The role of bipolar disorder and family wealth in choosing creative occupations.

Research in psychology and medicine has linked mental health disorders, and particularly bipolar disorder (BD), to employment in creative professions. Little is known, however, about the mechanisms for this link, which could be due to biology (primarily through a person's genes) or environmental (through socioeconomic status). Using administrative data on mental health diagnoses and occupations for the population of Denmark, we find that people with BD are more likely to be musicians than the population, but less likely to hold other creative jobs. Yet, we also show that healthy siblings of people with BD are significantly more likely to work in creative professions. Notably, people from wealthy families are consistently more likely to work in creative professions, and access to family wealth amplifies the likelihood that siblings of people with BD pursue creative occupations. Nevertheless, family wealth explains only a small share of the correlation between BD and creative employment.

Does depression co-occur within households? The moderating effects of financial resources and job insecurity on psychological contagion.

The empirically related psychopathologies of stress and depression exact an enormous economic toll and have many physical and behavioral health effects. Most studies of the effects of stress and depression focus on their causes and consequences for a single, focal individual. We examine the extent to which depression, as indicated by filling antidepressant prescriptions (SSRI and Benzodiazepines), co-occurs across spouses, constituting a negative spillover effect. To better understand the conditions that affect within-household contagion of depression, we examine whether the stress and uncertainty occasioned by job change and financial stress (net worth) increases spillover effects among spouses. We use panel data from various Danish administrative registers from the year 2001-2015 with more than 4.5 million observations on more than 900,000 unique individuals and their spouses from Danish health registers. Spouses in a household with their partner using antidepressants have a 62.1% higher chance of using antidepressants themselves, with the one year lagged effect being 29.3% and a two-year lagged effect of 15.1%. The effects become larger by 14.8% contemporaneously and 20% in the two-year lagged model if the focal individual changed employers. There was also a substantively unimportant effect of lower financial wealth to increase inter-spousal contagion.

Prehospital time and mortality in patients requiring a highest priority emergency medical response: a Danish registry-based cohort study.

OBJECTIVE: To examine the association between time from emergency medical service vehicle dispatch to hospital arrival and 1-day and 30-day mortality. DESIGN: Register-based cohort study. SETTING: North Denmark Region (≈8000 km2, catchment population ≈600 000). PARTICIPANTS: We included all highest priority dispatched ambulance transports in North Denmark Region in 2006-2012. INTERVENTIONS: Using logistic regression and the g-formula approach, we examined the association between time from emergency dispatch to hospital arrival and mortality for presumed heart, respiratory, cerebrovascular and other presumed medical conditions, as well as traffic or other accidents, as classified by emergency dispatch personnel. MAIN OUTCOME MEASURES: 1-day and 30-day mortality. RESULTS: Among 93 167 individuals with highest priority ambulances dispatched, 1948 (2.1%) were dead before the ambulance arrived and 19 968 (21.4%) were transported to the hospital under highest priority (median total prehospital time from dispatch to hospital arrival 47 min (25%-75%: 35-60 min); 95th percentile 84 min). Among 18 709 with population data, 1-day mortality was 10.9% (n=2038), and was highest for patients with dyspnoea (20.4%) and lowest for patients with traffic accidents (2.8%). Thirty-day mortality was 18.3% and varied between 36.6% (patients with dyspnoea) and 3.7% (traffic accidents). One-day mortality was not associated with total prehospital time, except for presumed heart conditions, where longer prehospital time was associated with decreased mortality: adjusted OR for >60 min vs 0-30 min was 0.61 (95% CI 0.40 to 0.91). For patients with dyspnoea, OR for >60 min vs 0-30 min was 0.90 (95% CI 0.56 to 1.45), for presumed cerebrovascular conditions OR 1.41 (95% CI 0.53 to 3.78), for other presumed medical conditions OR 0.84 (95% CI 0.70 to 1.02), for traffic accidents OR 0.65 (95% CI 0.29 to 1.48) and for other accidents OR 0.84 (95% CI 0.47 to 1.51). Similar findings were found for 30-day mortality. CONCLUSIONS: In this study, where time from emergency dispatch to hospital arrival mainly was <80 min, there was no overall relation between this prehospital time measure and mortality.

Dual-Pore Carbon Shells for Efficient Removal of Humic Acid from Water.

A template-mediated process for the preparation of mesoporous carbon shells with high surface area, dual-pore structure, and excellent performance in the adsorption of humic acid is reported. Their synthesis involves templating phenolic resin against wrinkled silica nanospheres, subsequent carbonization under Ar atmosphere, and final release of dual-pore mesoporous carbon shells by etching the silica templates. An additional silica layer was used to protect the phenolic resin from aggregation during carbonization, and its subsequent removal gives the carbon shells a hydrophilic surface, which significantly improves their dispersity in aqueous media. When used as adsorbents for humic acid removal, the as-prepared dual-pore mesoporous carbon shells show superior adsorption performance to activated carbon.

Can a central blood volume deficit be detected by systolic pressure variation during spontaneous breathing?

BACKGROUND: Whether during spontaneous breathing arterial pressure variations (APV) can detect a volume deficit is not established. We hypothesized that amplification of intra-thoracic pressure oscillations by breathing through resistors would enhance APV to allow identification of a reduced cardiac output (CO). This study tested that hypothesis in healthy volunteers exposed to central hypovolemia by head-up tilt. METHODS: Thirteen healthy volunteers were exposed to central hypovolemia by 45° head-up tilt while breathing through a facemask with 7.5 cmH2O inspiratory and/or expiratory resistors. A brachial arterial catheter was used to measure blood pressure and thus systolic pressure variation (SPV), pulse pressure variation and stroke volume variation . Pulse contour analysis determined stroke volume (SV) and CO and we evaluated whether APV could detect a 10 % decrease in CO. RESULTS: During head-up tilt SV decreased form 91 (±46) to 55 (±24) mL (mean ± SD) and CO from 5.8 (±2.9) to 4.0 (±1.8) L/min (p < 0.05), while heart rate increased (65 (±11) to 75 (±13) bpm; P < 0.05). Systolic pressure decreased from 127 (±14) to 121 (±13) mmHg during head-up tilt, while SPV tended to increase (from 21 (±15)% to 30 (±13)%). Yet during head-up tilt, a SPV ≥ 37 % predicted a decrease in CO ≥ 10 % with a sensitivity and specificity of 78 % and 100 %, respectively. CONCLUSION: In spontaneously breathing healthy volunteers combined inspiratory and expiratory resistors enhance SPV during head-up tilted induced central hypovolemia and allow identifying a 10 % reduction in CO. Applying inspiratory and expiratory resistors might detect a fluid deficit in spontaneously breathing patients. TRIAL REGISTRATION: ClinicalTrials.gov number NCT02549482 Registered September 10(th) 2015.

Water-assisted crystallization of mesoporous anatase TiO2 nanospheres.

We report a facile water-assisted crystallization process for the conversion of amorphous sol-gel derived TiO2 into mesoporous anatase nanostructures with a high surface area and well-controlled porosity and crystallinity. As an alternative to conventional calcination methods, this approach works under very mild conditions and is therefore much desired for broad biological, environmental and catalytic applications.

Ethylene glycol-assisted coating of titania on nanoparticles.

Coating titania shells onto sub-micron sized particles has been widely studied recently, with success mainly limited to objects with sizes above 50 nm. Direct coating on particles below this size has been difficult to attain especially with good control over properties such as thickness and crystallinity. Here we demonstrate that titanium-glycolate formed by reacting titanium alkoxide and ethylene glycol is an excellent precursor for coating titania on aqueous nanoparticles. The new coating method is particularly useful for its ability to coat materials lacking strong polymers or ligands which are frequently needed to facilitate typical titania coatings. We demonstrate the effectiveness of the process of coating titania on metal nanoparticles ranging from citrate-stabilized gold and silver spheres to gold nanorods and silver nanoplates, and larger particles such as SiO2 microspheres and polymer spheres. Further the thickness of these coatings can be tuned from a few nanometers to ∼40 nm through sequential coatings. These coatings can subsequently be crystallized into TiO2 through refluxing in water or by calcination to obtain crystalline shells. This procedure can be very useful for the production of TiO2 coatings with tunable thickness and crystallinity as well as for further study on the effect of TiO2 coatings on nanoparticles.

Photocatalytic Surface-Initiated Polymerization on TiO2 toward Well-Defined Composite Nanostructures.

We demonstrate the use of TiO2 nanospheres as the photoinitiator for photocatalytic surface-initiated polymerization for the synthesis of various inorganic/polymer nanocomposites with well-defined structures. The excitation of TiO2 by UV-light irradiation produces electrons and holes which drive the free radical polymerization near its surface, producing core/shell composite nanospheres with eccentric or concentric structures that can be tuned by controlling the surface compatibility between the polymer and the TiO2. When highly porous TiO2 nanospheres were employed as the photoinitiator, polymerization could disintegrate the mesoporous framework and give rise to nanocomposites with multiple TiO2 nanoparticles evenly distributed in the polymer spheres. Thanks to the well-developed sol-gel chemistry of titania, this synthesis is well-extendable to the coating of the polymers on many other substrates of interest such as silica and ZnS by simply premodifying their surface with a thin layer of titania. In addition, this strategy could be easily applied to coating of different types of polymers such as polystyrene, poly(methyl methacrylate), and poly(N-isopropylacrylamide). We expect this photocatalytic surface-initiated polymerization process could provide a platform for the synthesis of various inorganic/polymer hybrid nanocomposites for many interesting applications.

Kinematic and fatigue biomechanics of an interpositional facet arthroplasty device.

BACKGROUND CONTEXT: Although approximately 30% of chronic lumbar pain can be attributed to the facets, limited surgical options exist for patients. Interpositional facet arthroplasty (IFA) is a novel treatment for lumbar facetogenic pain designed to provide patients who gain insufficient relief from medical interventional treatment options with long-term relief, filling a void in the facet pain treatment continuum. PURPOSE: This study aimed to quantify the effect of IFA on segmental range of motion (ROM) compared with the intact state, and to observe device position and condition after 10,000 cycles of worst-case loading. STUDY DESIGN/SETTING: In situ biomechanical analysis of the lumbar spine following implantation of a novel IFA device was carried out. METHODS: Twelve cadaveric functional spinal units (L2-L3 and L5-S1) were tested in 7.5 Nm flexion-extension, lateral bending, and torsion while intact and following device implantation. Additionally, specimens underwent 10,000 cycles of worst-case complex loading and were testing in ROM again. Load-displacement and fluoroscopic data were analyzed to determine ROM and to evaluate device position during cyclic testing. Devices and facets were evaluated post testing. Institutional support for implant evaluation was received by Zyga Technology. RESULTS: Range of motion post implantation decreased versus intact, and then was restored post cyclic-testing. Of the tested devices, 6.5% displayed slight movement (0.5-2 mm), all from tight L2-L3 facet joints with misplaced devices or insufficient cartilage. No damage was observed on the devices, and wear patterns were primarily linear. CONCLUSIONS: The results from this in situ cadaveric biomechanics and cyclic fatigue study demonstrate that a low-profile, conformable IFA device can maintain position and facet functionality post implantation and through 10,000 complex loading cycles. In vivo conditions were not accounted for in this model, which may affect implant behavior not predictable via a biomechanical study. However, these data along with published 1-year clinical results suggest that IFA may be a valid treatment option in patients with chronic lumbar zygapophysial pain who have exhausted medical interventional options.

Thermal synthesis of silver nanoplates revisited: a modified photochemical process.

The well-known photochemical and thermal methods for silver nanoplate synthesis have been generally regarded as two parallel processes without strong connections. Here we report a surprising finding that both visible light and ambient O2, which are critically important in the photochemical process, also play determining roles in the thermal synthesis. By designing a series of control experiments, we reveal that the typical thermal synthesis is essentially a modified photochemical synthesis coupled with the unique redox properties of H2O2. Light irradiation and dissolved O2 are found to be essential for initiating the formation of nanoplates, but the continued growth of nanoplates is supported by the oxidative etching and subsequent reduction of Ag due to H2O2. O2 resulting from the catalytic decomposition of H2O2 etches small nanoparticles to produce Ag(+) ions, which are then reduced back to Ag(0) by anions of H2O2 to support the growth of nanoplate seeds. The involvement of H2O2 in the reaction significantly speeds up the nanoplate formation process. These findings not only greatly improve our understanding of the unique functions of H2O2 in the thermal synthesis, but also bridge the two well established synthesis processes with a unified mechanism, and significantly enhance the reproducibility of the thermal synthesis of Ag nanoplates by identifying the critical importance of ambient light and O2.

A sulfated ZrO2 hollow nanostructure as an acid catalyst in the dehydration of fructose to 5-hydroxymethylfurfural.

Mesoporous hollow colloidal particles with well-defined characteristics have potential use in many applications. In liquid-phase catalysis, in particular, they can provide a large active surface area, reduced diffusion resistance, improved accessibility to reactants, and excellent dispersity in reaction media. Herein, we report the tailored synthesis of sulfated ZrO2 hollow nanostructures and their catalytic applications in the dehydration of fructose. ZrO2 hollow nanoshells with controllable thickness were first synthesized through a robust sol-gel process. Acidic functional groups were further introduced to the surface of hollow ZrO2 shells by sulfuric acid treatment followed by calcination. The resulting sulfated ZrO2 hollow particles showed advantageous properties for liquid-phase catalysis, such as well-maintained structural integrity, good dispersity, favorable mesoporosity, and a strongly acidic surface. By controlling the synthesis and calcination conditions and optimizing the properties of sulfated ZrO2 hollow shells, we have been able to design superacid catalysts with superior performance in the dehydration of fructose to 5-hydroxymethyfurfural than the solid sulfated ZrO2 nanocatalyst.

In sickness and in wealth: psychological and sexual costs of income comparison in marriage.

As the percentage of wives outearning their husbands grows, the traditional social norm of the male breadwinner is challenged. The upward income comparison of the husband may cause psychological distress that affects partners' mental and physical health in ways that affect decisions on marriage, divorce, and careers. This article studies this impact through sexual and mental health problems. Using wage and prescription medication data from Denmark, we implement a regression discontinuity design to show that men outearned by their wives are more likely to use erectile dysfunction medication than their male breadwinner counterparts, even when this inequality is small. Breadwinner wives suffer increased insomnia/anxiety medication usage, with similar effects for men. We find no effects for unmarried couples or for men who earned less than their fiancée prior to marriage. Our results suggest that social norms play important roles in dictating how individuals respond to upward social comparisons.

The biomechanics of a multilevel lumbar spine hybrid using nucleus replacement in conjunction with fusion.

BACKGROUND CONTEXT: Degenerative disc disease is commonly a multilevel pathology with varying deterioration severity. The use of fusion on multiple levels can significantly affect functionality and has been linked to persistent adjacent disc degeneration. A hybrid approach of fusion and nucleus replacement (NR) has been suggested as a solution for mildly degenerated yet painful levels adjacent to fusion. PURPOSE: To compare the biomechanical metrics of different hybrid implant constructs, hypothesizing that an NR+fusion hybrid would be similar to a single-level fusion and perform more naturally compared with a two-level fusion. STUDY DESIGN: A cadaveric in vitro repeated-measures study was performed to evaluate a multilevel lumbar NR+fusion hybrid. METHODS: Eight cadaveric spines (L3-S1) were tested in a Spine Kinetic Simulator (Instron, Norwood, MA, USA). Pure moments of 8 Nm were applied in flexion/extension, lateral bending, and axial rotation as well as compression loading. Specimens were tested intact; fused (using transforaminal lumbar interbody fusion instrumentation with posterior rods) at L5-S1; with a nuclectomy at L4-L5 including fusion at L5-S1; with NR at L4-L5 including fusion at L5-S1; and finally with a two-level fusion spanning L4-S1. Repeated-measures analysis of variance and corrected t tests were used to statistically compare outcomes. RESULTS: The NR+fusion hybrid and single-level fusion exhibited no statistical differences for range of motion (ROM), stiffness, neutral zone, and intradiscal pressure in all loading directions. Compared with two-level fusion, the hybrid affords the construct 41.9% more ROM on average. Two-level fusion stiffness was statistically higher than all other constructs and resulted in significantly lower ROM in flexion, extension, and lateral bending. The hybrid construct produced approximately half of the L3-L4 adjacent-level pressures as the two-level fusion case while generating similar pressures to the single-level fusion case. CONCLUSIONS: These data portend more natural functional outcomes and fewer adjacent disc complications for a multilevel NR+fusion hybrid compared with the classical two-level fusion.

A comparison of the shock-absorbing properties of cervical disc prosthesis bearing materials.

BACKGROUND DATA: Cervical arthroplasty offers theoretical advantages over traditional spinal fusion, including elimination of adjacent segment disease and elimination of the risk of pseudoarthrosis formation. Initial studies of cervical arthroplasty have shown promising results, however, the ideal design characteristics for disc replacement constructs have not been determined. The current study seeks to quantify the differences in the shock absorption characteristics of three commonly used materials in cervical disc arthroplasty. METHODS: Three different nucleus materials, polyurethane (PU), polyethylene (PE) and a titanium-alloy (Ti) were tested in a humidity- and temperature-controlled chamber. Ten of each nucleus type underwent three separate mechanical testing protocols to measure 1) dynamic stiffness, 2) quasi-static stiffness, 3) energy absorption, and 4) energy dissipation. The results were compared using analysis of variance. RESULTS: PU had the lowest mean dynamic stiffness (435 ± 13 N/mm, P < .0001) and highest energy absorption (19.4 ± 0.1 N/mm, P < .0001) of all three nucleus materials tested. PU was found to have significantly higher energy dissipation (viscous damping ratio 0.017 ± 0,001, P < .0001) than the PE or TI nuclei. PU had the lowest quasi-static stiffness (598 ± 23 N/mm, P < .0001) of the nucleus materials tested. A biphasic response curve was observed for all of the PU nuclei tests. CONCLUSIONS: Polyurethane absorbs and dissipates more energy and is less stiff than either polyethylene or titanium. LEVEL OF EVIDENCE: Basic Science/Biomechanical Study. CLINICAL RELEVANCE: This study characterizes important differences in biomechanical properties of materials that are currently being used for different cervical disc prostheses.

The effects of becoming an entrepreneur on the use of psychotropics among entrepreneurs and their spouses.

AIMS: Entering entrepreneurship (i.e. becoming an entrepreneur) is known to be a demanding activity with increased workload, financial uncertainty and increased levels of stress. However, there are no systematic studies on how entering entrepreneurship affects the people involved. METHODS: The authors investigated prescriptions of psychotropics for 6,221 first-time entrepreneurs from 2001-2004 and their 2,381 spouses in the first two years after becoming entrepreneurs in a matched case-control study using linked data from three Danish national registries: The Danish database for Labor Market Research, the Danish Entrepreneurship database and the Danish Prescription database. RESULTS: Entrepreneurs were more likely to fill prescriptions at pharmacies for sedatives/hypnotics (adjusted odds ratio (AOR): 1.45 [95% CI: 1.26-1.66], p < .0001). However, they were less likely to fill prescriptions for antidepressants (AOR: 0.74 [95% CI: 0.59-0.92] p = 0.007). Spouses of these entrepreneurs were also more likely to fill prescriptions for sedatives/hypnotics (AOR: 1.36 [95% CI: 1.10-1.67], p = 0.005). No difference in prescription of antidepressants was found for spouses. CONCLUSIONS: This study showed that there was a significant relation between entering entrepreneurship and receiving prescriptions for sedative/ hypnotics both among the entrepreneurs themselves and their spouses, suggesting that entering entrepreneurship may be associated with increased stress for both the entrepreneurs and their families.

The restoration of lumbar intervertebral disc load distribution: a comparison of three nucleus replacement technologies.

STUDY DESIGN: A validated L3-L4 nonlinear finite element model was used to evaluate strain and pressure in the surrounding structures for 4 nucleus replacement technologies. OBJECTIVE: The objective of the current study was to compare subsidence and anular damage potential between 4 current nucleus replacement technologies. It was hypothesized that a fully conforming nucleus replacement would minimize the risk of both subsidence and anular damage. SUMMARY OF BACKGROUND DATA: Nucleus pulposus replacements are emerging as a less invasive alternative to total disc replacement and fusion as a solution to degenerative intervertebral discs. Multiple technologies have been developed and are currently undergoing clinical investigation. METHODS: The testing conditions were applied by excavating the nucleus of the intact model and virtually implanting models representing the various nucleus replacement technologies. The implants consisted of a conforming injectable polyurethane (E = 4 MPa), soft hydrogel (E = 4 MPa), stiff hydrogel (E = 20 MPa), and polyether-etherketone (PEEK) on PEEK articulating designs. The model was exercised in flexion, extension, lateral bending, axial rotation (7.5 Nm with 450 N preload), and compression (1000 N). Vertebral body strain, anular maximum shear strain, endplate contact pressure, anulus-implant contact pressure, and bone remodeling stimulus were reported. RESULTS: The PEEK implant induced strain maxima in the vertebral bodies with associated endplate contact pressure concentrations. For the PEEK and hydrogel implants, areas of nonconformity with the endplate indicated adjacent bone resorption. Lack of conformity between the implant and inner anulus for the PEEK and hydrogel implants resulted in inward anular bulging with associated increased maximum shear strain. The conforming polyurethane implant maintained outward bulging of the inner anular wall and indicated no bone resorption or stress shielding adjacent to the implant. CONCLUSION: A fully conforming nucleus replacement resulted in a decreased propensity for subsidence, anular bulging, and further degeneration of the anulus when compared with nonconforming implants.

The efficacy of using vibrometry to detect osteointegration of the Agility total ankle.

Arthritis is a chronic, debilitating disease affecting one in six people in the United States annually. One of the most promising surgical treatments is total joint replacement. After decades of development, some joint replacement (arthroplasty) systems such as the hip and knee enjoy high success rates while others, particularly newer ones for the ankle, have disappointing survival rates. The goal of this study was to investigate, develop, and test a methodology to assess implant osteointegration, specifically for the talar component of a total ankle prosthesis. A vibrometry technique using Doppler ultrasound was developed to non-invasively determine osteointegration clinically. This methodology was evaluated via preliminary experimentation, along with another validation methodology, to access whether design criteria have been met in order to initiate a clinical study of the technique. Bench-top and cadaveric testing demonstrated that the Doppler ultrasound technique could distinguish the level of osteointegration between loose and fixed implant components. The laser vibrometry technique, used for the validation of the ultrasound technique intraoperatively, was also shown to be functional and indicative of the ultrasound technique's testing results. This methodology can provide a much needed tool to determine the integration of implants non-invasively in the clinical and surgical setting, thus allowing each patient's rehabilitation program to be monitored and tailored to maximize the osteointegration and survival rate of their total joint replacement.

Helmet and shoulder pad removal in football players with unstable cervical spine injuries.

Football, one of the country's most popular team sports, is associated with the largest overall number of sports-related, catastrophic, cervical spine injuries in the United States (Mueller, 2007). Patient handling can be hindered by the protective sports equipment worn by the athlete. Improper stabilization of these patients can exacerbate neurologic injury. Because of the lack of consensus on the best method for equipment removal, a study was performed comparing three techniques: full body levitation, upper torso tilt, and log roll. These techniques were performed on an intact and lesioned cervical spine cadaveric model simulating conditions in the emergency department. The levitation technique was found to produce motion in the anterior and right lateral directions. The tilt technique resulted in motions in the posterior left lateral directions, and the log roll technique generated motions in the right lateral direction and had the largest amount of increased instability when comparing the intact and lesioned specimen. These findings suggest that each method of equipment removal displays unique weaknesses that the practitioner should take into account, possibly on a patient-by-patient basis.

Using an expiratory resistor, arterial pulse pressure variations predict fluid responsiveness during spontaneous breathing: an experimental porcine study.

INTRODUCTION: Fluid responsiveness prediction is difficult in spontaneously breathing patients. Because the swings in intrathoracic pressure are minor during spontaneous breathing, dynamic parameters like pulse pressure variation (PPV) and systolic pressure variation (SPV) are usually small. We hypothesized that during spontaneous breathing, inspiratory and/or expiratory resistors could induce high arterial pressure variations at hypovolemia and low variations at normovolemia and hypervolemia. Furthermore, we hypothesized that SPV and PPV could predict fluid responsiveness under these conditions. METHODS: Eight prone, anesthetized and spontaneously breathing pigs (20 to 25 kg) were subjected to a sequence of 30% hypovolemia, normovolemia, and 20% and 40% hypervolemia. At each volemic level, the pigs breathed in a randomized order either through an inspiratory and/or an expiratory threshold resistor (7.5 cmH2O) or only through the tracheal tube without any resistor. Hemodynamic and respiratory variables were measured during the breathing modes. Fluid responsiveness was defined as a 15% increase in stroke volume (DeltaSV) following fluid loading. RESULTS: Stroke volume was significantly lower at hypovolemia compared with normovolemia, but no differences were found between normovolemia and 20% or 40% hypervolemia. Compared with breathing through no resistor, SPV was magnified by all resistors at hypovolemia whereas there were no changes at normovolemia and hypervolemia. PPV was magnified by the inspiratory resistor and the combined inspiratory and expiratory resistor. Regression analysis of SPV or PPV versus DeltaSV showed the highest R2 (0.83 for SPV and 0.52 for PPV) when the expiratory resistor was applied. The corresponding sensitivity and specificity for prediction of fluid responsiveness were 100% and 100%, respectively, for SPV and 100% and 81%, respectively, for PPV. CONCLUSIONS: Inspiratory and/or expiratory threshold resistors magnified SPV and PPV in spontaneously breathing pigs during hypovolemia. Using the expiratory resistor SPV and PPV predicted fluid responsiveness with good sensitivity and specificity.