2022-07-08) Carraro, Ugo; Bittmann, Frank; Ivanova, Elena; Jónsson, Halldór; Kern, Helmut; Leeuwenburgh, Christiaan; Mayr, Winfried; Scalabrin, Mattia; Schaefer, Laura; Smeriglio, Piera; Zampieri, Sandra; Department of Engineering
Despite COVID-19 outbreak, the program of the 2022 Padua Days of Muscle and Mobility Medicine (PDM3) was confirmed On-site in February from March 30 to April 2, 2022 to be held at the University of Padua Aula Magna and at Conference Hall of the Hotel Petrarca of Thermae of Euganean Hills (Padua), Italy. Over 130 abstracts, including the last-minute submissionslisted below, convinced organizers to extend the program to five days. The sponsorship of the University of Florida and the willingness of attendees to meet friends after two years of virtual conferences were the keys of success, despite concerns for current events in East Europe. Only fourteen Virtual presentations were in the final program, eight due to last-minute Coronavirus infections and six for East Europe problems. The first two days of the program included scientists and clinicians of the University of Florida, USA and their invitees from Canada, France, Italy, Swiden, Swiss, UK and USA. Researchers and clinicians from Austria, Belgium, France, Germany, Iceland, Ireland, Italy, Russia, Slovakia, Slovenia, UK and USA filled the program of last three days more oriented to aging and rehabilitation. The large majority of abstracts was epublished before the meeting; here are last-minute abstracts and the final program. The program of the 2023 On-site PDM3 was informally designed during the Meeting, but will be circulated during 2022 summer. Fix the dates in your agenda from Thursday March 28 to Friday March 31. For now, please, submit Communications to the European Journal of Translational Myology, PAGEpress, Pavia, Italy and Original Articles or Reviews to the Journal Diagnostics, MDPI, Basel, Swiss. Both journals will host Special PDM3 Sections and will apply 50% discount on editorial processing fees to the first 15 accepted typescripts.
Verk
Mineralization in a Critical Size Bone-Gap in Sheep Tibia Improved by a Chitosan-Calcium Phosphate-Based Composite as Compared to Predicate Device
(2022-02-01) Örlygsson, Gissur; Laxdal, Elín H.; Kárason, Sigurbergur; Dagbjartsson, Atli; Gunnarsson, Eggert; Ng, Chuen How; Einarsson, Jón M.; Gíslason, Jóhannes; Jónsson, Halldór; Department of Engineering
Deacetylated chitin derivatives have been widely studied for tissue engineering purposes. This study aimed to compare the efficacy of an injectable product containing a 50% deacetylated chitin derivative (BoneReg-Inject™) and an existing product (chronOS Inject®) serving as a predicate device. A sheep model with a critical size drill hole in the tibial plateau was used. Holes of 8 mm diameter and 30 mm length were drilled bilaterally into the proximal area of the tibia and BoneReg-Inject™ or chronOS Inject® were injected into the right leg holes. Comparison of resorption and bone formation in vivo was made by X-ray micro-CT and histological evaluation after a live phase of 12 weeks. Long-term effects of BoneReg-Inject™ were studied using a 13-month live period. Significant differences were observed in (1) amount of new bone within implant (p < 0.001), higher in BoneReg-Inject™, (2) signs of cartilage tissue (p = 0.003), more pronounced in BoneReg-Inject™, and (3) signs of fibrous tissue (p < 0.001), less pronounced in BoneReg-Inject™. Mineral content at 13 months postoperative was significantly higher than at 12 weeks (p < 0.001 and p < 0.05, for implant core and rim, respectively). The data demonstrate the potential of deacetylated chitin derivatives to stimulate bone formation.
Verk
Bone remodeling effect of a chitosan and calcium phosphate-based composite
(2019-08-01) Kjalarsdóttir, Lilja; Dýrfjörd, Arna; Dagbjartsson, Atli; Laxdal, Elín H.; Örlygsson, Gissur; Gíslason, Jóhannes; Einarsson, Jón M.; Ng, Chuen How; Jónsson, Halldór; Department of Engineering
Chitosan is a biocompatible polymer that has been widely studied for tissue engineering purposes. The aim of this research was to assess bone regenerative properties of an injectable chitosan and calcium phosphate-based composite and identify optimal degree of deacetylation (%DDA) of the chitosan polymer. Drill holes were generated on the left side of a mandible in Sprague-Dawley rats, and the hole was either left empty or filled with the implant. The animals were sacrificed at several time points after surgery (7-22 days) and bone was investigated using micro-CT and histology. No significant new bone formation was observed in the implants themselves at any time points. However, substantial new bone formation was observed in the rat mandible further away from the drill hole. Morphological changes indicating bone formation were found in specimens explanted on Day 7 in animals that received implant. Similar bone formation pattern was seen in control animals with an empty drill hole at later time points but not to the same extent. A second experiment was performed to examine if the %DDA of the chitosan polymer influenced the bone remodeling response. The results suggest that chitosan polymers with %DDA between 50 and 70% enhance the natural bone remodeling mechanism.

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