Mandatory criteria for the application of variability-based parameters of fluid responsiveness: a prospective study in different groups of ICU patients

Background and objective

Stroke volume variation (SVV) has high sensitivity and specificity in predicting fluid responsiveness. However, sinus rhythm (SR) and controlled mechanical ventilation (CV) are mandatory for their application. Several studies suggest a limited applicability of SVV in intensive care unit (ICU) patients. We hypothesized that the applicability of SVV might be different over time and within certain subgroups of ICU patients. Therefore, we analysed the prevalence of SR and CV in ICU patients during the first 24 h of PiCCO-monitoring (primary endpoint) and during the total ICU stay. We also investigated the applicability of SVV in the subgroups of patients with sepsis, cirrhosis, and acute pancreatitis.

Methods

The prevalence of SR and CV was documented immediately before 1241 thermodilution measurements in 88 patients.Results: In all measurements, SVV was applicable in about 24%. However, the applicability of SVV was time-dependent: the prevalence of both SR and CV was higher during the first 24 h compared to measurements thereafter (36.1% vs. 21.9%; P<0.001). Within different subgroups, the applicability during the first 24 h of monitoring ranged between 0% in acute pancreatitis, 25.5% in liver failure, and 48.9% in patients without pancreatitis, liver failure, pneumonia or sepsis.

Conclusions

The applicability of SVV in a predominantly medical ICU is only about 25%–35%. The prevalence of both mandatory criteria decreases over time during the ICU stay. Furthermore, the applicability is particularly low in patients with acute pancreatitis and liver failure.

     

Presumed Media Influences and Demands for Restrictions: Using Panel Data to Examine the Causal Direction

In line with theoretical approaches, such as the influence of presumed influence approach, many studies have shown that the stronger individuals perceive the media’s influence to be on others, the more the individuals demand restrictions on the media and its influence. However, these studies provided information only about the correlation between the two constructs and did not test the direction of their causal relationship. To close this research gap, a two-wave panel study among German citizens was conducted. The results show that, rather than being the other way around, it is the presumed strength of online media’s political influence on others that affects demands for restrictions. Moreover, the findings indicate that the presumed political influence of online media on others also affects the presumed reach of online media.     

不同患者群体容量反应性变量参数应用的强制性标准:重症监护病人窦性节律和控制呼吸流行情况的前瞻性研究（英文）

目的:通过对危重病人在入院后24小时内和整个重症监护过程中窦性心律和控制呼吸情况的调查,分析每搏量变异在评估危重病人容量反应的适用性,并探究每搏量变异度在败血症、肝硬化和胰腺炎病人中的适用性。创新点:通过探究窦性节律和控制呼吸情况评估每搏量变异度在重症监护病人临床上的适用性,弥补重症监护病人窦性节律和控制呼吸情况数据的空白。方法:在进行1241次热稀释法血流量测量前,对88位病人的窦性节律和控制呼吸情况进行调查。结论:每搏量变异度在主要的医疗重症监护病房中的适用性只约为25%~35%。两项强制性指标的流行性在重症监护病房的情况随时间的延长而降低。此外,每搏量变异度在胰腺炎和肝功能衰竭患者中的适用性尤其低。     

Evaluating virtual reality and augmented reality training for industrial maintenance and assembly tasks

The current study evaluated the use of virtual reality (VR) and augmented reality (AR) platforms, developed within the scope of the SKILLS Integrated Project, for industrial maintenance and assembly (IMA) tasks training. VR and AR systems are now widely regarded as promising training platforms for complex and highly demanding IMA tasks. However, there is a need to empirically evaluate their efficiency and effectiveness compared to traditional training methods. Forty expert technicians were randomly assigned to four training groups in an electronic actuator assembly task: VR (training with the VR platform twice), Control-VR (watching a filmed demonstration twice), AR (training with the AR platform once), and Control-AR (training with the real actuator and the aid of a filmed demonstration once). A post-training test evaluated performance in the real task. Results demonstrate that, in general, the VR and AR training groups required longer training time compared to the Control-VR and Control-AR groups, respectively. There were fewer unsolved errors in the AR group compared to the Control-AR group, and no significant differences in final performance between the VR and Control-VR groups, probably due to a ceiling effect created by the use of two training trials in the selected task for participants who were expert technicians. The results suggest that use of the AR platform for training IMA tasks should be encouraged and use of the VR platform for that purpose should be further evaluated.     

Episodic Future Thinking Is Related to Impulsive Decision Making in Healthy Adolescents

Delay discounting is a stable trait measure of impulsivity. Engaging in episodic future thinking (EFT) can reduce discounting, but whether individual differences in discounting are associated with differences in future thinking remains unclear. Here, this association was tested in healthy adolescents (n = 49, age range = 12–16 years, fluent German speakers, from a large German city). Data collection was between December 2011 and December 2012. Vividness of EFT (assessed via the Autobiographical Memory Interview) was negatively correlated with discounting (r = ?.41, 95% CI [?.63, ?.13], r² = .17). Regression analyses confirmed that this association was stable when controlling for additional variables, including hormonal measures of pubertal maturation and intelligence. EFT may attenuate impulsivity in young people at risk of engaging in problematic behavior.