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Sample records for osa advanced chipset

  1. Advanced airway management strategies for severe OSAS and craniofacial anomalies.

    PubMed

    Gungor, Anil

    Pediatric OSAS and craniofacial malformations present challenges that require innovative approaches and comprehensive treatment strategies. Synchronous airway lesions, craniofacial malformations, obstructive anomalies of the tongue base, nasal vault and choanae are commonly addressed by subspecialists from various clinical and surgical academic traditions who practice variable levels of required communication. This is not a mere social requirement but an important requisite for intelligent and effective airway management. Membership of dedicated airway, aero digestive or craniofacial teams are desirable but not required. I expect this clinical brief to help many brilliant clinicians in their pursuit of perfection. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Effects of simultaneous palatal expansion and mandibular advancement in a child suffering from OSA.

    PubMed

    Galeotti, A; Festa, P; Pavone, M; De Vincentiis, G C

    2016-08-01

    This clinical report describes a child suffering from obstructive sleep apnoea (OSA) and class II skeletal malocclusion with maxillary contraction and anterior open bite. He presented moderate obstructive sleep apnoea with large impact on quality of life of patient and parents. He was treated using an innovative orthodontic device (Sleep Apnea Twin Expander) to simultaneously carry out palatal expansion and mandibular advancement. After orthodontic therapy, the OSA-18 questionnaire demonstrated an improvement of the main respiratory symptoms, while cardiorespiratory sleep study revealed a reduction in obstructive sleep apnoea events. Post-treatment, clinical assessment and cephalometric analysis showed a reduction of sagittal maxillary discrepancy and an extension of upper airway space. In conclusion, this case report suggests that orthodontic treatment might be a valuable alternative treatment in children with obstructive sleep apnoea related to craniofacial anomalies.

  3. Age, gender, neck circumference, and Epworth sleepiness scale do not predict obstructive sleep apnea (OSA) in moderate to severe chronic obstructive pulmonary disease (COPD): The challenge to predict OSA in advanced COPD.

    PubMed

    Soler, Xavier; Liao, Shu-Yi; Marin, Jose Maria; Lorenzi-Filho, Geraldo; Jen, Rachel; DeYoung, Pamela; Owens, Robert L; Ries, Andrew L; Malhotra, Atul

    2017-01-01

    The combination of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) is associated with substantial morbidity and mortality. We hypothesized that predictors of OSA among patients with COPD may be distinct from OSA in the general population. Therefore, we investigated associations between traditional OSA risk factors (e.g. age), and sleep questionnaires [e.g. Epworth Sleepiness Scale] in 44 patients with advanced COPD. As a second aim we proposed a pilot, simplified screening test for OSA in patients with COPD. In a prospective, observational study of patients enrolled in the UCSD Pulmonary Rehabilitation Program we collected baseline characteristics, cardiovascular events (e.g. atrial fibrillation), and sleep questionnaires [e.g. Pittsburgh Sleep Quality Index (PSQI)]. For the pilot questionnaire, a BMI ≥25 kg/m2 and the presence of cardiovascular disease were used to construct the pilot screening test. Male: 59%; OSA 66%. FEV1 (mean ± SD) = 41.0±18.2% pred., FEV1/FVC = 41.5±12.7%]. Male gender, older age, and large neck circumference were not associated with OSA. Also, Epworth Sleepiness Scale and the STOP-Bang questionnaire were not associated with OSA in univariate logistic regression. In contrast, BMI ≥25 kg/m2 (OR = 3.94, p = 0.04) and diagnosis of cardiovascular disease (OR = 5.06, p = 0.03) were significantly associated with OSA [area under curve (AUC) = 0.74]. The pilot COPD-OSA test (OR = 5.28, p = 0.05) and STOP-Bang questionnaire (OR = 5.13, p = 0.03) were both associated with OSA in Receiver Operating Characteristics (ROC) analysis. The COPD-OSA test had the best AUC (0.74), sensitivity (92%), and specificity (83%). A ten-fold cross-validation validated our results. We found that traditional OSA predictors (e.g. gender, Epworth score) did not perform well in patients with more advanced COPD. Our pilot test may be an easy to implement instrument to screen for OSA. However, a larger validation study is necessary before

  4. 75 FR 16837 - In the Matter of Certain Integrated Circuits, Chipsets, and Products Containing Same Including...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-02

    ... COMMISSION In the Matter of Certain Integrated Circuits, Chipsets, and Products Containing Same Including... the sale within the United States after importation of certain integrated circuits, chipsets, and... certain integrated circuits, chipsets, or products containing same including televisions, media...

  5. 76 FR 76434 - Certain Integrated Circuits, Chipsets, and Products Containing Same Including Televisions...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-07

    ... COMMISSION Certain Integrated Circuits, Chipsets, and Products Containing Same Including Televisions, Receipt... Commission has received a complaint entitled In Re Certain Integrated Circuits, Chipsets, And Products... importation of certain integrated circuits, chipsets, and products containing same including televisions....

  6. 76 FR 41521 - In the Matter of Certain Integrated Circuits, Chipsets, and Products Containing Same Including...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-14

    ... COMMISSION In the Matter of Certain Integrated Circuits, Chipsets, and Products Containing Same Including... integrated circuits, chipsets, and products containing same including televisions by reason of infringement... integrated circuits, chipsets, and products containing same including televisions that infringe one or...

  7. Volumetric analysis of the pharynx in patients with obstructive sleep apnea (OSA) treated with maxillomandibular advancement (MMA).

    PubMed

    Faria, Ana Célia; da Silva-Junior, Savio Nogueira; Garcia, Luis Vicente; dos Santos, Antonio Carlos; Fernandes, Maria Regina França; de Mello-Filho, Francisco Veríssimo

    2013-03-01

    Maxillomandibular advancement (MMA) has been reported to be the most effective surgical treatment of obstructive sleep apnea (OSA). Most reports about MMA aim to confirm the efficiency of this treatment modality, but few describe the anatomical changes produced in the pharynx by the surgery. Thus, the objective of the present investigation was to quantify the anatomical changes of the pharynx that occur in patients with OSA after MMA surgery using magnetic resonance (MR). Twenty patients with a polysomnographic diagnosis of OSA participated in the study. All patients were submitted to image acquisition by MR performed during wakefulness. Polysomnography and MR were performed preoperatively and 6 months after MMA. Volume analysis (in cubic millimeters) was performed as the sum of the areas multiplied by their thickness, with no intervals between sections. The pharyngeal air space of the region between the hard palate and the base of the epiglottis was divided into a retropalatal (RP) region and a retrolingual (RL) region. Postoperative MR showed a mean volumetric increase of 26.72 % in the RP region and of 27.2 % in the RL region. MMA increases the air space of the pharynx by expanding the facial skeletal structure to which the soft tissues of the pharynx and tongue are fixed, with a consequent reduction of collapsibility in the presence of negative pressure during inspiration. This reduced possibility of pharyngeal collapse may contribute to the reduction of obstructive events.

  8. 76 FR 34101 - In the Matter of Certain Integrated Circuits, Chipsets, and Products Containing Same Including...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-10

    ... From the Federal Register Online via the Government Publishing Office INTERNATIONAL TRADE COMMISSION In the Matter of Certain Integrated Circuits, Chipsets, and Products Containing Same Including... integrated circuits, chipsets, and products containing same including televisions, media players, and...

  9. 77 FR 42764 - Certain Integrated Circuits, Chipsets, & Products Containing Same Including Televisions; Notice...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-20

    ... From the Federal Register Online via the Government Publishing Office INTERNATIONAL TRADE COMMISSION Certain Integrated Circuits, Chipsets, & Products Containing Same Including Televisions; Notice of... limited exclusion order against certain integrated circuits, chipsets, and products containing the...

  10. Personalized Management Approach for OSA.

    PubMed

    Carberry, Jayne C; Amatoury, Jason; Eckert, Danny J

    2017-06-16

    OSA is a heterogeneous disorder. If left untreated, it has major health, safety, and economic consequences. In addition to varying levels of impairment in pharyngeal anatomy (narrow/collapsible airway), nonanatomical "phenotypic traits" are also important contributors to OSA for most patients. However, the majority of existing therapies (eg, CPAP, oral appliances, weight loss, positional therapy, upper airway surgery) target only the anatomical cause. These are typically administered as monotherapy according to a trial and error management approach in which the majority of patients are first prescribed CPAP. Despite its high efficacy, CPAP adherence remains unacceptably low, and second-line therapies have variable and unpredictable efficacies. Recent advances in knowledge regarding the multiple causes of OSA using respiratory phenotyping techniques have identified new targets or "treatable traits" to direct therapy. Identification of the traits and development of therapies that selectively target one or more of the treatable traits has the potential to personalize the management of this chronic health condition to optimize patient outcomes according to precision medicine principles. This brief review highlights the latest developments and emerging therapies for personalized management approaches for OSA. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  11. 75 FR 49524 - In the Matter of Certain Integrated Circuits, Chipsets, and Products Containing Same Including...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-13

    ... COMMISSION In the Matter of Certain Integrated Circuits, Chipsets, and Products Containing Same Including... sale for importation, and the sale within the United States after importation of certain integrated circuits, chipsets, and products containing same including televisions, media players, and cameras...

  12. 77 FR 1505 - Certain Integrated Circuits, Chipsets, and Products Containing Same Including Televisions; Notice...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-10

    ... COMMISSION Certain Integrated Circuits, Chipsets, and Products Containing Same Including Televisions; Notice... importation, and the sale within the United States after importation of certain integrated circuits, chipsets... importation, or the sale within the United States after importation of certain integrated circuits,...

  13. 75 FR 65654 - In the Matter of: Certain Integrated Circuits, Chipsets, and Products Containing Same Including...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-26

    ... COMMISSION In the Matter of: Certain Integrated Circuits, Chipsets, and Products Containing Same Including... sale for importation, and the sale within the United States after importation of certain integrated circuits, chipsets, and products containing same including televisions, media players, and cameras...

  14. 77 FR 57589 - Certain Integrated Circuits, Chipsets, and Products Containing Same Including Televisions...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-18

    ... COMMISSION Certain Integrated Circuits, Chipsets, and Products Containing Same Including Televisions... found that those Zoran products that were adjudicated in Integrated Circuits I are precluded under the... recommended a limited exclusion order barring entry of Zoran's and MediaTek's infringing integrated...

  15. Orthodontic and Orthognathic Surgical Treatment of a Pediatric OSA Patient

    PubMed Central

    2016-01-01

    A case report is presented which demonstrates the effectiveness of comprehensive orthodontic treatment combined with orthognathic surgery in the correction of malocclusion and reduction in the sequelae of Obstructive Sleep Apnea (OSA). The patient's severe OSA was improved to very mild as evaluated by full overnight polysomnogram. The orthodontic treatment included the expansion of both dental arches and mandibular advancement surgery. There was significant improvement in the patient's sleep continuity and architecture with the elimination of obstructive apneas. PMID:27668098

  16. OSA Proceedings on Advanced Solid-State Lasers. Vol. 10 - Proceedings of the Topical Meeting, Hilton Head, SC, Mar. 18-20, 1991

    SciTech Connect

    Dube, G.; Chase, L. Lawrence Livermore National Laboratory, Livermore, CA )

    1991-01-01

    The present volume on advanced solid-state lasers discusses Cr(3+), Cr(4+), short-pulse, titanium, F-center, mid-IR, and diode-pumped lasers, and nonlinear optics. Attention is given to the stabilization and a spectral characterization of an alexandrite laser for water vapor lidar measurements, crystal growth and spectroscopy of Cr:LiBaAlF6, a Q-switched tunable forsterite laser, and electron paramagnetic resonance spectroscopy of chromium-doped forsterite. Topics addressed include efficient frequency doubling of a self-starting additive-pulse mode-locked diode-pumped Nd:YAG laser, recent advances in Ti:Al2O3 unstable-resonator lasers, all-solid-state operation of a CW Ti:Al2O3 laser, and upconversion studies of flashlamp-pumped Cr,T,Ho:YAG. Also discussed are the top output parameters of an Ho-laser, spectroscopy and the 3-micron laser potential of Er crystals, the pulsed operation of microchip lasers, and blue optical parametric generation in LiB3O5.

  17. Chip-set for quality of service support in passive optical networks

    NASA Astrophysics Data System (ADS)

    Ringoot, Edwin; Hoebeke, Rudy; Slabbinck, B. Hans; Verhaert, Michel

    1998-10-01

    In this paper the design of a chip-set for QoS provisioning in ATM-based Passive Optical Networks is discussed. The implementation of a general-purpose switch chip on the Optical Network Unit is presented, with focus on the design of the cell scheduling and buffer management logic. The cell scheduling logic supports `colored' grants, priority jumping and weighted round-robin scheduling. The switch chip offers powerful buffer management capabilities enabling the efficient support of GFR and UBR services. Multicast forwarding is also supported. In addition, the architecture of a MAC controller chip developed for a SuperPON access network is introduced. In particular, the permit scheduling logic and its implementation on the Optical Line Termination will be discussed. The chip-set enables the efficient support of services with different service requirements on the SuperPON. The permit scheduling logic built into the MAC controller chip in combination with the cell scheduling and buffer management capabilities of the switch chip can be used by network operators to offer guaranteed service performance to delay sensitive services, and to efficiently and fairly distribute any spare capacity to delay insensitive services.

  18. Energy-efficient human body communication receiver chipset using wideband signaling scheme.

    PubMed

    Song, Seong-Jun; Cho, Namjun; Kim, Sunyoung; Yoo, Hoi-Jun

    2007-01-01

    This paper presents an energy-efficient wideband signaling receiver for communication channels using the human body as a data transmission medium. The wideband signaling scheme with the direct-coupled interface provides the energy-efficient transmission of multimedia data around the human body. The wideband signaling receiver incorporates with a receiver AFE exploiting wideband symmetric triggering technique and an all-digital CDR circuit with quadratic sampling technique. The AFE operates at 10-Mb/s data rate with input sensitivity of -27dBm and the operational bandwidth of 200-MHz. The CDR recovers clock and data of 2-Mb/s at a bit error rate of 10(-7). The receiver chipset consumes only 5-mW from a 1-V supply, thereby achieving the bit energy of 2.5-nJ/bit.

  19. An integrated low phase noise radiation-pressure-driven optomechanical oscillator chipset

    PubMed Central

    Luan, Xingsheng; Huang, Yongjun; Li, Ying; McMillan, James F.; Zheng, Jiangjun; Huang, Shu-Wei; Hsieh, Pin-Chun; Gu, Tingyi; Wang, Di; Hati, Archita; Howe, David A.; Wen, Guangjun; Yu, Mingbin; Lo, Guoqiang; Kwong, Dim-Lee; Wong, Chee Wei

    2014-01-01

    High-quality frequency references are the cornerstones in position, navigation and timing applications of both scientific and commercial domains. Optomechanical oscillators, with direct coupling to continuous-wave light and non-material-limited f × Q product, are long regarded as a potential platform for frequency reference in radio-frequency-photonic architectures. However, one major challenge is the compatibility with standard CMOS fabrication processes while maintaining optomechanical high quality performance. Here we demonstrate the monolithic integration of photonic crystal optomechanical oscillators and on-chip high speed Ge detectors based on the silicon CMOS platform. With the generation of both high harmonics (up to 59th order) and subharmonics (down to 1/4), our chipset provides multiple frequency tones for applications in both frequency multipliers and dividers. The phase noise is measured down to −125 dBc/Hz at 10 kHz offset at ~400 μW dropped-in powers, one of the lowest noise optomechanical oscillators to date and in room-temperature and atmospheric non-vacuum operating conditions. These characteristics enable optomechanical oscillators as a frequency reference platform for radio-frequency-photonic information processing. PMID:25354711

  20. An integrated low phase noise radiation-pressure-driven optomechanical oscillator chipset.

    PubMed

    Luan, Xingsheng; Huang, Yongjun; Li, Ying; McMillan, James F; Zheng, Jiangjun; Huang, Shu-Wei; Hsieh, Pin-Chun; Gu, Tingyi; Wang, Di; Hati, Archita; Howe, David A; Wen, Guangjun; Yu, Mingbin; Lo, Guoqiang; Kwong, Dim-Lee; Wong, Chee Wei

    2014-10-30

    High-quality frequency references are the cornerstones in position, navigation and timing applications of both scientific and commercial domains. Optomechanical oscillators, with direct coupling to continuous-wave light and non-material-limited f × Q product, are long regarded as a potential platform for frequency reference in radio-frequency-photonic architectures. However, one major challenge is the compatibility with standard CMOS fabrication processes while maintaining optomechanical high quality performance. Here we demonstrate the monolithic integration of photonic crystal optomechanical oscillators and on-chip high speed Ge detectors based on the silicon CMOS platform. With the generation of both high harmonics (up to 59 th order) and subharmonics (down to 1/4), our chipset provides multiple frequency tones for applications in both frequency multipliers and dividers. The phase noise is measured down to -125 dBc/Hz at 10 kHz offset at ~400 μW dropped-in powers, one of the lowest noise optomechanical oscillators to date and in room-temperature and atmospheric non-vacuum operating conditions. These characteristics enable optomechanical oscillators as a frequency reference platform for radio-frequency-photonic information processing.

  1. Intraoperative BiPAP in OSA Patients

    PubMed Central

    Singh, Bhavna P

    2015-01-01

    Obstructive sleep apnea syndrome (OSA) is characterized by recurrent episodes of partial or complete upper airway obstructions during sleep. Severe OSA presents with a number of challenges to the anesthesiologist, the most life threatening being loss of the airway. We are reporting a case where we successfully used intraoperative bi level positive pressure ventilation (BiPAP) with moderate sedation and a regional technique in a patient with severe OSA posted for total knee replacement (TKR). A 55-year-old lady with osteoarthritis of right knee joint was posted for total knee replacement. She had severe OSA with an apnea-hypopnea index of 35. She also had moderate pulmonary hypertension due to her long standing OSA. We successfully used in her a combined spinal epidural technique with intraoperative BiPAP and sedation. She had no complications intraoperatively or post operatively and was discharged on day 5. Patients with OSA are vulnerable to sedatives, anaesthesia and analgesia which even in small doses can cause complete airway collapse. The problem, with regional techniques is that it requires excellent patient cooperation. We decided to put our patient on intraoperative BiPAP hoping that this would allow us to sedate her adequately for the surgery. As it happened we were able to successfully sedate her with slightly lesser doses of the commonly used sedatives without any episodes of desaturation, snoring or exacerbation of pulmonary hypertension. Many more trials are required before we can conclusively say that intraoperative BiPAP allows us to safely sedate OSA patients but we hope that our case report draws light on this possibility. Planning ahead and having a BiPAP machine available inside the operating may allow us to use sedatives in these patients to keep them comfortable under regional anaesthesia. PMID:26023625

  2. Open-systems Architecture of a Standardized Command Interface Chip-set for Switching and Control of a Spacecraft Power Bus

    NASA Technical Reports Server (NTRS)

    Ruiz, B. Ian; Burke, Gary R.; Lung, Gerald; Whitaker, William D.; Nowicki, Robert M.

    2004-01-01

    This viewgraph presentation reviews the architecture of the The CIA-AlA chip-set is a set of mixed-signal ASICs that provide a flexible high level interface between the spacecraft's command and data handling (C&DH) electronics and lower level functions in other spacecraft subsystems. Due to the open-systems architecture of the chip-set including an embedded micro-controller a variety of applications are possible. The chip-set was developed for the missions to the outer planets. The chips were developed to provide a single solution for both the switching and regulation of a spacecraft power bus. The Open-Systems Architecture allows for other powerful applications.

  3. Open-systems Architecture of a Standardized Command Interface Chip-set for Switching and Control of a Spacecraft Power Bus

    NASA Technical Reports Server (NTRS)

    Ruiz, B. Ian; Burke, Gary R.; Lung, Gerald; Whitaker, William D.; Nowicki, Robert M.

    2004-01-01

    This viewgraph presentation reviews the architecture of the The CIA-AlA chip-set is a set of mixed-signal ASICs that provide a flexible high level interface between the spacecraft's command and data handling (C&DH) electronics and lower level functions in other spacecraft subsystems. Due to the open-systems architecture of the chip-set including an embedded micro-controller a variety of applications are possible. The chip-set was developed for the missions to the outer planets. The chips were developed to provide a single solution for both the switching and regulation of a spacecraft power bus. The Open-Systems Architecture allows for other powerful applications.

  4. Intermittent hypoxemia and OSA: implications for comorbidities.

    PubMed

    Dewan, Naresh A; Nieto, F Javier; Somers, Virend K

    2015-01-01

    OSA is a common chronic disorder that is associated with significant morbidity and mortality including cardiovascular, metabolic, and neurocognitive disease and increased cancer-related deaths. OSA is characterized by recurrent episodes of apneas and hypopneas associated with repetitive episodes of intermittent hypoxemia, intrathoracic pressure changes, and arousals. Intermittent hypoxemia (IH) is now being recognized as a potential major factor contributing to the pathogenesis of OSA-related comorbidities. OSA-related high-frequency IH is characterized by cycles of hypoxemia with reoxygenation that is distinctly different than sustained low-frequency hypoxia and contributes to ischemia-reperfusion injury. Data from both animal and human studies support mechanistic links between IH and its adverse impact at the tissue level. IH promotes oxidative stress by increased production of reactive oxygen species and angiogenesis, increased sympathetic activation with BP elevation, and systemic and vascular inflammation with endothelial dysfunction that contributes to diverse multiorgan chronic morbidity and mortality affecting cardiovascular disease, metabolic dysfunction, cognitive decline, and progression of cancer. Data from observational studies in large population groups also support the role for hypoxia in the pathogenesis of OSA comorbidity. Treatment with CPAP to reverse OSA-related symptoms and comorbidities has been shown to provide variable benefit in some but not all patient groups. Early treatment with CPAP makes intuitive sense to promote maximal functional recovery and minimize residual injury. More studies are needed to determine the interacting effects of IH and obesity, differential effects of both short-term and long-term hypoxemia, and the effect of CPAP treatment.

  5. Multiple-input multiple-output (MIMO) analog-to-feature converter chipsets for sub-wavelength acoustic source localization and bearing estimation

    NASA Astrophysics Data System (ADS)

    Chakrabartty, Shantanu

    2010-04-01

    Localization of acoustic sources using miniature microphone arrays poses a significant challenge due to fundamental limitations imposed by the physics of sound propagation. With sub-wavelength distances between the microphones, resolving acute localization cues become difficult due to precision artifacts. In this work, we present the design of a miniature, microphone array sensor based on a patented Multiple-input Multiple-output (MIMO) analog-to-feature converter (AFC) chip-sets which overcomes the limitations due to precision artifacts. Measured results from fabricated prototypes demonstrate a bearing range of 0 degrees to 90 degrees with a resolution less than 2 degrees. The power dissipation of the MIMO-ADC chip-set for this task was measured to be less than 75 microwatts making it ideal for portable, battery powered sniper and gunshot detection applications.

  6. Open-systems architecture of a standardized command interface chip-set for switching and control of a spacecraft power bus

    NASA Technical Reports Server (NTRS)

    Ruiz, Ian B.; Burke, Gary R.; Lung, Gerald; Whitaker, William D.; Nowicki, Robert M.

    2004-01-01

    The Jet Propulsion Laboratory (JPL) has developed a command interface chip-set that primarily consists of two mixed-signal ASICs'; the Command Interface ASIC (CIA) and Analog Interface ASIC (AIA). The Open-systems architecture employed during the design of this chip-set enables its use as both an intelligent gateway between the system's flight computer and the control, actuation, and activation of the spacecraft's loads, valves, and pyrotechnics respectfully as well as the regulator of the spacecraft power bus. Furthermore, the architecture is highly adaptable and employed fault-tolerant design methods enabling a host of other mission uses including reliable remote data collection. The objective of this design is to both provide a needed flight component that meets the stringent environmental requirements of current deep space missions and to add a new element to a growing library that can be used as a standard building block for future missions to the outer planets.

  7. Open-systems architecture of a standardized command interface chip-set for switching and control of a spacecraft power bus

    NASA Technical Reports Server (NTRS)

    Ruiz, Ian B.; Burke, Gary R.; Lung, Gerald; Whitaker, William D.; Nowicki, Robert M.

    2004-01-01

    The Jet Propulsion Laboratory (JPL) has developed a command interface chip-set that primarily consists of two mixed-signal ASICs'; the Command Interface ASIC (CIA) and Analog Interface ASIC (AIA). The Open-systems architecture employed during the design of this chip-set enables its use as both an intelligent gateway between the system's flight computer and the control, actuation, and activation of the spacecraft's loads, valves, and pyrotechnics respectfully as well as the regulator of the spacecraft power bus. Furthermore, the architecture is highly adaptable and employed fault-tolerant design methods enabling a host of other mission uses including reliable remote data collection. The objective of this design is to both provide a needed flight component that meets the stringent environmental requirements of current deep space missions and to add a new element to a growing library that can be used as a standard building block for future missions to the outer planets.

  8. Analytical and Experimental Performance Evaluation of BLE Neighbor Discovery Process Including Non-Idealities of Real Chipsets

    PubMed Central

    Perez-Diaz de Cerio, David; Hernández, Ángela; Valenzuela, Jose Luis; Valdovinos, Antonio

    2017-01-01

    The purpose of this paper is to evaluate from a real perspective the performance of Bluetooth Low Energy (BLE) as a technology that enables fast and reliable discovery of a large number of users/devices in a short period of time. The BLE standard specifies a wide range of configurable parameter values that determine the discovery process and need to be set according to the particular application requirements. Many previous works have been addressed to investigate the discovery process through analytical and simulation models, according to the ideal specification of the standard. However, measurements show that additional scanning gaps appear in the scanning process, which reduce the discovery capabilities. These gaps have been identified in all of the analyzed devices and respond to both regular patterns and variable events associated with the decoding process. We have demonstrated that these non-idealities, which are not taken into account in other studies, have a severe impact on the discovery process performance. Extensive performance evaluation for a varying number of devices and feasible parameter combinations has been done by comparing simulations and experimental measurements. This work also includes a simple mathematical model that closely matches both the standard implementation and the different chipset peculiarities for any possible parameter value specified in the standard and for any number of simultaneous advertising devices under scanner coverage. PMID:28273801

  9. Analytical and Experimental Performance Evaluation of BLE Neighbor Discovery Process Including Non-Idealities of Real Chipsets.

    PubMed

    Perez-Diaz de Cerio, David; Hernández, Ángela; Valenzuela, Jose Luis; Valdovinos, Antonio

    2017-03-03

    The purpose of this paper is to evaluate from a real perspective the performance of Bluetooth Low Energy (BLE) as a technology that enables fast and reliable discovery of a large number of users/devices in a short period of time. The BLE standard specifies a wide range of configurable parameter values that determine the discovery process and need to be set according to the particular application requirements. Many previous works have been addressed to investigate the discovery process through analytical and simulation models, according to the ideal specification of the standard. However, measurements show that additional scanning gaps appear in the scanning process, which reduce the discovery capabilities. These gaps have been identified in all of the analyzed devices and respond to both regular patterns and variable events associated with the decoding process. We have demonstrated that these non-idealities, which are not taken into account in other studies, have a severe impact on the discovery process performance. Extensive performance evaluation for a varying number of devices and feasible parameter combinations has been done by comparing simulations and experimental measurements. This work also includes a simple mathematical model that closely matches both the standard implementation and the different chipset peculiarities for any possible parameter value specified in the standard and for any number of simultaneous advertising devices under scanner coverage.

  10. Back to sleep or not: the effect of the supine position on pediatric OSA: Sleeping position in children with OSA.

    PubMed

    Walter, Lisa M; Dassanayake, Daranagama U N; Weichard, Aidan J; Davey, Margot J; Nixon, Gillian M; Horne, Rosemary S C

    2017-09-01

    In both adults and children, obstructive sleep apnea (OSA) has significant adverse cardiovascular consequences. In adults, sleeping position has a marked effect on the severity of OSA; however, the limited number of studies conducted in children have reported conflicting findings. We aimed to evaluate the effect of sleeping position on OSA severity and the cardiovascular consequences in preschool-aged children. This was a retrospective analysis of children (3-5 years of age) diagnosed with OSA (n = 75) and nonsnoring controls (n = 25). Sleeping position was classified as supine, semi-supine, left lateral, right lateral, prone, and semi-prone by using video recordings during one night of attended polysomnography. OSA severity and cardiovascular parameters were compared between the positions. All children spent significantly more sleep time in the supine position than in any other position. The obstructive apnea-hypopnea index was higher in the supine position than in the other sleeping positions during NREM (p < 0.05), higher in the moderate/severe OSA group when sleeping in the supine position than when sleeping in the left and right lateral positions (p < 0.05 for both) and prone position (p = 0.007) during REM. Sympathovagal balance was decreased in children with OSA in the supine and lateral positions (p < 0.05). This study identified that preschool-aged children, whether nonsnoring controls or children with OSA, predominately sleep in the supine position, and OSA was more severe in the supine position. We suggest that to avoid the supine sleep position, positional therapy has the potential to ameliorate OSA severity, and the known cardiovascular consequences. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Obstructive Sleep Apnea Syndrome (OSAS) and Cardiovascular System.

    PubMed

    Lombardi, Carolina; Tobaldini, Eleonora; Montano, Nicola; Losurdo, Anna; Parati, Gianfranco

    2017-08-28

    There is increasing evidence of a relationship between Obstructive Sleep Apnea (OSA) and cardiovascular diseases. The strong association between OSA and arterial hypertension, in particular in patients with resistant hypertension and/or a non-dipping profile, has been extensively reported. The relationship between OSA and high blood pressure (BP) has been found independent from a number of confounders, but several factors may affect this relationship, including age and sex. It is thus important to better assess pathophysiologic and clinical interactions between OSA and arterial hypertension, also aimed at optimizing treatment approaches in OSA and hypertensive patients with co-morbidities. Among possible mechanisms, cardiovascular autonomic control alterations, altered mechanics of ventilation, inflammation, endothelial dysfunction, and renin-angiotensin-aldosterone system should be considered with particular attention. Additionally, available studies also support the occurrence of a bidirectional association between OSA and cardiovascular alterations, in particular heart failure, stroke and cardiac arrhythmias, emphasizing that greater attention is needed to both identify and treat sleep apneas in patients with cardiovascular diseases. However, a number of aspects of such a relationship are still to be clarified, in particular with regard to gender differences, effect of sleep-related breathing disorders in childhood, and influence of OSA treatment on cardiovascular risk, and they may represent important targets for future studies.

  12. Digital Morphometrics: A New Upper Airway Phenotyping Paradigm in OSA.

    PubMed

    Schwab, Richard J; Leinwand, Sarah E; Bearn, Cary B; Maislin, Greg; Rao, Ramya Bhat; Nagaraja, Adithya; Wang, Stephen; Keenan, Brendan T

    2017-08-01

    OSA is associated with changes in pharyngeal anatomy. The goal of this study was to objectively and reproducibly quantify pharyngeal anatomy by using digital morphometrics based on a laser ruler and to assess differences between subjects with OSA and control subjects and associations with the apnea-hypopnea index (AHI). To the best of our knowledge, this study is the first to use digital morphometrics to quantify intraoral risk factors for OSA. Digital photographs were obtained by using an intraoral laser ruler and digital camera in 318 control subjects (mean AHI, 4.2 events/hour) and 542 subjects with OSA (mean AHI, 39.2 events/hour). The digital morphometric paradigm was validated and reproducible over time and camera distances. A larger modified Mallampati score and having a nonvisible airway were associated with a higher AHI, both unadjusted (P < .001) and controlling for age, sex, race, and BMI (P = .015 and P = .018, respectively). Measures of tongue size were larger in subjects with OSA vs control subjects in unadjusted models and controlling for age, sex, and race but nonsignificant controlling for BMI; similar results were observed with AHI severity. Multivariate regression suggests photography-based variables capture independent associations with OSA. Measures of tongue size, airway visibility, and Mallampati scores were associated with increased OSA risk and severity. This study shows that digital morphometrics is an accurate, high-throughput, and noninvasive technique to identify anatomic OSA risk factors. Morphometrics may also provide a more reproducible and standardized measurement of the Mallampati score. Digital morphometrics represent an efficient and cost-effective method of examining intraoral crowding and tongue size when examining large populations, genetics, or screening for OSA. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  13. Obstructive sleep apnea (OSA) in preadolescent girls is associated with delayed breast development compared to girls without OSA.

    PubMed

    Shaw, Natalie D; Goodwin, James L; Silva, Graciela E; Hall, Janet E; Quan, Stuart F; Malhotra, Atul

    2013-08-15

    Adults with obstructive sleep apnea (OSA) have lower sex steroid levels than controls. We sought to determine whether OSA also interferes with reproductive hormones in adolescence by tracking the pace of pubertal development. One hundred seventy-two children in the Tucson Children's Assessment of Sleep Apnea study (TuCASA) underwent two home polysomnographic studies, spaced 4-5 years apart. Height and weight were measured at both visits, and Tanner staging of breasts/genitals and pubic hair were self-assessed by a pictorial questionnaire at follow-up. Eighty-seven girls and 85 boys, age 8.9 ± 1.6 years (mean ± SD) at baseline and 13.4 ± 1.6 years at follow-up, participated. Twenty-seven percent of participants were over-weight or obese at baseline, and the majority remained so at follow-up. Twenty-six percent of girls and 28% of boys met criteria for OSA, defined as a respiratory disturbance index (RDI) ≥ 1/h associated with a 3% desaturation (RDI 3%), at baseline. There was an inverse relationship between baseline log RDI 3% and Tanner breast stage at follow-up (coefficient -1.3, p = 0.02) in girls after adjusting for age (p < 0.001), body mass index (p < 0.005), and ethnicity. Girls with OSA at baseline were more than 1 Tanner breast stage behind girls without OSA at follow-up. OSA did not affect genital development in boys or pubic hair development in either sex. OSA in preadolescent girls predicts delayed breast development relative to girls without OSA. Sleep fragmentation and/or hypoxia seen in OSA may interfere with reproductive development in girls.

  14. Obstructive Sleep Apnea (OSA) in Preadolescent Girls is Associated with Delayed Breast Development Compared to Girls without OSA

    PubMed Central

    Shaw, Natalie D.; Goodwin, James L.; Silva, Graciela E.; Hall, Janet E.; Quan, Stuart F.; Malhotra, Atul

    2013-01-01

    Study Objective: Adults with obstructive sleep apnea (OSA) have lower sex steroid levels than controls. We sought to determine whether OSA also interferes with reproductive hormones in adolescence by tracking the pace of pubertal development. Methods: One hundred seventy-two children in the Tucson Children's Assessment of Sleep Apnea study (TuCASA) underwent two home polysomnographic studies, spaced 4-5 years apart. Height and weight were measured at both visits, and Tanner staging of breasts/genitals and pubic hair were self-assessed by a pictorial questionnaire at follow-up. Results: Eighty-seven girls and 85 boys, age 8.9 ± 1.6 years (mean ± SD) at baseline and 13.4 ± 1.6 years at follow-up, participated. Twenty-seven percent of participants were over-weight or obese at baseline, and the majority remained so at follow-up. Twenty-six percent of girls and 28% of boys met criteria for OSA, defined as a respiratory disturbance index (RDI) ≥ 1/h associated with a 3% desaturation (RDI 3%), at baseline. There was an inverse relationship between baseline log RDI 3% and Tanner breast stage at follow-up (coefficient -1.3, p = 0.02) in girls after adjusting for age (p < 0.001), body mass index (p < 0.005), and ethnicity. Girls with OSA at baseline were more than 1 Tanner breast stage behind girls without OSA at follow-up. OSA did not affect genital development in boys or pubic hair development in either sex. Conclusions: OSA in preadolescent girls predicts delayed breast development relative to girls without OSA. Sleep fragmentation and/or hypoxia seen in OSA may interfere with reproductive development in girls. Citation: Shaw ND; Goodwin JL; Silva GE; Hall JE; Quan SF; Malhotra A. Obstructive sleep apnea (OSA) in preadolescent girls is associated with delayed breast development compared to girls without OSA. J Clin Sleep Med 2013;9(8):813-818. PMID:23946712

  15. Obstructive sleep apnea syndrome (OSAS) in mouth breathing children.

    PubMed

    Izu, Suemy Cioffi; Itamoto, Caroline Harumi; Pradella-Hallinan, Márcia; Pizarro, Gilberto Ulson; Tufik, Sérgio; Pignatari, Shirley; Fujita, Reginaldo Raimundo

    2010-01-01

    It is well known that mouth breathing is associated with adenotonsillar hypertrophy - which is the main cause of obstructive sleep apnea among children. Despite the importance of this matter, there are only a handful of studies showing the relationship between OSAS and mouth breathing. to determine the prevalence of obstructive sleep disorders in mouth breathing children and study its correlation with otorhinolaryngological findings. Retrospective cohort study. Data analysis from 248 medical charts of mouth breathing children seen at the Pediatric Otolaryngologic Division of a large medical institution between the years of 2000 and 2006. All patients had nasofibroscopy and or Cavum radiographs and polysomnographic exams. According to the Apnea index, patients were classified as primary snorers (AI<1); and as OSAS (>1). From 248 patients included in the study, 144 (58%) were primary snorers and 104 (42%) had OSAS. The most prevalent otorhinolaryngological findings were adenotonsillar hypertrophy (n=152; 61.2%), tonsilar hypertrophy (n=17; 6.8%), adenoid hypertrophy (n=37; 14.9%), rhinitis (n=155; 62.5%) and secretory otitis (n=36; 14.5%). primary snoring and OSAS are frequent findings in mouth breathing children. The most frequent otorhinolaryngological disorder in children with OSAS is adenotonsillar hypertrophy with or without rhinitis.

  16. Prognosis for Spontaneous Resolution of OSA in Children

    PubMed Central

    Ellenberg, Susan S.; Hou, Xiaoling; Marcus, Carole L.; Garetz, Susan L.; Katz, Eliot S.; Hodges, Elise K.; Mitchell, Ron B.; Jones, Dwight T.; Arens, Raanan; Amin, Raouf; Redline, Susan; Rosen, Carol L.; Katz, Eliot; Ware, Janice; Jones, Dwight; Redline, Susan; Wang, Rui; Mitchell, Ron; Paruthi, Shalini; Snyder, Karen; Marcus, Carole; Thomas, Nina H.; Elden, Lisa; Amin, Raouf; Beebe, Dean; Willging, Paul; Arens, Raanan; Muzumdar, Hiren; Harris, Shelby; Rosen, Carol; Taylor, H. Gerry; Sprecher, Robert; Arnold, James; Gozal, David; Chervin, Ronald; Garetz, Susan; Giordani, Bruno; Hoban, Tim; Ellenberg, Susan; Moore, Reneé H.; Lacy, Kim

    2015-01-01

    BACKGROUND: Adenotonsillectomy (AT) is commonly performed for childhood OSA syndrome (OSAS), but little is known about prognosis without treatment. METHODS: The Childhood Adenotonsillectomy Trial (CHAT) randomized 50% of eligible children with OSAS to a control arm (watchful waiting), with 7-month follow-up symptom inventories, physical examinations, and polysomnography. Polysomnographic and symptomatic resolution were defined respectively by an apnea/hypopnea index (AHI) <2 and obstructive apnea index (OAI) <1 and by an OSAS symptom score (Pediatric Sleep Questionnaire [PSQ]) < 0.33 with ≥ 25% improvement from baseline. RESULTS: After 194 children aged 5 to 9 years underwent 7 months of watchful waiting, 82 (42%) no longer met polysomnographic criteria for OSAS. Baseline predictors of resolution included lower AHI, better oxygen saturation, smaller waist circumference or percentile, higher-positioned soft palate, smaller neck circumference, and non-black race (each P < .05). Among these, the independent predictors were lower AHI and waist circumference percentile < 90%. Among 167 children with baseline PSQ scores ≥ 0.33, only 25 (15%) experienced symptomatic resolution. Baseline predictors were low PSQ and PSQ snoring subscale scores; absence of habitual snoring, loud snoring, observed apneas, or a household smoker; higher quality of life; fewer attention-deficit/hyperactivity disorder symptoms; and female sex. Only lower PSQ and snoring scores were independent predictors. CONCLUSIONS: Many candidates for AT no longer have OSAS on polysomnography after 7 months of watchful waiting, whereas meaningful improvement in symptoms is not common. In practice, a baseline low AHI and normal waist circumference, or low PSQ and snoring score, may help identify an opportunity to avoid AT. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT00560859; URL: www.clinicaltrials.gov. PMID:25811889

  17. Colloid Characteristics and Emulsifying Properties of OSA Starches

    NASA Astrophysics Data System (ADS)

    Dokić, Petar; Dokić, Ljubica; Dapčević, Tamara; Krstonošić, Veljko

    The objective of this paper was to characterize commercially available octenyl-succinate starches (OSA starches), Purity Gum 2000 and Hi-cap 100, by determining their viscous behaviour and characteristics and molecular mass, as well as to examine their emulsifying properties in corn oil-in-water emulsion system.

  18. [Quality of life in adult patient (Tunisian) with severe OSA].

    PubMed

    Kacem, I; Kalboussi, H; Ben Salem, H; Maoua, M; El Guedri, S; Laayouni, M; Abdelghani, A; Boughattas, W; Brahem, A; Debbabi, F; El Maalel, O; Chatti, S; Benzarti, M; Mrizak, N

    2017-09-01

    The negative impact of obstructive sleep apnea (OSA) on quality of life of affected individuals is a central consequence of this disease. The recognition of the quality of life as a therapeutic target is a relatively new concept. To evaluate the quality of life and its determinants in patients with OSA. We conducted a cross-sectional study during the period from 1st July 2012 to 30th June 2013. The target population was patients with OSA and in employment examined in consultations of pneumology in the teaching hospital Farhat-Hached in Sousse (Tunisia). This study was based on a generic questionnaire (SF-36) to assess the quality of life. The study population included 103 cases with a mean age of 55.15±11.4years and a sex ratio of 0.71. Our patients were obese in 95.1 % of cases with an average BMI of 39.13±7.19kg/m(2). The majority of our patients had an impaired quality of life with an average score of 44.76 (SF36) and extremes of 22 and 70. There was a positive linear relationship between physical and mental components of the SF-36 and gender, age, BMI, and anxiety and depressive disorders. The OSA is a demanding disease whose impact on the quality of life seems important and requires special attention. The management of this disease should not be limited to controlling the disease but aspire to overall patient satisfaction. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  19. Ensuring a Future for Marine Corps Operational Support Airlift (OSA)

    DTIC Science & Technology

    2013-04-29

    purchase of the C-12 in the 1980’s. The C- 12, which is a military version of the Beech Craft ‘ King Air’ was subsequently used by the Marine Corps...MAGTF. The C-12 (Figure 2) is the military version of the Beechcraft King Air. It is often referred to as the ‘workhorse’ of OSA. There are...during major exercises such as Cobra Gold. 39 This would also allow the aircraft to 20 normalize operations in the region, which would better

  20. Obstructive sleep apnea syndrome (OSAS) and hypertension: Pathogenic mechanisms and possible therapeutic approaches

    PubMed Central

    Zhang, Wang

    2012-01-01

    Obstructive sleep apnea syndrome (OSAS), a chronic condition characterized by collapse of the pharynx during sleep, has been increasingly recognized as a health issue of growing importance over the last decade. Recently emerging evidence suggests that there is a causal link between OSAS and hypertension, and hypertension represents an independent risk factor in OSAS patients. However, the pathophysiological basis for patients with OSAS having an increased risk for hypertension remains to be elucidated. The main acute physiological outcomes of OSAS are intermittent hypoxia, intrapleural pressure changes, and arousal from sleep, which might induce endothelial dysfunction, sympathetic activation, renin–angiotensin–aldosterone system activation, lipid metabolism dysfunction, and increased oxidative stress. This brief review focuses on the current understanding of the complex association between OSAS and hypertension. PMID:23009224

  1. OSA Syndrome and Posttraumatic Stress Disorder: Clinical Outcomes and Impact of Positive Airway Pressure Therapy.

    PubMed

    Lettieri, Christopher J; Williams, Scott G; Collen, Jacob F

    2016-02-01

    We sought to determine the impact of OSA syndrome (OSAS) on symptoms and quality of life (QoL) among patients with posttraumatic stress disorder (PTSD). In addition, we assessed adherence and response to positive airway pressure (PAP) therapy in this population. This was a case-controlled observational cohort study at the Sleep Disorders Center of an academic military medical center. Two hundred consecutive patients with PTSD underwent sleep evaluations. Patients with PTSD with and without OSAS were compared with 50 consecutive age-matched patients with OSAS without PTSD and 50 age-matched normal control subjects. Polysomnographic data, sleep-related symptoms and QoL measures, and objective PAP usage were obtained. Among patients with PTSD, more than one-half (56.6%) received a diagnosis of OSAS. Patients with PTSD and OSAS had lower QoL and more somnolence compared with the other groups. Patients with PTSD demonstrated significantly lower adherence and response to PAP therapy. Resolution of sleepiness occurred in 82% of patients with OSAS alone, compared with 62.5% of PAP-adherent and 21.4% of nonadherent patients with PTSD and OSAS (P < .001). Similarly, posttreatment Functional Outcomes of Sleep Questionnaire ≥ 17.9 was achieved in 72% of patients with OSAS, compared with only 56.3% of patients with PTSD and OSA who were PAP adherent and 26.2% who were nonadherent (P < .03). In patients with PTSD, comorbid OSAS is associated with worsened symptoms, QoL, and adherence and response to PAP. Given the negative impact on outcomes, the possibility of OSAS should be considered carefully in patients with PTSD. Close follow-up is needed to optimize PAP adherence and efficacy in this at-risk population. Published by Elsevier Inc.

  2. Effectiveness of Maxillomandibular advancement (MMA) surgery in sleep apnea treatment: Case report.

    PubMed

    Ferraz, Otávio; Guimarães, Thais M; Rossi, Rowdley R; Cunali, Paulo A; Fabbro, Cibele Dal; Chaves, Cauby M; Maluly, Milton; Bittencourt, Lia; Tufik, Sergio

    2016-01-01

    Obstructive sleep apnea (OSA) is characterized by episodes of pharyngeal collapse during sleep. Craniofacial alterations such as retrognathia are often found in OSA patients. Maxillomandibular advancement (MMA) surgeries increase the pharyngeal space and are a treatment option for OSA. The aim of this study was to present a successful case of MMA surgery in the treatment of OSA. A patient with moderate OSA (apnea-hypopnea index (AHI)=25.2) and mandibular retrognathism and Maxillomandibular asymmetry underwent MMA surgery. The apnea-hypopnea index (AHI) were considerably improved after six months (IAH =6.7) and one year of treatment (IAH=0.2).

  3. Obesity and obstructive sleep apnea: or is it OSA and obesity?

    PubMed

    Carter, Robert; Watenpaugh, Donald E

    2008-08-01

    Obstructive sleep apnea (OSA) consists of repetitive choking spells due to sleep-induced reduction of upper airway muscle tone. Millions of adults and children live unaware of this condition, which can have a profound affect on their health and quality of life. Obesity, gender, genetic, and hormonal factors mediate risk for OSA and interact in a multifaceted manner in the pathogenesis of this disease. Obesity is the most established and primary risk factor given that body mass index, visceral fat, and neck circumference are major predictors in the clinical expression of OSA. Many studies have shown weight loss or gain significantly impacts OSA severity. More recently, accumulating evidence indicates OSA promotes weight gain, obesity, and type II diabetes in a variety of ways, such that obesity and OSA form multiple interleaved vicious cycles. Thus, creative strategies to increase physical activity, improve diet, and otherwise facilitate weight management become particularly vital given the epidemics of obesity and OSA in the United States. In this regard, the American College of Sports Medicine recently launched the "Exercise is Medicine" (initiative exerciseismedicine.org). In the future, medications may emerge to treat obesity, OSA, and their sequelae with minimal side effects. However, there are effective ways to approach these problems now without waiting for "the magic pill".

  4. Mathematical Objects through the Lens of Two Different Theoretical Perspectives: APOS and OSA

    ERIC Educational Resources Information Center

    Font Moll, Vicenç; Trigueros, María; Badillo, Edelmira; Rubio, Norma

    2016-01-01

    This paper presents a networking of two theories, the APOS Theory and the ontosemiotic approach (OSA), to compare and contrast how they conceptualize the notion of a mathematical object. As context of reflection, we designed an APOS genetic decomposition for the derivative and analyzed it from the point of view of OSA. Results of this study show…

  5. Mathematical Objects through the Lens of Two Different Theoretical Perspectives: APOS and OSA

    ERIC Educational Resources Information Center

    Font Moll, Vicenç; Trigueros, María; Badillo, Edelmira; Rubio, Norma

    2016-01-01

    This paper presents a networking of two theories, the APOS Theory and the ontosemiotic approach (OSA), to compare and contrast how they conceptualize the notion of a mathematical object. As context of reflection, we designed an APOS genetic decomposition for the derivative and analyzed it from the point of view of OSA. Results of this study show…

  6. Osa-containing Brahma chromatin remodeling complexes are required for the repression of Wingless target genes

    PubMed Central

    Collins, Russell T.; Treisman, Jessica E.

    2000-01-01

    The Wingless signaling pathway directs many developmental processes in Drosophila by regulating the expression of specific downstream target genes. We report here that the product of the trithorax group gene osa is required to repress such genes in the absence of the Wingless signal. The Wingless-regulated genes nubbin, Distal-less, and decapentaplegic and a minimal enhancer from the Ultrabithorax gene are misexpressed in osa mutants and repressed by ectopic Osa. Osa-mediated repression occurs downstream of the up-regulation of Armadillo but is sensitive both to the relative levels of activating Armadillo/Pangolin and repressing Groucho/Pangolin complexes present and to the responsiveness of the promoter to Wingless. Osa functions as a component of the Brahma chromatin-remodeling complex; other components of this complex are likewise required to repress Wingless target genes. These results suggest that altering the conformation of chromatin is an important mechanism by which Wingless signaling activates gene expression. PMID:11124806

  7. The WOPR Domain Protein OsaA Orchestrates Development in Aspergillus nidulans

    PubMed Central

    Alkahyyat, Fahad; Ni, Min; Kim, Sun Chang; Yu, Jae-Hyuk

    2015-01-01

    Orchestration of cellular growth and development occurs during the life cycle of Aspergillus nidulans. A multi-copy genetic screen intended to unveil novel regulators of development identified the AN6578 locus predicted to encode a protein with the WOPR domain, which is a broadly present fungi-specific DNA-binding motif. Multi-copy of AN6578 disrupted the normal life cycle of the fungus leading to enhanced proliferation of vegetative cells, whereas the deletion resulted in hyper-active sexual fruiting with reduced asexual development (conidiation), thus named as osaA (Orchestrator of Sex and Asex). Further genetic studies indicate that OsaA balances development mainly by repressing sexual development downstream of the velvet regulator VeA. The absence of osaA is sufficient to suppress the veA1 allele leading to the sporulation levels comparable to veA+ wild type (WT). Genome-wide transcriptomic analyses of WT, veA1, and ΔosaA veA1 strains by RNA-Seq further corroborate that OsaA functions in repressing sexual development downstream of VeA. However, OsaA also plays additional roles in controlling development, as the ΔosaA veA1 mutant exhibits precocious and enhanced formation of Hülle cells compared to WT. The OsaA orthologue of Aspergillus flavus is able to complement the osaA null phenotype in A. nidulans, suggesting a conserved role of this group of WOPR domain proteins. In summary, OsaA is an upstream orchestrator of morphological and chemical development in Aspergillus that functions downstream of VeA. PMID:26359867

  8. Comparative Emulsifying Properties of Octenyl Succinic Anhydride (OSA)-Modified Starch: Granular Form vs Dissolved State

    PubMed Central

    Marefati, Ali; Gutiérrez, Gemma; Wahlgren, Marie; Rayner, Marilyn

    2016-01-01

    The emulsifying ability of OSA-modified and native starch in the granular form, in the dissolved state and a combination of both was compared. This study aims to understand mixed systems of particles and dissolved starch with respect to what species dominates at droplet interfaces and how stability is affected by addition of one of the species to already formed emulsions. It was possible to create emulsions with OSA-modified starch isolated from Quinoa as sole emulsifier. Similar droplet sizes were obtained with emulsions prepared at 7% (w/w) oil content using OSA-modified starch in the granular form or molecularly dissolved but large differences were observed regarding stability. Pickering emulsions kept their droplet size constant after one month while emulsions formulated with OSA-modified starch dissolved exhibited coalescence. All emulsions stabilized combining OSA-modified starch in granular form and in solution showed larger mean droplet sizes with no significant differences with respect to the order of addition. These emulsions were unstable due to coalescence regarding presence of free oil. Similar results were obtained when emulsions were prepared by combining OSA-modified granules with native starch in solution. The degree of surface coverage of starch granules was much lower in presence of starch in solution which indicates that OSA-starch is more surface active in the dissolved state than in granular form, although it led to unstable systems compared to starch granule stabilized Pickering emulsions, which demonstrated to be extremely stable. PMID:27479315

  9. Comparative Emulsifying Properties of Octenyl Succinic Anhydride (OSA)-Modified Starch: Granular Form vs Dissolved State.

    PubMed

    Matos, María; Marefati, Ali; Gutiérrez, Gemma; Wahlgren, Marie; Rayner, Marilyn

    2016-01-01

    The emulsifying ability of OSA-modified and native starch in the granular form, in the dissolved state and a combination of both was compared. This study aims to understand mixed systems of particles and dissolved starch with respect to what species dominates at droplet interfaces and how stability is affected by addition of one of the species to already formed emulsions. It was possible to create emulsions with OSA-modified starch isolated from Quinoa as sole emulsifier. Similar droplet sizes were obtained with emulsions prepared at 7% (w/w) oil content using OSA-modified starch in the granular form or molecularly dissolved but large differences were observed regarding stability. Pickering emulsions kept their droplet size constant after one month while emulsions formulated with OSA-modified starch dissolved exhibited coalescence. All emulsions stabilized combining OSA-modified starch in granular form and in solution showed larger mean droplet sizes with no significant differences with respect to the order of addition. These emulsions were unstable due to coalescence regarding presence of free oil. Similar results were obtained when emulsions were prepared by combining OSA-modified granules with native starch in solution. The degree of surface coverage of starch granules was much lower in presence of starch in solution which indicates that OSA-starch is more surface active in the dissolved state than in granular form, although it led to unstable systems compared to starch granule stabilized Pickering emulsions, which demonstrated to be extremely stable.

  10. Endothelial nitric oxide synthase uncoupling: a novel pathway in OSA induced vascular endothelial dysfunction.

    PubMed

    Varadharaj, Saradhadevi; Porter, Kyle; Pleister, Adam; Wannemacher, Jacob; Sow, Angela; Jarjoura, David; Zweier, Jay L; Khayat, Rami N

    2015-02-01

    The mechanism of vascular endothelial dysfunction (VED) and cardiovascular disease in obstructive sleep apnea (OSA) is unknown. We performed a comprehensive evaluation of endothelial nitric oxide synthase (eNOS) function directly in the microcirculatory endothelial tissue of OSA patients who have very low cardiovascular risk status. Nineteen OSA patients underwent gluteal biopsies before, and after effective treatment of OSA. We measured superoxide (O2(•-)) and nitric oxide (NO) in the microcirculatory endothelium using confocal microscopy. We evaluated the effect of the NOS inhibitor l-Nitroarginine-Methyl-Ester (l-NAME) and the NOS cofactor tetrahydrobiopterin (BH4) on endothelial O2(•-) and NO in patient endothelial tissue before and after treatment. We found that eNOS is dysfunctional in OSA patients pre-treatment, and is a source of endothelial O2(•-) overproduction. eNOS dysfunction was reversible with the addition of BH4. These findings provide a new mechanism of endothelial dysfunction in OSA patients and a potentially targetable pathway for treatment of cardiovascular risk in OSA. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Network science meets respiratory medicine for OSAS phenotyping and severity prediction

    PubMed Central

    Mihaicuta, Stefan; Topirceanu, Alexandru; Udrescu, Lucretia

    2017-01-01

    Obstructive sleep apnea syndrome (OSAS) is a common clinical condition. The way that OSAS risk factors associate and converge is not a random process. As such, defining OSAS phenotypes fosters personalized patient management and population screening. In this paper, we present a network-based observational, retrospective study on a cohort of 1,371 consecutive OSAS patients and 611 non-OSAS control patients in order to explore the risk factor associations and their correlation with OSAS comorbidities. To this end, we construct the Apnea Patients Network (APN) using patient compatibility relationships according to six objective parameters: age, gender, body mass index (BMI), blood pressure (BP), neck circumference (NC) and the Epworth sleepiness score (ESS). By running targeted network clustering algorithms, we identify eight patient phenotypes and corroborate them with the co-morbidity types. Also, by employing machine learning on the uncovered phenotypes, we derive a classification tree and introduce a computational framework which render the Sleep Apnea Syndrome Score (SASScore); our OSAS score is implemented as an easy-to-use, web-based computer program which requires less than one minute for processing one individual. Our evaluation, performed on a distinct validation database with 231 consecutive patients, reveals that OSAS prediction with SASScore has a significant specificity improvement (an increase of 234%) for only 8.2% sensitivity decrease in comparison with the state-of-the-art score STOP-BANG. The fact that SASScore has bigger specificity makes it appropriate for OSAS screening and risk prediction in big, general populations. PMID:28503375

  12. Color opponency and scale uniformity in the OSA-UCS system: the geometrical structure

    NASA Astrophysics Data System (ADS)

    Oleari, Claudio

    2002-06-01

    Two different transformations between the (X10, Y10, Z10) coordinates and the (LOSA, g, j) ones of the Uniform Color System of the Optical Society of America (OSA- UCS) are given related to two possible different geometrical structures. Both transformations are logarithmic functions obtained by integration of Weber fractions of ratios of suitable color stimuli. The first structure is related to the color opponency proper of the (g, j) coordinates of the OSA-UCS) system and the second one to a mixing of the (g, j) coordinates. The second transformation has a simpler and highly symmetrical structure, and the regularity of the OSA- UCS lattice is higher.

  13. Driving Simulator Performance Remains Impaired In Patients With Severe OSA after CPAP Treatment

    PubMed Central

    Vakulin, Andrew; Baulk, Stuart D.; Catcheside, Peter G.; Antic, Nick A.; van den Heuvel, Cameron J.; Dorrian, Jillian; McEvoy, R. Doug

    2011-01-01

    Study Objectives: To assess the effectiveness of CPAP treatment in improving 90-minute driving simulator performance in severe OSA patients compared to age/gender matched controls. Design: Driving simulator performance was assessed at baseline and 3 months later, with OSA patients treated with CPAP during the interval. Setting: University Teaching Hospital. Participants: Patients with severe OSA (n = 11) and control subjects without OSA (n = 9). Interventions: CPAP Measurements and Results: Simulator driving parameters of steering deviation, braking reaction time and crashes were measured at baseline and ∼3 months follow-up. At baseline, OSA subjects demonstrated significantly greater steering deviation compared to controls (mean [95% CI], OSA group, 49.9 cm [43.7 to 56.0 cm] vs control group, 34.9 cm [28.1 to 41.7 cm], p = 0.003). Following ∼3 months of CPAP treatment (mean ± SD 6.0 ± 1.4 h/night), steering deviation in OSA subjects improved by an average of 3.1 cm (CI, 1.4 to 4.9), p < 0.001, while no significant steering changes were observed in the control group. Despite the improvement, steering deviation in the OSA group remained significantly higher than in controls (OSA group, 46.7 cm [CI, 40.6 to 52.8 cm] vs control group, 36.1 cm [CI, 29.3 to 42.9 cm], p = 0.025). Conclusions: While driving simulator performance improved after ∼3 months of CPAP treatment with high adherence in patients with severe OSA, performance remained impaired compared to control subjects. These results add to the growing body of evidence that some neurobehavioral deficits in patients with severe OSA are not fully reversed by treatment. Further studies are needed to assess causes of residual driving simulator impairment and to determine whether this is associated with persistent elevated real-life accident risk. Trial Registration: Data presented in this manuscript was collected as part of a clinical trial “Experimental Investigations of Driving Impairment in Obstructive

  14. Advanced Optical Fiber Development for kW Fiber Lasers with Sub-GHz Linewidth

    DTIC Science & Technology

    2016-01-12

    Advanced Optical Fiber Development for kW Fiber Lasers with Sub-GHz Linewidth The project is for acquiring an optical spectrum analyzer (OSA) covering...Report Title The project is for acquiring an optical spectrum analyzer (OSA) covering wavelength range from 1900nm to 3400nm (Yokogawa AQ6375- Z-D/FC/RFC...STATEMENT 13. SUPPLEMENTARY NOTES 14. ABSTRACT The project is for acquiring an optical spectrum analyzer (OSA) covering wavelength range

  15. Characterization of obstructive sleep apnea-hypopnea syndrome (OSA) population by means of cluster analysis.

    PubMed

    Lacedonia, Donato; Carpagnano, Giovanna Elisiana; Sabato, Roberto; Storto, Maria Maddalena Lo; Palmiotti, Giuseppe Antonio; Capozzi, Vito; Barbaro, Maria Pia Foschino; Gallo, Crescenzio

    2016-12-01

    Obstructive sleep apnea-hypopnea syndrome (OSA) is being identified increasingly as an important health issue. It is typified by repeated episodes of upper airway collapse during sleep leading to occasional hypoxaemia, sleep fragmentation and poor sleep quality. OSA is also being considered as an independent risk factor for hypertension, diabetes and cardiovascular diseases, leading to increased multi-morbidity and mortality. Cluster analysis, a powerful statistical set of techniques, may help in investigating and classifying homogeneous groups of patients with similar OSA characteristics. This study aims to investigate the (possible) different groups of patients in an OSA population, and to analyse the relationships among the main clinical variables in each group to better understand the impact of OSA on patients. Starting from a well-characterized OSA population of 198 subjects afferent to our sleep centre, we identified three different communities of OSA patients. The first has a very severe disease [apnea-hypopnea index (AHI) = 65.91 ± 22.47] and sleep disorder has a strong impact on daily life: a low level of diurnal partial pressure of oxygen (PaO2 ) (77.39 ± 11.64 mmHg) and a high prevalence of hypertension (64%); the second, with less severe disease (AHI = 28.88 ± 17.13), in which sleep disorders seem to be less important for diurnal PaO2 and have a minimum impact on comorbidity; and the last with very severe OSA (AHI = 57.26 ± 15.09) but with a low risk of nocturnal hypoxaemia (T90 = 11.58 ± 8.54) and less sleepy (Epworth Sleepiness Scale 10.00 ± 4.77).

  16. Executive Dysfunction in OSA Before and After Treatment: A Meta-Analysis

    PubMed Central

    Olaithe, Michelle; Bucks, Romola S.

    2013-01-01

    Study Objectives: Obstructive sleep apnea (OSA) is a frequent and often underdiagnosed condition that is associated with upper airway collapse, oxygen desaturation, and sleep fragmentation leading to cognitive dysfunction. There is meta-analytic evidence that subdomains of attention and memory are affected by OSA. However, a thorough investigation of the impact of OSA on different subdomains of executive function is yet to be conducted. This report investigates the impact of OSA and its treatment, in adult patients, on 5 theorized subdomains of executive function. Design: An extensive literature search was conducted of published and unpublished materials, returning 35 studies that matched selection criteria. Meta-analysis was used to synthesize the results from studies examining the impact of OSA on executive functioning compared to controls (21 studies), and before and after treatment (19 studies); 5 studies met inclusion in both categories. Measurements: Research papers were selected which assessed 5 subdomains of executive function: Shifting, Updating, Inhibition, Generativity, and Fluid Reasoning. Results: All 5 domains of executive function demonstrated medium to very large impairments in OSA independent of age and disease severity. Furthermore, all subdomains of executive function demonstrated small to medium improvements with CPAP treatment. Discussion: Executive function is impaired across all five domains in OSA; these difficulties improved with CPAP treatment. Age and disease severity did not moderate the effects found; however, further studies are needed to explore the extent of primary and secondary effects, and the impact of age and premorbid intellectual ability (cognitive reserve). Citation: Olaithe M; Bucks RS. Executive dysfunction in OSA before and after treatment: a meta-analysis. SLEEP 2013;36(9):1297-1305. PMID:23997362

  17. Obstructive Sleep Apnea Syndrome (OSAS) Increases Pedestrian Injury Risk in Children

    PubMed Central

    Avis, Kristin T.; Gamble, Karen L.; Schwebel, David C

    2014-01-01

    Objectives To evaluate pedestrian behavior, including reaction time, impulsivity, risk-taking, attention, and decision-making, in children with obstructive sleep apnea syndrome (OSAS) compared with healthy controls. Study design Using a case control design, sixty 8- to 16-year-olds with newly diagnosed and untreated OSAS engaged in a virtual reality pedestrian environment. Sixty-one healthy children matched using a yoke-control procedure by age, race, gender and household income served as controls. Results Children with OSAS were riskier pedestrians than healthy children of the same age, race, and sex. Children with OSAS waited less time to cross (p<.01). The groups did not differ in looking at oncoming traffic or taking longer to decide to cross. Conclusions Results suggest OSAS may have significant consequences on children’s daytime functioning in a critical domain of personal safety, pedestrian skills. Children with OSAS appeared to have greater impulsivity when crossing streets. Results highlight the need for heightened awareness of the consequences of untreated sleep disorders and identify a possible target for pediatric injury prevention. PMID:25444002

  18. Is There a Relationship Between Snoring Sound Intensity and Frequency and OSAS Severity?

    PubMed

    Acar, Mustafa; Yazıcı, Demet; Bayar Muluk, Nuray; Hancı, Deniz; Seren, Erdal; Cingi, Cemal

    2016-01-01

    We investigated the relationship between snoring sounds and severity of obstructive sleep apnea syndrome (OSAS). A total number of 103 snoring patients (60 males and 43 females) were evaluated by means of polysomnographic findings and snoring sound recordings. Snoring sound intensity was assessed using fast Fourier transform (FFT) method by measuring maximal frequency (Fmax) and average snoring sound intensity level (SSIL). Maximal frequency and SSIL are correlated with apnea-hypopnea index (AHI), REM AHI, and severity of the OSAS. So, as the severity of the OSAS increased, so did the Fmax and SSIL of the snoring recordings, meaning patients started snoring louder with more frequency. In older patients, in females, in severe OSAS group, and in patients with higher body mass index (BMI), AHI and AHI REM values and SSIL and Fmax values increased. As mean oxygen (O2) saturation and lowest O2 saturation decreased, SSIL and Fmax values increased. Maximal frequency and SSIL analysis of the snoring sound increased in severe OSAS patients. People should be aware of the importance of snoring sounds. In particular, patients with snoring sounds increasing in intensity and of higher frequency should discuss with their physicians the possibility of OSAS. © The Author(s) 2015.

  19. Effect of CPAP Therapy in Improving Daytime Sleepiness in Indian Patients with Moderate and Severe OSA

    PubMed Central

    Battan, Gulshan; Panwar, Ajay; Atam, Virendra; Kumar, Pradeep; Gangwar, Anil; Roy, Ujjawal

    2016-01-01

    Introduction Obstructive Sleep Apnoea (OSA) is a highly prevalent disease and a major public health issue in India. Excessive daytime sleepiness is an almost ubiquitous symptom of OSA. Epworth Sleepiness Scale (ESS) score is a validated objective score to measure the degree of daytime sleepiness. Continuous Positive Airway Pressure (CPAP) therapy has been established as the gold standard treatment modality for OSA patients. A few Indian studies have reported the effectiveness of CPAP therapy in improving ESS scores after 1st month of CPAP use. Aim To observe both, short-term (one month) and long-term (three month) effects of CPAP therapy on ESS scores in moderate to severe OSA patients. Materials and Methods The patients complaining of excessive day-time sleepiness, snoring and choking episodes during sleep, consecutively presenting to medicine OPD over a period of 2 years, were subjected to Polysomnography (PSG). Seventy-three patients with apnoea-hypopnea index (AHI) ≥15 were categorised as having moderate to severe forms of OSA (moderate OSA with AHI=15-30 and severe OSA with AHI >30), and were scheduled for an initial trial of CPAP therapy. Forty-seven patients reported good tolerance to CPAP therapy after a trial period of 2 weeks and comprised the final study group. ESS scores in these patients were recorded at the baseline, and after 1st and 3rd month of CPAP therapy, and statistically analysed for significance. Results Mean ESS score at the baseline among moderate and severe OSA patients were 13.67±2.29 and 16.56 ±1.87, respectively. ESS score in both these subgroups improved significantly to 11.63±3.79, p=0.022, CI (0.3293-4.0106)} and 14.13 ±3.74, p < 0.001, CI (1.2991-4.5408), respectively after one month of CPAP therapy. Likewise, mean ESS scores among moderate and severe OSA patients improved significantly to 9.84 ±2.97, p = 0.022, CI (0.3293-4.0106) and 12.29 ±3.97, p <0.001, CI (2.9414-6.1385), respectively after three months of CPAP therapy

  20. Relationship between energy expenditure, physical activity and weight loss during CPAP treatment in obese OSA subjects.

    PubMed

    Bamberga, Michele; Rizzi, Maurizio; Gadaleta, Felice; Grechi, Attilio; Baiardini, Renata; Fanfulla, Francesco

    2015-04-01

    Increased energy expenditure (EE) has been reported in patients with obstructive sleep apnea (OSA). It has been postulated that CPAP treatment may induce weight reduction in obese patients, even if it has not been confirmed by recent studies. In the present study we investigated the effect of OSA on EE and the effect of CPAP on body weight and physical activity. One hundred and seven obese OSA patients and 25 healthy obese volunteers, as control group, matched for age, sex and BMI, were enrolled. The following evaluation was performed only in OSA patients after 6 months of CPAP treatment. Baseline total EE was similar in the two groups, but OSA patients showed higher EE during the night, while control group during daytime. In patients, EE correlates with OSA severity, degree of daytime sleepiness or obesity. At follow-up evaluation, BMI and total EE were unchanged. However, daytime EE increased (1066 ± 131.5 vs 1104 ± 133 Kcal/die, p < 0.001, respectively) and night EE decreased (694 ± 69 vs 595 ± 73, p < 0.0001, respectively). Statistically significant changes in BMI, sleepiness scale, blood gases and EE were found only in patients who were compliant to CPAP. Obese OSA patients showed an increased night EE that was normalized only in those patients compliant to CPAP. Body weight and daily physical activity did not change in statistically significant way. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Paediatric obstructive sleep apnoea syndrome (OSAS) is associated with tonsil colonisation by Streptococcus pyogenes

    PubMed Central

    Viciani, Elisa; Montagnani, Francesca; Tavarini, Simona; Tordini, Giacinta; Maccari, Silvia; Morandi, Matteo; Faenzi, Elisa; Biagini, Cesare; Romano, Antonio; Salerni, Lorenzo; Finco, Oretta; Lazzi, Stefano; Ruggiero, Paolo; De Luca, Andrea; Barocchi, Michèle A.; Manetti, Andrea G. O.

    2016-01-01

    The involvement of pathogenic bacteria in obstructive sleep apnoea syndrome (OSAS) has yet to be elucidated. We investigated the possible role of group A streptococcus (GAS) in OSAS pathogenesis. In 40 tonsillectomized patients affected by OSAS and 80 healthy controls, significant (p < 0.0001) association of GAS with paediatric OSAS was found. Supernatant from streptolysin O (SLO)-producing GAS induced production of cysteinyl leukotrienes (CysLTs) in tonsil mononuclear cells (TMCs). CysLTs-treated TMCs showed significant (p < 0.05) proliferation of CD4+ T, CD19+ and CD19+CD27+CD38+ B lymphocytes. We discovered a SLO-dependent activation of CysLTs production through a pathway involving TOLL-like receptor 4 (TLR4), TIR-domain-containing adapter-inducing interferon-β (TRIF), Myeloid differentiation primary response gene 88 (MyD88), and p38 MAP Kinase. In conclusion, we hypothesise that GAS may contribute to paediatric tonsillar hyperplasia through CysLTs production induced by SLO, and this might explain its association with OSAS. PMID:26860261

  2. MR image analytics to characterize upper airway architecture in children with OSAS

    NASA Astrophysics Data System (ADS)

    Tong, Yubing; Udupa, Jayaram K.; Torigian, Drew A.; Matsumoto, Monica M. S.; Sin, Sanghun; Arens, Raanan

    2015-03-01

    Mechanisms leading to Obstructive Sleep Apnea Syndrome (OSAS) in obese children are not well understood. We previously analyzed polysomnographic and demographic data to study the anatomical characteristics of the upper airway and body composition in two groups of obese children with and without OSAS, where object volume was evaluated. In this paper, in order to better understand the disease we expand the analysis considering a variety of features that include object-specific features such as size, surface area, sphericity, and image intensity properties of fourteen objects in the vicinity of the upper airway, as well as inter-object relationships such as distance between objects. Our preliminary results indicate several interesting phenomena: volumes and surface areas of adenoid and tonsils increase statistically significantly in OSAS. Standardized T2-weighted MR image intensities differ statistically significantly between the two groups, implying that perhaps intrinsic tissue composition undergoes changes in OSAS. Inter-object distances are significantly different between the two groups for object pairs (skin, oropharynx), (skin, fat pad), (skin, soft palate), (mandible, tongue), (oropharynx, soft palate), (left tonsil, oropharynx), (left tonsil, fat pad) and (left tonsil, right tonsil). We conclude that treatment methods for OSAS such as adenotonsillectomy should respect proportional object size relationships and spatial arrangement of objects as they exist in control subjects.

  3. Reviewing the relationship between OSA and cognition: Where do we go from here?

    PubMed

    Bucks, Romola S; Olaithe, Michelle; Rosenzweig, Ivana; Morrell, Mary J

    2017-10-01

    Obstructive sleep apnoea (OSA) is a disorder of breathing during sleep resulting in temporary reduction in cerebral oxygenation and sleep disruption. A growing body of research reveals a relatively consistent pattern of deficits in cognition, particularly in attention, episodic memory, and executive function, which are partially remediated by treatment. This is where the consensus ends. Despite a number of competing explanations regarding how OSA affects cognition, reliable evidence is hard to find, which may relate to the many, common conditions co-morbid with OSA or to the methodological challenges in this field. This paper reviews the evidence for cognitive impairment in OSA, the proposed models of cognitive harm, the impact of co-morbidities and the many methodological and theoretical challenges of exploring the effect of OSA on cognition. To overcome some of these challenges, we end by proposing a number of future directions for the field, including suggesting some core design elements for future studies. © 2017 Asian Pacific Society of Respirology.

  4. Blood Pressure Increases in OSA due to Maintained Neurovascular Sympathetic Transduction: Impact of CPAP

    PubMed Central

    Tamisier, Renaud; Tan, Can Ozan; Pepin, Jean-Louis; Levy, Patrick; Taylor, J. Andrew

    2015-01-01

    Study Objectives: To test the hypothesis that greater resting sympathetic activity in obstructive sleep apnea (OSA) syndrome would not induce a lesser sympathetic neurovascular transduction. Design: Case-controlled cohort study. Participants: 33 patients with newly diagnosed OSA without comorbidities and 14 healthy controls. Interventions: 6 months of continuous positive airway pressure (CPAP) treatment for OSA patients and follow-up for 9 healthy controls. Measurements and Results: We assessed resting sympathetic outflow and sympathetic neurovascular transduction. Sympathetic activity was directly measured (microneurography) at rest and in response to sustained isometric handgrip exercise. Neurovascular transduction was derived from the relationship of sympathetic activity and blood pressure to leg blood flow during exercise. Despite an elevated sympathetic activity of ∼50% in OSA compared to controls, neurovascular transduction was not different (i.e., absence of tachyphylaxis). After six months of CPAP, there were significant declines in diastolic pressure, averaging ∼4 mm Hg, and in sympathetic activity, averaging ∼20% with no change in transduction. Conclusions: Greater sympathetic activity in obstructive sleep apnea does not appear to be associated with lesser neurovascular transduction. Hence, elevated sympathetic outflow without lesser transduction may underlie the prevalent development of hypertension in this population that is well controlled by continuous positive airway pressure treatment. Citation: Tamisier R, Tan CO, Pepin JL, Levy P, Taylor JA. Blood pressure increases in OSA due to maintained neurovascular sympathetic transduction: impact of CPAP. SLEEP 2015;38(12):1973–1980. PMID:26039959

  5. Performance analysis and overload control of an open service access (OSA) architecture

    NASA Astrophysics Data System (ADS)

    Andersson, Jens K.; Nyberg, Christian; Kihl, Maria

    2003-08-01

    The trend of the service architectures developed in telecommunications today is that they should be open in the sense that they can communicate over the borders of different networks. Instead of each network having their own service architecture with their own applications, all networks should be able to use the same applications. 3GPP, the organization developing specifications for the 3G networks has specified the standard Open Service Access (OSA), as a part of the 3G specification. OSA offers different Application Protocol Interfaces that enable an application that resides outside a network to use the capabilities of the network. This paper analyses the performance of an OSA gateway. It is examined how the overload control can be dealt with in a way to best satisfy the operators and the 3'rd parties. There are some guiding principles in the specifications, but a lot of decisions have to be made by the implementors of application servers and OSA gateways. Proposals of different requirements for an OSA architecture exist such as, minimum amount of accepted calls per second and time constraint for the maximal total delay for an application. Maximal and fair throughput have to be prioritized from the 3'rd parties view, but profit is the main interest from the operators point of view. Therefore this paper examines a priority based proposal of an overload control mechanism taking these aspects and requirements into account.

  6. Can sleep microstructure improve diagnosis of OSAS? Integrative information from CAP parameters.

    PubMed

    Milioli, Giulia; Bosi, Marcello; Grassi, Andrea; Riccardi, Silvia; Terzano, Mario Giovanni; Cortelli, Pietro; Poletti, Venerino; Parrino, Liborio

    2015-01-01

    The scoring of American Academy of Sleep Medicine (AASM) arousal is mandatory for the definition of respiratory event-related arousal (RERA). However there are other EEG activation phenomena, such as A phases of cyclic alternating pattern (CAP) which are associated with respiratory events in non rapid eye movements (NREM) sleep. This study aims at quantifying the additional value of CAP for the definition of respiratory events and sleep alterations in OSAS. Analysis of polysomnographic recordings from nineteen OSAS patients was carried out. Scoring was focused on investigation of the cerebral response to flow limitation (FL) events. For this purpose we used both CAP rules and AASM arousal criteria. While no difference was demonstrated in the arousal index between mild and moderate-severe OSAS patients, CAP time showed a progressive enhancement from normal subjects (152.5±20.76) to mild (180.64±34.76) and moderate-severe (282.27±58.02) OSAS patients. In NREM sleep, only 41.1% of FL events met the criteria for the definition of RERA, while, 75.5% of FL events ended with a CAP A phase and most FL CAP (69.1%) terminated with a CAP phase A3 subtype. Our data indicate that the RERA scoring has a limited accuracy in the detection of FL events. In NREM sleep, CAP rules provided more information than AASM arousal for the definition of respiratory events and sleep alterations in OSAS.

  7. OSAS-related inflammatory mechanisms of liver injury in nonalcoholic fatty liver disease.

    PubMed

    Paschetta, Elena; Belci, Paola; Alisi, Anna; Liccardo, Daniela; Cutrera, Renato; Musso, Giovanni; Nobili, Valerio

    2015-01-01

    Obstructive sleep apnoea syndrome (OSAS) is a common sleep disorder, affecting over 4% of the general population, and is associated with metabolic syndrome and cardiovascular disease, independent of obesity and traditional risk factors. OSAS has been recently connected to nonalcoholic fatty liver disease (NAFLD), the most common chronic liver disease in the world, which can be found in 30% of the general adult population. Several studies suggest that the chronic intermittent hypoxia (CIH) of OSAS patients may per se trigger liver injury, inflammation, and fibrogenesis, promoting NAFLD development and the progression from steatosis to steatohepatitis, cirrhosis, and hepatocellular carcinoma. In NAFLD patients, liver disease may be caused by hypoxia both indirectly by promoting inflammation and insulin resistance and directly by enhancing proinflammatory cytokine production and metabolic dysregulation in liver cells. In this review, we focus on molecular mechanisms linking OSAS to NAFLD, including hypoxia inducible factor (HIF), nuclear factor kappa B (NF-κB), YKL-40, unfolded protein response, and hypoxic adipose tissue inflammation, which all could provide novel potential therapeutic approaches for the management of NAFLD patients with OSAS.

  8. Italian recommendations on dental support in the treatment of adult obstructive sleep apnea syndrome (OSAS)

    PubMed Central

    Levrini, Luca; Sacchi, Franco; Milano, Francesca; Polimeni, Antonella; Cozza, Paolo; Bernkopf, Edoardo; Segù, Marzia; Zucconi, Marco; Vicini, Claudio; Brunello, Enrico

    2015-01-01

    Summary Background The aim of the present article is to present a set of proposed clinical recommendations aimed at Italian dentists involved in the management of patients with obstructive sleep apnea syndrome or snoring. Methods With the purpose of creating a study group, some of the most important Italian scientific societies operating in fields relevant to the issue of sleep medicine in dentistry were asked to appoint a representative. Each member of the study group was required to answer questions regarding the clinical management of OSAS and snoring. Results Oral appliances can be used to treat: - simple snoring, in patients who do not respond to, or do not appear to be suitable candidates for behavioral measures such as weight loss or positional therapy; - mild or moderate OSAS, in patients who prefer OAs to continuous positive airway pressure (CPAP) or who are not suitable candidates for CPAP, because of its failure or failure of behavioral approaches like weight loss or positional therapy; - severe OSAS, in patients who do not respond to or do not tolerate CPAP and in whom no indication for either maxillofacial or ENT surgery appears applicable. Conclusions The application of oral appliances is highly desirable in cases of simple snoring or mild to moderate OSAS, whereas considerable caution is warranted when treating severe OSAS. It is fundamental to ensure that the patient understands his problem and, at the same time, to present all the various treatment options. PMID:26941893

  9. Automatic anatomy recognition in post-tonsillectomy MR images of obese children with OSAS

    NASA Astrophysics Data System (ADS)

    Tong, Yubing; Udupa, Jayaram K.; Odhner, Dewey; Sin, Sanghun; Arens, Raanan

    2015-03-01

    Automatic Anatomy Recognition (AAR) is a recently developed approach for the automatic whole body wide organ segmentation. We previously tested that methodology on image cases with some pathology where the organs were not distorted significantly. In this paper, we present an advancement of AAR to handle organs which may have been modified or resected by surgical intervention. We focus on MRI of the neck in pediatric Obstructive Sleep Apnea Syndrome (OSAS). The proposed method consists of an AAR step followed by support vector machine techniques to detect the presence/absence of organs. The AAR step employs a hierarchical organization of the organs for model building. For each organ, a fuzzy model over a population is built. The model of the body region is then described in terms of the fuzzy models and a host of other descriptors which include parent to offspring relationship estimated over the population. Organs are recognized following the organ hierarchy by using an optimal threshold based search. The SVM step subsequently checks for evidence of the presence of organs. Experimental results show that AAR techniques can be combined with machine learning strategies within the AAR recognition framework for good performance in recognizing missing organs, in our case missing tonsils in post-tonsillectomy images as well as in simulating tonsillectomy images. The previous recognition performance is maintained achieving an organ localization accuracy of within 1 voxel when the organ is actually not removed. To our knowledge, no methods have been reported to date for handling significantly deformed or missing organs, especially in neck MRI.

  10. Effects of hydrothermal pretreatment on subsequent octenylsuccinic anhydride (OSA) modification of cornstarch.

    PubMed

    Chen, Xu; He, Xiaowei; Huang, Qiang

    2014-01-30

    Cornstarch granules were hydrothermally pretreated and then esterified with octenylsuccinic anhydride (OSA). The physicochemical properties of cornstarch and hydrothermally pretreated OS-starch (H-OS-starch) were investigated. Results showed that hydrothermal pretreatments significantly increased the degree of substitution (DS) and reaction efficiency (RE) of H-OS-starch compared with the control. The higher the pretreatment temperature was, the more the OSA could go deep into the internal starch granules. The optimal pretreatment temperature for the OSA modification was 60°C. In addition, the OS groups appeared to be distributed throughout the OS-starch granules, especially on the surface, as shown by confocal laser scanning microscopy (CLSM). H-OS-starch had a slightly higher peak viscosity (Pv) and break down (BD) values, but lower pasting temperature (Tp) compared with the control OS-starch.

  11. Applying time, frequency and nonlinear features from nocturnal oximetry to OSA diagnosis.

    PubMed

    Alvarez, Daniel; Hornero, Roberto; Victor Marcos, J; Del Campo, Felix; Zamarron, Carlos; Lopez, Miguel

    2008-01-01

    This study is aimed to improve the diagnostic ability of blood oxygen saturation (SaO(2)) in obstructive sleep apnea (OSA) detection. We studied 74 patients suspected of suffering from OSA. Ten characteristics were derived from each SaO2 recording: arithmetic mean, variance, skewness and kurtosis from both time and frequency domains, central tendency measure and Lempel-Ziv complexity. The diagnostic ability of each feature was assessed by means of a receiver operating characteristics (ROC) analysis. Additionally, forward stepwise logistic regression (LR) was applied. The kurtosis in the time domain and the nonlinear measure of complexity were automatically selected. This methodology reached 93.2% sensitivity, 80.0% specificity and 87.8% accuracy, improving the results from each feature individually. Our study showed that common statistics in the time and frequency domains and nonlinear features could provide additional and complementary information to help in OSA diagnosis.

  12. Evidence of perceptive impairment in OSA patients investigated by means of a visual search task.

    PubMed

    Giora, Enrico; Galbiati, Andrea; Marelli, Sara; Zucconi, Marco; Ferini-Strambi, Luigi

    2017-10-01

    Obstructive Sleep Apnoea (OSA) is a common sleep disorder characterized by episodes of complete or partial obstruction of respiratory airways during sleep that leads to hypoxaemia and sleep fragmentation. One relevant daytime consequence of OSA is a negative impact on neurocognitive domain, ranging from psychomotor performance to executive function. In spite of a huge amount of evidence regarding cognitive impairment, little is known about perceptual processing in these patients. The aim of this research is to investigate the effects of OSA on visual mechanisms by employing a visual search paradigm. 19 OSA patients and 19 age-matched healthy controls (HC) participated in a case-control study. After a nocturnal cardiorespiratory monitoring, patients performed a visual search task in which they had to detect the presence/absence of a target (letter T) embedded in the 50% of trials into a set of distractors (letters Os, Xs, or Ls). Target's salience and distractors' numerosity were manipulated as independent variables, whereas accuracy and reaction times (RT) were recorded as dependent variables. HC, after the exclusion of any sleep disorder or sleepiness, performed the same experiments. Results generally confirmed the typical effects of visual search. OSA patients reported significantly slower RT in comparison with HC, indicating an overall perceptual deficit consisting in a harder extraction of relevant information from noise. Neither patients' age nor the objective clinical indices were associated with RT. This study indicates the presence of an impairment in OSA patients involving basic mechanisms of visual processing and likely ascribable to the disorder per se. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Genetic analysis of candidate SNPs for metabolic syndrome in obstructive sleep apnea (OSA)

    PubMed Central

    Grilo, Antonio; Ruiz-Granados, Elena S.; Moreno-Rey, Concha; Rivera, Jose M.; Ruiz, Agustin; Real, Luis M.; Sáez, Maria E.

    2014-01-01

    Obstructive sleep apnea (OSA) is a common disorder characterized by the reduction or complete cessation in airflow resulting from an obstruction of the upper airway. Several studies have observed an increased risk for cardiovascular morbidity and mortality among OSA patients. Metabolic syndrome (MetS), a cluster of cardiovascular risk factors characterized by the presence of insulin resistance, is often found in patients with OSA, but the complex interplay between these two syndromes is not well understood. In this study, we present the results of a genetic association analysis of 373 candidate SNPs for MetS selected in a previous genome wide association analysis (GWAS). The 384 selected SNPs were genotyped using the Illumina VeraCode Technology in 387 subjects retrospectively assessed at the Internal Medicine Unit of the “Virgen de Valme” University Hospital (Seville, Spain). In order to increase the power of this study and to validate our findings in an independent population, we used data from the Framingham Sleep study which comprises 368 individuals. Only the rs11211631 polymorphism was associated with OSA in both populations, with an estimated OR=0.57 (0.42-0.79) in the joint analysis (p=7.21 × 10-4). This SNP was selected in the previous GWAS for MetS components using a digenic approach, but was not significant in the monogenic study. We have also identified two SNPs (rs2687855 and rs4299396) with a protective effect from OSA only in the abdominal obese subpopulation. As a whole, our study does not support that OSA and MetS share major genetic determinants, although both syndromes share common epidemiological and clinical features. PMID:23524009

  14. OSA screening with the pediatric sleep questionnaire for adolescents undergoing bariatric surgery in teen-LABS.

    PubMed

    Ishman, Stacey; Heubi, Christine; Jenkins, Todd; Michalsky, Marc; Simakajornboon, Narong; Inge, Thomas

    2016-11-01

    Obstructive sleep apnea (OSA) is reported in 70% of adolescents who present for bariatric surgery. The Pediatric Sleep Questionnaire (PSQ) was developed to identify children at risk for OSA but is not validated in adolescents with obesity. The aims of this study were: (1) to assess validity of the PSQ to detect OSA and (2) to determine the correlation between anthropometric and polysomnography measurements. A cross-sectional assessment of Teen-Longitudinal Assessment of Bariatric Surgery participants at high risk for OSA was performed. Participants completed an overnight polysomnography, and caregivers completed the PSQ. Forty-five participants (84% female, 78% Caucasian, mean age = 16.7 ± 1.5 years) were evaluated. Mean BMI was 51.3 ± 7.7 kg/m(2) and mean obstructive apnea-hypopnea index (oAHI) was 6.1 ± 5.9 events/h. For diagnosis of OSA (oAHI ≥5), the total PSQ score sensitivity, specificity, and positive predictive value (PPV) were 86%, 38%, and 55%, respectively. For snoring >50% of the time, PPV was 84%, sensitivity was 64%, and specificity was 43%. Sagittal abdominal diameter correlated with oAHI and oxygen saturation nadir (ρ = 0.34, P = 0.027), whereas BMI, neck, and waist circumference correlated with neither. The PSQ demonstrated low specificity, and PPV and the question regarding snoring >50% of the time did not effectively identify OSA. Sagittal abdominal diameter correlated with oAHI and oxygen saturation nadir. © 2016 The Obesity Society.

  15. Resting energy expenditure in OSAS: the impact of a single CPAP application.

    PubMed

    Fekete, Katalin; Boutou, Afroditi K; Pitsiou, Georgia; Chavouzis, Nikolaos; Pataka, Athanasia; Athanasiou, Ioanna; Ilonidis, Georgios; Kontakiotis, Theodoros; Argyropoulou, Paraskevi; Kioumis, Ioannis

    2016-03-01

    Data on the impact of obstructive sleep apnea syndrome (OSAS) and its treatment on resting energy expenditure (REE) are currently few and conflicting. The purpose of the present study was to investigate the impact of OSAS on REE, as measured before and after sleep, and the changes in REE after a single continuous positive airway pressure (CPAP) application, for the first time in literature. This is a nested case-control study. From the initial study population, two groups were formed, based on the results of nocturnal polysomnography: a group of male OSAS patients and a group of male, age-matched non-OSAS controls. REE was measured in both groups before and after sleep by indirect calorimetry, while patients repeated REE measurements before and after a single nasal CPAP application. Ninety-two male OSAS patients (45.3 ± 12.8 years old) and 19 male non-OSAS controls (50.8 ± 11.7 years old) were studied. REE/lean body mass (LBM) was higher among patients compared to controls both pre- (29.6 ± 12 vs 22.9 ± 7.9 kcal/kg; p = 0.022, correspondingly) and post-sleep (26.4 ± 9.6 vs 21.6 ± 9 kcal/kg; p = 0.047 correspondingly). REE/LBM decreased significantly after sleep in OSAS patients (p = 0.002), but not in controls; this difference was most evident among patients with more severe disease and higher desaturation. A single nasal CPAP application diminished the pre-post REE/LBM difference (30.3 ± 8.2 vs 28.3 ± 10.3 kcal/kg; p = 0.265), but only among responders. In OSAS patients, REE values are high and vary significantly before and after sleep. A single nasal CPAP application diminishes this difference among responders, possibly through reversal of nocturnal desaturation.

  16. Obstructive sleep apnea syndrome (OSAS) and social support in elder patients.

    PubMed

    Tutuncu, Recep; Karabulut, Hayriye; Acar, Baran; Babademen, Mehmet Ali; Ciftçi, Bülent; Karaşen, Riza Murat

    2012-01-01

    Social support is a very important aspect in debilitating diseases. OSAS is a disabling disease that impairs social functioning and accounts for a large socio-economic burden for the community. In this study our aim is to investigate social support levels among OSAS patients: 85 of them with the diagnosis of OSAS were enrolled in the study. Multidimensional scale of perceived social support (MSPSS) is used to measure the perception of individuals' social support sufficiency. In contrast to many studies, we found that social support levels of elder patients were higher than the young ones and family subscale was significantly higher. It might be both due to Turkish family structure that the grands are in close relationship with the other family members and the adverse effects of the disease which have more negative impact on young patients' life. In conclusion, social support is an important aspect in OSAS patients. The interventions for the enhancement of social support could lead to substantial cost-savings, reduce morbidity, and increase well-being. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  17. Evaluation of a biological wastewater treatment system combining an OSA process with ultrasound for sludge reduction.

    PubMed

    Romero-Pareja, P M; Aragon, C A; Quiroga, J M; Coello, M D

    2017-05-01

    Sludge production is an undesirable by-product of biological wastewater treatment. The oxic-settling-anaerobic (OSA) process constitutes one of the most promising techniques for reducing the sludge produced at the treatment plant without negative consequences for its overall performance. In the present study, the OSA process is applied in combination with ultrasound treatment, a lysis technique, in a lab-scale wastewater treatment plant to assess whether sludge reduction is enhanced as a result of mechanical treatment. Reported sludge reductions of 45.72% and 78.56% were obtained for the two regimes of combined treatment tested in this study during two respective stages: UO1 and UO2. During the UO1 stage, the general performance and nutrient removal improved, obtaining 47.28% TN removal versus 21.95% in the conventional stage. However, the performance of the system was seriously damaged during the UO2 stage. Increases in dehydrogenase and protease activities were observed during both stages. The advantages of the combined process are not necessarily economic, but operational, as US treatment acts as contributing factor in the OSA process, inducing mechanisms that lead to sludge reduction in the OSA process and improving performance parameters. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Transcriptional regulation of the Drosophila moira and osa genes by the DREF pathway.

    PubMed

    Nakamura, Kumi; Ida, Hiroyuki; Yamaguchi, Masamitsu

    2008-07-01

    The DNA replication-related element binding factor (DREF) plays an important role in regulation of cell proliferation in Drosophila, binding to DRE and activating transcription of genes carrying this element in their promoter regions. Overexpression of DREF in eye imaginal discs induces a rough eye phenotype in adults, which can be suppressed by half dose reduction of the osa or moira (mor) genes encoding subunits of the BRM complex. This ATP-dependent chromatin remodeling complex is known to control gene expression and the cell cycle. In the 5' flanking regions of the osa and mor genes, DRE and DRE-like sequences exist which contribute to their promoter activities. Expression levels and promoter activities of osa and mor are decreased in DREF knockdown cells and our results in vitro and in cultured cells indicate that transcription of osa and mor is regulated by the DRE/DREF regulatory pathway. In addition, mRNA levels of other BRM complex subunits and a target gene, string/cdc25, were found to be decreased by knockdown of DREF. These results indicate that DREF is involved in regulation of the BRM complex and thereby the cell cycle.

  19. Cognition and nocturnal disturbance in OSA: the importance of accounting for age and premorbid intelligence.

    PubMed

    Olaithe, Michelle; Skinner, Timothy C; Hillman, David; Eastwood, Peter E; Bucks, Romola S

    2015-03-01

    Obstructive sleep apnea (OSA) is a common disorder that is associated with impaired attention, memory and executive function. However, the mechanisms underlying such dysfunction are unclear. To determine the influence of sleep fragmentation and hypoxia, this study examined the effect of sleep fragmentation and hypoxia on cognition in OSA, while controlling for potentially confounding variables including sleepiness, age and premorbid intelligence. Participants with and without OSA (N = 150) were recruited from the general community and a tertiary hospital sleep clinic. All underwent comprehensive, laboratory-based polysomnography (PSG) and completed assessments of cognition including attention, short- and long-term memory and executive function. Structural equation modelling (SEM) was used to construct a theoretically-driven model to examine the relationships between hypoxia and sleep fragmentation, and cognitive function. Although after controlling for IQ, increased sleep disturbance was a significant predictor of decreased attention (p = 0.04) and decreased executive function (p = 0.05), controlling for age removes these significant relationships. No significant predictors of memory function were found. The mechanisms underlying the effects of OSA on cognition remain to be defined. Implications are discussed in light of these findings.

  20. Is There a Relationship Between Obstructive Sleep Apnea (OSA) and Hearing Loss?

    PubMed Central

    Ekin, Selami; Turan, Mahfuz; Arısoy, Ahmet; Gunbatar, Hulya; Sunnetcioglu, Aysel; Asker, Selvi; Yıldız, Hanifi

    2016-01-01

    Background Obstructive sleep apnea (OSA) is a common disorder with an estimated prevalence in the general population of 2–5%. Its main clinical features are loud snoring and breathing stoppage during sleep. Ischemia could be a consequence of noise-induced hearing loss because cochlear oxygen tension is reduced during and after noise exposure. In this study, we evaluated auditory function in patients affected by OSA and simple snoring. Material/Methods A total of 66 participants (male to female ratio: 40:26) were included in the study, of which 21 were in the control group, 18 were in the simple snoring group, and 27 were in the OSA patient group. Polysomnography and audiometric examination were performed in all participants. Results The mean ages of the participants in the control, simple snoring, and OSA groups were 39.14±9.9, 37.28±8.2, and 41.56±8.99 years, respectively. There were no statistically significant differences among groups regarding age or sex; however, there were statistically significant differences among groups in body mass index, apnea-hypopnea index scores, mean saturation, and duration under 90% saturation. In addition, statistically significant differences were found between the patient group and the control and simple snoring groups concerning the mean saturation, duration under 90% saturation, and the extended high frequency of hearing. Conclusions These data show that snoring may cause hearing loss at extended high frequencies. PMID:27588548

  1. OSAS Surgery and Postoperative Discomfort: Phase I Surgery versus Phase II Surgery

    PubMed Central

    Gasparini, Giulio; Pelo, Sandro; Foresta, Enrico; Boniello, Roberto; Romandini, Mario; Cervelli, Daniele; Azzuni, Camillo; Marianetti, Tito Matteo

    2015-01-01

    Introduction. This study aims to investigate the reasons that discourage the patients affected by OSAS to undergo orthognathic surgery and compares the postoperative discomfort of phase I (soft tissue surgery) and phase II (orthognathic surgery) procedures for treatment of OSAS. Material and Methods. A pool of 46 patients affected by OSAS was divided into two groups: “surgery patients” who accepted surgical treatments of their condition and “no surgery patients” who refused surgical procedures. The “surgery patients” group was further subdivided into two arms: patients who accepted phase I procedures (IP) and those who accepted phase II (IIP). To better understand the motivations behind the refusal of II phase procedures, we asked the patients belonging to both the IP group and “no surgery” group to indicate the main reason that influenced their decision to avoid II phase procedures. We also monitored and compared five parameters of postoperative discomfort: pain, painkiller assumption, length of hospitalization, foreign body sensation, and diet assumption following IP and IIP procedures. Results. The main reason to avoid IIP procedures was the concern of a more severe postoperative discomfort. Comparison of the postoperative discomfort following IP versus IIP procedures showed that the former scored worse in 4 out of 5 parameters analyzed. Conclusion. IIP procedures produce less postoperative discomfort. IIP procedures, namely, orthognathic surgery, should be the first choice intervention in patients affected by OSAS and dentoskeletal malformation. PMID:25695081

  2. Blood pressure effects of CPAP in nonresistant and resistant hypertension associated with OSA: A systematic review of randomized clinical trials.

    PubMed

    Feldstein, Carlos A

    Obstructive sleep apnea (OSA) is a rather common chronic disorder, associated with increased prevalence of hypertension. The pathophysiological mechanisms for hypertension in OSA are at least in part linked to intermittent hypoxia developed during nightly hypopneas and apneas. Hypoxemia stimulates sympathetic overactivity, systemic inflammation, oxidative stress, and endothelial dysfunction. However, it appears that intermittent hypoxemia is not the only factor in the development of hypertension in OSA. Supplemental oxygen therapy that improved oxyhemoglobin saturation to similar levels to those achieved with CPAP treatment did not reduce BP. In this scenario, it could be proposed that hypoxemia acts as a trigger of sympathetic overdrive, which when set is the main factor in the development of hypertension in OSA. This review appraises evidence provided by randomized controlled trials on the BP-lowering effectiveness of continuous positive airway pressure (CPAP) treatment of OSA patients with nonresistant and resistant hypertension. It suggests that CPAP treatment is more effective in treating resistant hypertension than nonresistant hypertension. A possible explanation is that sympathetic overactivity and altered vascular reactivity in OSA could be more severe in resistant hypertension than in nonresistant hypertension. An intricate interaction among compliance, adherence, and their interaction with demographic characteristics, genetic factors, and comorbidities of the population included might explain the differences found between trials on their influence over the antihypertensive effectiveness of CPAP. Further long-term trials are needed in hypertensive OSA patients to assess whether CPAP treatment in OSA patients consistently restores physiological nocturnal BP fall and adjusts resting and circadian heart rate.

  3. The USC-OSA Student Chapter: goals and benefits for the optics community

    NASA Astrophysics Data System (ADS)

    Gómez-Varela, A. I.; Gargallo, Ana; González Núñez, Héctor; Delgado-García, Tamara; Almaguer-Gómez, Citlalli; Cambronero-López, F.; Flores-Arias, M. T.

    2014-07-01

    The USC-OSA Student Chapter has been constituted in March 2013 by members of the University of Santiago de Compostela (USC) in Spain and sponsored by The Optical Society of America (OSA). It is formed by five graduate and one undergraduate students with the common interest in Optics and Photonics research and a professor of the USC is also involved as a faculty advisor. We decided to start this group with the aim of involving kids, precollege and undergraduate students in the world of Optics and Photonics. The activities that the USC-OSA Student Chapter members intend to realize are mainly educational tasks for the spreading of knowledge in Photonics by means of basic experiments, demonstrations and lectures by leading researchers and teachers. Most of the needed resources to accomplish these activities are provided by the OSA, such as educational posters and a portable kit for demonstrating Optics to students. At this moment the USC-OSA Student Chapter is carrying out several activities, as educational journeys at the Santiago de Compostela University Hospital Complex (CHUS), where hospitalized children can approach to Optics through some simple experiments and games. A teaching program is also being organized in collaboration with Galician secondary schools in order to show students the importance and uses of Optics and Photonics and to arouse their interest in this field, as well as encouraging them to develop their scientific thinking. Another activity will take place in November during the Science Week, which includes a program of lectures targeted to undergraduate students and an exposition of several demonstrations

  4. Cancer and OSA: Current Evidence From Human Studies.

    PubMed

    Martínez-García, Miguel Ángel; Campos-Rodriguez, Francisco; Barbé, Ferrán

    2016-08-01

    Despite the undeniable medical advances achieved in recent decades, cancer remains one of the main causes of mortality. It is thus extremely important to make every effort to discover new risk factors for this disease, particularly ones that can be treated or modified. Various pathophysiologic pathways have been postulated as possible causes of cancer or its increased aggressiveness, and also of greater resistance to antitumoral treatment, in the presence of both intermittent hypoxia and sleep fragmentation (both inherent to sleep apnea). Thus far, these biological hypotheses have been supported by various experimental studies in animals. Meanwhile, recent human studies drawing on preexisting databases have observed an increase in cancer incidence and mortality in patients with a greater severity of sleep-disordered breathing. However, the methodologic limitations of these studies (which are mostly retrospective and lack any measurement of direct markers of intermittent hypoxia or sleep fragmentation) highlight the need for controlled, prospective studies that would provide stronger scientific evidence regarding the existence of this association and its main characteristics, as well as explore its nature and origin in greater depth. The great epidemiologic impact of both cancer and sleep apnea and the potential for clinical treatment make this field of research an exciting challenge. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  5. Brain stem activity changes associated with restored sympathetic drive following CPAP treatment in OSA subjects: a longitudinal investigation.

    PubMed

    Lundblad, Linda C; Fatouleh, Rania H; McKenzie, David K; Macefield, Vaughan G; Henderson, Luke A

    2015-08-01

    Obstructive sleep apnea (OSA) is associated with significantly elevated muscle sympathetic nerve activity (MSNA), leading to hypertension and increased cardiovascular morbidity. Although little is known about the mechanisms responsible for the sympathoexcitation, we have recently shown that the elevated MSNA in OSA is associated with altered neural processing in various brain stem sites, including the dorsolateral pons, rostral ventrolateral medulla, medullary raphe, and midbrain. Given the risk associated with elevated MSNA, we aimed to determine if treatment of OSA with continuous positive airway pressure (CPAP) would reduce the elevated MSNA and reverse the brain stem functional changes associated with the elevated MSNA. We performed concurrent recordings of MSNA and blood oxygen level-dependent (BOLD) signal intensity of the brain stem, using high-resolution functional magnetic resonance imaging, in 15 controls and 13 subjects with OSA, before and after 6 mo CPAP treatment. As expected, 6 mo of CPAP treatment significantly reduced MSNA in subjects with OSA, from 54 ± 4 to 23 ± 3 bursts/min and from 77 ± 7 to 36 ± 3 bursts/100 heart beats. Importantly, we found that MSNA-coupled changes in BOLD signal intensity within the dorsolateral pons, medullary raphe, and rostral ventrolateral medulla returned to control levels. That is, CPAP treatment completely reversed brain stem functional changes associated with elevated MSNA in untreated OSA subjects. These data highlight the effectiveness of CPAP treatment in reducing one of the most significant health issues associated with OSA, that is, elevated MSNA and its associated elevated morbidity.

  6. The effectiveness of combined tonsillectomy and anterior palatoplasty in the treatment of snoring and obstructive sleep apnoea (OSA).

    PubMed

    Adzreil, Bakri; Wong, Eugene Hung Chih; Saraiza, Abu Bakar; Raman, Rajagopalan; Amin, Jalaludin

    2017-04-01

    The prevalence of obstructive sleep apnoea (OSA) is increasing due to a rising rate of obesity. Multiple surgical techniques used to address obstruction at the palatal level have been associated with significant morbidities. Few studies have reported good outcomes of anterior palatoplasty (AP) in mild-to-moderate OSA. The aim of this study is to investigate the effectiveness of combining tonsillectomy and anterior palatoplasty in the treatment of snoring and OSA. All patients with snoring and OSA treated with tonsillectomy and anterior palatoplasty were analyzed. The primary outcome was reduction of the apnoea hypopnoea index (AHI) with surgical success criteria; reduction of AHI by ≥50% and AHI ≤10. The secondary outcomes measured were patients' Epworth Sleepiness Scale (ESS) and snoring visual analogue scale (VAS) scores. Thirty one patients completed the study, where 19% had mild, 42% moderate, and 39% had severe OSA. The mean surgical success rate was 45% at 3 months and 32% at 1-year post-operatively. There was a significant reduction of ESS and VAS at 3 months and 1-year post-operatively (p < 0.05). Combination of tonsillectomy and anterior palatoplasty could be considered as a treatment option for snoring and OSA in selected groups of patients (mild-to-moderate OSA with mainly retropalatal obstruction). The surgical success was found to reduce with time, and BMI optimization should be emphasized as part of post-operative care.

  7. [Specific features of wounds with a self-defense traumatic weapon "Osa"].

    PubMed

    Khodov, A M; Zolotov, A S; Filipchenkov, L S

    2012-01-01

    Specific features and outcomes of wounds with a traumatic weapon of self-defense "Osa" were analyzed in 24 patients. Mean age of the wounded was from 21 to76 years. In 20 patients there was a single wound, in 4 patients it was multiple, in 7--blunt, in 12--perforating and 5 patients had gutter wounds. All the patients were treated according to the principles of field military surgery. Five patients had severe wounds: penetrating fracture of the skull (2 of them died), fracture of the shoulder (1 case), injury of the main artery (1 case), of the pleura (1 case). The wounds were closed up by primary intention in 19 patients, by second intention in 4 patients. The authors' experience shows that a traumatic weapon of self-defense "Osa" rather often caused permanent harm to health and can be mortal. Active surgical strategy in treatment of such patients prevents the development of serious infectious complications.

  8. Corresponding color datasets and a chromatic adaptation model based on the OSA-UCS system.

    PubMed

    Oleari, Claudio

    2014-07-01

    Today chromatic adaptation transforms (CATs) are reconsidered, since their mathematical inconsistency has been shown in Color Res. Appl.38, 188 (2013) and by the CIE technical committee TC 8-11: CIECAM02 Mathematics. In 2004-2005 the author proposed an adaptation transform based on the uniform color scale system of the Optical Society of America (OSA-UCS) [J. Opt. Soc. Am. A21, 677 (2004); Color Res. Appl. 30, 31 (2005)] that transforms the cone-activation stimuli into adapted stimuli. The present work considers all the 37 available corresponding color (CC) datasets selected by CIE and (1) shows that the adapted stimuli obtained from CC data are defined up to an unknown transformation, and an unambiguous definition of the adapted stimuli requires additional hypotheses or suitable experimental data (as it is in the OSA-UCS system); (2) produces a CAT, represented by a linear transformation between CCs, associated with any CC dataset, whose high quality measured in ΔE units discards the possibility of nonlinear transformations; (3) analyzes these color-conversion matrices in a heuristic way with a reference adaptation that is approximately that of the OSA-UCS adapted colors for the D65 illuminant and particularly shows accordance with the Hunt effect and the Bezold-Brücke hue shift; (4) proposes the measurements of CC stimuli with a reference adaptation equal to that of the visual situation of the OSA-UCS system for defining adapted colors for any considered illumination adaptation and therefore for defining a general CAT formula.

  9. Upper Airway Stimulation for OSA: Early Adherence and Outcome Results of One Center.

    PubMed

    Kent, David T; Lee, Jake J; Strollo, Patrick J; Soose, Ryan J

    2016-07-01

    To review outcome measures and objective adherence data for patients treated with hypoglossal nerve stimulation (HNS) therapy for moderate to severe obstructive sleep apnea (OSA). Case series with chart review. Academic sleep medicine center. The first 20 implanted patients to complete postoperative sleep laboratory testing were assessed. All patients had moderate to severe OSA, were unable to adhere to positive pressure therapy, and met previously published inclusion criteria for the commercially available implantable HNS system. Data included demographics, body mass index (BMI), apnea-hypopnea index (AHI), Epworth Sleepiness Score (ESS), nightly hours of device usage, and procedure- and therapy-related complications. Mean age was 64.8 ± 12.0 years, with 50% female. Mean BMI was unchanged postoperatively (26.5 ± 4.2 to 26.8 ± 4.5 kg/m(2); P > .05). Mean AHI (33.3 ± 13.0 to 5.1 ± 4.3; P < .0001) and mean ESS (10.3 ± 5.2 to 6.0 ± 4.4; P < .01) decreased significantly. Seventy percent (14/20) of patients achieved a treatment AHI <5, 85% (17/20) an AHI <10, and 95% (19/20) an AHI <15. Average stimulation amplitude was 1.89 ± 0.50 V after titration. Adherence monitoring via device interrogation showed high rates of voluntary device use (mean 7.0 ± 2.2 h/night). For a clinical and anatomical subset of patients with OSA, HNS therapy is associated with good objective adherence, low morbidity, and improved OSA outcome measures. Early results at one institution suggest that HNS therapy can be implemented successfully into routine clinical practice, outside of a trial setting. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  10. A Randomized Controlled Study to Examine the Effect of a Lifestyle Modification Program in OSA.

    PubMed

    Ng, Susanna S S; Chan, Ruth S M; Woo, Jean; Chan, Tat-On; Cheung, Bernice H K; Sea, Mandy M M; To, Kin-Wang; Chan, Ken K P; Ngai, Jenny; Yip, Wing-Ho; Ko, Fanny W S; Hui, David S C

    2015-11-01

    Obesity is an important risk factor for OSA. This study aimed to assess the effect of weight reduction through a lifestyle modification program (LMP) on patients with moderate to severe OSA. This was a parallel group, randomized controlled trial. Altogether, 104 patients with moderate to severe OSA diagnosed on portable home sleep monitoring were randomized to receive a dietician-led LMP or usual care for 12 months. The primary outcome was reduction of apnea-hypopnea index (AHI) at 12 months as assessed by portable home sleep monitoring. In the intention-to-treat analysis (ITT), LMP (n = 61) was more effective in reducing AHI from baseline (16.9% fewer events in the LMP group vs 0.6% more events in the control group, P = .011). LMP was more effective in reducing BMI (-1.8 kg/m2, 6.0% of the initial BMI; -0.6 kg/m2, 2.0% of the initial BMI in control group; P < .001). The reduction in daytime sleepiness as assessed by Epworth Sleepiness Scale was not significant in ITT but was more in the LMP group (-3.5 in the LMP group vs -1.1 in the control group, P = .004) by treatment per protocol analysis. There was modest improvement in mental health in the Short Form Health Survey. Eating behavior was improved with increased intake of protein and fiber. These changes were observed 4 months after the initial intensive diet counseling and persisted at 12 months. LMP was effective in reducing the severity of OSA and daytime sleepiness. The beneficial effect was sustained in 12 months. ClinicalTrials.gov; No.: NCT01384760; URL: www.clinicaltrials.gov.

  11. Effect of oxygen desaturation threshold on determination of OSA severity during weight loss.

    PubMed

    Myllymaa, Katja; Myllymaa, Sami; Leppänen, Timo; Kulkas, Antti; Kupari, Salla; Tiihonen, Pekka; Mervaala, Esa; Seppä, Juha; Tuomilehto, Henri; Töyräs, Juha

    2016-03-01

    Weight loss leads to improvement of obstructive sleep apnea (OSA), based on frequency of respiratory events (apnea-hypopnea index, AHI). However, AHI does not incorporate the severity of individual obstruction events. The American Academy of Sleep Medicine suggests two alternative oxygen desaturation thresholds (ODT) for scoring of hypopneas. We hypothesize that lowering the ODT level increases the determined impact of weight loss on OSA severity. We investigate this during weight change with AHI and adjusted AHI. Adjusted AHI is a novel parameter incorporating both severity and number of the events. Ambulatory polygraphic data of 54 OSA patients (F 15/M 39, 51.7 ± 8.4 years), divided into weight loss (>5 %, n = 20), control (weight change 0-5 %, n = 26), and weight gain (>5 %, n = 8) groups, were evaluated at baseline and after 5-year follow-up. Effect of ODT (ODT2%-ODT6%) on AHI and adjusted AHI was investigated. The greatest changes in AHI (decrease in weight loss group and increase in weight gain group) were observed with ODT2%. Changes in AHI diminished with increasing ODT. In weight loss group, adjusted AHI showed a similar but non-significant trend. In contrast, the higher ODT was used in weight gain group, the greater increase in adjusted AHI resulted. Using adjusted AHI instead of AHI, led to a smaller number of patients (20 vs. 55 %, ODT3%) whose OSA severity category improved along weight loss. Weight loss significantly reduced AHI. This reduction was highly dependent on selected ODT. The change in adjusted AHI did not occur in the same extent. This was expected as the more severe events which tend to remain during the weight loss have greater importance in adjusted AHI, while the event severity is neglected in AHI.

  12. OSA-18 survey in evaluation of sleep-disordered breathing in children with adenotonsillar hypertrophy.

    PubMed

    Hasukic, Begzada

    2013-01-01

    The aim of this study was to estimate the quality of life (QOL) in children with sleep-disordered breathing (SDB) before and after adenoidectomy and before and after adenotonsillectomy using the OSA-18 survey. The prospective study included sixty children with symptoms of SDB caused by enlarged adenoids or tonsils, of both sexes, aged 3-12 years, consecutively admitted into the ENT Clinic in Tuzla, for adenoidectomy or adenotonsillectomy. Patients were divided in two subgroups: thirty patients who underwent adenoidectomy and thirty patients who underwent adenotonsillectomy. Parents or caregivers completed the OSA-18 survey before surgery and 5 weeks after surgery. For statistical analysis was used Student's t-test of pared samples. The values p < 0.05 were accepted as significant. Mean total score before adenoidectomy was 3.44 (SD = 0.77) and after surgery was 1.30 (SD = 0.46).Mean total score before adenotonsillectomy was 3.69 (SD = 0.80), after surgery was 1.22 (SD = 0.27). The difference between preoperative and postoperative scores in both subgroups of patients was significant (p < 0.01). Adenoidectomy and adenotonsillectomy improve QOL in children with SDB, which is caused by adenotonsillar hypertrophy. The OSA-18 survey is a useful tool for the selection of children for surgery with SDB caused by adenotonsillar hypertrophy and to assess quality of life after surgery.

  13. Physiology of Arousal in OSA and Potential Impacts for Sedative Treatment.

    PubMed

    Jordan, Amy S; O'Donoghue, Fergal J; Cori, Jennifer M; Trinder, John

    2017-04-11

    Treatment options for patients with obstructive sleep apnea (OSA) intolerant of continuous positive airway pressure (CPAP) are limited. Thus, new therapies are sought. Recently, there has been interest in using sedatives to delay arousal from sleep, allowing upper airway dilator muscle recruitment sufficient to re-open the airway while maintaining sleep. In this review the rationale for sedative use and prior sedative studies in OSA are presented, along with a description of six factors that may determine sedative treatment success. It is proposed that in order for a sedative to treat OSA the patient must have each of the following three traits: 1) a mild to moderately collapsible upper airway, 2) responsive and effective upper airway dilator muscles and 3) a low to moderate arousal threshold. In addition (4), proponents of sedative treatment generally believe that to be effective the sedative must increase the arousal threshold. Finally (5), sedatives may have additional utility in patients with large ventilatory responses to arousal and (6) the metric used to define sedative success needs to be considered. To date, few of these factors have been evaluated in sedative trials. Further, it is likely only a relatively small percentage of patients will have all of the required traits. If sedative treatment is successful in appropriate patients, easily measured surrogate markers for the factors that determine sedative success will be critical for implementation in the clinic. Finally, sedatives may have detrimental outcomes for some patients and prospective identification of such patients will be required.

  14. Everyday life for the spouses of patients with untreated OSA syndrome.

    PubMed

    Stålkrantz, Anna; Broström, Anders; Wiberg, Jan; Svanborg, Eva; Malm, Dan

    2012-06-01

    The aim of this study was to generate a theoretical model describing concerns for spouses of patients with untreated obstructive sleep apnoea syndrome (OSAS) and how they manage these concerns in their everyday life. Twelve spouses were interviewed about their experiences and how they manage everyday life. The interviews were analysed according to the Grounded Theory method as described by Strauss and Corbin. Two main categories emerged from the data: 'Social adjustment' and 'New feelings'. 'Social adjustment' reveals how the spouses made adjustments in their daily lives, both according to their partners' tiredness and owing to their own fatigue. 'New feelings' reveals emotional reactions related to the effects of their partner's illness and the impact it had on the spouse's everyday life. These two main categories could be seen in relation to four dimensions describing how the spouses manage their everyday life: 'Sacrificing', 'Controlling', 'Changing' and 'Understanding'. The results show how the spouses made adjustments in everyday life and how their feelings were affected by their partner's OSAS. Healthcare personnel could use information from this study to gain a deeper understanding and knowledge of what spouses of untreated patients with OSAS experience as their main concerns and how they manage their everyday life. This knowledge can be used to improve the support to the spouses, as well as in the educational situation concerning the illness, as well as the treatment. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

  15. Orbital Signature Analyzer (OSA): A spacecraft health/safety monitoring and analysis tool

    NASA Technical Reports Server (NTRS)

    Weaver, Steven; Degeorges, Charles; Bush, Joy; Shendock, Robert; Mandl, Daniel

    1993-01-01

    Fixed or static limit sensing is employed in control centers to ensure that spacecraft parameters remain within a nominal range. However, many critical parameters, such as power system telemetry, are time-varying and, as such, their 'nominal' range is necessarily time-varying as well. Predicted data, manual limits checking, and widened limit-checking ranges are often employed in an attempt to monitor these parameters without generating excessive limits violations. Generating predicted data and manual limits checking are both resource intensive, while broadening limit ranges for time-varying parameters is clearly inadequate to detect all but catastrophic problems. OSA provides a low-cost solution by using analytically selected data as a reference upon which to base its limits. These limits are always defined relative to the time-varying reference data, rather than as fixed upper and lower limits. In effect, OSA provides individual limits tailored to each value throughout all the data. A side benefit of using relative limits is that they automatically adjust to new reference data. In addition, OSA provides a wealth of analytical by-products in its execution.

  16. Does CPAP treatment lead to gastroesophageal reflux in patients with moderate and severe OSA?

    PubMed

    Ozcelik, Hatice; Kayar, Yusuf; Danalioglu, Ahmet; Arabaci, Elif; Uysal, Omer; Yakar, Fatih; Kart, Levent

    2017-03-01

    Obstructive sleep apnea (OSA) leads to upper respiratory tract obstruction, causing increased abdominal-gastric pressure and decreased lower esophageal sphincter (LES) pressure and thus gastroesophageal reflux (GER). Continuous positive airway pressure (CPAP) is known to be an effective method for OSA treatment, but its effect on GER is still controversial. There are a very few studies investigating CPAP and GER relationship and performed based on pre- and post-treatment objective parameters of GER in patients with OSA. The study investigated the effect of CPAP treatment in patients with moderate and severe OSA without GER complaints on pre- and post-treatment objective GER parameters. The study included 25 patients with respiratory disturbance indices >15 without reflux symptoms who had undergone polysomnography at sleep laboratory. Age, sex, body mass index (BMI), waist, and neck circumference of the patients were documented. DeMeester score, LES pressure, and polysomnography parameters were evaluated pre- and post-CPAP. The results were statistically evaluated, and p value <0.05 is considered significant. Out of 25 patients, 21 were male (84 %) and mean age was 49.2 ± 8.6 (range 31-66). At the pre-CPAP phase, mean sphincter pressure was 22.2 ± 1.2 (range 8-73), and mean DeMeester score was 18 ± 15.5 (range 0.2-57). At the post-CPAP, mean sphincter pressure was 22.9 ± 1.6 (range 9-95), and mean DeMeester score was 16.3 ± 14.8 (range 0.2-55). No significant difference (p > 0.05) was found comparing pre-CPAP and post-CPAP measurements. Objective criteria show that CPAP treatment does not cause reflux in patients with OSA. Unlike studies reported in the literature, this conclusion has been reached by pre- and post-CPAP assessments.

  17. Obstructive Sleep Apnea Is Associated with Nonalcoholic Steatohepatitis and Advanced Liver Histology.

    PubMed

    Corey, Kathleen E; Misdraji, Joseph; Gelrud, Lou; King, Lindsay Y; Zheng, Hui; Malhotra, Atul; Chung, Raymond T

    2015-08-01

    Nonalcoholic fatty liver disease (NAFLD) and obstructive sleep apnea (OSA) are growing in prevalence in the USA. Existing data on the relationship between OSA and NAFLD are conflicting and limited by the use of various histologic definitions of nonalcoholic steatohepatitis (NASH). Using a robust definition of NASH in a large, well-characterized cohort, we sought to evaluate whether OSA was associated with NASH and advanced fibrosis. Two hundred and thirteen subjects undergoing weight loss surgery were queried for OSA and then underwent liver biopsy. NASH was defined, as recommended by the American Association for the Study of Liver Disease, by the presence of all of the following: >5 % macrovesicular steatosis, lobular inflammation, and hepatocyte ballooning. NAFLD activity score (NAS) was also determined for each subject. Subjects with OSA had significantly higher alanine and aspartate aminotransferase levels than subjects without OSA (ALT 54.1 vs. 37.7 U/L, P = 0.0007; AST 31.7 vs. 20.5 U/L, P = 0.0007). OSA was associated with the presence of NASH, and this remained significant after adjusting for age, gender, race, and diabetes mellitus (P = 0.03 OR 2.01; 95 %, 1.05-3.87). Steatosis grade, lobular inflammation grade, NAS score, and fibrosis stage were all significantly associated with the presence of OSA and remained so after adjustment. OSA is associated with elevated aminotransferase levels, the presence of NASH, and advanced NASH histology. Further studies are needed to evaluate the impact of OSA treatment on NASH.

  18. Valuation of OSA process and folic acid addition as excess sludge minimization alternatives applied in the activated sludge process.

    PubMed

    Martins, C L; Velho, V F; Ramos, S R A; Pires, A S C D; Duarte, E C N F A; Costa, R H R

    2016-01-01

    The aim of this study was to investigate the ability of the oxic-settling-anaerobic (OSA)-process and the folic acid addition applied in the activated sludge process to reduce the excess sludge production. The study was monitored during two distinct periods: activated sludge system with OSA-process, and activated sludge system with folic acid addition. The observed sludge yields (Yobs) were 0.30 and 0.08 kgTSS kg(-1) chemical oxygen demand (COD), control phase and OSA-process (period 1); 0.33 and 0.18 kgTSS kg(-1) COD, control phase and folic acid addition (period 2). The Yobs decreased by 73 and 45% in phases with the OSA-process and folic acid addition, respectively, compared with the control phases. The sludge minimization alternatives result in a decrease in excess sludge production, without negatively affecting the performance of the effluent treatment.

  19. A 3-week dietary safety study of octenyl succinic anhydride (OSA)-modified starch in neonatal farm piglets.

    PubMed

    Mahadevan, Brinda; Thorsrud, Bjorn A; Brorby, Gregory P; Ferguson, Heather E

    2014-10-01

    Octenyl succinic anhydride (OSA)-modified starch functions as both an emulsifier and emulsion stabilizer in foods, and is intended for use in infant formula, follow-on formula, and formulae for special medical purposes. These formulae predominantly include extensively hydrolyzed protein or free amino acids, rather than intact protein, which otherwise would provide emulsifying functionality. The study objectives were to evaluate (1) the safety of OSA-modified starch after three weeks of administration to neonatal farm piglets, beginning 2 days after birth and (2) the impact of OSA-modified starch on piglet growth. OSA-modified starch was added to formula at concentrations of 2, 4, and 20 g/L. The vehicle control, low-dose, and mid-dose diets were supplemented with Amioca™ Powder to balance the nutritional profiles of all formulations. There were no test article-related effects of any diet containing OSA-modified starch on piglet growth and development (clinical observations, body weight, feed consumption), or clinical pathology parameters (hematology, clinical chemistry, coagulation, urinalysis). In addition, there were no adverse effects at terminal necropsy (macro- and microscopic pathology evaluations). Therefore, dietary exposure to OSA-modified starch at concentrations up to 20 g/L was well tolerated by neonatal farm piglets and did not result in adverse health effects or impact piglet growth. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Influence of Tonsillar Size on OSA Improvement in Children Undergoing Adenotonsillectomy.

    PubMed

    Tang, Alice; Benke, James R; Cohen, Aliza P; Ishman, Stacey L

    2015-08-01

    To determine if pediatric obstructive sleep apnea (OSA) improves after adenotonsillectomy (AT) regardless of tonsil size. Case series with chart review. Pediatric Otolaryngology Department, Johns Hopkins Hospital. Seventy children 1 to 18 years of age who underwent polysomnography (PSG) before and after AT. Tonsil size was evaluated using the Brodsky grading scale. Children were stratified by tonsil size as 2+ (n = 20), 3+ (n = 36), and 4+ (n = 14). There was a significant improvement in obstructive apnea-hypopnea index (oAHI), apnea index (AI), and saturation nadir across all 3 groups after AT. Preoperative oAHI, AI, and hypopnea index (HI) were similar regardless of tonsil size (P > .05). Overall, oAHI improved from a median of 11.8 ± 21.7 to 2.0 ± 6.1 events/h, with 40% (28/70) of children having complete resolution. The oAHI (P < .0001-0.02), AI (P < .0001-0.017), HI (P < .0001-0.058), and saturation nadir (P < .0001-0.017) significantly improved for the 2+, 3+, and 4+ groups. Only the HI (P = .058) in the 2+ group did not. The median oAHI improvement was 3.4 ± 26.4 events/h in the 2+ group, 8.3 ± 16.6 events/h in the 3+ group, and 12.3 ± 19.5 events/h in the 4+ group, with 25% (5/20), 50% (18/36), and 36% (5/14), respectively, having complete resolution. There was no correlation between OSA severity and tonsil or adenoid size (P > .32). Tonsil size did not correlate with OSA severity. While a larger proportion of patients classified as 3+ and 4+ had complete resolution after surgery, significant improvement was seen in AI and saturation nadir even in those classified as 2+. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  1. The relationship between AHI, Epworth scores and sleep endoscopy in patients with OSAS.

    PubMed

    Belgü, Ayfer Ulçay; Erdoğan, Barış; San, Turhan; Gürkan, Emre

    2015-01-01

    This prospective study aimed to evaluate the relationship between sleep endoscopy findings, the apnea-hypopnea index (AHI) or the Epworth sleepiness scale in patients and obstructive sleep apnea syndrome (OSAS). Patients with symptoms of OSAS were searched, and their polysomnography findings, Epworth sleepiness scales and sleep endoscopy findings were recorded. Those who were diagnosed with mild, moderate or heavy OSAS were included in the study. Patients included in the study were observed under sedative-induced sleep in the operation room using flexible nasopharyngoscopy. The obstruction levels and degrees were recorded and compared with other variables. Of the 88 patients included in the study, 67 (76.1 %) were male, and 21 (23.9 %) were female. The mean age (±standard deviation) of all 88 patients was 43.77 ± 10.07 years (range 21-65 years). Sleep endoscopy findings were classified as uvulopalatal, lateral pharyngeal, tongue base and laryngeal collapses. The Epworth sleepiness scale showed no significant correlation with the sleep endoscopy findings. No significant relationship was found between the AHI and collapses in the uvulopalatal, lateral and laryngeal zones (p > 0.05). However, tongue base collapse was correlated with AHI (p < 0.05). AHI increased with the degree of collapse in the tongue base. No meaningful relationship was noted among the Epworth sleepiness scale, AHI, and number of involved zones (p > 0.05). The degree of collapse in the related zones was not meaningfully associated with AHI, which is accepted as the indicator of disease severity.

  2. Recognition of upper airway and surrounding structures at MRI in pediatric PCOS and OSAS

    NASA Astrophysics Data System (ADS)

    Tong, Yubing; Udupa, J. K.; Odhner, D.; Sin, Sanghun; Arens, Raanan

    2013-03-01

    Obstructive Sleep Apnea Syndrome (OSAS) is common in obese children with risk being 4.5 fold compared to normal control subjects. Polycystic Ovary Syndrome (PCOS) has recently been shown to be associated with OSAS that may further lead to significant cardiovascular and neuro-cognitive deficits. We are investigating image-based biomarkers to understand the architectural and dynamic changes in the upper airway and the surrounding hard and soft tissue structures via MRI in obese teenage children to study OSAS. At the previous SPIE conferences, we presented methods underlying Fuzzy Object Models (FOMs) for Automatic Anatomy Recognition (AAR) based on CT images of the thorax and the abdomen. The purpose of this paper is to demonstrate that the AAR approach is applicable to a different body region and image modality combination, namely in the study of upper airway structures via MRI. FOMs were built hierarchically, the smaller sub-objects forming the offspring of larger parent objects. FOMs encode the uncertainty and variability present in the form and relationships among the objects over a study population. Totally 11 basic objects (17 including composite) were modeled. Automatic recognition for the best pose of FOMs in a given image was implemented by using four methods - a one-shot method that does not require search, another three searching methods that include Fisher Linear Discriminate (FLD), a b-scale energy optimization strategy, and optimum threshold recognition method. In all, 30 multi-fold cross validation experiments based on 15 patient MRI data sets were carried out to assess the accuracy of recognition. The results indicate that the objects can be recognized with an average location error of less than 5 mm or 2-3 voxels. Then the iterative relative fuzzy connectedness (IRFC) algorithm was adopted for delineation of the target organs based on the recognized results. The delineation results showed an overall FP and TP volume fraction of 0.02 and 0.93.

  3. Rapid maxillary expansion in children with Obstructive Sleep Apnoea Syndrome (OSAS).

    PubMed

    Marino, A; Ranieri, R; Chiarotti, F; Villa, M P; Malagola, C

    2012-03-01

    to evaluate the effects of rapid maxillary expansion (RME) in a group of OSAS preschool children. Lateral cephalograms of 15 OSAS children (8 boys and 7 girls, age mean ± SD: 5.94 ± 1.64 years) were analysed at the start of treatment with RME (T0). All subjects were revaluated after a mean period of 1.57 ± 0.58 years (T1). At this time the sample was divided into 2 groups according to the change in the respiratory disturbance index (RDI): an improved group (I: 8 subjects) and a stationary/worsened group (SW: 7 subjects). Differences between I and SW children with respect to values of cephalometric variables at T0 and to variations between T0 and T1 were evaluated using Mann-Whitney U test. Differences between T0 and T1 values in the overall group of children and separately in I and SW groups were assessed using Wilcoxon test. At the start of treatment, the I group was characterised by more retrognathic jaws with lower values of SNA (p=0.055) and SNB (p=0.020) and higher age values (p=0.093) when compared to SW group. After treatment, the I group showed an increase in SNA and SNB angle significantly higher than SW group (p=0.004 and p=0.003, respectively). On the contrary, I and SW groups did not differ as for variation in the skeletal divergency and in the total facial height. OSAS preschool children with retrognathic jaws could benefit from RME treatment.

  4. [Prevalence of obstructive sleep apnea syndrome (OSA) in patients with sudden hearing loss. A pilot study].

    PubMed

    Fischer, Y; Yakinthou, A; Mann, W J

    2003-06-01

    It is estimated that in patients with sleep-related breathing disorders the probability of a cerebral vascular infarction (CVI) is 3.1 times that in patients without sleep apnea and that 25-50% of all patients who have a stroke suffer from sleep apnea (OSA) and have a respiratory disturbance index (RDI) higher than 10. CVI may be caused by variations in intracranial pressure or in intracranial hemodynamics owing to decreasing pO(2) and increasing pCO(2) during cessation of airflow. It is suspected that the most common causes of sudden deafness are vasospasm, thrombosis, embolism, hypercoagulation and sludging. The present study analyzed the prevalence of sleep apnea in patients with sudden hearing loss. A 7-channel polygraph was used to test 33 subjects with normal hearing and 27 patients suffering from sudden hearing loss. Statistical analyses were performed with a Chi-square test and the Mann-Whitney test. We found that 29.6% of the patient group and 21.2% of those in the study control group were suffering from OSA and had RDI >10; this difference was not significant ( p=0.554). Sudden hearing loss may also be an indicator of arteriosclerosis secondary to such risk factors as hypertension ( p=0.005), diabetes ( p=0.003), and hyperlipidemia ( p=0.004), which were highly significant for the patient group. Patients who develop sudden hearing loss tend to have OSA more frequently than those in the control group owing to the similar risk factors for cerebral infarction and sudden hearing loss.

  5. Nasal and oral snoring endoscopy: novel and promising diagnostic tools in OSAS patients.

    PubMed

    Lovato, Andrea; Kotecha, Bhik; Vianello, Andrea; Giacomelli, Luciano; Staffieri, Alberto; Marchese-Ragona, Rosario

    2015-07-01

    The aim of the present study was to investigate if any of the three awake procedures [fiberoptic nasopharyngoscopy with modified Müller Maneuver (FNMM), nasal snoring endoscopy (NSE), or oral snoring endoscopy (OSE)] could efficiently predict the grade or pattern of upper airway (UA) collapse found with drug-induced sleep endoscopy (DISE), which is considered by many authors as the current gold standard in optimizing obstructive sleep apnea syndrome (OSAS) patient selection for UA surgery. Twenty consecutive patients (simple snorers and OSAS patients) were studied with FNMM, NSE, OSE, and DISE. The inter-test agreement was evaluated with Cohen's kappa coefficient (κ). In the current series, we found that NSE and OSE were better than FNMM in predicting the pattern of collapse found with DISE. A significant pattern agreement between NSE and DISE was present in all sub-sites, and the agreement was measured with a scale proposed by Landis and Koch as: moderate in velo- and oropharynx (κ = 0.52, p = 0.001, and κ = 0.47, p = 0.003, respectively), and substantial in hypopharynx (κ = 0.63, p < 0.00001). Comparing OSE with DISE, the pattern agreement was almost perfect at oropharyngeal level (κ = 0.82, p < 0.00001), and moderate at hypopharyngeal level (κ = 0.55, p = 0.0002); while a trend towards significance was found at velopharyngeal level (κ = 0.20, p = 0.07). FNMM showed a fair pattern agreement with DISE only at oropharyngeal level (κ = 0.31, p = 0.009); while in the other sub-sites, no significant agreement was found. NSE and OSE are new promising diagnostic tools in OSAS patients. Further investigations are needed to see if they could predict the effectiveness of UA surgery.

  6. Positional OSA part 2: retrospective cohort analysis with a new classification system (APOC).

    PubMed

    Ravesloot, M J L; Frank, M H; van Maanen, J P; Verhagen, E A; de Lange, J; de Vries, N

    2016-05-01

    In Part 1 of this two-part article, the Amsterdam Positional Obstructive Sleep Apnoea Classification (APOC) was recently introduced, a classification system aimed at facilitating the identification of suitable candidates for positional therapy (PT): patients who will benefit from a clinically significant improvement of their obstructive sleep apnoea (OSA) with PT. APOC was developed with new generation PT devices in mind rather than conventional PT (tennis ball technique). New generation PT can be defined as a well-tolerated device which prevents a patient from adopting the worst sleeping position (WSP) without negatively influencing sleep efficiency, as objectified by a full night polysomnography (PSG). PT is rapidly gaining momentum in the scope of OSA treatment. The objective of this manuscript is to measure the prevalence of position-dependent obstructive sleep apnoea (POSA) according to the APOC, in a consecutive series of patients referred for PSG as well as an investigation of associations between POSA and certain patient characteristics. We performed a retrospective, single-centre cohort study including a consecutive series of patients who underwent a PSG during the period of April 2010 until October 2010. Within this OSA-cohort (n = 253), a prevalence of POSA of 69 % when applying APOC is measured, compared to 64 % when applying Cartwright's classification. An inverse relation between POSA and BMI was observed, likewise between POSA and apnoea hypopnoea index (AHI). We are of opinion that APOC is a suitable tool to identify patients who will or will not benefit from PT, thus resulting in more cost-efficient treatment.

  7. Drug-induced sleep endoscopy: A new gold standard for evaluating OSAS? Part I: Technique.

    PubMed

    Blumen, M; Bequignon, E; Chabolle, F

    2017-04-01

    Surgical results in obstructive sleep apnea syndrome (OSAS) vary greatly, whatever the surgical technique or site treated. Most authors agree that rigorous patient selection is logical and mandatory. Drug-induced sleep endoscopy (DISE) was introduced in 1991 and has been rediscovered and used extensively since the 2000s. It mimics sleep in order to observe the upper airway on flexible endoscopy. A review of the DISE literature was performed, and is reported in two parts. The present first part describes the technique: drugs, practical anesthesiologic and ENT modalities, reproducibility, and limitations. Copyright © 2016. Published by Elsevier Masson SAS.

  8. Brain stem activity changes associated with restored sympathetic drive following CPAP treatment in OSA subjects: a longitudinal investigation

    PubMed Central

    Lundblad, Linda C.; Fatouleh, Rania H.; McKenzie, David K.; Macefield, Vaughan G.

    2015-01-01

    Obstructive sleep apnea (OSA) is associated with significantly elevated muscle sympathetic nerve activity (MSNA), leading to hypertension and increased cardiovascular morbidity. Although little is known about the mechanisms responsible for the sympathoexcitation, we have recently shown that the elevated MSNA in OSA is associated with altered neural processing in various brain stem sites, including the dorsolateral pons, rostral ventrolateral medulla, medullary raphe, and midbrain. Given the risk associated with elevated MSNA, we aimed to determine if treatment of OSA with continuous positive airway pressure (CPAP) would reduce the elevated MSNA and reverse the brain stem functional changes associated with the elevated MSNA. We performed concurrent recordings of MSNA and blood oxygen level-dependent (BOLD) signal intensity of the brain stem, using high-resolution functional magnetic resonance imaging, in 15 controls and 13 subjects with OSA, before and after 6 mo CPAP treatment. As expected, 6 mo of CPAP treatment significantly reduced MSNA in subjects with OSA, from 54 ± 4 to 23 ± 3 bursts/min and from 77 ± 7 to 36 ± 3 bursts/100 heart beats. Importantly, we found that MSNA-coupled changes in BOLD signal intensity within the dorsolateral pons, medullary raphe, and rostral ventrolateral medulla returned to control levels. That is, CPAP treatment completely reversed brain stem functional changes associated with elevated MSNA in untreated OSA subjects. These data highlight the effectiveness of CPAP treatment in reducing one of the most significant health issues associated with OSA, that is, elevated MSNA and its associated elevated morbidity. PMID:25995345

  9. Treatment of obstructive sleep apnea with mandibular advancement appliance over prostheses: A case report

    PubMed Central

    Guimarães, Thais Moura; Colen, Sâmia; Cunali, Paulo Afonso; Rossi, Rowdley; Dal-Fabbro, Cibele; Ferraz, Otávio; Tufik, Sergio; Bittencourt, Lia

    2015-01-01

    Treatment with a mandibular advancement device (MAD) is recommended for mild obstructive sleep apnea (OSA), primary snoring and as a secondary option for Continuous Positive Airway Pressure, because it has better adherence and acceptance. However, edentulous patients do not have supports to hold the MAD. This study aimed to present a possible to OSA treatment with MAD in over complete upper and partial lower dentures. The patient, a 38-year-old female with mild OSA, was treated with a MAD. The respiratory parameter, such as apnea–hypopnea index, arousal index and oxyhemoglobin saturation was improved after treatment. PMID:26483952

  10. An automatic rules extraction approach to support OSA events detection in an mHealth system.

    PubMed

    Sannino, Giovanna; De Falco, Ivanoe; De Pietro, Giuseppe

    2014-09-01

    Detection and real time monitoring of obstructive sleep apnea (OSA) episodes are very important tasks in healthcare. To suitably face them, this paper proposes an easy-to-use, cheap mobile-based approach relying on three steps. First, single-channel ECG data from a patient are collected by a wearable sensor and are recorded on a mobile device. Second, the automatic extraction of knowledge about that patient takes place offline, and a set of IF…THEN rules containing heart-rate variability (HRV) parameters is achieved. Third, these rules are used in our real-time mobile monitoring system: the same wearable sensor collects the single-channel ECG data and sends them to the same mobile device, which now processes those data online to compute HRV-related parameter values. If these values activate one of the rules found for that patient, an alarm is immediately produced. This approach has been tested on a literature database with 35 OSA patients. A comparison against five well-known classifiers has been carried out.

  11. Characterization of Antibiotic-Loaded Alginate-Osa Starch Microbeads Produced by Ionotropic Pregelation

    PubMed Central

    Fontes, Gizele Cardoso; Calado, Verônica Maria Araújo; Rossi, Alexandre Malta; da Rocha-Leão, Maria Helena Miguez

    2013-01-01

    The aim of this study was to characterize the penicillin-loaded microbeads composed of alginate and octenyl succinic anhydride (OSA) starch prepared by ionotropic pregelation with calcium chloride and to evaluate their in vitro drug delivery profile. The beads were characterized by size, scanning electron microscopy (SEM), zeta potential, swelling behavior, and degree of erosion. Also, the possible interaction between penicillin and biopolymers was investigated by differential scanning calorimetry (DSC), powder X-ray diffraction (XRD), and Fourier transform infrared (FTIR) analysis. The SEM micrograph results indicated a homogeneous drug distribution in the matrix. Also, based on thermal analyses (TGA/DSC), interactions were detected between microbead components. Although FTIR spectra of penicillin-loaded microbeads did not reveal the formation of new chemical entities, they confirmed the chemical drug stability. XRD patterns showed that the incorporated crystalline structure of penicillin did not significantly alter the primarily amorphous polymeric network. In addition, the results confirmed a prolonged penicillin delivery system profile. These results imply that alginate and OSA starch beads can be used as a suitable controlled-release carrier for penicillin. PMID:23862146

  12. Obstructive sleep apnea (OSA) does not affect ventilatory and perceptual responses to exercise in morbidly obese subjects.

    PubMed

    Innocenti Bruni, Giulia; Gigliotti, Francesco; Scano, Giorgio

    2012-09-30

    We have tested the hypothesis that high mass loading effects and obstructive sleep apnea (OSA) constrain the ventilatory response to exercise in morbidly obese subjects as compared to their counterparts without OSA. Fifteen obese patients with (8) and without OSA and 12 lean healthy subjects performed incremental cycle exercise. The functional evaluation included ventilation, oxygen uptake, carbon dioxide production, end-expiratory-lung-volumes (EELV), inspiratory capacity, heart rate, dyspnea and leg effort (by a modified Borg scale). Changes in ventilation and dyspnea per unit changes in work rate and metabolic variables were similar in the three groups. Breathing pattern and heart rate increased from rest to peak exercise similarly in the three groups. Leg effort was the prevailing symptom for stopping exercise in most subjects. In conclusion, OSA does not limit exercise capacity in morbidly obese subjects. Ventilation contributes to exertional dyspnea similarly as in lean subjects and in obese patients regardless of OSA. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. Oryza sativa H+-ATPase (OSA) is Involved in the Regulation of Dumbbell-Shaped Guard Cells of Rice.

    PubMed

    Toda, Yosuke; Wang, Yin; Takahashi, Akira; Kawai, Yuya; Tada, Yasuomi; Yamaji, Naoki; Feng Ma, Jian; Ashikari, Motoyuki; Kinoshita, Toshinori

    2016-06-01

    The stomatal apparatus consists of a pair of guard cells and regulates gas exchange between the leaf and atmosphere. In guard cells, blue light (BL) activates H(+)-ATPase in the plasma membrane through the phosphorylation of its penultimate threonine, mediating stomatal opening. Although this regulation is thought to be widely adopted among kidney-shaped guard cells in dicots, the molecular basis underlying that of dumbbell-shaped guard cells in monocots remains unclear. Here, we show that H(+)-ATPases are involved in the regulation of dumbbell-shaped guard cells. Stomatal opening of rice was promoted by the H(+)-ATPase activator fusicoccin and by BL, and the latter was suppressed by the H(+)-ATPase inhibitor vanadate. Using H(+)-ATPase antibodies, we showed the presence of phosphoregulation of the penultimate threonine in Oryza sativa H(+)-ATPases (OSAs) and localization of OSAs in the plasma membrane of guard cells. Interestingly, we identified one H(+)-ATPase isoform, OSA7, that is preferentially expressed among the OSA genes in guard cells, and found that loss of function of OSA7 resulted in partial insensitivity to BL. We conclude that H(+)-ATPase is involved in BL-induced stomatal opening of dumbbell-shaped guard cells in monocotyledon species.

  14. OsWS1 involved in cuticular wax biosynthesis is regulated by osa-miR1848.

    PubMed

    Xia, Kuaifei; Ou, Xiaojin; Gao, Chunzhi; Tang, Huadan; Jia, Yongxia; Deng, Rufang; Xu, Xinlan; Zhang, Mingyong

    2015-12-01

    Cuticular wax forms a hydrophobic layer covering aerial plant organs and acting as a protective barrier against biotic and abiotic stresses. Compared with well-known wax biosynthetic pathway, molecular regulation of wax biosynthesis is less known. Here, we show that rice OsWS1, a member of the membrane-bound O-acyl transferase gene family, involved in wax biosynthesis and was regulated by an osa-miR1848. OsWS1-tagged green fluorescent protein localized to the endoplasmic reticulum (ER). Compared with wild-type rice, OsWS1 overexpression plants displayed a 3% increase in total wax, especially a 35% increase in very long-chain fatty acids, denser wax papillae around the stoma, more cuticular wax crystals formed on leaf and stem surfaces, pollen coats were thicker and more seedlings survived after water-deficit treatment. In contrast, OsWS1-RNAi and osa-miR1848 overexpression plants exhibited opposing changes. Gene expression analysis showed that overexpression of osa-miR1848 down-regulated OsWS1 transcripts; furthermore, expression profiles of OsWS1 and osa-miR1848 were inversely correlated in the leaf, panicle and stem, and upon water-deficit treatment. These results suggest that OsWS1 is regulated by osa-miR1848 and participates in cuticular wax formation. © 2015 John Wiley & Sons Ltd.

  15. Oryza sativa H+-ATPase (OSA) is Involved in the Regulation of Dumbbell-Shaped Guard Cells of Rice

    PubMed Central

    Toda, Yosuke; Wang, Yin; Takahashi, Akira; Kawai, Yuya; Tada, Yasuomi; Yamaji, Naoki; Feng Ma, Jian; Ashikari, Motoyuki; Kinoshita, Toshinori

    2016-01-01

    The stomatal apparatus consists of a pair of guard cells and regulates gas exchange between the leaf and atmosphere. In guard cells, blue light (BL) activates H+-ATPase in the plasma membrane through the phosphorylation of its penultimate threonine, mediating stomatal opening. Although this regulation is thought to be widely adopted among kidney-shaped guard cells in dicots, the molecular basis underlying that of dumbbell-shaped guard cells in monocots remains unclear. Here, we show that H+-ATPases are involved in the regulation of dumbbell-shaped guard cells. Stomatal opening of rice was promoted by the H+-ATPase activator fusicoccin and by BL, and the latter was suppressed by the H+-ATPase inhibitor vanadate. Using H+-ATPase antibodies, we showed the presence of phosphoregulation of the penultimate threonine in Oryza sativa H+-ATPases (OSAs) and localization of OSAs in the plasma membrane of guard cells. Interestingly, we identified one H+-ATPase isoform, OSA7, that is preferentially expressed among the OSA genes in guard cells, and found that loss of function of OSA7 resulted in partial insensitivity to BL. We conclude that H+-ATPase is involved in BL-induced stomatal opening of dumbbell-shaped guard cells in monocotyledon species. PMID:27048369

  16. Enhancer-promoter communication mediated by Chip during Pannier-driven proneural patterning is regulated by Osa.

    PubMed

    Heitzler, Pascal; Vanolst, Luc; Biryukova, Inna; Ramain, Philippe

    2003-03-01

    The GATA factor Pannier activates proneural achaete/scute (ac/sc) expression during development of the sensory organs of Drosophila through enhancer binding. Chip bridges Pannier with the (Ac/Sc)-Daughterless heterodimers bound to the promoter and facilitates the enhancer-promoter communication required for proneural development. We show here that this communication is regulated by Osa, which is recruited by Pannier and Chip. Osa belongs to Brahma chromatin remodeling complexes and we show that Osa negatively regulates ac/sc. Consequently, Pannier and Chip also play an essential role during repression of proneural gene expression. Our study suggests that altering chromatin structure is essential for regulation of enhancer-promoter communication.

  17. Amsterdam positional OSA classification: the AASM 2012 recommended hypopnoea criteria increases the number of positional therapy candidates.

    PubMed

    Duce, Brett; Kulkas, Antti; Langton, Christian; Töyräs, Juha; Hukins, Craig

    2017-05-01

    This study examined the effect of hypopnoea criteria on the prevalence of positional obstructive sleep apnoea (pOSA) identified under the Amsterdam Positional OSA Classification (APOC) system. Three hundred three consecutive patients undertaking polysomnography (PSG) for the suspicion of OSA were included in this retrospective investigation. PSGs were scored using both the 2007 American Academy of Sleep Medicine (AASM) recommended hypopnoea criteria (AASM2007Rec) and the 2012 AASM recommended hypopnoea criteria (AASM2012Rec). For each hypopnoea criteria, OSA patients were grouped according to the APOC categories (I, II or II) or else deemed non-APOC if they did not meet the APOC criteria. Outcome measures, such as Functional Outcomes of Sleep Questionnaire (FOSQ), MOS 36-item short-form health survey (SF-36) and psychomotor vigilance task (PVT), were also compared between the groups. The AASM2012Rec increased the prevalence of OSA compared to AASM2007Rec. The AASM2012Rec trebled the number of APOC I patients compared to AASM2007Rec (297% increase) as well as increased the proportion of females in the APOC I group. AASM2012Rec did not change the number of APOC II and APOC III patients. In fact, the same patients were present in these categories irrespective of hypopnoea criteria. The proportion of non-APOC patients proportionally decreased with the AASM2012Rec criteria. There were no differences in outcome measures between the AASM2012Rec and AASM2007Rec groups. This study demonstrates that, compared to AASM2007Rec, AASM2012Rec increases the prevalence of who could be successfully treated with positional therapy. The proportion of females with pOSA also increases as a consequence of AASM2012Rec.

  18. Total analysis of clinical factors for surgical success of adenotonsillectomy in pediatric OSAS.

    PubMed

    Chang, Ting-So; Chiang, Rayleigh Ping-Ying

    2017-01-01

    The objective of this study is the total evaluation of most common clinical factors influencing the successful rate of adenotonsillectomy for pediatric obstructive sleep apnea syndrome (OSAS). Retrospectively, 63 pediatric patients ranged from 2 to 16 years old were included. Syndromics and patients who had received orthodontic treatment or orthognathic surgery were excluded. All patients received pre-operative and postoperative polysomnography and cephalometry. Each patient received adenotonsillectomy by single surgeon. Surgical success was defined as apneahypopnea index (AHI) decreased ≧50 % or post-operative AHI <5. Total evaluated clinical factors related to success of adenotonsillectomy for pediatric OSAS include age, gender, body mass index (BMI), tonsil size, adenoid/nasopharynx ratio (A/N Ratio), pre-operative data of polysomnography, including AHI, apnea index (AI), hypopnea index (HI), mean O2 saturation and nadir O2 saturation, and 18 cephalometry parameters. Mean age of the total 63 patients was 7.78 years old. Mean BMI of the patients was 19.02. The proportion of obese patients was 25.4% (16/63). Surgical success was achieved in 42 out of 63 patients (66.7%). The surgical success was not statistically significant related to all pre-operative cephalometric parameters, age, gender, BMI and adenoid size by multiple logistic regression model. However, the surgical success was significantly related to pre-operative AHI and tonsil size. In addition, all patients who received adenotonsillectomy showed improved polysomnography parameters, including AHI, AI, HI, mean O2 saturation and nadir O2 saturation which all reached statistically significant improvement. Although adenotonsillectomy cannot cure pediatric OSAS in our research, all patients showed significant improvement of polysomnography parameters after this procedure. Pre-operative cephalometry parameters, BMI and age did not show significant correlation with surgical success, however, pre-op AHI and

  19. Impact of CPAP on Activity Patterns and Diet in Patients with Obstructive Sleep Apnea (OSA)

    PubMed Central

    Batool-Anwar, Salma; Goodwin, James L.; Drescher, Amy A.; Baldwin, Carol M.; Simon, Richard D.; Smith, Terry W.; Quan, Stuart F.

    2014-01-01

    Study Objectives: Patients with severe OSA consume greater amounts of cholesterol, protein, and fat as well as have greater caloric expenditure. However, it is not known whether their activity levels or diet change after treatment with CPAP. To investigate this issue, serial assessments of activity and dietary intake were performed in the Apnea Positive Pressure Long-term Efficacy Study (APPLES); a 6-month randomized controlled study of CPAP vs. sham CPAP on neurocognitive outcomes. Methods: Subjects were recruited into APPLES at 5 sites through clinic encounters or public advertisement. After undergoing a diagnostic polysomnogram, subjects were randomized to CPAP or sham if their AHI was ≥ 10. Adherence was assessed using data cards from the devices. At the Tucson and Walla Walla sites, subjects were asked to complete validated activity and food frequency questionnaires at baseline and their 4-month visit. Results: Activity and diet data were available at baseline and after 4 months treatment with CPAP or sham in up to 231 subjects (117 CPAP, 114 Sham). Mean age, AHI, BMI, and Epworth Sleepiness Score (ESS) for this cohort were 55 ± 13 [SD] years, 44 ± 27 /h, 33 ± 7.8 kg/m2, and 10 ± 4, respectively. The participants lacking activity and diet data were younger, had lower AHI and arousal index, and had better sleep efficiency (p < 0.05). The BMI was higher among women in both CPAP and Sham groups. However, compared to women, men had higher AHI only in the CPAP group (50 vs. 34). Similarly, the arousal index was higher among men in CPAP group. Level of adherence defined as hours of device usage per night at 4 months was significantly higher among men in CPAP group (4.0 ± 2.9 vs. 2.6 ± 2.6). No changes in consumption of total calories, protein, carbohydrate or fat were noted after 4 months. Except for a modest increase in recreational activity in women (268 ± 85 vs. 170 ± 47 calories, p < 0.05), there also were no changes in activity patterns. Conclusion

  20. Drug-induced sleep endoscopy: A new gold standard for evaluating OSAS? Part II: Results.

    PubMed

    Blumen, M; Bequignon, E; Chabolle, F

    2017-04-01

    Surgical results in obstructive sleep apnea syndrome (OSAS) vary greatly, whatever the surgical technique or site. Most authors agree that rigorous patient selection is logical and mandatory. Drug-induced sleep endoscopy (DISE) was introduced in 1991 and has been rediscovered and used extensively since the 2000s. It attempts to mimic natural sleep in order to observe the upper airway on flexible endoscopy in a situation in which obstruction may occur. A review of the DISE literature was performed, and is reported in two parts. The present second part reports DISE results concerning obstruction sites, impact on treatment efficacy and the consequent indications for this exploration. Copyright © 2016. Published by Elsevier Masson SAS.

  1. Epidemiological analysis of structural alterations of the nasal cavity associated with obstructive sleep apnea syndrome (OSA).

    PubMed

    Mekhitarian Neto, Levon; Fava, Antonio Sérgio; Lopes, Hugo Canhete; Stamm, Aldo

    2005-01-01

    The objective of this paper is to demonstrate that structural alterations of the nasal cavity, e.g. septal deviation and conchal hypertrophy have high incidence in patients with sleep apnea and hypopnea syndrome and must be addressed with associated specific procedures of the syndrome. Clinical retrospective. A retrospective study of 200 patients was performed, with 196 male and 4 female, attended at the otorhinolaryngology ambulatory of Hospital Prof. Edmundo Vasconcelos and Unidade Paulista de Otorrinolaringologia, all of them subjected to polysomnography, otorhinolaryngological physical exam, endoscopy exam, and surgical treatment with nasal and pharyngeal procedures. All of them were subjected to pharyngeal procedure: uvulopalatopharyngoplasty or uvulopalatoplasty and nose procedure: 176 septoplasty with partial turbinectomy (88%) and 24 isolated turbinectomy, with satisfactory results. We can see that structural alterations of the nasal cavity have high incidence in patients with OSA.

  2. Landscape-Scale Controls on Aboveground Forest Carbon Stocks on the Osa Peninsula, Costa Rica

    PubMed Central

    Taylor, Philip; Asner, Gregory; Dahlin, Kyla; Anderson, Christopher; Knapp, David; Martin, Roberta; Mascaro, Joseph; Chazdon, Robin; Cole, Rebecca; Wanek, Wolfgang; Hofhansl, Florian; Malavassi, Edgar; Vilchez-Alvarado, Braulio; Townsend, Alan

    2015-01-01

    Tropical forests store large amounts of carbon in tree biomass, although the environmental controls on forest carbon stocks remain poorly resolved. Emerging airborne remote sensing techniques offer a powerful approach to understand how aboveground carbon density (ACD) varies across tropical landscapes. In this study, we evaluate the accuracy of the Carnegie Airborne Observatory (CAO) Light Detection and Ranging (LiDAR) system to detect top-of-canopy tree height (TCH) and ACD across the Osa Peninsula, Costa Rica. LiDAR and field-estimated TCH and ACD were highly correlated across a wide range of forest ages and types. Top-of-canopy height (TCH) reached 67 m, and ACD surpassed 225 Mg C ha-1, indicating both that airborne CAO LiDAR-based estimates of ACD are accurate in tall, high-biomass forests and that the Osa Peninsula harbors some of the most carbon-rich forests in the Neotropics. We also examined the relative influence of lithologic, topoedaphic and climatic factors on regional patterns in ACD, which are known to influence ACD by regulating forest productivity and turnover. Analyses revealed a spatially nested set of factors controlling ACD patterns, with geologic variation explaining up to 16% of the mapped ACD variation at the regional scale, while local variation in topographic slope explained an additional 18%. Lithologic and topoedaphic factors also explained more ACD variation at 30-m than at 100-m spatial resolution, suggesting that environmental filtering depends on the spatial scale of terrain variation. Our result indicate that patterns in ACD are partially controlled by spatial variation in geologic history and geomorphic processes underpinning topographic diversity across landscapes. ACD also exhibited spatial autocorrelation, which may reflect biological processes that influence ACD, such as the assembly of species or phenotypes across the landscape, but additional research is needed to resolve how abiotic and biotic factors contribute to ACD

  3. 5-years APAP adherence in OSA patients--do first impressions matter?

    PubMed

    van Zeller, Mafalda; Severo, Milton; Santos, Ana Cristina; Drummond, Marta

    2013-12-01

    Although continuous positive airway pressure (CPAP) is effective in treating obstructive sleep apnoea (OSA), inadequate adherence remains a major cause of treatment failure. This study aimed to determine long term adherence to auto adjusting-CPAP (APAP) and its influencing factors including the role of initial compliance. Eighty-eight male patients with newly diagnosed moderate/severe OSA were included. After initiation of APAP treatment, patients had periodic follow-up appointments at 2 weeks, 6 months and then annually for at least 5 years. Patient's compliance to therapy was assessed in each appointment and predictors to treatment abandonment and poor compliance were evaluated. The studied population had a mean age of 53.8 years and mean apnoea-hypopnoea index of 52.71/h. The mean time of follow-up was 5.2 (± 1.6) years, during that time 22 (25%) patients abandoned APAP, those who maintained treatment had good compliance to it since 94% of them used it more than 4 h/day for at least 70% of days. A significant negative association was found between age, % of days and mean time of APAP use on 12th day and 6th month and the risk of abandoning. APAP use lower than 33% and 57% of days at 12th day and 6th month, respectively had high specificity (≈ 100%) to detect treatment abandonment. the majority of patients adheres to long term APAP treatment and has good compliance after 5-years of follow-up. Age and initial compliance (% days of use and mean hour/day) have the ability to predict future adherence, as soon as 12 days and 6 months after initiation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. Misclassification of OSA severity with automated scoring of home sleep recordings.

    PubMed

    Aurora, R Nisha; Swartz, Rachel; Punjabi, Naresh M

    2015-03-01

    The advent of home sleep testing has allowed for the development of an ambulatory care model for OSA that most health-care providers can easily deploy. Although automated algorithms that accompany home sleep monitors can identify and classify disordered breathing events, it is unclear whether manual scoring followed by expert review of home sleep recordings is of any value. Thus, this study examined the agreement between automated and manual scoring of home sleep recordings. Two type 3 monitors (ApneaLink Plus [ResMed] and Embletta [Embla Systems]) were examined in distinct study samples. Data from manual and automated scoring were available for 200 subjects. Two thresholds for oxygen desaturation (≥ 3% and ≥ 4%) were used to define disordered breathing events. Agreement between manual and automated scoring was examined using Pearson correlation coefficients and Bland-Altman analyses. Automated scoring consistently underscored disordered breathing events compared with manual scoring for both sleep monitors irrespective of whether a ≥ 3% or ≥ 4% oxygen desaturation threshold was used to define the apnea-hypopnea index (AHI). For the ApneaLink Plus monitor, Bland-Altman analyses revealed an average AHI difference between manual and automated scoring of 6.1 (95% CI, 4.9-7.3) and 4.6 (95% CI, 3.5-5.6) events/h for the ≥ 3% and ≥ 4% oxygen desaturation thresholds, respectively. Similarly for the Embletta monitor, the average difference between manual and automated scoring was 5.3 (95% CI, 3.2-7.3) and 8.4 (95% CI, 7.2-9.6) events/h, respectively. Although agreement between automated and manual scoring of home sleep recordings varies based on the device used, modest agreement was observed between the two approaches. However, manual review of home sleep test recordings can decrease the misclassification of OSA severity, particularly for those with mild disease. ClinicalTrials.gov; No.: NCT01503164; www.clinicaltrials.gov.

  5. Landscape-Scale Controls on Aboveground Forest Carbon Stocks on the Osa Peninsula, Costa Rica.

    PubMed

    Taylor, Philip; Asner, Gregory; Dahlin, Kyla; Anderson, Christopher; Knapp, David; Martin, Roberta; Mascaro, Joseph; Chazdon, Robin; Cole, Rebecca; Wanek, Wolfgang; Hofhansl, Florian; Malavassi, Edgar; Vilchez-Alvarado, Braulio; Townsend, Alan

    2015-01-01

    Tropical forests store large amounts of carbon in tree biomass, although the environmental controls on forest carbon stocks remain poorly resolved. Emerging airborne remote sensing techniques offer a powerful approach to understand how aboveground carbon density (ACD) varies across tropical landscapes. In this study, we evaluate the accuracy of the Carnegie Airborne Observatory (CAO) Light Detection and Ranging (LiDAR) system to detect top-of-canopy tree height (TCH) and ACD across the Osa Peninsula, Costa Rica. LiDAR and field-estimated TCH and ACD were highly correlated across a wide range of forest ages and types. Top-of-canopy height (TCH) reached 67 m, and ACD surpassed 225 Mg C ha-1, indicating both that airborne CAO LiDAR-based estimates of ACD are accurate in tall, high-biomass forests and that the Osa Peninsula harbors some of the most carbon-rich forests in the Neotropics. We also examined the relative influence of lithologic, topoedaphic and climatic factors on regional patterns in ACD, which are known to influence ACD by regulating forest productivity and turnover. Analyses revealed a spatially nested set of factors controlling ACD patterns, with geologic variation explaining up to 16% of the mapped ACD variation at the regional scale, while local variation in topographic slope explained an additional 18%. Lithologic and topoedaphic factors also explained more ACD variation at 30-m than at 100-m spatial resolution, suggesting that environmental filtering depends on the spatial scale of terrain variation. Our result indicate that patterns in ACD are partially controlled by spatial variation in geologic history and geomorphic processes underpinning topographic diversity across landscapes. ACD also exhibited spatial autocorrelation, which may reflect biological processes that influence ACD, such as the assembly of species or phenotypes across the landscape, but additional research is needed to resolve how abiotic and biotic factors contribute to ACD

  6. Fate of trace organic contaminants in oxic-settling-anoxic (OSA) process applied for biosolids reduction during wastewater treatment.

    PubMed

    Semblante, Galilee U; Hai, Faisal I; McDonald, James; Khan, Stuart J; Nelson, Mark; Lee, Duu-Jong; Price, William E; Nghiem, Long D

    2017-09-01

    This study investigated the fate of trace organic contaminants (TrOCs) in an oxic-settling-anoxic (OSA) process consisting of a sequencing batch reactor (SBR) with external aerobic/anoxic and anoxic reactors. OSA did not negatively affect TrOC removal of the SBR. Generally, low TrOC removal was observed under anoxic and low substrate conditions, implicating the role of co-metabolism in TrOC biodegradation. Several TrOCs that were recalcitrant in the SBR (e.g., benzotriazole) were biodegraded in the external aerobic/anoxic reactor. Some hydrophobic TrOCs (e.g., triclosan) were desorbed in the anoxic reactor possibly due to loss of sorption sites through volatile solids destruction. In OSA, the sludge was discharged from the aerobic/anoxic reactor which contained lower concentration of TrOCs (e.g., triclosan and triclocarban) than that of the control aerobic digester, suggesting that OSA can also help to reduce TrOC concentration in residual biosolids. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Improved stability and controlled release of CLA with spray-dried microcapsules of OSA-modified starch and xanthan gum.

    PubMed

    He, Huizi; Hong, Yan; Gu, Zhengbiao; Liu, Guodong; Cheng, Li; Li, Zhaofeng

    2016-08-20

    The objective of this investigation was to improve the stability of CLA and to allow for its controlled release by encapsulating it with combinations of octenyl-succinic anhydride (OSA) starch and xanthan gum (XG) in three ratios (OSA/XG: 60/1, 80/1, and 100/1, w/w). The wall material was examined using FTIR and TGA. The microcapsules were characterized by laser particle size analysis (LPS) and SEM. Oxidation of the microcapsules was monitored by headspace method. The results revealed that microcapsules created with an OSA/XG ratio of 60/1 provided superior protection to CLA against oxidation. When CLA-microcapsules were subjected to conditions simulating those in the human gastrointestinal system, 12.1%-50.1% of the CLA was released. CLA encapsulation in spray-dried microcapsules of OSA/XG appears to be an effective technique that provides good protection against oxidation and could be useful in the targeted delivery of functional lipids or other bioactive components to the small intestine.

  8. CPAP treatment supported by telemedicine does not improve blood pressure in high cardiovascular risk OSA patients: a randomized, controlled trial.

    PubMed

    Mendelson, Monique; Vivodtzev, Isabelle; Tamisier, Renaud; Laplaud, David; Dias-Domingos, Sonia; Baguet, Jean-Philippe; Moreau, Laurent; Koltes, Christian; Chavez, Léonidas; De Lamberterie, Gilles; Herengt, Frédéric; Levy, Patrick; Flore, Patrice; Pépin, Jean-Louis

    2014-11-01

    Obstructive sleep apnea (OSA) has been associated with hypertension, which is one of the intermediary mechanisms leading to increased cardiovascular morbidity. This study aimed at evaluating the effects of a combination of continuous positive airway pressure (CPAP) and telemedicine support on blood pressure (BP) reduction in high cardiovascular risk OSA patients. A multi-center randomized controlled trial that compared standard CPAP care and CPAP care and a telemedicine intervention. Sleep clinics in France. 107 adult (18-65 years old) OSA patients (AHI > 15 events/h) with a high cardiovascular risk (cardiovascular SCORE > 5% or secondary prevention). Patients were randomized to either standard care CPAP (n = 53) or CPAP and telemedicine (n = 54). Patients assigned to telemedicine were equipped with a smartphone for uploading BP measurements, CPAP adherence, sleepiness, and quality of life data; in return, they received pictograms containing health-related messages. The main outcome was home self-measured BP and secondary outcomes were cardiovascular risk evolution, objective physical activity, CPAP adherence, sleepiness and quality of life. Self-measured BP did not improve in either group (telemedicine or standard care). Patients in primary prevention showed greater BP reduction with CPAP treatment than those in secondary prevention. CPAP treatment supported by telemedicine alone did not improve blood pressure and cardiovascular risk in high cardiovascular risk OSA patients. This study emphasizes the need for diet and physical activity training programs in addition to CPAP when aiming at decreasing cardiometabolic risk factors in these patients. ClinicalTrials.gov identifier: NCT01226641.

  9. Morbidity and Mortality Rates After Maxillomandibular Advancement for Treatment of Obstructive Sleep Apnea.

    PubMed

    Passeri, Luis A; Choi, James G; Kaban, Leonard B; Lahey, Edward T

    2016-10-01

    To compare morbidity and mortality rates in obstructive sleep apnea (OSA) versus dentofacial deformity (DFD) patients undergoing equivalent maxillofacial surgical procedures. Patients with OSA who underwent maxillomandibular advancement with genial tubercle advancement in the Massachusetts General Hospital Department of Oral and Maxillofacial Surgery from December 2002 to June 2011 were matched to patients with DFD undergoing similar maxillofacial procedures during the same period. They were compared regarding demographic variables, medical comorbidities, perioperative management, intraoperative complications, early and late postoperative complications, and mortality rate. A study group of 28 patients with OSA and a control group of 26 patients with DFD were compared. The patients with OSA were older (41.9 ± 12.5 years vs 21.7 ± 8.6 years), had a higher American Society of Anesthesiologists classification (2.0 ± 0.5 vs 1.3 ± 0.6), and had a higher body mass index (29.6 ± 4.7 kg/m(2) vs 23.0 ± 3.1 kg/m(2)). They also had a greater number of medical comorbidities (2.4 ± 2.3 vs 0.7 ± 1.0). More OSA patients than DFD patients had complications (28 [100%] vs 19 [73%], P = .003), and the total number of complications in the OSA group was higher (108 vs 33, P < .001). Of the complications, 13.9% in the OSA group and 3.0% in the DFD group were classified as major. The absolute risk of a complication was 3.9 for the OSA group versus 1.3 for the DFD group. The relative risk of complications in OSA patients compared with DFD patients was 3.0. No difference in mortality rate was found. The patients in the OSA group were older, had more comorbidities, and ultimately had a greater number of early, late, minor, and major complications than those in the DFD group. The incidence of death in both groups was zero. Maxillomandibular advancement appears to be a safe procedure regarding mortality rate, but OSA patients should be counseled preoperatively regarding the

  10. Mandibular Advancement Device as a Comparable Treatment to Nasal Continuous Positive Airway Pressure for Positional Obstructive Sleep Apnea

    PubMed Central

    Takaesu, Yoshikazu; Tsuiki, Satoru; Kobayashi, Mina; Komada, Yoko; Nakayama, Hideaki; Inoue, Yuichi

    2016-01-01

    Study Objectives: Positional obstructive sleep apnea (P-OSA) is a clinically common phenotype of OSA, which can be treated effectively with mandibular advancement devices (MADs). We hypothesized that the efficacy of an MAD is comparable to that of nasal continuous positive airway pressure (nCPAP) in P-OSA patients. Methods: Among patients diagnosed with OSA at a single sleep center from January 2008 to May 2014, male subjects with moderate OSA were recruited and stringently categorized as having P-OSA when the ratio of their lateral apnea-hypopnea index (AHI) to supine AHI was ≤ 0.5, their lateral sleep time was > 60 minutes, and their lateral REM sleep time was longer than 10 minutes. Treatment efficacy was compared between P-OSA subjects with an MAD (n = 34) and those with nCPAP (n = 34) after matching for age, body-mass index, and baseline AHI. Results: There were no significant differences in baseline AHI (MAD: nCPAP = 20.6 ± 3.9/h: 21.3 ± 1.7/h, p = 0.35) or in follow-up AHI (MAD: nCPAP = 4.7 ± 3.5/h: 3.4 ± 3.7/h, p = 0.12) between the 2 treatment groups, and hence MADs lowered the AHI to the same extent as nCPAP. Conclusions: These findings suggest that an MAD is as efficacious as nCPAP for P-OSA patients. MAD treatment for this specific phenotype may be a promising patient-tailored and first-line approach to OSA. Commentary: A commentary on this article appears in this issue on page 1079. Citation: Takaesu Y, Tsuiki S, Kobayashi M, Komada Y, Nakayama H, Inoue Y. Mandibular advancement device as a comparable treatment to nasal continuous positive airway pressure for positional obstructive sleep apnea. J Clin Sleep Med 2016;12(8):1113–1119. PMID:27250814

  11. Misclassification of OSA Severity With Automated Scoring of Home Sleep Recordings

    PubMed Central

    Aurora, R. Nisha; Swartz, Rachel

    2015-01-01

    BACKGROUND: The advent of home sleep testing has allowed for the development of an ambulatory care model for OSA that most health-care providers can easily deploy. Although automated algorithms that accompany home sleep monitors can identify and classify disordered breathing events, it is unclear whether manual scoring followed by expert review of home sleep recordings is of any value. Thus, this study examined the agreement between automated and manual scoring of home sleep recordings. METHODS: Two type 3 monitors (ApneaLink Plus [ResMed] and Embletta [Embla Systems]) were examined in distinct study samples. Data from manual and automated scoring were available for 200 subjects. Two thresholds for oxygen desaturation (≥ 3% and ≥ 4%) were used to define disordered breathing events. Agreement between manual and automated scoring was examined using Pearson correlation coefficients and Bland-Altman analyses. RESULTS: Automated scoring consistently underscored disordered breathing events compared with manual scoring for both sleep monitors irrespective of whether a ≥ 3% or ≥ 4% oxygen desaturation threshold was used to define the apnea-hypopnea index (AHI). For the ApneaLink Plus monitor, Bland-Altman analyses revealed an average AHI difference between manual and automated scoring of 6.1 (95% CI, 4.9-7.3) and 4.6 (95% CI, 3.5-5.6) events/h for the ≥ 3% and ≥ 4% oxygen desaturation thresholds, respectively. Similarly for the Embletta monitor, the average difference between manual and automated scoring was 5.3 (95% CI, 3.2-7.3) and 8.4 (95% CI, 7.2-9.6) events/h, respectively. CONCLUSIONS: Although agreement between automated and manual scoring of home sleep recordings varies based on the device used, modest agreement was observed between the two approaches. However, manual review of home sleep test recordings can decrease the misclassification of OSA severity, particularly for those with mild disease. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01503164; www

  12. Topographic Distributions of Emergent Trees in Tropical Forests of the Osa Peninsula, Costa Rica

    NASA Astrophysics Data System (ADS)

    Balzotti, C.; Asner, G. P.; Taylor, P.; Cole, R. J.; Osborne, B. B.; Cleveland, C. C.; Porder, S.; Townsend, A. R.

    2015-12-01

    Tropical rainforests are reservoirs of terrestrial carbon and biodiversity. Large and often emergent trees store disproportionately large amounts of aboveground carbon and greatly influence the structure and functioning of tropical rainforests. Despite their importance, controls on the abundance and distribution of emergent trees are largely unknown across tropical landscapes. Conventional field approaches are limited in their ability to characterize patterns in emergent trees across vast landscapes with varying environmental conditions and floristic composition. Here we used a high-resolution light detection and ranging (LiDAR) sensor, aboard the Carnegie Airborne Observatory Airborne Taxonomic Mapping System (CAO-AToMS), to examine the abundance and distribution of tall emergent tree canopies (ETC) relative to surrounding tree canopies (STC), across the Osa Peninsula, a geologically and topographically diverse region of Costa Rica. The abundance of ETC was clearly influenced by fine-scale topographic variation, with distribution patterns that held across a variety of geologic substrates. Specifically, the density of ETC was much greater on lower slopes and in valleys, compared to upper slopes and ridges. Furthermore, using the CAO high-fidelity imaging spectrometer, ETC had a different spectral signature than that of the STC. Most notably, ETC had lower foliar N than STC, which was verified with an independent field survey of canopy leaf chemistry. The underlying mechanisms to explain the topographic-dependence of ETCs and linkages to canopy N are unknown, and remain an important area of research.

  13. Quantifying the dynamic of OSA brain using multifractal formalism: A novel measure for sleep fragmentation.

    PubMed

    Raiesdana, Somayeh

    2017-01-01

    It is thought that the critical brain dynamics in sleep is modulated during frequent periods of wakefulness. This paper utilizes the capacity of EEG based scaling analysis to quantify sleep fragmentation in patients with obstructive sleep apnea. The scale-free (fractal) behavior refers to a state where no characteristic scale dominates the dynamics of the underlying process which is evident as long range correlations in a time series. Here, Multiscaling (multifractal) spectrum is utilized to quantify the disturbed dynamic of an OSA brain with fragmented sleep. The whole night multichannel sleep EEG recordings of 18 subjects were employed to compute and quantify variable power-law long-range correlations and singularity spectra. Based on this characteristic, a new marker for sleep fragmentation named ``scaling based sleep fragmentation'' was introduced. This measure takes into account the sleep run length and stage transition quality within a fuzzy inference system to improve decisions made on sleep fragmentation. The proposed index was implemented, validated with sleepiness parameters and compared to some common indexes including sleep fragmentation index, arousal index, sleep diversity index, and sleep efficiency index. Correlations were almost significant suggesting that the sleep characterizing measure, based on singularity spectra range, could properly detect fragmentations and quantify their rate. This method can be an alternative for quantifying the sleep fragmentation in clinical practice after being approved experimentally. Control of sleep fragmentation and, subsequently, suppression of excessive daytime sleepiness will be a promising outlook of this kind of researches.

  14. Heart rate recovery post 6-minute walking test in obstructive sleep apnea: cycle ergometry versus 6-minute walking test in OSA patients.

    PubMed

    Cholidou, Kyriaki G; Manali, Effrosyni D; Kapsimalis, Fotis; Kostakis, Ioannis D; Vougas, Konstantinos; Simoes, Davina; Markozannes, Evaggelos; Vogiatzis, Ioannis; Bakakos, Petros; Koulouris, Nikolaos; Alchanatis, Manos

    2014-10-01

    To examine the clinical usefulness of heart rate recovery (HRR) post 6-minute walking test (6MWT) as a simple marker of cardiovascular risk in obstructive sleep apnea (OSA) patients in comparison to HRR post cycle ergometry, the validated and more sophisticated protocol. Seventy-four participants underwent full overnight polysomnography, cycle ergometry and 6MWT. The HRR at 1, 2 and 3 min (HRR-1, HRR-2 and HRR-3) 6MWT was compared to HRR at 1, 2, and 3 min post cycle ergometry in normal subjects and in moderate and severe OSA patients before and after 6-month CPAP treatment. The HRR-1, HRR-2 and HRR-3 in 6MWT were significantly different between normal, moderate and severe OSA patients with higher rates achieved in normal. The higher the severity of OSA the lower the HRR was. There were also no differences found between work rate and distance walked during cycle ergometry or 6MWT, respectively, concerning normal, moderate and severe OSA patients. Heart rate recovery was further associated with minimum saturation of oxygen during sleep independently of the duration of apnea episodes of BMI and ESS. The treatment with CPAP had a beneficial effect on HRR both post-6MWT and post cycle ergometry. Autonomic nervous system dysfunction in OSA can be found even with submaximal exertion. Heart rate recovery post-6MWT, such as HRR post cycle ergometry, was significantly impaired in OSA patients in comparison to normals and was favorably influenced from CPAP treatment. Furthermore, it was found to be more sensitive compared with distance walked in 6MWT in discriminating severity of OSA. The HRR post-6MWT was found to be an easily measured and reliable marker of OSA severity both before and after CPAP treatment.

  15. Program for catenary-pantograph analysis, PrOSA statement of methods and validation according EN 50318

    NASA Astrophysics Data System (ADS)

    Finner, Lars; Poetsch, Gero; Sarnes, Bernhard; Kolbe, Michael

    2015-03-01

    DB Systemtechnik is a high-performing, customer-driven service provider that, as well as authoritatively serving the Deutsche Bahn Group by dint of its specialist knowledge is also increasingly active on the global railway market. Development and testing of pantograph models and catenary systems have been part of the company's essential activity fields from the beginning. Therefore, an efficient and high-performing simulation tool is indispensable. That is why DB Systemtechnik spent high efforts to develop the program PrOSA in cooperation with the Heinz-Nixdorf-Institut (HNI) of the university Paderborn to simulate the interaction of pantograph and catenary. This article gives an overview of the most relevant properties of PrOSA. Furthermore, it is described how the benchmark requirements were implemented and processed.

  16. Protective Effect of Long-Term CPAP Therapy on Cognitive Performance in Elderly Patients with Severe OSA: The PROOF Study

    PubMed Central

    Crawford-Achour, Emilie; Dauphinot, Virginie; Saint Martin, Magali; Tardy, Magali; Gonthier, Régis; Barthelemy, Jean Claude; Roche, Frédéric

    2015-01-01

    Objective: Obstructive sleep apnea syndrome (OSA) leads to a deterioration in cognitive functions, with regard to memory and executive functions. However, few studies have investigated the impact of treatment on these cognitive functions in elderly subjects. Methods: The study was conducted in a large cohort of subjects aged 65 years or older (the PROOF cohort). Subjects were not diagnosed or treated for OSA. Subjects underwent a polygraphic recording. Cognitive performance was assessed in all OSA subjects at baseline and 10 years later, whether or not they were receiving continuous positive airway pressure (CPAP) therapy. Results: A group of 126 patients were analyzed. Only 26% of them were treated, with therapy initiated at the discretion of the primary care physician. Among treated subjects, self-reported compliance with therapy was good (> 6 h/night on average), and 66% of them reported an improvement in their quality of life. Patients receiving CPAP treatment had a higher apneahypopnea index (p = 0.006), a higher oxygen desaturation index (p < 0.001), and experienced more pronounced daytime repercussions (p = 0.004). These patients showed a statistically significant improvement in mental agility (similarities test; p < 0.0001) and memory performance (Grober and Buschke delayed free recall; p = 0.02). Conclusion: CPAP treatment is associated with the maintenance of memory performance over time. Citation: Crawford-Achour E, Dauphinot V, Saint Martin M, Tardy M, Gonthier R, Barthelemy JC, Roche F. Protective effect of long-term CPAP therapy on cognitive performance in elderly patients with severe OSA: the PROOF study. J Clin Sleep Med 2015;11(5):519–524. PMID:25700873

  17. Effects of a lifestyle intervention on REM sleep-related OSA severity in obese individuals with type 2 diabetes.

    PubMed

    Shechter, Ari; Foster, Gary D; Lang, Wei; Reboussin, David M; St-Onge, Marie-Pierre; Zammit, Gary; Newman, Anne B; Millman, Richard P; Wadden, Thomas A; Jakicic, John M; Strotmeyer, Elsa S; Wing, Rena R; Pi-Sunyer, F Xavier; Kuna, Samuel T

    2017-05-31

    The aim of this study was to determine if an intensive lifestyle intervention (ILI) reduces the severity of obstructive sleep apnea (OSA) in rapid-eye movement (REM) sleep, and to determine if longitudinal changes in glycaemic control are related to changes in OSA severity during REM sleep over a 4-year follow-up. This was a randomized controlled trial including 264 overweight/obese adults with type 2 diabetes (T2D) and OSA. Participants were randomized to an ILI targeted to weight loss or a diabetes support and education (DSE) control group. Measures included anthropometry, apnea-hypopnea index (AHI) during REM sleep (REM-AHI) and non-REM sleep (NREM-AHI) and glycated haemoglobin (HbA1c) at baseline and year 1, year 2 and year 4 follow-ups. Mean baseline values of REM-AHI were significantly higher than NREM-AHI in both groups. Both REM-AHI and NREM-AHI were reduced significantly more in ILI versus DSE, but these differences were attenuated slightly after adjustment for weight changes. Repeated-measure mixed-model analyses including data to year 4 demonstrated that changes in HbA1c were related significantly to changes in weight, but not to changes in REM-AHI and NREM-AHI. Compared to control, the ILI reduced REM-AHI and NREM-AHI during the 4-year follow-up. Weight, as opposed to REM-AHI and NREM-AHI, was related to changes in HbA1c. The findings imply that weight loss from a lifestyle intervention is more important than reductions in AHI for improving glycaemic control in T2D patients with OSA. © 2017 European Sleep Research Society.

  18. Coexistence of OSA may compensate for sleep related reduction in neural respiratory drive in patients with COPD

    PubMed Central

    He, Bai-Ting; Lu, Gan; Xiao, Si-Chang; Chen, Rui; Steier, Joerg; Moxham, John; Polkey, Michael I; Luo, Yuan-Ming

    2017-01-01

    Background The mechanisms underlying sleep-related hypoventilation in patients with coexisting COPD and obstructive sleep apnoea (OSA), an overlap syndrome, are incompletely understood. We compared neural respiratory drive expressed as diaphragm electromyogram (EMGdi) and ventilation during stage 2 sleep in patients with COPD alone and patients with overlap syndrome. Methods EMGdi and airflow were recorded during full polysomnography in 14 healthy subjects, 14 patients with OSA and 39 consecutive patients with COPD. The ratio of tidal volume to EMGdi was measured to indirectly assess upper airway resistance. Results Thirty-five patients with COPD, 12 healthy subjects and 14 patients with OSA completed the study. Of 35 patients with COPD, 19 had COPD alone (FEV1 38.5%±16.3%) whereas 16 had an overlap syndrome (FEV1 47.5±16.2%, AHI 20.5±14.1 events/hour). Ventilation (VE) was lower during stage 2 sleep than wakefulness in both patients with COPD alone (8.6±2.0 to 6.5±1.5 L/min, p<0.001) and those with overlap syndrome (8.3±2.0 to 6.1±1.8 L/min). Neural respiratory drive from wakefulness to sleep decreased significantly for patients with COPD alone (29.5±13.3% to 23.0±8.9% of maximal, p<0.01) but it changed little in those with overlap syndrome. The ratio of tidal volume to EMGdi was unchanged from wakefulness to sleep in patients with COPD alone and healthy subjects but was significantly reduced in patients with OSA or overlap syndrome (p<0.05). Conclusions Stage 2 sleep-related hypoventilation in COPD alone is due to reduction of neural respiratory drive, but in overlap syndrome it is due to increased upper airway resistance. PMID:27807016

  19. Predicting compliance for mandible advancement splint therapy in 96 obstructive sleep apnea patients.

    PubMed

    Ingman, Tuula; Arte, Sirpa; Bachour, Adel; Bäck, Leif; Mäkitie, Antti

    2013-12-01

    The treatment of choice in obstructive sleep apnea (OSA) is continuous positive airway pressure (CPAP). Mandible advancement splint (MAS) offers an option for patients with mild or moderate OSA, who refuse or are unable to tolerate CPAP. The aim of the study was to find predictive factors in OSA for MAS therapy. The study group comprised 96 consecutive OSA patients who were sent for MAS therapy during 2008. Data were collected on the patients' general and dental condition, diagnosis, and treatment for OSA. Panoramic and cephalometric radiographs were analysed. The treatment compliance rate and problems with the use of the MAS were recorded. This rate was 57% and the significant affecting factors were protrusion of the mandible with MAS during the adaptation to the appliance as well as shorter maxillary and mandible lengths. The compliance of the MAS therapy was best in patients with short maxilla and mandible, which should be taken into consideration when planning MAS therapy for OSA patients. Finally, a sleep study should be part of the follow-up in this patient population.

  20. Microencapsulation of white champaca (Michelia alba D.C.) extract using octenyl succinic anhydride (OSA) starch for controlled release aroma.

    PubMed

    Samakradhamrongthai, Rajnibhas; Thakeow, Prodpran; Kopermsub, Phikunthong; Utama-Ang, Niramon

    2016-12-01

    The objective of the study was to optimise the encapsulation of Michelia alba D.C. (MAD) extract using octenyl succinic anhydride (OSA) starch. The MAD extract (5-10 g/100 g of dry starch) and the OSA starch (25-100 g/100 ml of water) was used in microcapsule preparation and analysed for the physicochemical and encapsulation properties. The optimised formula using the MAD extract and the OSA starch were 15.00 g/100 g of dry starch and 96.32 g/100 g water, which provided the highest in yield recovery (40.65% ± 0.99) and encapsulation efficiency (68.91% ± 1.50), with the lowest moisture content (3.19% ± 0.06) and water activity (0.236 ± 0.004). The aroma release from the optimum encapsulated powder in simulated artificial saliva fluid (SSF) suggested that linalool retention in microcapsules was higher than verbenone and 2-methyl butanoic acid. This study shows that the optimised formulation of MAD encapsulated flavour powder was found to be effective for controlling the aroma release.

  1. What is known about the experiences of using CPAP for OSA from the users' perspective? A systematic integrative literature review.

    PubMed

    Ward, Kim; Hoare, Karen J; Gott, Merryn

    2014-08-01

    Economic, social and personal costs of untreated obstructive sleep apnoea (OSA) are high. Continuous positive airway pressure (CPAP) is recommended and cost effective. Increasing OSA prevalence may accompany predicted globally increasing obesity. To synthesise international evidence regarding personal experiences using CPAP for OSA. A systematic integrative literature review was conducted and quality assessment criteria applied. 22, of 538, identified papers met inclusion criteria. Thematic analysis identified three themes: 1) users' beliefs about CPAP influence users' experiences of CPAP; 2) CPAP users are primed to reflect negatively on experiences of CPAP; and 3) spouse and family influence users' experiences of CPAP. Personality and attitude impact expectations about CPAP prior to use, whilst engagement of spouse and family also influence experiences. Analysis highlighted that users' reporting of CPAP experiences is constrained by investigator defined assessment methods. Overall, research relating to experiences using CPAP is limited. Users' perspectives of CPAP are constrained by researchers' concern with non-compliance. Typically experiences are not defined by the user, but from an 'expert' healthcare perspective, using words which frame CPAP as problematic. Family and social support is a significant, but neglected area of experiencing CPAP warranting further investigation. More information from users is required to determine how CPAP can be managed successfully. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Investigation of resectability degree for adenoidal surgery in OSA children with the method of computational fluid dynamics.

    PubMed

    Hu, Changlong; Han, Demin; Zhou, Bing; Zhang, Luo; Li, Yunchuan; Zang, HongRui; Li, LiFeng

    2017-01-01

    From aspect of fluid dynamics, expanding patients' nasopharyngeal coronal-sectional area to 48.3-54.7% of normal area will bring the airflow velocity back to normal in adenoidal hypertrophy children. It might provide a suggestion for adenoidectomy range selection and whether total resection is necessary. To evaluate the nasopharyngeal airflow characteristics in pediatric OSA patients with adenoidal hypertrophy, and to explore the proper resection range for adenoidectomy Method: Nine OSA patients and four normal children were recruited. The CT scans of their upper airway were collected and used to construct three dimensional models for fluid dynamics analysis. Using computational fluid dynamics, indices such as velocity, pressure, and coronal-sectional area were calculated. Compared with the normal, the OSA children showed three characteristics in nasopharyngeal: the airflow velocity was significantly higher (p < 0.05), the coronal-sectional area was significantly smaller (p < 0.01), while pressure showed no difference (p > 0.05). In a study of the relationship between velocity and coronal-sectional area, this study investigates different coronal-sectional areas from 30-300 mm(2). It was found that, when patients' nasopharyngeal coronal-sectional area was expanded over 155-170 mm(2), namely 48.3-54.7% of normal area, airflow velocity in nasopharyngeal showed no difference than normal.

  3. Nasal Expiratory Positive Airway Pressure Devices (Provent) for OSA: A Systematic Review and Meta-Analysis

    PubMed Central

    Riaz, Muhammad; Certal, Victor; Nigam, Gaurav; Abdullatif, Jose; Zaghi, Soroush; Kushida, Clete A.; Camacho, Macario

    2015-01-01

    Objective. To quantify the effectiveness of nasal expiratory positive airway pressure (nasal EPAP) devices or Provent as treatment for obstructive sleep apnea (OSA). Methods. PubMed and six other databases were searched through November 15, 2015, without language limitations. Results. Eighteen studies (920 patients) were included. Pre- and post-nasal EPAP means ± standard deviations (M ± SD) for apnea-hypopnea index (AHI) in 345 patients decreased from 27.32 ± 22.24 to 12.78 ± 16.89 events/hr (relative reduction = 53.2%). Random effects modeling mean difference (MD) was −14.78 events/hr [95% CI −19.12, −10.45], p value < 0.00001. Oxygen desaturation index (ODI) in 247 patients decreased from 21.2 ± 19.3 to 12.4 ± 14.1 events/hr (relative reduction = 41.5%, p value < 0.00001). Lowest oxygen saturation (LSAT) M ± SD improved in 146 patients from 83.2 ± 6.8% to 86.2 ± 11.1%, MD 3 oxygen saturation points [95% CI 0.57, 5.63]. Epworth Sleepiness Scale (ESS) M ± SD improved (359 patients) from 9.9 ± 5.3 to 7.4 ± 5.0, MD −2.5 [95% CI −3.2, −1.8], p value < 0.0001. Conclusion. Nasal EPAP (Provent) reduced AHI by 53.2%, ODI by 41.5% and improved LSAT by 3 oxygen saturation points. Generally, there were no clear characteristics (demographic factors, medical history, and/or physical exam finding) that predicted favorable response to these devices. However, limited evidence suggests that high nasal resistance could be associated with treatment failure. Additional studies are needed to identify demographic and polysomnographic characteristics that would predict therapeutic success with nasal EPAP (Provent). PMID:26798519

  4. Clinical analysis of drug-induced sleep endoscopy for the OSA patient.

    PubMed

    Golbin, Dina; Musgrave, Brandon; Succar, Eric; Yaremchuk, Kathleen

    2016-01-01

    To determine if the use of drug-induced sleep endoscopy (DISE) and transoral robotic surgery (TORS) for the treatment of obstructive sleep apnea (OSA) is associated with improved outcomes and acceptable complication rates when compared to uvulopalatopharyngoplasty (UPPP) with or without tonsillectomy (± T). A retrospective cohort review was performed comparing 40 patients who had previously undergone UPPP ± T with 64 patients who had DISE, UPPP ± T, and possible TORS base-of-tongue resection and/or partial epiglottectomy. Apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), body mass index, sex, hospital length of stay, hospital charges, hospital readmissions, emergency department visits, and major complications were compared for both groups. The 40 patients who underwent UPPP ± T without DISE showed a significant reduction in AHI of -20.1 (P = 0.001) and a complication rate of 3% (P = 0.001). There was no significant change in ESS (-2.2; P = 0.734). The 64 patients who underwent DISE and subsequent procedures showed a significant reduction in AHI of -21.4 (P = 0.001) and a complication rate of 34.7% (P = 0.001). There was no significant difference in the ESS (+0.1; P = 0.734) or AHI (P = 0.092) between the two groups. Patients who underwent UPPP ± T without DISE did not show a statistically significant difference in outcomes compared to the patients who underwent DISE with other procedures, including TORS. The TORS patients had increased total costs and length of stay that were statistically significant and had increased complications that were not statistically significant. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  5. [Forest and population at Península de Osa, Costa Rica].

    PubMed

    Rosero-Bixby, Luis; Maldonado-Ulloa, Tirso; Bonilla-Carrión, Roger

    2002-06-01

    The research is focused on the relationship between population growth and conservation of the forest on the Osa Peninsula. Data of the geo-referenced censuses and information on land-use, derived from satellite images and aerial photography, were integrated into a GIS. We undertook an historical inventory of the changes in the population and the forest coverage, and the key events in the land tenure and economy of the region. Deforestation, reforestation, and fragmentation of the forest during the period 1980-1995 were analyzed. Relationships with the population potential, derived from the 1984 Costa Rican censuses, were identified, and the effects of third variables were controlled such as distances to the roads, rain, distances to the forest frontier, level of protection, etc. Both strong and significant associations between 1984 population potential and the three processes were detected. The probability of deforestation is null in unpopulated areas, 35% in areas with 25-30 potential farmers and to 65% in areas with 50 farmers and over. The probability of reforestation decreases from 100% to 28% and to 18% in these three categories. This kind of relationship persists in the multivariable analysis. An increase of 0.63% in the number of household, results in an increment of 1% in the risk of deforestation (elasticity). The elasticity in the chances of reforestation is -0.37 and 1% in fragmentation of the forest. An evaluation in the risk of deforestation for the period 1995-2005 was done. The most recent population data were used and it identifies several geographic areas with high deforestation risk.

  6. High Adherence to CPAP Treatment Does Not Prevent the Continuation of Weight Gain among Severely Obese OSAS Patients

    PubMed Central

    Myllylä, Minna; Kurki, Samu; Anttalainen, Ulla; Saaresranta, Tarja; Laitinen, Tarja

    2016-01-01

    Study Objectives: Obstructive sleep apnea syndrome (OSAS) patients benefit from continuous positive airway pressure (CPAP) treatment in a dose-response manner. We determined adherence and weight control, as well as their predictors, among long-term CPAP users. Methods: Cohort of 1,023 OSAS patients had used CPAP on average of 6.6 ± 1.2 years. BMI was determined at baseline and at follow-up visits. There were 7.4 ± 1.7 BMI and 6.5 ± 1.8 CPAP usage measurements per patient on average. Using the Bayesian hierarchical model, we determined the patients' individual trends of BMI and adherence development. Patients with significantly increasing or decreasing trends were identified at the posterior probability level of > 90%. Results: The mean age in the cohort was 55.6 ± 9.8 years, BMI 33.5 ± 6.4 kg/m2, apnea-hypopnea index 33.7 ± 23.1, and CPAP usage 6.0 ± 1.8 h/day. The majority of patients had no significant change in BMI (mean annual weight gain 0.04 ± 0.29 kg/m2) or CPAP adherence (mean annual increase 11.4 ± 7.0 min/day). However, at the individual level, 10% of the patients showed significant annual weight gain (0.63 ± 0.35 kg/m2) during the 5-year follow-up period. At baseline these patients were already more severely obese (mean BMI 40.0 ± 5.9 kg/m2) despite being younger (mean 50.9 ± 9.5 years) than the rest of the cohort. Conclusions: In the majority of CPAP-treated OSAS patients, weight did not significantly change but gained slightly slower than in age-matched population in general. However, in 10% of patients, high adherence to CPAP treatment did not prevent the continuation of weight gain. These patients present a high-risk group for OSAS-related multimorbidity later in life. Citation: Myllylä M, Kurki S, Anttalainen U, Saaresranta T, Laitinen T. High adherence to CPAP treatment does not prevent the continuation of weight gain among severely obese OSAS patients. J Clin Sleep Med 2016;12(4):519–528. PMID:26888588

  7. Auto bi-level pressure relief-PAP is as effective as CPAP in OSA patients--a pilot study.

    PubMed

    Blau, Alexander; Minx, Mihaela; Peter, Jan Giso; Glos, Martin; Penzel, Thomas; Baumann, Gert; Fietze, Ingo

    2012-09-01

    Continuous positive airway pressure (CPAP) is the therapy of choice for the treatment of obstructive sleep apnea (OSA). Not all patients can use CPAP therapy with adequate compliance. There is a need to develop more comfortable modes. Auto bi-level Pressure Relief-Positive Airway Pressure (ABPR-PAP) can be an alternative. We conducted a prospective double-blind, randomised trial to evaluate the efficacy and compliance of ABPR-PAP compared with CPAP in OSA patients. We included 35 CPAP naive patients (age 53.3 ± 10.3 years, BMI 31.0 ± 5.0 kg/m(2), ESS 10.0 ± 4.2) diagnosed with moderate to severe OSA who underwent a successful CPAP titration. Patients were randomised into the CPAP or the ABPR-PAP treatment group. We used the same device (BIPAP® Auto, Philips Respironics) for CPAP or ABPR-PAP. Apnea-hypopnea index (AHI) was determined using polysomnography before (AHI 40.6 ± 18.3 per hour) and after treatment. Eighteen patients received CPAP and the remaining 17 received APBR-PAP. Groups were similar in terms of demographics and OSA severity. There were no serious adverse events during the trial. CPAP was fixed by a sleep expert and ABPR-PAP varied (range 5-15 cmH(2)O). AHI decreased in the CPAP group to 6.4 ± 5.7 per hour and in the ABPR-PAP group to 4.8 ± 3.6 per hour in the first night (N = 35). After 3 months, the AHI decreased in the CPAP group to 4.4 ± 5.3 per hour and in the ABPR-PAP group to 2.6 ± 3.8 per hour (N = 32). Differences between the groups were not statistically significant. There were no differences in compliance. ABPR-PAP is a promising new ventilation mode that enables effective treatment of OSA patients.

  8. A pilot validation study for the NOX T3(TM) portable monitor for the detection of OSA.

    PubMed

    Cairns, Alyssa; Wickwire, Emerson; Schaefer, Edward; Nyanjom, David

    2014-09-01

    The aim of the current pilot study is to compare the diagnostic accuracy of the NOX T3(TM) (T3) portable sleep monitor (PM) to that of simultaneously recorded in-lab polysomnogram (PSG). A total of 40 participants were recruited following face-to-face evaluation at a sleep disorders clinic. Each participant wore both PSG and PM equipment simultaneously during their in-lab PSG. PSG records were manually scored using the American Academy of Sleep Medicine (AASM) criteria, and PM records were double-scored using the device's autoscore algorithm as well as manual scoring. The final sample consisted of 32 participants (56% male, 50% black) with a mean ESS, BMI, and apnea-hypopnea index (AHI) of 10.4, 32.8, and 16.3, respectively. Three participants (7.5%) were excluded for poor PM signal quality. Mean AHI derived from the T3's autoscore algorithm was similar to that from manual scoring (19.6 ± 18.9 vs. 18.6 ± 19.1, respectively). Autoscore-derived T3 AHI and PSG-derived AHI were strongly related (r = .93). The T3 (autoscored AHI) demonstrated a high degree of sensitivity for the presence of obstructive sleep apnea syndrome (OSA; 100%) and acceptable specificity for the exclusion of OSA using an AHI cutoff of ≥5 events/h (70%). The unit (autoscored) had a high degree of both sensitivity (92%) and specificity (85%) when the presence of OSA was defined more conservatively (AHI > 15 events/h). For OSA defined as an AHI of ≥5, the T3 (autoscored) correctly identified 88% of positive cases and 100% of negative cases. In this small, clinic-based sample, the T3 demonstrated very good measurement agreement compared to PSG and a high degree of sensitivity for detecting even mild OSA. False positives appeared to be due to respiratory effort-related arousals (RERAs) being autoscored as obstructive apneas and may be due to inherent discrepancy in flow measurement sensitivity between PSG and portable monitors.

  9. Comparison of Cognitive Functions Between Obstructive Sleep Apnea Syndrome and Simple Snoring Patients: OSAS May Be a Modifiable Risk Factor for Cognitive Decline.

    PubMed

    Arli, Berna; Bilen, Sule; Titiz, Ayse Pinar; Ulusoy, Ersin Kasim; Mungan, Semra; Gurkas, Erdem; Oztekin, Zeynep Nese; Ozcan, Muge; Ak, Fikri

    2015-01-01

    By comparing neurocognitive test results from patients with obstructive sleep apnea syndrome (OSAS) and those from patients with simple snoring, we aimed to establish whether OSAS negatively influences cognition. Patients with mild-to-severe OSAS (n = 29) and nonhypoxic simple-snoring patients (n = 30) were admitted to the study. All participants in both groups were evaluated with polysomnography and neurocognitive tests, including the Stroop Test, Rey Auditory Verbal Learning Test, Judgment of Line Orientation, Trail-Making Test, and Symbol Digit Modalities Test (SDMT). Significant differences were identified between the groups for test scores on the Rey 1, SDMT, and Stroop tests. We propose that accurate OSAS diagnosis and treatment might help to prevent cognitive decline.

  10. Maxillary expansion and maxillomandibular expansion for adult OSA: A systematic review and meta-analysis.

    PubMed

    Abdullatif, Jose; Certal, Victor; Zaghi, Soroush; Song, Sungjin A; Chang, Edward T; Gillespie, M Boyd; Camacho, Macario

    2016-05-01

    This study sought to systematically review the international literature for articles evaluating maxillary expansion and maxillomandibular expansion as treatments for obstructive sleep apnea (OSA) in adults and to perform a meta-analysis. Nine databases (including MEDLINE/PubMed). Searches were performed through January 8, 2016. The PRISMA statement was followed. Eight adult studies (39 patients) reported polysomnography and/or sleepiness outcomes. Six studies reported outcomes for maxillary expansion (36 patients), and the apnea-hypopnea index (AHI) decreased from a mean (M) ± standard deviation (SD) of 24.3 ± 27.5 [95% CI 15.3, 33.3] to 9.9 ± 13.7 [95% CI 5.4, 14.4] events/hr (relative reduction: 59.3%). Maxillary expansion improved lowest oxygen saturation (LSAT) from a M ± SD of 84.3 ± 8.1% [95% CI 81.7, 87.0] to 86.9 ± 5.6% [95% CI 85.1, 88.7]. Maxillomandibular expansion was reported in two studies (3 patients) and AHI decreased from a M ± SD of 47.53 ± 29.81 [95% CI -26.5 to 121.5] to 10.7 ± 3.2 [95% CI 2.8, 18.6] events/hr (relative reduction: 77.5%). Maxillomandibular expansion improved LSAT from a M ± SD of 76.7 ± 14.5% [95% CI 40.7, 112.7] to 89.3 ± 3.1 [95% CI 81.6, 97]. The current literature demonstrates that maxillary expansion can improve and maxillomandibular expansion can possibly improve AHI and LSAT in adults; however, given the paucity of studies, these remain open for additional research efforts. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. All rights reserved.

  11. Summary of IODP Expedition 344, CRISP-A2, offshore the Osa Peninsula, Costa Rica

    NASA Astrophysics Data System (ADS)

    Harris, R. N.; Sakaguchi, A.; Petronotis, K. E.

    2013-12-01

    The Costa Rica Seismogenesis Project (CRISP) is designed to elucidate the processes that control nucleation and seismic rupture of large earthquakes at erosional subduction zones. The CRISP study area is located offshore the Osa Peninsula where the incoming Cocos Ridge has lifted the seismogenic zone to within reach of scientific drilling. The incoming plate is characterized by low sediment supply, a fast convergence rate, abundant plate interface seismicity, and a change in subducting plate relief along strike. In addition to elucidating processes at erosional convergent margins, this project is complementary to other IODP deep fault drilling projects (e.g., NanTroSEIZE and J-FAST). Expedition 344 (23 October - 11 December, 2012) is the second expedition of CRISP Program A (Integrated Ocean Drilling Program Proposal 537A-Full5) that focused on the shallow lithologic, hydrologic, stress, and thermal conditions that lead to unstable slip in the seismogenic zone. With the exception of not reaching the décollement and the underthrust sediment at the toe site (U1412), Expedition 344 exceeded expectations. Material was recovered from the incoming Cocos plate (Sites U1381 and U1414), the toe of the margin (Site U1412), the mid-slope region (Site U1380), and the upper-slope region (Site U1413). Input sites U1381 and U1414 are characterized by anomalously high heat flow and the flow of fluids. These sites contained abundant ash that will be used to assess the impact of Cocos Ridge subduction on the evolution of the Central American volcanic arc. Although toe Site U1412 did not cross the décollement we did penetrate terrigenous sediments interrupted by a Miocene ooze that may reflect accretion of a frontal prism sliver. Mid-slope Site U1380 yielded a major result in that the upper plate material is not a mélange of oceanic material or the offshore extension of the Caribbean large igneous complex, but forearc basin material consisting of lithic sedimentary units. Upper

  12. Do field walking tests produce similar cardiopulmonary demands to an incremental treadmill test in obese individuals with treated OSA?

    PubMed

    Evans, Rachael A; Dolmage, Thomas E; Robles, Priscila G; Goldstein, Roger S; Brooks, Dina

    2014-07-01

    Cardiorespiratory fitness, assessed during cardiopulmonary exercise tests by peak oxygen uptake (Vo2pk), is an independent predictor of mortality in obesity. We investigated whether Vo2pk and systemic responses measured during field walking tests were similar to those measured during an incremental treadmill test (ITMT) in obese individuals with treated OSA. Individuals with treated OSA and a BMI > 30 kg/m2 were recruited. Participants completed an ITMT, two 6-min walk tests (6MWTs), and two incremental shuttle walk tests (ISWTs) on three separate days in a randomized order. Expired gas analysis was performed during all tests. The study was completed by 16 patients (nine men) (mean [SD] age, 58 [12] y; BMI, 36.1 [7.6] kg/m2). There was no difference (P = .27) in Vo2pk assessed by the ITMT and the ISWT (2,266 [478] and 2,017 [561] mL/min, respectively). The Vo2pk measured by the 6MWT (1,778 [360] mL/min) was lower than that measured by the ITMT (P < .01). The limits of agreement for Vo2pk between the ISWT and the ITM were ± 730 mL/min. Cardiorespiratory responses during the ISWT and the ITMT reflected a graded response to a peak, whereas the 6MWT demonstrated a rapid rise to a plateau. The ISWT can be used instead of an ITMT and in preference to the 6MWT to assess cardiorespiratory fitness for a cohort of obese people with treated OSA. However, the imprecision of the agreement in Vo2pk between the ITMT and ISWT means they cannot be used interchangeably in an individual. ClinicalTrials.gov; No.: NCT01930513; www.clinicaltrials.gov.

  13. Treatment of obese patients with obstructive sleep apnea syndrome (OSAS): effect of weight loss and interference of otorhinolaryngoiatric pathology.

    PubMed

    Pasquali, R; Colella, P; Cirignotta, F; Mondini, S; Gerardi, R; Buratti, P; Rinaldi Ceroni, A; Tartari, F; Schiavina, M; Melchionda, N

    1990-03-01

    The role of weight loss in the therapy of obstructive sleep apnea syndrome (OSAS) was investigated in 23 affected patients with various degrees of obesity (body mass index range 26.6-61.0) free of cranio-facial malformations. Weight loss resulted 18.5 +/- 14.7 (s.d.) kg and was significantly correlated with baseline BMI value (r = 0.94; P less than 0.0001). Weight loss significantly reduced the number of apneas + hypopneas per hour of sleep ((A + H)I) from 66.5 +/- 23.0 to 33.0 +/- 26.2 (P less than 0.0001) and improved the mean of oxygen desaturation peaks during apneas (mSaO2) from 81.9 +/- 6.9 to 87.6 +/- 3.9; P less than 0.001). A significant correlation was found between weight loss and changes in the (A + H)I (r = -0.55; P less than 0.01) and the mSaO2 (r = 0.46; P less than 0.05). The (A + H)I significantly improved in both patients who lost more than 10 kg (basal BMI: 42.3 +/- 10.0) and in those who lost less than 10 kg (basal BMI: 30.2 +/- 2.3), whereas the mSaO2 improved only in the former. Obese patients with moderate to heavy ORL pathological findings had worse pretreatment and final OSAS parameters than those with absent or mild ORL lesions. However, both groups showed a significant, although quantitatively different, improvement of the (A + H)I and mSaO2 after weight loss. Compared to those who were cured or improved after the treatment, patients who failed to obtain significant effects on OSAS clinical presentation also had a significantly higher prevalence of ORL pathology. It is concluded that: (1) weight loss improves parameters and clinical presentation of OSAS in the majority of affected obese patients; (2) a relationship exists between the entity of weight loss and that of improvement of the syndrome; (3) weight loss must be encouraged even in patients with mild to moderate overweight; (4) the presence of ORL pathology may represent a confusing factor in the interpretation of the results obtained after weight loss.

  14. Upper airway structural changes induced by CPAP in OSAS patients: a study using drug-induced sleep endoscopy.

    PubMed

    Jung, Sung Hoon; Koo, Soo Kweon; Choi, Jang Won; Moon, Ji Seung; Lee, Sang Hoon

    2017-01-01

    We studied upper airway structural changes induced by continuous positive airway pressure (CPAP) in obstructive sleep apnea syndrome (OSAS) patients using drug-induced sleep endoscopy (DISE). This prospective study was conducted at an academic secondary referral center. In total, 28 male OSAS patients (mean age 41.1 years) with only retropalatal level obstructions were enrolled. Measurements of the obstruction site were obtained in two steps: first a measurement was taken of the obstruction site in accordance with sleep apnea, then, a measurement was taken of the obstruction site in accordance with DISE-assisted CPAP titration, including quantitative changes in the occlusion site before and after CPAP in pixel format using an area calculation program. There was a tendency for persistent closing in cases of antero-posterior (AP) obstruction versus cases of lateral (Lat) obstruction in the CPAP titration. Lat obstructions showed a tendency to be wider than AP obstructions in the quantitative analysis. These results show that the pattern and degree of airway expansion after CPAP differ in accordance with the obstruction site.

  15. Michels syndrome, Carnevale syndrome, OSA syndrome, and Malpuech syndrome: variable expression of a single disorder (3MC syndrome)?

    PubMed

    Titomanlio, Luigi; Bennaceur, Selim; Bremond-Gignac, Dominique; Baumann, Clarisse; Dupuy, Olivier; Verloes, Alain

    2005-09-01

    We report on a 3-year-old girl with Michels syndrome, a rare condition characterized by craniosynostosis, blepharophimosis, ptosis, epicanthus inversus, cleft lip/palate, abnormal supra-umbilical abdominal wall, and mental deficiency. The phenotypic findings are compared with the six previously reported Michels cases, and with patients referred to as Carnevale, OSA, and Malpuech syndromes. Michels syndrome is characterized by cleft lip and palate, anterior chamber anomalies, blepharophimosis, epicanthus inversus, and craniosynostosis. Carnevale syndrome shows hypertelorism, downslanting palpebral fissures, ptosis, strabismus synophrys, large and fleshy ears, and lozenge-shaped diastasis around the umbilicus. OSA syndrome resembles Carnevale, with humeroradial synostoses, and spinal anomalies as extra features. Malpuech syndrome shows IUGR, hypertelorism, cleft lip and palate, micropenis, hypospadias, renal anomalies, and caudal appendage. All are autosomal recessive. Despite the presence of apparently distinctive key features, it appears that these four entities share multiple similarities in the facial Gestalt and the pattern of MCA. Those similarities lead us to postulate that they belong to the same spectrum, which could be referred to as "3MC syndrome" (Malpuech-Michels-Mingarelli-Carnevale syndrome).

  16. Identification of impact damage in sandwich structures by application of high speed MEMS-OSA to FBG sensors

    NASA Astrophysics Data System (ADS)

    Okabe, Y.; Minakuchi, S.; Takeda, N.

    2005-05-01

    In this research, the authors developed various detection techniques for particular damages, such as debonding and impact damage, in sandwich panels consisting of composite face-sheets and aluminum honeycomb core with small-diameter optical fiber sensors. First, two methods for debonding detection were established taking advantage of the behavior of fillets formed on the adhesive layer between the core and the skin. One method uses the fracture of optical fibers, and the other one uses the shape recovery of the reflection spectrum from a fiber Bragg grating (FBG) sensor because of the release of thermal residual stress in the fillets. Secondly, as for impact damages, chirped FBG sensors were applied to monitor the change in strain distribution of the face-sheet due to the dent caused by the impact loadings. Furthermore, a newly developed MEMS-optical spectrum analyzer (MEMS-OSA) was introduced to identification of impact points and damages. This system could measure the reflection spectrum at very high speed. The change in the form of the reflection spectrum during the impact loading was found to be different depending on the impact energy and the impact location, and this tendency was confirmed by theoretical simulations using the change in the strain distribution obtained by foil strain gauges. These results show that the high speed measurement of the reflection spectrum by MEMS-OSA has a potential to identify the impact location and damage magnitude through the comparison with theoretical simulations.

  17. Uniformities in OSA-UCS and in NCS tested by color difference prediction based on principal hue components

    NASA Astrophysics Data System (ADS)

    Indow, Tarow

    2002-06-01

    The OSA uniform color system is a 3-D collection of color samples according to the regular rhombohedral structure in which each color is surrounded by its 12 nearest neighbors, all perceptually equally different (local uniformity). The Swedish NCS system is a 3-D collection of color samples that vary gradually in each of the three perceptual attributes. It is not clear that this arrangement implies all neighboring pairs along the respective coordinates being perceptually equally different (local uniformity). Of pairs (j,k) of interest, predicted color differences djk were calculated that have the following property. Suppose an observer selects a pair of Munsell grays (Va, Vb) that matches in size with the color difference between (j,k), then djk=|Va-Vb| is predicted by djk, on the average, with error of 0.34 in Munsell V-unit. Variation of djk in this unit was in the order of 0.22V for nearest neighboring pairs (j,k) in various cleavage planes of OSA-UCS and in the order of 0.11V for neighboring pairs (j,k) along s-coordinate and c-coordinate in sheets with fixed hue of NCS. Both were well within the prediction error range, but some systematic trends in values of djk were found.

  18. One night's CPAP withdrawal in otherwise compliant OSA patients: marked driving impairment but good awareness of increased sleepiness.

    PubMed

    Filtness, Ashleigh J; Reyner, Louise A; Horne, James A

    2012-09-01

    Obstructive sleep apnoea (OSA) patients effectively treated by and compliant with continuous positive air pressure (CPAP) occasionally miss a night's treatment. The purpose of this study was to use a real car interactive driving simulator to assess the effects of such an occurrence on the next day's driving, including the extent to which these drivers are aware of increased sleepiness. Eleven long-term compliant CPAP-treated 50-75-year-old male OSA participants completed a 2-h afternoon, simulated, realistic monotonous drive in an instrumented car, twice, following one night: (1) normal sleep with CPAP and (2) nil CPAP. Drifting out of road lane ('incidents'), subjective sleepiness every 200 s and continuous electroencephalogram (EEG) activities indicative of sleepiness and compensatory effort were monitored. Withdrawal of CPAP markedly increased sleep disturbance and led to significantly more incidents, a shorter 'safe' driving duration, increased alpha and theta EEG power and greater subjective sleepiness. However, increased EEG beta activity indicated that more compensatory effort was being applied. Importantly, under both conditions, there was a highly significant correlation between subjective and EEG measures of sleepiness, to the extent that participants were well aware of the effects of nil CPAP. Patients should be aware that compliance with treatment every night is crucial for safe driving.

  19. Nasal Dilators (Breathe Right Strips and NoZovent) for Snoring and OSA: A Systematic Review and Meta-Analysis

    PubMed Central

    Malu, Omojo O.; Kram, Yoseph A.; Song, Sungjin A.; Tolisano, Anthony M.; Kushida, Clete A.

    2016-01-01

    Objective. To systematically review the international literature for studies evaluating internal (NoZovent) and external (Breathe Right Strips) nasal dilators as treatment for obstructive sleep apnea (OSA). Study Design. Systematic review with meta-analysis. Methods. Four databases, including PubMed/MEDLINE, were searched through September 29, 2016. Results. One-hundred twelve studies were screened, fifty-eight studies were reviewed, and fourteen studies met criteria. In 147 patients, the apnea-hypopnea index (AHI) was reported, and there was an improvement from a mean ± standard deviation (M ± SD) of 28.7 ± 24.0 to 27.4 ± 23.3 events/hr, p value 0.64. There was no significant change in AHI, lowest oxygen saturation, or snoring index in OSA patients when using nasal dilators. However, a subanalysis demonstrated a slight reduction in apnea index (AI) with internal nasal dilators (decrease by 4.87 events/hr) versus minimal change for external nasal dilators (increase by 0.64 events/hr). Conclusion. Although nasal dilators have demonstrated improved nasal breathing, they have not shown improvement in obstructive sleep apnea outcomes, with the exception of mild improvement in apnea index when internal nasal dilators were used. PMID:28070421

  20. [Treatment compliance with continuous positive airway pressure device among adults with obstructive sleep apnea (OSA): how many adhere to treatment?].

    PubMed

    Sarrell, E Michael; Chomsky, Ofer; Shechter, Dalia

    2013-03-01

    Obstructive sleep apnea syndrome (OSA) afflicts approximately 5% of the adult population and increases with age. The gold standard treatment is with the Continuous Positive Airways Pressure (CPAP) machine. Well-designed prospective trials to elucidate long term compliance with CPAP machine are rare. Assessing compliance and long-term use of CPAP machines among patients with OSA who were referred for treatment with this machine. A 4 years prospective cohort observational study was conducted using telephone interviews of 371 newly diagnosed patients with moderate to severe OSA, who received a specialist recommendation to use the CPAP machine which was bought and adjusted to their use. At the end of the first year, 126 (34%) of the OSA patients used the CPAP machine on a nightly basis (regular users), 120 (32.3%) had not used it at all, and 125 (33.7%) had used it only intermittently. The number of regular users increased between the 1st and 2nd year from 126 (34%), to 163 (44%) (p < 0.07) due to additions from the intermittent users group. The non-users group grew from 120 (32.3%) in the first year, and every year afterwards, up to 221 (59.6%) in the fourth year (p < 0.02). In contrast, there was a significant decrease in the intermittent users group, which declined from 125 (33.7%) in the first year to only 18 (4.8%) in the 4th year (p < 0.005). Most of the patients (92.9%) were males. The average age of the regular users was 59.6 years (+/- 11), which was higher in comparison to 55.9 years (+/- 10.3) for the non-users or 58.9 years (+/- 12.6) among the intermittent users (p = 0.064). There were no statistical differences in co-morbidities or demographics between the three groups. However, the regular users were found to have a higher score in the Epworth Sleepiness Scale (ESS) and a minimal arterial oxygen saturation (SaO2) level lower than the patients in the non-users and intermittent users groups (p = 0.019 and p = 0.03 respectively). Four years follow

  1. Therapeutic outcomes of mandibular advancement devices as an initial treatment modality for obstructive sleep apnea

    PubMed Central

    Park, Pona; Jeon, Hyoung Won; Han, Doo Hee; Won, Tae-Bin; Kim, Dong-Young; Rhee, Chae-Seo; Kim, Hyun Jik

    2016-01-01

    Abstract Although continuous positive airway pressure (CPAP) is a highly efficacious treatment for obstructive sleep apnea (OSA), there is a need for alternative treatment options, such as sleep surgeries and mandibular advancement devices (MADs), to overcome the limitations of CPAP. This study aimed to analyze the therapeutic outcomes of OSA subjects who were treated with a MAD, and to estimate the clinical impact of MAD as a first-line treatment for OSA. Forty-seven patients diagnosed with OSA received an adjustable MAD as an initial treatment. Drug-induced sleep endoscopic findings and sleep parameters (both pre-MAD and post-MAD treatment), such as apnea index, oxygen saturation, and degree of daytime sleepiness, were assessed retrospectively. The MAD treatment resulted in a significant reduction in apnea–hypopnea index, and also a significant elevation in lowest oxygen saturation. Satisfactory results of MAD treatment as a first treatment modality were observed in 27 patients, and a successful outcome was reached in approximately 72% of patients. The OSA patients who had lower body mass index and upper airway narrowing at the level of palate and tongue base showed relatively higher rates of a satisfactory outcome even in cases of moderate or severe OSA. These results suggest that the use of a MAD may be an alternative treatment option in OSA patients with retropalatal and retroglossal area narrowing regardless of disease severity. Additionally, MADs can be recommended as an initial treatment modality, and the effectiveness of MADs in achieving success may not be inferior to CPAP. PMID:27861349

  2. Does a patient's Mallampati score predict outcome after maxillomandibular advancement for obstructive sleep apnoea?

    PubMed

    Islam, Shofiq; Selbong, Uthaya; Taylor, Christopher J; Ormiston, Ian W

    2015-01-01

    The Mallampati airway classification has been used to estimate the success of uvulopalatopharyngoplasty in patients with obstructive sleep apnoea (OSA) but its predictive value in maxillomandibular advancement has not been proved. We aimed to explore the association between preoperative Mallampati scores and surgical outcome after bimaxillary advancement for OSA. We retrospectively analysed data on 50 patients who had maxillofacial operations for OSA at our hospital and stratified them into two groups based on Mallampati scores: high (class III/IV) and low (class I/II). We compared pre- and postoperative apnoea/hypopnoea indices (AHIs), Epworth sleepiness scores, and lowest recorded oxygen saturation in both groups. The postoperative values for all three outcome measures were not significantly different when patients were stratified according to the Mallampati classification (mean (SD) AHI was 41(19) before and 7 (6) after operation in the low group, and 42 (15) before and 9 (7) after in the high group). Success rates (AHI less than 15 postoperatively) were similar in both low and high score groups (p>0.05). Maxillomandibular advancement alleviates obstruction at multiple levels and our study has shown comparable surgical outcomes in both groups. The Mallampati score can be used to optimise patient selection for surgeons considering single-level procedures for OSA. Our study suggests that the Mallampati classification is less useful for the prediction of surgical outcome after maxillomandibular advancement surgery.

  3. [Maxillomandibular advancement surgery as an optional therapy for patiens with severe obstructive sleep apnoea].

    PubMed

    de Ruiter, M H T; Apperloo, R C; de Lange, J

    2013-09-01

    Obstructive sleep apnoea (OSA) is a common chronic disorder which often requires lifelong treatment. Its prevalence in the Netherlands is estimated to be around 300.000 people. In this study 12 patients with severe OSA were treated with maxillomandibular advancement surgery between 2011 and 2012. The mean advancement during surgery was 8.7 mm and the mean postoperative admission was 4 days. All patients underwent polysomnography at 3 months. Three months after surgical treatment, the apnoea-hypopnea index had decreased with 74.9% (57.3 to 14.4). The subjective sleepiness of the patients had also decreased with a mean of 57.5%. The literature indicates comparable results in patients with severe OSAS, specifically a reduction of the apnoea-hypopnea index of 80-90%. Considering the successful results following maxillomandibular advancement surgery, this therapy is an appropriate alternative for patients who cannot cope with 'continuous positive airway pressure' or patients who want a permanent therapeutic solution. Further research is recommended to achieve higher levels ofevidence for maxillomandibular advancement surgery in patients with OSA.

  4. The effect of continuous positive air pressure (CPAP) on nightmares in patients with posttraumatic stress disorder (PTSD) and obstructive sleep apnea (OSA).

    PubMed

    Tamanna, Sadeka; Parker, Jefferson D; Lyons, Judith; Ullah, M I

    2014-06-15

    Post-Traumatic Stress Disorder (PTSD) is increasingly prevalent among Veterans characterized by recurrent nightmare and disrupted sleep. Veterans with PTSD also have a high prevalence of obstructive sleep apnea (OSA) and untreated OSA worsens the sleep-related symptoms of PTSD. In our study, we hypothesized that among PTSD-afflicted Veterans with OSA, CPAP therapy may reduce the frequency of nightmares and a better CPAP compliance may be associated with increased symptom improvement. We retrospectively reviewed medical records to identify OSA patients treated in a VA medical center who also carried a diagnosis of PTSD (n = 69). Data about patient characteristics and polysomnographic findings were extracted. Repeated-measures t-tests were performed, comparing mean nightmare frequency and Epworth sleepiness score (ESS) before and after CPAP treatment. Multiple linear regressions were done to identify factors predicting CPAP compliance. A logistic regression analysis was also done to estimate the odds of subjective improvement in PTSD symptoms with CPAP. CPAP therapy reduced the mean ESS from 14.62 to 8.52 (p < 0.001) and the mean number of nightmares per week from 10.32 to 5.26 (p < 0.01). Reduced nightmare frequency after CPAP treatment was best predicted by CPAP compliance (p < 0.001). Every 10% increase in CPAP compliance almost doubled the odds of benefitting by CPAP (odds ratio = 1.92, 95% CI = 1.47-2.5). In Veterans with PTSD and OSA, CPAP therapy reduces PTSD-associated nightmares and improves overall PTSD symptoms. We recommend that all PTSD patients should be screened clinically for symptoms of OSA and receive CPAP treatment whenever possible to improve PTSD symptoms.

  5. PREVALENCE AND FACTORS ASSOCIATED WITH VITAMIN B12 DEFICIENCY IN ELDERLY FROM VIÇOSA/MG, BRASIL.

    PubMed

    Oliveira Martinho, Karina; Luiz Araújo Tinôco, Adelson; Queiroz Ribeiro, Andréia

    2015-11-01

    La prevalencia de deficiencia nutricional de vitamina B12 aumenta con la edad y es especialmente común en la población mayor. El objetivo de este estudio consistió en determinar su prevalencia y los factores asociados a esta carencia en mayores no institucionalizados de Viçosa, Estado de Minas Gerais, Brasil. Métodos: estudio poblacional interseccional, realizado para identificar la prevalencia y los factores asociados a deficiencia de vitamina B12 entre la población de mayores en Viçosa (MG). Los datos fueron recopilados desde agosto de 2011 hasta junio de 2012 mediante una encuesta en los hogares y pruebas hematológicas y bioquímicas realizadas en 340 mayores. Resultados: la prevalencia de deficiencia de vitamina B12 en este grupo fue del 17,4% (95% CI, 13,4% - 21,4%). La deficiencia cognitiva se presenta como un factor importante relacionado con la deficiencia de vitamina B12. Conclusiones: el informe actual contribuye a los estudios que destacan ciertos factores que podrían afectar al rendimiento de las personas mayores en su proceso de envejecimiento natural, especialmente cuando estos factores están asociados con deficiencia cognitiva y dan lugar a una discapacidad significativa así como pérdida de calidad de vida. Así, los resultados aquí presentados han servido para aportar un conocimiento más comprensivo sobre la relación entre deficiencia de B12 y su impacto sobre este grupo de población. También han demostrado su relevancia de cara a la planificación de programas e iniciativas de salud pública centrados en este grupo de población.

  6. Preservation of Oxygen Isotope Stage 3 Marine Terrace Deposits along the Southwest Coast of the Osa Peninsula, Corcovado National Park, Costa Rica

    NASA Astrophysics Data System (ADS)

    Hoffman, W. N.; Sak, P. B.

    2007-12-01

    Subduction of the aseismic Cocos Ridge at the Middle American Trench outboard of the Osa Peninsula results in rapid late Quaternary surface uplift. The distribution of surface uplift corresponds with the imaged bathymetric relief. On the Osa Peninsula, inboard of the northwest flank of the Cocos Ridge, exposures of the Late Pleistocene Puerto Armuelles Formation are recognized. The Puerto Armuelles Fm consists of poorly consolidated sands, silts, and muds from shallow marine, estuarine, and mangrove systems. Along the southwest coast, Puerto Armuelles Fm sediment infills paleo-topographic depressions. AMS radiocarbon dates obtained on 4 marine macrofossil samples yield ages ranging from 38.51 ka B.P. to 42.35 ka B.P. Dates obtained on multiple samples from individual sections are internally consistent, recording younger ages at higher stratigraphic levels within two fining upward deposits. The sections are displaced relative to one another across a northeast striking fault. The two measured stratigraphic sections are used to quantify a minimum Late Pleistocene to recent separation rate of 0.54 m ka-1. A suite of 15 radiocarbon dates on exposures of the Puerto Armuelles Fm from the eastern portion of the Osa Peninsula (Gardner et al., 1992) and 14 radiocarbon dates obtained from equivalent strata along the northwestern portions of the Osa Peninsula (Sak et al., 2004) clearly and consistently indicate a Late Pleistocene age of deposition during Oxygen Isotope Stage 3.

  7. Capability of Paraguaçu estuary (Todos os Santos Bay, Brazil) to form oil-SPM aggregates (OSA) and their ecotoxicological effects on pelagic and benthic organisms.

    PubMed

    Rios, Mariana C; Moreira, Ícaro T A; Oliveira, Olívia M C; Pereira, Taís S; de Almeida, Marcos; Trindade, Maria Clara L F; Menezes, Leonardo; Caldas, Alex S

    2017-01-15

    For experiments concerning the formation of oil-suspended particulate matter (SPM) aggregates (OSA), oil and sediment samples were collected from Campos Basin and six stations of Paraguaçu estuary, Todos os Santos Bay, Brazil, respectively. The sediments samples were analyzed for organic matter determined by the EMBRAPA method, nitrogen determined by the Kjeldahl method, and phosphorus determined by the method described by Aspila. The oil trapped in OSA was extracted following the method described by Moreira. The experiment showed a relationship between the amount of organic matter and OSA formation and consequently the dispersion of the studied oil. On the basis of the buoyancy of OSA and the ecotoxicological effects on pelagic and benthic community, the priority areas for application of remediation techniques are Cachoeira, Maragogipe, and Salinas da Margarida because of the large amount of oil that accumulated at the bottom of the experiment flask (5.85%, 27.95%, and 38,98%; 4.2%, 17.66%, and 32.64%; and 11.82%, 8.07%, and 10.91% respectively).

  8. [Application medical history indicators and goals for the diagnosis of OSAS in a cohort of workers of the private car transportation: results of a year of health surveillance].

    PubMed

    Romano, C; Ricco, G; Launaro, N; Ceccarelli, M; Cravero, A; Manassero, F

    2012-01-01

    Even though Obstructive Sleep Apnea Syndrome (OSAS) is one of the main causes of daytime sleepiness with high subsequent risk for causing vehicle accidents, its evaluation is not usually included among the criteria used for the certification of job fitness among professional drivers. In order to assess the feasibility of a screening method that allows the occupational physician to identify the subjects at risk for OSAS which should undergo second level tests (cardiorespiratory monitoring), we recorded and subsequently processed appropriate subjective and objective indicators among 455 professional drivers employed in private transportation companies. Only 17 subjects (47%) out of 36 tested positive underwent cardiorespiratory monitoring (due to technical and organizational difficulties and to the poor compliance of workers). OSAS was confirmed in 15 subjects out of 17 showing an excellent positive predictive value of the screening. Risk management for OSAS is currently unavoidable yet not formally provided by law. Our results show the possibility of completing the health surveillance program with feasible and valuable screening tests. Difficulties (hardly compliant with a timely certification of the job fitness) arise instead as far as second level confirmatory procedures are involved.

  9. Osa Protein Constitutes a Strong Oncogenic Suppression System That Can Block vir-Dependent Transfer of IncQ Plasmids between Agrobacterium Cells and the Establishment of IncQ Plasmids in Plant Cells

    PubMed Central

    Lee, Lan-Ying; Gelvin, Stanton B.

    2004-01-01

    The osa (oncogenic suppressive activity) gene of the IncW group plasmid pSa is sufficient to suppress tumorigenesis by Agrobacterium tumefaciens. osa confers oncogenic suppression by inhibiting VirE2 protein export. This result is similar, but not identical, to that of oncogenic suppression by the IncQ plasmid RSF1010. We conducted a series of experiments to compare oncogenic suppression by these two systems. Agrobacterium strains harboring plasmids containing osa are more able to effect oncogenic suppression than are similar strains containing various RSF1010 derivatives. When osa is present within a donor Agrobacterium strain that also carries a derivative of RSF1010, the transfer of RSF1010 derivatives to recipient bacteria and their establishment in plants are blocked. Oncogenic suppression is still effected when the osa gene is integrated into the Agrobacterium chromosome, suggesting that it is the osa gene product that is active in suppression and that suppression does not require a protein-nucleic acid intermediate like that described for IncQ plasmids. Extracellular complementation experiments with tobacco leaf disks indicated that Osa blocks stable transfer of RSF1010 to plant cells by inhibiting transfer of VirE2, which is essential for the transfer of RSF1010 into plant cells, and not by inhibiting the actual transfer of RSF1010 itself. Our results suggest that Osa and RSF1010 cause oncogenic suppression by using different mechanisms. PMID:15489437

  10. Minimizing the mandibular advancement in an oral appliance for the treatment of obstructive sleep apnea.

    PubMed

    Anitua, Eduardo; Durán-Cantolla, Joaquín; Almeida, Gabriela Zamora; Alkhraisat, Mohammad Hamdan

    2017-06-01

    In the treatment of obstructive sleep apnea (OSA) with an oral appliance (OA), there is no gold standard method to fine-tune the mandibular advancement. This study aimed to analyze the effect of gradual increment of mandibular advancement on the evolution of the apnea-hypopnea index (AHI). OSA patients were recruited from a sleep unit. All treatments started with an oral appliance without mandibular advancement. After two weeks, the AHI was assessed with respiratory polygraphy. Mandibular advancement was initiated with a step size of 1 mm and evolution in the AHI was assessed. The target protrusion was the one that achieved the highest reduction in AHI and the least side effects. Anthropometric data, sleep questionnaire and Epworth sleepiness scale score were obtained. Thirty six patients (22 men) participated in this study. The patient's mean age was 57 ± 12 years and the body mass index was 25.4 ± 4.1 kg/m(2). The oral appliance reduced the AHI from 20.8 ± 12.9/h to 8.4 ± 5.1/h (P = 0.000). Ten of the 26 patients with ≥50% reduction in AHI (39%) had zero advancement. The mean mandibular advancement was 1.7 ± 1.5 mm achieving ≥50% reduction in AHI in 72% of the patients. Twenty seven patients had an AHI <10/h. Of the 21 patients with moderate-severe OSA, 17 had the highest decrease in the AHI in a mandibular advancement ≤3 mm. Monitoring the subjective symptoms of the patient and objective evolution in the AHI could minimize the mandibular advancement needed for the treatment of OSA. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Cardiovascular and psychiatric morbidity in obstructive sleep apnea (OSA) with insomnia (sleep apnea plus) versus obstructive sleep apnea without insomnia: a case-control study from a Nationally Representative US sample.

    PubMed

    Gupta, Madhulika A; Knapp, Katie

    2014-01-01

    To evaluate cardiovascular and psychiatric morbidity in patient visits with obstructive sleep apnea (OSA) with insomnia (OSA+Insomnia) versus OSA without insomnia (OSA-Insomnia) in a nationally representative US sample. A retrospective case-control study of epidemiologic databases (National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey) representing an estimated ± standard error (SE) 62,253,910 ± 5,274,747 (unweighted count=7234) patient visits with diagnosis of OSA from 1995-2010, was conducted. An estimated 3,994,104 ± 791,386 (unweighted count=658) were classified as OSA+Insomnia and an estimated 58,259,806 ± 4,849,800 (unweighted count=6576) as OSA-Insomnia. Logistic regression analysis was carried out using OSA+Insomnia versus OSA-Insomnia as the dependent variable, and age (>50 years versus ≤ 50 years), sex, race ('White' versus 'non-White'), essential hypertension, heart failure, ischemic heart disease, cardiac dysrhythmia, cerebrovascular disease, diabetes, obesity, hyperlipidemia, depressive, anxiety, and adjustment disorders (includes PTSD), hypersomnia and all medications used as independent variables. All comorbidities were physician diagnosed using the ICD9-CM. Among patient visits with OSA, an estimated 6.4%± 0.9% also had insomnia. Logistic regression analysis revealed that the OSA+Insomnia group was significantly more likely to have essential hypertension (all ICD9-CM codes 401) (OR=1.83, 95% CI 1.27-2.65) and provisionally more likely to have cerebrovascular disease (ICD9-CM codes 430-438) (OR=6.58, 95% CI 1.66-26.08). The significant OR for cerebrovascular disease was considered provisional because the unweighted count was <30. In a nationally representative sample, OSA+Insomnia was associated significantly more frequently with essential hypertension than OSA-Insomnia, a finding that has not been previously reported. In contrast to studies that have considered patient self-reports of psychological

  12. Advanced age and apnea-hypopnea index predict subclinical atherosclerosis in patients with obstructive sleep apnea syndrome.

    PubMed

    Arik, Bilal; Inci, Mehmet Fatih; Gumus, Cesur; Varol, Kenan; Ege, Meltem Refiker; Dogan, Omer Tamer; Zorlu, Ali

    2013-02-06

    Both obstructive sleep apnea syndrome (OSAS) and coronary artery calcification (CAC) are considered to be related with the presence of coronary artery disease (CAD). In this study we evaluate the association between OSAS and presence of subclinical atherosclerosis assessed by tomographic coronary calcium score in patients who had OSAS but no history of known CAD. Seventy-three patients who were asymptomatic for CAD and had suspected OSAS were referred to overnight attended polysomnography. Patients were classified into 4 groups according to the Apnea-Hypopnea Index (AHI). All patients underwent computed tomographic examination for tomographic coronary calcification scoring. Physical examination, sleep study recordings, complete blood count and serum biochemistry were obtained from all patients. In the whole group, AHI levels were weakly correlated with coronary calcium score (r = 0.342, p = 0.003) and body mass index (r = 0.337, p = 0.004), moderately correlated with basal oxygen saturation (r = -0.734, p < 0.001), and strongly correlated with oxygen desaturation index (r = 0.844, p < 0.001). In an univariate analysis, age, AHI, basal oxygen saturation, and oxygen desaturation index were associated with CAC in patients with OSAS. In a multiple logistic regression model, age (OR 1.108,%95 CI 1.031-1.191, p = 0.005) and AHI (OR 1.036,% 95 CI 1.003-1.070, p = 0.033) were only independent predictors of CAC in patients with OSAS with a sensitivity of 88.9% and 77.8% and a specificity of 54.3% and 56.5% respectively. Our findings suggest that in patients with moderate or severe OSAS and advanced age, physicians should be alert for the presence of subclinical atherosclerosis.

  13. Control of OSA during automatic positive airway pressure titration in a clinical case series: predictors and accuracy of device download data.

    PubMed

    Huang, Hsin-Chia Carol; Hillman, David R; McArdle, Nigel

    2012-09-01

    To investigate the factors associated with physiologic control of obstructive sleep apnea (OSA) during automatic positive airway pressure (APAP) titration in a clinical series. To also assess the usefulness of apnea-hypopnea index (AHI) data downloaded from the APAP device (Dev AHI). Retrospective review of a consecutive series of patients with OSA who underwent APAP titration (Autoset Spirit, ResMed, Bella Vista, New South Wales, Australia ) with simultaneous polysomnographic (PSG) monitoring in the sleep laboratory. Tertiary sleep clinic. There were 190 consecutive patients with OSA referred for APAP titration. There were 58% of patients who achieved optimal or good control of OSA (titration PSG AHI < 10, or at least 50% reduction in AHI if diagnostic AHI < 15/hr) during APAP titration. The independent predictors of titration PSG AHI were a history of cardiac disease and elevated central apnea and arousal indices during the diagnostic study. Although the median and interquartile range (IQR) AHI from the device (7.0, 3.9-11.6 events/hr) was only slightly less than the PSG AHI (7.8, 3.9-14.4 events/hr, P = 0.04) during titration, case-by-case agreement between the two measures was poor (chi-square < 0.001). In a clinical sample control of OSA during APAP titration is often poor, and close clinical follow-up is particularly needed in patients with a history of cardiac disease or with high arousal or central apnea indices on the diagnostic study. Device AHI does not reliably assess control during APAP titration, and PSG assessment may be required if clinical response to treatment is poor. The findings relate to the ResMed AutoSet device and may not apply to other devices.

  14. The Effect of CPAP in Normalizing Daytime Sleepiness, Quality of Life, and Neurocognitive Function in Patients with Moderate to Severe OSA

    PubMed Central

    Antic, Nick A.; Catcheside, Peter; Buchan, Catherine; Hensley, Michael; Naughton, Matthew T.; Rowland, Sharn; Williamson, Bernadette; Windler, Samantha; McEvoy, R. Doug

    2011-01-01

    Study Objectives: The study aimed to document the neurobehavioral outcomes of patients referred to and treated by a sleep medicine service for moderate to severe obstructive sleep apnea (OSA). In particular, we aimed to establish the proportion of patients who, while appearing to have optimal continuous positive airway pressure (CPAP) adherence, did not normalize their daytime sleepiness or neurocognitive function after 3 months of CPAP therapy despite effective control of OSA. Design: Multicenter clinical-effectiveness study. Setting: Three academic sleep centers in Australia. Participants: Patients referred to a sleep medicine service with moderate to severe OSA (n = 174). Intervention: CPAP. Measurements and Results: Participants were assessed pretreatment and again after 3 months of CPAP therapy. At the beginning and at the conclusion of the trial, participants completed a day of testing that included measures of objective and subjective daytime sleepiness, neurocognitive function, and quality of life. In patients with symptomatic moderate to severe OSA (i.e., apnea-hypopnea index > 30/h), we found a treatment dose-response effect for CPAP in terms of Epworth Sleepiness Scale scores (P < 0.001). Several key indexes of neurobehavior (e.g., Functional Outcomes of Sleep Questionnaire, Epworth Sleepiness Scale) currently used to assess treatment response failed to normalize in a substantial group of patients after 3 months of CPAP treatment, even in those who were maximally compliant with treatment. Forty percent of patients in this trial had an abnormal Epworth Sleepiness Scale score at the conclusion of the trial. In addition, we showed no dose-response effect with the Maintenance of Wakefulness Test, raising doubts as to the clinical utility of the Maintenance of Wakefulness Test in assessing treatment response to CPAP in patients with OSA. Conclusions: Our study suggests that a greater percentage of patients achieve normal functioning with longer nightly CPAP

  15. Control of OSA During Automatic Positive Airway Pressure Titration in a Clinical Case Series: Predictors and Accuracy of Device Download Data

    PubMed Central

    Huang, Hsin-Chia Carol; Hillman, David R.; McArdle, Nigel

    2012-01-01

    Study Objectives: To investigate the factors associated with physiologic control of obstructive sleep apnea (OSA) during automatic positive airway pressure (APAP) titration in a clinical series. To also assess the usefulness of apnea-hypopnea index (AHI) data downloaded from the APAP device (Dev AHI). Design: Retrospective review of a consecutive series of patients with OSA who underwent APAP titration (Autoset Spirit, ResMed, Bella Vista, New South Wales, Australia ) with simultaneous polysomnographic (PSG) monitoring in the sleep laboratory. Setting: Tertiary sleep clinic. Participants: There were 190 consecutive patients with OSA referred for APAP titration. Measurements and Results: There were 58% of patients who achieved optimal or good control of OSA (titration PSG AHI < 10, or at least 50% reduction in AHI if diagnostic AHI < 15/hr) during APAP titration. The independent predictors of titration PSG AHI were a history of cardiac disease and elevated central apnea and arousal indices during the diagnostic study. Although the median and interquartile range (IQR) AHI from the device (7.0, 3.9-11.6 events/hr) was only slightly less than the PSG AHI (7.8, 3.9-14.4 events/hr, P = 0.04) during titration, case-by-case agreement between the two measures was poor (chi-square < 0.001). Conclusion: In a clinical sample control of OSA during APAP titration is often poor, and close clinical follow-up is particularly needed in patients with a history of cardiac disease or with high arousal or central apnea indices on the diagnostic study. Device AHI does not reliably assess control during APAP titration, and PSG assessment may be required if clinical response to treatment is poor. The findings relate to the ResMed AutoSet device and may not apply to other devices. Citation: Huang HCC; Hillman DR; McArdle N. Control of OSA during automatic positive airway pressure titration in a clinical case series: predictors and accuracy of device download data. SLEEP 2012;35(9):1277

  16. Altered gut-liver axis and hepatic adiponectin expression in OSAS: novel mediators of liver injury in paediatric non-alcoholic fatty liver.

    PubMed

    Nobili, Valerio; Alisi, Anna; Cutrera, Renato; Carpino, Guido; De Stefanis, Cristiano; D'Oria, Valentina; De Vito, Rita; Cucchiara, Salvatore; Gaudio, Eugenio; Musso, Giovanni

    2015-08-01

    Mechanism(s) connecting obstructive sleep apnoea syndrome (OSAS) to liver injury in paediatric non-alcoholic fatty liver disease (NAFLD) are unknown. We hypothesised alterations in gut-liver axis and in the pool and phenotype of hepatic progenitor cells (HPCs) may be involved in OSAS-associated liver injury in NAFLD. Eighty biopsy-proven NAFLD children (age, mean±SD, 11.4±2.0 years, 56% males, body mass index z-score 1.95±0.57) underwent a clinical-biochemical assessment, with measurement of insulin sensitivity, plasma cytokines, lipopolysaccharide (LPS), an intestinal permeability test and a standard polysomnography. Hepatic toll-like receptor (TLR)-4 expression by liver-resident cells and overall number and expression of resistin and adiponectin by HPCs were assessed by immunofluorescence and immunohistochemistry. OSAS was defined by an apnoea/hypopnoea index ≥1. OSAS was characterised by an increased intestinal permeability and endotoxemia, coupled with TLR-4 upregulation in hepatocytes, Kupffer and hepatic stellate cells (HSCs) and by an expansion of an adiponectin-deficient HPC pool, key features of steatohepatitis and fibrosis.The duration of haemoglobin desaturation (SaO2 <90%) independently predicted intestinal permeability (β: 0.396; p=0.026), plasma LPS (β: 0.358; p=0.008) and TLR-4 expression by hepatocytes (β: 0.332; p=0.009), Kupffer cells (β: 0.357; p=0.006) and HSCs (β:0.445; p=0.002).SaO2 <90% predicted also HPC number (β: 0.471; p=0.001) and impaired adiponectin expression by HPC pool (β: -0.532; p=0.0009).These relationships were observed in obese and non-obese children. In paediatric NAFLD, OSAS is associated with increased endotoxemia coupled with impaired gut barrier function, with increased TLR-4-mediated hepatic susceptibility to endotoxemia and with an expansion of an adiponectin-deficient HPC pool. These alterations may represent a novel pathogenic link and a potential therapeutic target for OSAS-associated liver injury in

  17. Scarlet Macaw (Ara macao, Psittaciformes: Psittacidae) nest characteristics in the Osa Peninsula Conservation Area (ACOSA), Costa Rica.

    PubMed

    Guittar, John L; Dear, Fiona; Vaughan, Christopher

    2009-01-01

    The Scarlet Macaw (Ara macao) is an endangered species. In Costa Rica, the Scarlet Macaw population of the Central Pacific Conservation Area (ACOPAC, n =432 individuals) has undergone considdrable study and has been used effectively as a flagship species for regional conservation. Costa Rica's only other viable Scarlet Macaw population, located in the Osa Peninsula Conservation Area (ACOSA, n=800-1200 individuals), remains virtually unstudied. We studied ACOSA Scarlet Macaw nest cavities from February 19th to March 22nd 2006. Through informal interviews with park guards and residents, we found a total of 57 potential nests in 52 trees. Eleven nests were reported as frequently poached. Scarlet Macaws used 14 identified tree species, ten of which are unrecorded in Costa Rica. The most common nesting trees were Caryocar costaricense (n=12, 24%), Schizolobium parahyba (n=9, 18.0%), Ceibapentandra (n=7, 14.0%) and Ficus sp. (n=5, 10.0%). We compare nesting characteristics to those recorded in ACOPAC. A combination of bottom-up and top-down strategies are necessary to ensure the Scarlet Macaw's long-term success, including environmental education in local schools, community stewardship of active nests, and the advertisement of stricter penalties for poaching.

  18. MASP1 Mutations in Patients with Facial, Umbilical, Coccygeal, and Auditory Findings of Carnevale, Malpuech, OSA, and Michels Syndromes

    PubMed Central

    Sirmaci, Asli; Walsh, Tom; Akay, Hatice; Spiliopoulos, Michail; Şakalar, Yıldırım Bayezit; Hasanefendioğlu-Bayrak, Aylin; Duman, Duygu; Farooq, Amjad; King, Mary-Claire; Tekin, Mustafa

    2010-01-01

    Distinctive facial features consisting of hypertelorism, telecanthus, blepharophimosis, blepharoptosis, epicanthus inversus, periumbilical defects, and skeletal anomalies are seen in autosomal-recessive Carnevale, Malpuech, Michels, and oculo-skeletal-abdominal (OSA) syndromes. The gene or genes responsible for these syndromes were heretofore unknown. We report on three individuals from two consanguineous Turkish families with findings characteristic of these syndromes, including facial dysmorphism, periumbilical depression, mixed hearing loss, radioulnar synostosis, and coccygeal appendage. Homozygosity mapping yielded an autozygous region on chromosome 3q27 in both families. In one family, whole exome sequencing revealed a missense mutation, MASP1 c.2059G>A (p.G687R), that cosegregated with the phenotype. In the second family, Sanger sequencing of MASP1 revealed a nonsense mutation, MASP1 c.870G>A (p.W290X), that also cosegregated with the phenotype. Neither mutation was found in 192 Turkish controls or 1200 controls of various other ancestries. MASP1 encodes mannan-binding lectin serine protease 1. The two mutations occur in a MASP1 isoform that has been reported to process IGFBP-5, thereby playing a critical role in insulin growth factor availability during craniofacial and muscle development. These results implicate mutations of MASP1 as the cause of a human malformation syndrome and demonstrate the involvement of MASP1 in facial, umbilical, and ear development during the embryonic period. PMID:21035106

  19. Environmental service payments: evaluating biodiversity conservation trade-offs and cost-efficiency in the Osa Conservation Area, Costa Rica.

    PubMed

    Barton, D N; Faith, D P; Rusch, G M; Acevedo, H; Paniagua, L; Castro, M

    2009-02-01

    The cost-efficiency of payments for environmental services (PES) to private landowners in the Osa Conservation Area, Costa Rica, is evaluated in terms of the trade-off between biodiversity representation and opportunity costs of conservation to agricultural and forestry land-use. Using available GIS data and an 'off-the-shelf' software application called TARGET, we find that the PES allocation criteria applied by authorities in 2002-2003 were more than twice as cost-efficient as criteria applied during 1999-2001. Results show that a policy relevant assessment of the cost-effectiveness of PES relative to other conservation policies can be carried out at regional level using available studies and GIS data. However, there are a number of data and conceptual limitations to using heuristic optimisation algorithms in the analysis of the cost-efficiency of PES. Site specific data on probabilities of land-use change, and a detailed specification of opportunity costs of farm land, labour and capital are required to use algorithms such as TARGET for ranking individual sites based on cost-efficiency. Despite its conceptual soundness for regional conservation analysis, biodiversity complementarity presents a practical challenge as a criterion for PES eligibility at farm level because it varies depending on the set of areas under PES contracts at any one time.

  20. Underwater topography determines critical breeding habitat for humpback whales near Osa Peninsula, Costa Rica: implications for marine protected areas.

    PubMed

    Oviedo, L; Solís, M

    2008-06-01

    Migrating humpback whales from northern and southern feeding grounds come to the tropical waters near Osa Peninsula, Pacific of Costa Rica, to reproduce and raise their calves. Planning effective marine protected areas that encompass humpback critical habitats require data about which oceanographic features influence distribution during the breeding period. This study examines the relationship between water depth and ocean floor slope with humpback whale distribution, based on sightings during two breeding seasons (2005 and 2006). Data are from the Southern and Northern subpopulations in the Eastern Tropical Pacific (ETP). Analysis followed the basic principles of the Ecological Niche Factors Analysis (ENFA), where indices of Marginality and Tolerance provide insights on the restrictiveness of habitat use. At a fine scale, physical factors such as water depth and slope define the critical breeding and nursing habitat for M. novaeangliae. Divergence in the subsamples means of depths and slope distribution, with the global mean of the study area in both eco-geographical variables, determine habitat requirements restricted by topographic features such as depths (< 100 m) and slope (< 10%), and locate the key breeding and nursing habitat of the species within the continental shelf domains. Proposed Marine Protected Areas (MPA's) network plans should consider connectivity of Cafio Island-Drake Bay and the extension of Corcovado National Park maritime borders.

  1. Impact of continuous positive airway pressure (CPAP) on quality of life in patients with obstructive sleep apnea (OSA).

    PubMed

    Batool-Anwar, Salma; Goodwin, James L; Kushida, Clete A; Walsh, James A; Simon, Richard D; Nichols, Deborah A; Quan, Stuart F

    2016-12-01

    Obstructive sleep apnea is a chronic illness with increasing prevalence. In addition to associated cardiovascular comorbidities, obstructive sleep apnea syndrome has been linked to poor quality of life, occupational accidents, and motor vehicle crashes secondary to excessive daytime sleepiness. Although continuous positive airway pressure is the gold standard for sleep apnea treatment, its effects on quality of life are not well defined. In the current study we investigated the effects of treatment on quality of life using the data from the Apnea Positive Pressure Long-term Efficacy Study (APPLES), a randomized controlled trial of continuous positive airway pressure (CPAP) versus sham CPAP. The Calgary Sleep Apnea Quality of Life Index (SAQLI) was used to assess quality of life. Overall we found no significant improvement in quality of life among sleep apnea patients after CPAP treatment. However, after stratifying by OSA severity, it was found that long-term improvement in quality of life might occur with the use of CPAP in people with severe and possibly moderate sleep apnea, and no demonstrable improvement in quality of life was noted among participants with mild obstructive sleep apnea. © 2016 European Sleep Research Society.

  2. Comparison between ozonation and the OSA process: analysis of excess sludge reduction and biomass activity in two different pilot plants.

    PubMed

    Torregrossa, Michele; Di Bella, Gaetano; Di Trapani, Daniele

    2012-01-01

    The excess biomass produced during biological treatment of municipal wastewater represents a major issue worldwide, as its disposal implies environmental, economic and social impacts. Therefore, there has been a growing interest in developing technologies to reduce sludge production. The main proposed strategies can be categorized according to the place inside the wastewater treatment plant (WWTP) where the reduction takes place. In particular, sludge minimization can be achieved in the wastewater line as well as in the sludge line. This paper presents the results of two pilot scale systems, to evaluate their feasibility for sludge reduction and to understand their effect on biomass activity: (1) a pilot plant with an ozone contactor in the return activated sludge (RAS) stream for the exposition of sludge to a low ozone dosage; and (2) an oxic-settling-anaerobic (OSA) process with high retention time in the anaerobic sludge holding tank have been studied. The results showed that both technologies enabled significant excess sludge reduction but produced a slight decrease of biomass respiratory activity.

  3. Terrestrial ecosystems of the Osa-Golfito region: one component of an integrative cross-disciplinary initiative for sustainability

    NASA Astrophysics Data System (ADS)

    Broadbent, E. N.; Dirzo, R.; Morales Barquero, L.

    2012-12-01

    Sustainability science seeks to develop approaches incorporating simultaneous human and environmental well-being. The Osa-Golfito Initiative (InOGo), as described in the previous presentation by Dr. Hunt et al. in this session, represents a cutting edge project seeking to develop both a fundamental framework for linking interdisciplinary components to address this objective with the creation of an applied approach for a sustainable future in this area of exceptional cultural and environmental diversity. In this presentation we describe the terrestrial ecosystems component of InOGo. This component incorporates four primary research approaches: (a) an extensive literature review; (b) spatial and non-spatial data aggregation; (c) change analysis via remote sensing; and (d) a questionnaire and participatory mapping survey with relevant experts. Integrating these approaches we seek to: (a) establish a detailed baseline understanding of the terrestrial ecosystems and their spatial distribution in the study region; (b) quantify temporal changes in their extent, connectivity, and ecosystem services; (c) identify the principal conservation priorities and threats in the region; and (d) isolate specific actions to address identified threats. We highlight both the overall approach developed for this component, which is broadly applicable throughout similar tropical regions, as well as results specific to the initiative.;

  4. Rice microRNA osa-miR1848 targets the obtusifoliol 14α-demethylase gene OsCYP51G3 and mediates the biosynthesis of phytosterols and brassinosteroids during development and in response to stress.

    PubMed

    Xia, Kuaifei; Ou, Xiaojing; Tang, Huadan; Wang, Ren; Wu, Ping; Jia, Yongxia; Wei, Xiaoyi; Xu, Xinlan; Kang, Seung-Hye; Kim, Seong-Ki; Zhang, Mingyong

    2015-11-01

    Phytosterols are membrane components or precursors for brassinosteroid (BR) biosynthesis. As they cannot be transported long distances, their homeostasis is tightly controlled through their biosynthesis and metabolism. However, it is unknown whether microRNAs are involved in their homeostatic regulation. Rice (Oryza sativa) plants transformed with microRNA osa-miR1848 and its target, the obtusifoliol 14α-demethylase gene, OsCYP51G3, were used to investigate the role of osa-miR1848 in the regulation of phytosterol biosynthesis. osa-miR1848 directs OsCYP51G3 mRNA cleavage to regulate phytosterol and BR biosynthesis in rice. The role of OsCYP51G3 as one of the osa-miR1848 targets is supported by the opposite expression patterns of osa-miR1848 and OsCYP51G3 in transgenic rice plants, and by the identification of OsCYP51G3 mRNA cleavage sites. Increased osa-miR1848 and decreased OsCYP51G3 expression reduced phytosterol and BR concentrations, and caused typical phenotypic changes related to phytosterol and BR deficiency, including dwarf plants, erect leaves, semi-sterile pollen grains, and shorter cells. Circadian expression of osa-miR1848 regulated the diurnal abundance of OsCYP51G3 transcript in developing organs, and the response of OsCYP51G3 to salt stress. We propose that osa-miR1848 regulates OsCYP51G3 expression posttranscriptionally, and mediates phytosterol and BR biosynthesis. osa-miR1848 and OsCYP51G3 might have potential applications in rice breeding to modulate leaf angle, and the size and quality of seeds.

  5. Rice osa-miR171c Mediates Phase Change from Vegetative to Reproductive Development and Shoot Apical Meristem Maintenance by Repressing Four OsHAM Transcription Factors.

    PubMed

    Fan, Tian; Li, Xiumei; Yang, Wu; Xia, Kuaifei; Ouyang, Jie; Zhang, Mingyong

    2015-01-01

    Phase change from vegetative to reproductive development is one of the critical developmental steps in plants, and it is regulated by both environmental and endogenous factors. The maintenance of shoot apical meristem (SAM) identity, miRNAs and flowering integrators are involved in this phase change process. Here, we report that the miRNA osa-miR171c targets four GRAS (GAI-RGA-SCR) plant-specific transcription factors (OsHAM1, OsHAM2, OsHAM3, and OsHAM4) to control the floral transition and maintenance of SAM indeterminacy in rice (Oryza sativa). We characterized a rice T-DNA insertion delayed heading (dh) mutant, where the expression of OsMIR171c gene is up-regulated. This mutant showed pleiotropic phenotypic defects, including especially prolonged vegetative phase, delayed heading date, and bigger shoot apex. Parallel expression analysis showed that osa-miR171c controlled the expression change of four OsHAMs in the shoot apex during floral transition, and responded to light. In the dh mutant, the expression of the juvenile-adult phase change negative regulator osa-miR156 was up-regulated, expression of the flowering integrators Hd3a and RFT1 was inhibited, and expression of FON4 negative regulators involved in the maintenance of SAM indeterminacy was also inhibited. From these data, we propose that the inhibition of osa-miR171c-mediated OsHAM transcription factors regulates the phase transition from vegetative to reproductive development by maintaining SAM indeterminacy and inhibiting flowering integrators.

  6. Rice osa-miR171c Mediates Phase Change from Vegetative to Reproductive Development and Shoot Apical Meristem Maintenance by Repressing Four OsHAM Transcription Factors

    PubMed Central

    Yang, Wu; Xia, Kuaifei; Ouyang, Jie; Zhang, Mingyong

    2015-01-01

    Phase change from vegetative to reproductive development is one of the critical developmental steps in plants, and it is regulated by both environmental and endogenous factors. The maintenance of shoot apical meristem (SAM) identity, miRNAs and flowering integrators are involved in this phase change process. Here, we report that the miRNA osa-miR171c targets four GRAS (GAI-RGA-SCR) plant-specific transcription factors (OsHAM1, OsHAM2, OsHAM3, and OsHAM4) to control the floral transition and maintenance of SAM indeterminacy in rice (Oryza sativa). We characterized a rice T-DNA insertion delayed heading (dh) mutant, where the expression of OsMIR171c gene is up-regulated. This mutant showed pleiotropic phenotypic defects, including especially prolonged vegetative phase, delayed heading date, and bigger shoot apex. Parallel expression analysis showed that osa-miR171c controlled the expression change of four OsHAMs in the shoot apex during floral transition, and responded to light. In the dh mutant, the expression of the juvenile-adult phase change negative regulator osa-miR156 was up-regulated, expression of the flowering integrators Hd3a and RFT1 was inhibited, and expression of FON4 negative regulators involved in the maintenance of SAM indeterminacy was also inhibited. From these data, we propose that the inhibition of osa-miR171c-mediated OsHAM transcription factors regulates the phase transition from vegetative to reproductive development by maintaining SAM indeterminacy and inhibiting flowering integrators. PMID:26023934

  7. Dental changes evaluated with a 3D computer-assisted model analysis after long-term tongue retaining device wear in OSA patients.

    PubMed

    Chen, Hui; Lowe, Alan A; Strauss, Arthur M; de Almeida, Fernanda Riberiro; Ueda, Hiroshi; Fleetham, John A; Wang, Bangkang

    2008-05-01

    Oral appliances (OAs) have been used to treat obstructive sleep apnea (OSA) patients for decades. However, detailed dental side effects in long-term OA cases analyzed with an accurate three-dimensional (3D) measurement tool have seldom been reported. The purpose of this study is to evaluate dental side effects in five OSA patients, who had used a tongue retaining device (TRD) (with occasional other OA wear) for an average of 6 years and 4 months. The baseline and follow-up orthodontic study models were measured with a newly developed MicroScribe-3DX analysis system. High compliance of TRD wear was confirmed in all cases and different patterns and amounts of dental changes were observed. The most common appliance-induced dental changes included anterior and/or unilateral posterior open-bites and reduced anterior overjets. It was hypothesized that there might be two possible mechanisms for the TRD side effects--one is the forward pressure of the tongue upon the anterior dental arch and the other is the lateral pressure of the tongue upon the posterior arch. Considerations to correct the TRD dental side effects should be guided by these different mechanisms of the tongue on the dental arch. Possible solutions to minimize occlusal changes and maximize the benefits for OSA patients are also discussed.

  8. AtSIA1 AND AtOSA1: two Abc1 proteins involved in oxidative stress responses and iron distribution within chloroplasts.

    PubMed

    Manara, Anna; DalCorso, Giovanni; Leister, Dario; Jahns, Peter; Baldan, Barbara; Furini, Antonella

    2014-01-01

    The Abc1 protein kinases are a large family of functionally diverse proteins with multiple roles in the regulation of respiration and oxidative stress tolerance. A functional characterization was carried out for AtSIA1, an Arabidopsis thaliana Abc1-like protein, focusing on its potential redundancy with its homolog AtOSA1. Both proteins are located within chloroplasts, even if a different subplastidial localization seems probable. The comparison of atsia1 and atosa1 mutants, atsia1/atosa1 double mutant and wild-type plants revealed a reduction in plastidial iron-containing proteins of the Cytb6 f complex in the mutants. Iron uptake from soil is not hampered in mutant lines, suggesting that AtSIA1 and AtOSA1 affect iron distribution within the chloroplast. Mutants accumulated more ferritin and superoxide, and showed reduced tolerance to reactive oxygen species (ROS), potentially indicating a basal role in oxidative stress. The mutants produced higher concentrations of plastochromanol and plastoquinones than wild-type plants, but only atsia1 plants developed larger plastoglobules and contained higher concentrations of α- and γ-tocopherol and VTE1. Taken together, these data suggest that AtSIA1 and AtOSA1 probably act in signaling pathways that influence responses to ROS production and oxidative stress.

  9. Potential application of oil-suspended particulate matter aggregates (OSA) on the remediation of reflective beaches impacted by petroleum: a mesocosm simulation.

    PubMed

    Silva, Carine S; de Oliveira, Olivia M C; Moreira, Icaro T A; Queiroz, Antonio F S; de Almeida, Marcos; Silva, Jessica V L; da Silva Andrade, Igor Oliveira

    2015-08-28

    This paper presents the oil-suspended particulate matter aggregate (OSA) resulted from the interaction of droplets of dispersed oil in a water column and particulate matter. This structure reduces the adhesion of oil on solid surfaces, promotes dispersion, and may accelerate degradation processes. The effects of the addition of fine sediments (clay + silt) on the formation of OSA, their impact on the dispersion and degradation of the oil, and their potential use in recovering reflective sandy beaches were evaluated in a mesoscale simulation model. Two simulations were performed (21 days), in the absence and presence of fine sediments, with four units in each simulation using oil from the Recôncavo Basin. The results showed that the use of fine sediment increased the dispersion of the oil in the water column up to four times in relation to the sandy sediment. There was no evidence of the transport of hydrocarbons in bottom sediments associated with fine sediments that would have accelerated the dispersion and degradation rates of the oil. Most of the OSA that formed in this process remained in the water column, where the degradation processes were more effective. Over the 21 days of simulation, we observed a 40 % reduction on average of the levels of saturated hydrocarbons staining the surface oil.

  10. The geology, geochemistry and emplacement of the Cretaceous—Tertiary ophiolitic Nicoya Complex of the Osa Peninsula, southern Costa Rica

    NASA Astrophysics Data System (ADS)

    Berrangé, J. P.; Thorpe, R. S.

    1988-04-01

    The Nicoya Complex of the Osa Peninsula is essentially an obducted segment of oceanic crust comprising basaltic lavas and associated intrusive dolerite and gabbro, interstratified with lesser amounts of pelagic limestones, cherts and argillites. The sediments contain a minor clastic component and were deposited on an ocean floor of considerable relief and distant from a major landmass. The extrusive and intrusive basaltic rocks have geochemical affinities to large ion lithophile (LIL) element-enriched oceanic crust, and are interpreted to have formed in a back-arc basin analagous to the Mariana Trough, Lau Basin or Gulf of California. One sample has distinctly different geochemical characteristics and may represent a younger within-plate seamount. In the Late Cretaceous, an E-W-trending intra-oceanic trench/volcanic/back-arc system developed in association with an active southward-dipping subduction zone located south of the present-day southern Central American isthmus. Pelagic sediments and basaltic lavas accumulated in the back-arc over a period of at least 34 Ma spanning the Late Cretaceous and Early Tertiary. During this period there were three major volcanic events dated respectively as Santonian-Campanian (78.0 ± 2 Ma), Palaeocene (60.2 ± 7.6 Ma) and Middle Eocene (44.0 ± 4.4 Ma). Continuing northward movement of the southern plate caused overthrusting of the volcanic arc onto the northern plate and production of a thickened embryonic continental crust. Inferred reorganization of crustal stress in the Late Eocene caused fragmentation of the single ancestral plate into the Caribbean and "East Pacific" plates, with a flipping of the subduction zone accompanying development of the NE-dipping Middle America subduction zone and andesitic volcanism. During the Oligocene, the ancestral East Pacific plate split into the NE-moving Cocos plate and the eastward-moving Nazca plate, separated by the E-W-trending Colón spreading ridge and a series of N

  11. LIPID PROFILE AND ASSOCIATED FACTORS AMONG ELDERLY PEOPLE, ATTENDED AT THE FAMILY HEALTH STRATEGY, VIÇOSA/MG.

    PubMed

    Danésio de Souza, Jacqueline; Queiroz Ribeiro, Andréia; Oliveira Martinho, Karina; Silva Franco, Fernanda; Vidal Martins, Marcos; Gonçalves Rodrigues, Meirele; Wick, Jeannette Y; Araújo Tinôco, Adelson Luiz

    2015-08-01

    the aging population has been accompanied by epidemiological changes of the Brazilian population, with the highlight being the continued growth of the prevalence of non-communicable chronic diseases especially cardiovascular or artery-coronary, resulting from changes in the lipid profile of the elderly. this study had the aim to describe the behavioral, anthropometric, lifestyle and body composition factors and their association with changes in the lipid profile of elderly people. the sample included 402 participants attended at the Family Health Strategy, Viçosa (MG), to which a questionnaire with socio-demographic, behavioral and lifestyle information was applied. Blood sample was collected to obtain the lipid fractions, and the weight, height, waist circumference and body fat percentage were measured. Multiple linear regression was performed to identify independently associated factors with changes in each of the selected lipid fractions. the factors independently associated with increased levels of total cholesterol were the presence of sedentary behavior, high body fat percentage, greater waist height and greater waist circumference. The consumption of alcoholic beverages and a higher waist-hip ratio remained independently associated with decreased high-density lipoprotein levels. The increased waist circumference was independently associated with low values of the low-density lipoprotein levels. The value of increased triglyceride was independently associated with higher waist-hip ratio, higher body mass index and smoking. modifiable risk factors associated with a changed lipid profile should be prioritized among the actions to be considered in structuring health programs for the elderly. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  12. ROLE OF SPOUSAL INVOLVEMENT IN CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) ADHERENCE IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA (OSA)

    PubMed Central

    Batool-Anwar, Salma; Baldwin, Carol M.; Fass, Shira; Quan, Stuart F.

    2017-01-01

    Introduction Little is known about the impact of spousal involvement on continuous positive airway pressure (CPAP) adherence. The aim of this study was to determine whether spouse involvement affects adherence with CPAP therapy, and how this association varies with gender. Methods 194 subjects recruited from Apnea Positive Pressure Long Term Efficacy Study (APPLES) completed the Dyadic Adjustment Scale (DAS). The majority of participants were Caucasian (83%), and males (73%), with mean age of 56 years, mean BMI of 31 kg/m2. & 62% had severe OSA. The DAS is a validated 32-item self-report instrument measuring dyadic consensus, satisfaction, cohesion, and affectional expression. A high score in the DAS is indicative of a person’s adjustment to the marriage. Additionally, questions related to spouse involvement with general health and CPAP use were asked. CPAP use was downloaded from the device and self-report, and compliance was defined as usage ≥ 4 h per night. Results There were no significant differences in overall marital quality between the compliant and noncompliant subjects. However, level of spousal involvement was associated with increased CPAP adherence at 6 months (p=0.01). After stratifying for gender these results were significant only among males (p=0.03). Three years after completing APPLES, level of spousal involvement was not associated with CPAP compliance even after gender stratification. Conclusion Spousal involvement is important in determining CPAP compliance in males in the 1st 6 months after initiation of therapy but is not predictive of longer-term adherence. Involvement of the spouse should be considered an integral part of CPAP initiation procedures. Support HL068060 PMID:28725492

  13. Neighborhood Walking Environment and Activity Level Are Associated With OSA: The Multi-Ethnic Study of Atherosclerosis.

    PubMed

    Billings, Martha E; Johnson, Dayna A; Simonelli, Guido; Moore, Kari; Patel, Sanjay R; Diez Roux, Ana V; Redline, Susan

    2016-11-01

    There has been growing interest in understanding how neighborhoods may be related to cardiovascular risk. Neighborhood effects on sleep apnea could be one contributing mechanism. We investigated whether neighborhood walking environment and personal activity levels are related to OSA. Data were analyzed from a subpopulation of the Multi-Ethnic Study of Atherosclerosis (MESA), including subjects who participated in both the MESA Sleep and Neighborhood studies (N = 1,896). Perceived neighborhood walking environment and subjects' objective activity were evaluated in multivariate, multilevel models to determine any association with sleep apnea severity as defined by using the apnea-hypopnea index. Sex, race/ethnicity, and obesity were examined as moderators. Residing in the lowest quartile walking environment neighborhoods (score < 3.75) was associated with more severe sleep apnea (mean, 2.7 events/h greater AHI [95% CI, 0.7 to 4.6]), after adjusting for demographic characteristics, BMI, comorbidities, health behaviors, neighborhood socioeconomic status, and site. Associations were stronger among obese and male individuals. Approximately 1 SD greater objective activity in men was associated with a lower AHI (mean, -2.4 events/h [95% CI, -3.5 to -1.3]). This association was partially mediated by BMI (P < .001). Living in neighborhoods with a low walking environment score is associated with greater severity of sleep apnea, especially in male and obese individuals. In men, greater activity level is associated with less severe sleep apnea, independent of BMI, comorbidities, and socioeconomic status. Neighborhood-level interventions that increase walkability and enable increased physical activity may potentially reduce the severity of sleep apnea. Copyright © 2016 American College of Chest Physicians. All rights reserved.

  14. Mapping Tropical Forest Mosaics with C- and L-band SAR: First Results from Osa Peninsula, Costa Rica

    NASA Astrophysics Data System (ADS)

    Pinto, N.; Hensley, S.; Aguilar-Amuchastegui, N.; Broadbent, E. N.; Ahmed, R.

    2016-12-01

    In tropical countries, economic incentives and improved infrastructure are creating forest mosaics where small-scale farming and industrial plantations are embedded within and potentially replacing native ecosystems. Practices such as agroforestry, slash-and-burn cultivation, and oil palm monocultures bring widely different impacts on carbon stocks. Characterizing these production systems is not only critical to ascribe deforestation to particular drivers, but also essential to understand the impact of macroeconomic scenarios, national policies, and land tenure schemes on carbon fluxes. The last decade has experienced a dramatic improvement in the extent and consistency of tree cover and gross deforestation products from optical imagery. At the same time, recent work shows that Synthetic Aperture Radar (SAR) can complement optical data and reveal structural types that cannot be easily resolved with reflectance measurements alone. While these results demonstrate the validity of sensor fusion methodologies, they typically rely on local classifications or even manual delineation and as such they cannot support large-scale investigations. Furthermore, there have been few attempts to exploit PolInSAR or multiple wavelengths that can provide critical information to resolve natural and anthropogenic land cover types. We report results from our research at Costa Rica's Osa Peninsula. This site is ideal for algorithm development as it includes a highly diverse tropical forest within Corcovado National Park, as well as agroforestry zones, mangroves, and palm plantations. We first integrate SAR backscatter and coherence data from NASA's L-band UAVSAR, JAXA's ALOS/PALSAR, and ESA's Sentinel to produce a map of structural types. Second, we assess whether coherence measurements and PolInSAR retrievals can be used to resolve forest stand differences at 30m resolution and disitinguish between primary and secondary forest sites.

  15. In patients with minimally symptomatic OSA can baseline characteristics and early patterns of CPAP usage predict those who are likely to be longer-term users of CPAP

    PubMed Central

    Bratton, Daniel J.; Craig, Sonya E.; Kohler, Malcolm; Stradling, John R.

    2016-01-01

    Background Long-term continuous positive airway pressure (CPAP) usage varies between individuals. It would be of value to be able to identify those who are likely to benefit from CPAP (and use it long term), versus those who would not, and might therefore benefit from additional help early on. First, we explored whether baseline characteristics predicted CPAP usage in minimally symptomatic obstructive sleep apnoea (OSA) patients, a group who would be expected to have low usage. Second, we explored if early CPAP usage was predictive of longer-term usage, as has been shown in more symptomatic OSA patients. Methods The MOSAIC trial was a multi-centre randomised controlled trial where minimally symptomatic OSA patients were randomised to CPAP, or standard care, for 6 months. Here we have studied only those patients randomised to CPAP treatment. Baseline characteristics including symptoms, questionnaires [including the Epworth sleepiness score (ESS)] and sleep study parameters were recorded. CPAP usage was recorded at 2–4 weeks after initiation and after 6 months. The correlation and association between baseline characteristics and 6 months CPAP usage was assessed, as was the correlation between 2 and 4 weeks CPAP usage and 6 months CPAP usage. Results One hundred and ninety-five patients randomised to CPAP therapy had median [interquartile range (IQR)] CPAP usage of 2:49 (0:44, 5:13) h:min/night (h/n) at the 2–4 weeks visit, and 2:17 (0:08, 4:54) h/n at the 6 months follow-up visit. Only male gender was associated with increased long-term CPAP use (male usage 2:56 h/n, female 1:57 h/n; P=0.02). There was a moderate correlation between the usage of CPAP at 2–4 weeks and 6 months, with about 50% of the variability in long-term use being predicted by the short-term use. Conclusions In patients with minimally symptomatic OSA, our study has shown that male gender (and not OSA severity or symptom burden) is associated with increased long-term use of CPAP at 6 months

  16. Modified maxillomandibular advancement for obstructive sleep apnoea: towards a better outcome for Asians.

    PubMed

    Liao, Y-F; Chiu, Y-T; Lin, C-H; Chen, Y-A; Chen, N-H; Chen, Y-R

    2015-02-01

    Excluding tracheostomy, maxillomandibular advancement (MMA) is the most effective surgical treatment for obstructive sleep apnoea (OSA). However, the anticipated facial changes may prevent acceptance of this procedure by patients with bimaxillary protrusion, a common feature of Asian faces. We therefore developed a modified MMA technique for such cases, consisting of anterior segmental osteotomies together with standard Le Fort I and bilateral sagittal split osteotomies. A prospective study of 20 consecutive Taiwanese adults with moderate-to-severe OSA who underwent modified MMA and postsurgical orthodontics was undertaken to evaluate the efficacy with regard to OSA and the postoperative facial appearance and dental occlusion. After modified MMA, the mean apnoea-hypopnoea index decreased from 41.6±19.2 n/h to 5.3±4.0 n/h (P<0.001). All patients had a successful outcome. No patient was dissatisfied with their postoperative facial appearance. The mean Peer Assessment Rating score decreased from 21.9±14.3 to 1.7±1.6 (P=0.001). The data suggest that the modified MMA is effective in treating patients with moderate-to-severe OSA without negatively affecting facial appearance or dental occlusion. To achieve a better outcome, surgical-orthodontic integration is warranted. The surgery-first approach can achieve early improvement.

  17. An evaluation of two different mandibular advancement devices on craniofacial characteristics and upper airway dimensions of Chinese adult obstructive sleep apnea patients.

    PubMed

    Geoghegan, Finn; Ahrens, Anika; McGrath, Colman; Hägg, Urban

    2015-11-01

    To evaluate the effects of two different mandibular advancement devices (MADs) on craniofacial characteristics and upper airway dimensions of Chinese adult patients with obstructive sleep apnea (OSA). Forty-five patients with OSA were recruited as part of a prospective randomized crossover trial for treatment with two different MADs. Lateral cephalograms were taken, and the Epworth Sleepiness Scale and the Sleep Apnea Quality of Life Index were completed at baseline. The Apnea-Hypoxia Index was highly significantly reduced with the monoblock (P < .001) and significantly reduced with the twin block (P < .01). The monoblock demonstrated a superior result than the twin block (P < .05). A significant reduction was found in the distances between the hyoid bone to retrognathia (monoblock, P < .01; twin block, P < .001) as well as the distance between the hyoid bone and mandibular plane angle (P < .001). Furthermore, soft palate length increased significantly (P < .05) with both MADs. However, the changes did not differ in favor of either MAD. Monoblock was the better MAD to improve OSA severity. No difference could be found in changes of subjective OSA indicators. Significant but similar cephalometric changes were observed, indicating both MADs alter the position of the surrounding musculature and improve upper airway patency. Therefore, the different design features of the MADs suggest an impact on some OSA indicators.

  18. Tracking Pulse Oximeter Findings Before, During and After Titration of Mandibular Advancement Devices (MAD) for Patients With Mild to Moderate Obstructive Sleep Apnea (OSA)

    DTIC Science & Technology

    2015-06-01

    medical 25 histmy and examination of extra- and intra-oral tissues. Soft tissue anatomy, periodontal status, dental caries, the TMJ, muscles of...8. Do not need any restorative, periodontal , or root canal dental treatment 9. Do not have evidence of intraoral soft tissue and bone pathology b...posterior teeth 5. Restricted jaw opening :<:: 25 mm 6. TMD symptoms that prevent MAD wear 7. Caries, periodontal disease, oral pathology 8. Previous

  19. Non-CPAP therapies in obstructive sleep apnoea: mandibular advancement device therapy.

    PubMed

    Marklund, Marie; Verbraecken, Johan; Randerath, Winfried

    2012-05-01

    Mandibular advancement devices (MADs) represent the main non-continuous positive airway pressure (non-CPAP) therapy for patients with obstructive sleep apnoea (OSA). The aim of the European Respiratory Society Task Force was to review the evidence in favour of MAD therapy. Effects of tongue-retaining devices are not included in this report. Custom-made MADs reduce apnoea/hypopnoea index (AHI) and daytime sleepiness compared with placebo devices. CPAP more effectively diminishes AHI, while increasing data suggest fairly similar outcomes in relation to symptoms and cardiovascular health from these treatments. Patients often prefer MADs to CPAP. Milder cases and patients with a proven increase in upper airway size as a result of mandibular advancement are most likely to experience treatment success with MADs. A custom-made device titrated from an initial 50% of maximum mandibular advancement has been recommended. More research is needed to define the patients who will benefit from MAD treatment compared with CPAP, in terms of the effects on sleep-disordered breathing and on other diseases related to OSA. In conclusion, MADs are recommended for patients with mild to moderate OSA (Recommendation Level A) and for those who do not tolerate CPAP. The treatment must be followed up and the device adjusted or exchanged in relation to the outcome.

  20. Adaptation and Validation of the Spanish Version of OSA-18, a Quality of Life Questionnaire for Evaluation of Children with Sleep Apnea-Hypopnea Syndrome.

    PubMed

    Chiner, Eusebi; Landete, Pedro; Sancho-Chust, José Norberto; Martínez-García, Miguel Ángel; Pérez-Ferrer, Patricia; Pastor, Esther; Senent, Cristina; Arlandis, Mar; Navarro, Cristina; Selma, María José

    2016-11-01

    To analyze the reliability and validity of the Spanish version of the OSA-18 quality of life questionnaire in children with apnea-hypopnea syndrome (SAHS). Children with suspected SAHS were studied with polysomnography (PSG) before and after adenotonsillectomy (AA). Age, gender, clinical data, PSG, anthropometric data, and Mallampati and Brodsky scales were analyzed. OSA-18 was administered at baseline and 3-6months post AA. After translation and backtranslation by bilingual professionals, the internal consistency, reliability, construct validity, concurrent validity, predictive validity and sensitivity to change of the questionnaire was assessed. In total, 45 boys and 15 girls were evaluated, showing BMI 18±4, neck 28±5, Brodsky (0: 7%; <25%: 12%; 25-50%: 27%; >50 to <75%: 45%; >75%: 6%), AHI 12±7 pre AA. Global Cronbach alpha was 0.91. Correlations between domains were significant except for emotional aspects, although the total scores correlated with all domains (0.50 to 0.90). The factorial analysis was virtually identical to the original structure. The total scores showed good correlation for concurrent validity (0.2-0.45). With regard to predictive validity, the questionnaire adequately differentiated levels of severity according to Mallampati (ANOVA P=.002) and apnea-hypopnea index (ANOVA P=.006). Test-retest reliability was excellent, as was sensitivity to change, both in the total scores (P<.001) and in each domain (P<.001). The Spanish adaptation of the OSA-18 and its psychometric characteristics suggest that the Spanish version is equivalent to the original and can be used in Spanish-speaking countries. Copyright © 2016 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Effect of Armodafinil on Cortical Activity and Working Memory in Patients with Residual Excessive Sleepiness Associated with CPAP-Treated OSA: A Multicenter fMRI Study

    PubMed Central

    Greve, Douglas N.; Duntley, Stephen P.; Larson-Prior, Linda; Krystal, Andrew D.; Diaz, Michele T.; Drummond, Sean P. A.; Thein, Stephen G.; Kushida, Clete A.; Yang, Ronghua; Thomas, Robert J.

    2014-01-01

    Study Objective: To assess the effect of armodafinil on task-related prefrontal cortex activation using functional magnetic resonance imaging (fMRI) in patients with obstructive sleep apnea (OSA) and excessive sleepiness despite continuous positive airway pressure (CPAP) therapy. Methods: This 2-week, multicenter, prospective, randomized, double-blind, placebo-controlled, parallel-group study was conducted at five neuroimaging sites and four collaborating clinical study centers in the United States. Patients were 40 right-handed or ambidextrous men and women aged between 18 and 60 years, with OSA and persistent sleepiness, as determined by multiple sleep latency and Epworth Sleepiness Scale scores, despite effective, stable use of CPAP. Treatment was randomized (1:1) to once-daily armodafinil 200 mg or placebo. The primary efficacy outcome was a change from baseline at week 2 in the volume of activation meeting the predefined threshold in the dorsolateral prefrontal cortex during a 2-back working memory task. The key secondary measure was the change in task response latency. Results: No significant differences were observed between treatment groups in the primary or key secondary outcomes. Armodafinil was generally well tolerated. The most common adverse events (occurring in more than one patient [5%]) were headache (19%), nasopharyngitis (14%), and diarrhea (10%). Conclusions: Armodafinil did not improve fMRI-measured functional brain activation in CPAP-treated patients with OSA and excessive sleepiness. Study Registration: Double-Blind, Placebo-Controlled, Functional Neuroimaging Study of Armodafinil (200 mg/Day) on Prefrontal Cortical Activation in Patients With Residual Excessive Sleepiness Associated With Obstructive Sleep Apnea/Hypopnea. ClinicalTrials.gov Identifier: NCT00711516. http://www.clinicaltrials.gov/ct2/show/study/NCT00711516 Citation: Greve DN; Duntley SP; Larson-Prior L; Krystal AD; Diaz MT; Drummond SP; Thein SG; Kushida CA; Yang R; Thomas RJ

  2. Effect of CPAP on Cardiac Function in Minimally Symptomatic Patients with OSA: Results from a Subset of the MOSAIC Randomized Trial

    PubMed Central

    Craig, Sonya; Kylintireas, Ilias; Kohler, Malcolm; Nicoll, Debby; Bratton, Daniel J.; Nunn, Andrew J.; Leeson, Paul; Neubauer, Stefan; Stradling, John R.

    2015-01-01

    Study Objectives: Minimally symptomatic obstructive sleep apnea (OSA) is highly prevalent, and the effects of continuous positive airway pressure (CPAP) on myocardial function in these patients are unknown. The MOSAIC randomized, controlled trial of CPAP for minimally symptomatic OSA assessed the effect of CPAP on myocardial function in a subset of patients. Methods: Two centers taking part in the MOSAIC trial randomized 238 patients in parallel to 6 months of CPAP (120) or standard care (118). Of these, 168 patients had echocardiograms, and 68 patients had a cardiac magnetic resonance scan (CMR). A larger group (314) from 4 centers had brain natriuretic peptide (BNP) measured. Results: Mean (SD) baseline oxygen desaturation index (ODI) and Epworth sleepiness score (ESS) were 13.5 (13.2), and 8.4 (4.0), respectively. CPAP significantly reduced ESS and ODI. Baseline LV ejection fraction (LVEF) was well preserved (60.4%). CPAP had no significant effect on echo-derived left atrial (LA) area (−1.0 cm2, 95% CI −2.6 to +0.6, p = 0.23) or early to late left ventricular filling velocity (E/A) ratio (−0.01, 95% CI −0.07 to +0.05, p = 0.79). There was a small change in echo-derived LV end diastolic volume (EDV) with CPAP (−5.9 mL, 95% CI −10.6 to −1.2, p = 0.015). No significant changes were detected by CMR on LV mass index (+1.1 g/m2, 95% CI −5.9 to +8.0, p = 0.76) or LVEF (+0.8%, 95% CI −1.2 to +2.8, p = 0.41). CPAP did not affect BNP levels (p = 0.16). Conclusions: Six months of CPAP therapy does not change cardiac functional or structural parameters measured by echocardiogram or CMR in patients with minimally symptomatic mild-to-moderate OSA. Clinical Trial Registration: ISRCTN 34164388 (http://isrctn.org). Citation: Craig S, Kylintireas I, Kohler M, Nicoll D, Bratton DJ, Nunn AJ, Leeson P, Neubauer S, Stradling JR. Effect of CPAP on cardiac function in minimally symptomatic patients with OSA: results from a subset of the MOSAIC randomized trial. J Clin

  3. Osa Creek gabbro-granite ring complex, Sierra Nevada, CA, by degassing-driven subsidence of mafic-magmatic sheets

    NASA Astrophysics Data System (ADS)

    Sisson, T. W.; Moore, J. G.

    2010-12-01

    Intrusive ring complexes commonly represent the shallow substrates of calderas, with arcuate intrusions forming as ring dikes engulfing subsiding caldera blocks, and as cone sheets injected during magmatic repressurization. The Osa Creek ring complex, southern Sierra Nevada batholith, differs in having formed by axial subsidence of solidifying gabbro-diorite sheets that injected a coeval mushy granitic magma body. The result is a remarkable nearly circular (6×10 km) steep-sided bimodal intrusive body, exposed 60 km east of Porterville and 30 km southwest of Owens Lake on the east side of the Kern Canyon. Zircon ages (SHRIMP) of both gabbro and granite are 146 ±1.5 Ma (1-sigma), slightly younger than, or concurrent with, the Independence Dike Swarm. Much of the structure is hornblende-biotite gabbro and diorite (SiO2, 47-51 wt %) emplaced as sheets 0.1-5 m thick, with each mafic sheet commonly chilled against and separated by thin (1-25 cm) septa of lighter colored and coarser rock ranging from granite to hornblende-plagioclase pegmatite. Mutually intrusive relations indicate that the septa were partly molten during sheet injection. In the outer portions of the complex the mafic sheets strike parallel to the margins and dip vertically-to-steeply radially inward. Dips of mafic sheets shallow toward the center of the complex, and are sub-horizontal in the center, defining a cup or basin structure. At least 28 thicker (5-250 m) conformable granitic sheets (SiO2, 70-77 wt. %) are spaced through the gabbroic layers and are increasingly thicker and abundant toward the higher elevation outer edges of the structure. Granite sheets also dip steeply inward, further defining the basin-shaped structure. Subsidence of the complex’s interior is indicated by rotation of igneous geopetal (way-up) indicators. These are in the form of small flames and pipes (to ~10 cm across) of the comagmatic inter-sheet septa granitoids that inject adjacent mafic sheets consistently toward the

  4. Randomized controlled study of a mandibular advancement appliance for the treatment of obstructive sleep apnea in children: A pilot study

    PubMed Central

    Signorelli, Luiz-Gabriel; Zancanella, Edilson; Crespo, Agrício-Nubiato

    2016-01-01

    Background The current limited evidence may be suggestive that mandibular advancement appliance (MAAs) result in improvements in AHI scores, but it is not possible to conclude that MAAs are effective to treat paediatric OSA. There are significant weaknesses in the existing evidence due primarily to absence of control groups, small sample sizes, lack of randomization and short-term results. Aim: the objective of the present study was to evaluate MAAs in children with OSA. Material and Methods Children presenting an apnea-hypopnea index (AHI) greater than or equal to one event per hour were considered to be apneic. This group of children with AHI greater than or equal to one was randomly divided through a draw into two subgroups: half of them in an experimental subgroup and half of them in a control subgroup. In the experimental subgroup, molds of each of these children’s maxillary and mandibular arches were taken using standard molds and molding material. The control group did not use any intraoral device and did not undergo any type of treatment for OSAS. The MAAs used in this study had the aim of achieving mandibular advancement, thereby correcting the mandibular position and dental occlusion, and perhaps increasing the airway and treating OSAS. After 12 consecutive months of use of the mandibular advancement devices, polysomnography examinations using the same parameters as in the initial examinations were requested for both the experimental and the control subgroup. Results There was a decrease in AHI in the experimental group and an increase in the control group, with statistical significance. These data were used to calculate the sample size, which was 28 children in total in the groups. Conclusions There was a decrease in AHI one year after implementing use of mandibular advancement devices, in comparison with the group that did not use these devices. Key words:Mandibular advancement appliance, obstructive sleep apnea. PMID:26946208

  5. Maxillomandibular advancement as the initial treatment of obstructive sleep apnoea: Is the mandibular occlusal plane the key?

    PubMed

    Rubio-Bueno, P; Landete, P; Ardanza, B; Vázquez, L; Soriano, J B; Wix, R; Capote, A; Zamora, E; Ancochea, J; Naval-Gías, L

    2017-07-28

    Maxillomandibular advancement (MMA) can be effective for managing obstructive sleep apnoea (OSA); however, limited information is available on the predictor surgical variables. This study investigated whether normalization of the mandibular occlusal plane (MOP) was a determinant factor in curing OSA. Patients with moderate or severe OSA who underwent MMA were evaluated by preoperative and postoperative three-dimensional (3D) scans and polysomnograms. The postoperative value of MOP and the magnitude of skeletal advancement were the predictor variables; change in the apnoea-hypopnoea index (AHI) was the main outcome variable. Thirty-four subjects with a mean age of 41±14years and 58,8% female were analysed. The Epworth Sleepiness Scale (ESS) was 17.4±5.4 and AHI was 38.3±10.7 per hour before surgery. Postoperative AHI was 6.5±4.3 per hour (P<0.001) with 52.94% of the patients considered as cured, and 47.06% suffering from a mild residual OSA with ESS 0.8±1.4 (P<0.001). 3D changes revealed a volume increase of 106.3±38.8%. The mandible was advanced 10.4±3.9mm and maxilla 4.9±3.2mm. MOP postoperative value was concluded to be the best predictor variable. Treatment planning should include MOP normalization and a mandibular advancement between 6 and 10mm. The maxillary advancement would depend on the desired aesthetic changes and final occlusion. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. Olive Volatiles from Portuguese Cultivars Cobrançosa, Madural and Verdeal Transmontana: Role in Oviposition Preference of Bactrocera oleae (Rossi) (Diptera: Tephritidae)

    PubMed Central

    Malheiro, Ricardo; Casal, Susana; Cunha, Sara C.; Baptista, Paula; Pereira, José Alberto

    2015-01-01

    The olive fly, Bactrocera oleae (Rossi), a serious threat to the olive crop worldwide, displays ovipositon preference for some olive cultivars but the causes are still unclear. In the present work, three Portuguese olive cultivars with different susceptibilities to olive fly (Cobrançosa, Madural, and Verdeal Transmontana) were studied, aiming to determine if the olive volatiles are implicated in this interaction. Olive volatiles were assessed by SPME-GC-MS in the three cultivars during maturation process to observe possible correlations with olive fly infestation levels. Overall, 34 volatiles were identified in the olives, from 7 chemical classes (alcohols, aldehydes, aromatic hydrocarbons, esters, ketones, sesquiterpenes, and terpenes). Generally, total volatile amounts decrease during maturation but toluene, the main compound, increased in all cultivars, particularly in those with higher susceptibility to olive fly. Sesquiterpenes also raised, mainly α-copaene. Toluene and α-copaene, recognized oviposition promoters to olive fly, were correlated with the infestation level of cvs. Madural and Verdeal Trasnmontana (intermediate and highly susceptible cultivars respectively), while no correlations were established with cv. Cobrançosa (less susceptible). No volatiles with inverse correlation were observed. Volatile composition of olives may be a decisive factor in the olive fly choice to oviposit and this could be the basis for the development of new control strategies for this pest. PMID:25985460

  7. Olive Volatiles from Portuguese Cultivars Cobrançosa, Madural and Verdeal Transmontana: Role in Oviposition Preference of Bactrocera oleae (Rossi) (Diptera: Tephritidae).

    PubMed

    Malheiro, Ricardo; Casal, Susana; Cunha, Sara C; Baptista, Paula; Pereira, José Alberto

    2015-01-01

    The olive fly, Bactrocera oleae (Rossi), a serious threat to the olive crop worldwide, displays ovipositon preference for some olive cultivars but the causes are still unclear. In the present work, three Portuguese olive cultivars with different susceptibilities to olive fly (Cobrançosa, Madural, and Verdeal Transmontana) were studied, aiming to determine if the olive volatiles are implicated in this interaction. Olive volatiles were assessed by SPME-GC-MS in the three cultivars during maturation process to observe possible correlations with olive fly infestation levels. Overall, 34 volatiles were identified in the olives, from 7 chemical classes (alcohols, aldehydes, aromatic hydrocarbons, esters, ketones, sesquiterpenes, and terpenes). Generally, total volatile amounts decrease during maturation but toluene, the main compound, increased in all cultivars, particularly in those with higher susceptibility to olive fly. Sesquiterpenes also raised, mainly α-copaene. Toluene and α-copaene, recognized oviposition promoters to olive fly, were correlated with the infestation level of cvs. Madural and Verdeal Trasnmontana (intermediate and highly susceptible cultivars respectively), while no correlations were established with cv. Cobrançosa (less susceptible). No volatiles with inverse correlation were observed. Volatile composition of olives may be a decisive factor in the olive fly choice to oviposit and this could be the basis for the development of new control strategies for this pest.

  8. Management of severe sleep apnea secondary to juvenile arthritis with temporomandibular joint replacement and mandibular advancement

    PubMed Central

    Paul, S. Arun; Simon, S. Sibu; Issac, Barney; Kumar, Saurav

    2015-01-01

    Variations affecting the growth centers can severely affect the normal formation and subsequent function of vital musculoskeletal structures. We report a case of bilateral condylar atrophy with a history of juvenile arthritis (JA) resulting in progressive obstructive sleep apnea (OSA) in adulthood. In addition to this, the case report emphasizes the role of temporomandibular joint replacement and advancement of the mandible to correct progressive OSA secondary to idiopathic JA. Computed tomography revealed micrognathia, condylar hypoplasia, and decreased pharyngeal airway space. The resultant increase in the retrolingual-pharyngeal airway space following the surgery, helped to completely resolve the presenting symptoms. It is hoped that the described technique could be used in similar cases with a predictable outcome. PMID:26538944

  9. Does the Kushida morphometric model predict outcomes following maxillomandibular advancement surgery for obstructive sleep apnoea?

    PubMed

    Islam, Shofiq; Aleem, Fahd; Ormiston, Ian W

    2014-12-01

    The primary aim of this study was to explore the predictive potential of the preoperative Kushida index score and subsequent outcome following maxillomandibular advancement surgery (MMA). Secondarily we looked at how well the Kushida values of our OSA patients matched the morphometric models diagnostic thresholds. We performed a retrospective analysis of patients who underwent MMA for OSA at our institution. Kushida morphometric scores were calculated using the described formula: P + (Mx - Mn) + 3 × OJ + 3 × [Max (BMI - 25)] × (NC ÷ BMI). Regression analysis was performed to explore the possible association between Kushida index score and outcome variables of postoperative apnoea/hypopnea indices (AHI) and Epworth Sleepiness Scores (ESS). We identified 28 patients with complete data available for analysis. The mean age was 45 years (SD 6) with mean BMI of 28 (SD 3). All, but one patient underwent bi-maxillary procedure with or without genioplasty, with a mean advancement of 8.5 mm (SD 2). The mean Kushida index score in our sample was 79 (SD 14). 89% of patients had postoperative AHI <15 in keeping with surgical success. We found no statistically significant relationship with Kushida morphometric model variables and overall score with either of our outcome variables. The mean Kushida index score in our patients was in the range consistent with the morphometric models diagnostic cut-off for OSA. Kushida's morphometric model does not appear to be a good predictor of postoperative success in individuals following MMA. The morphometric model represents a clinical adjunct in the initial diagnostic work-up of OSA patients referred for surgery. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  10. [Prevalence and factors associated with the presence of anemia in the elderly of the municipality of Viçosa, State of Minas Gerais, Brazil].

    PubMed

    Milagres, Clarice Santana; de Moraes, Keila Bacelar Duarte; Franceschini, Sylvia Carmo Castro; Sant'Ana, Luciana Ferreira Rocha; Lima, Luciana Moreira; Ribeiro, Andréia Queiroz

    2015-12-01

    Anemia is the most common hematological problem encountered in the elderly population. A cross-sectional, population-based survey was conducted to evaluate the prevalence and factors associated with anemia in the elderly in Viçosa (State of Minas Gerais). Data were collected by means of a household survey and conducting biochemical tests on 349 elderly between June and December 2009. The prevalence of anemia was 11.7% (95% CI 8.3% -15.1%) and was found to be higher among men (15.4%) among those aged 80 years and older (30%) and those who practiced polypharmacy (16.8%). The results obtained indicate anemia determinants similar to those observed in developed countries. The real need of polypharmacy should be evaluated in health care for the elderly, in order to prevent iatrogenic complications, of which anemia is one such complication.

  11. Socio-Economic Status: A Barrier to Access to Mandibular Advancement Device Therapy for Patients with Obstructive Sleep Apnea Syndrome in France

    PubMed Central

    Fleury, Marion; Le Vaillant, Marc; Pelletier-Fleury, Nathalie

    2015-01-01

    Background Obstructive sleep apnea syndrome (OSAS) is a major public health problem which affects between 5 to 10% of the general population. OSAS is known to be associated with high rates of morbidity and mortality mainly due to cardiovascular diseases and traffic accidents. The burden of illness is high for the individual and society. There are 2 treatment options for OSAS, Continuous Positive Airway Pressure (CPAP) and Mandibular Advancement Device therapy (MAD). CPAP is known to be an effective but very constraining treatment. Patients are usually poorly adherent. MAD is a more recent treatment easier to use and consequently better tolerated, but MAD can only be prescribed to patients with satisfactory oral hygiene. Oral health constitutes a real issue particularly among underprivileged groups in France. Through this link, the question of whether low socio-economic status constitutes a barrier to access to care for patients with OSAS is raised. Methods and Principal Findings In a multicenter prospective cohort of 2822 consecutive OSAS patients in whom MAD has been proposed as an alternative to CPAP between May 15, 2007 and December 1st, 2014, we identified the factors that lead to a patient diagnosed with OSAS to be treated by MAD instead of CPAP. A logistic regression was performed using a stepwise forward procedure. The main outcome of the study was that treatment by MAD was significantly associated with both educational attainment, as determined by the age at which the patient left full-time education, ≥18 years compared with <18 (adjusted odds ratio (aOR): 1.64, 95% CI 1.23 to 2.20), and the patient's occupational category. Executives and higher intellectual professions, intermediate professions, technicians, foremen and employees were significantly more likely to be treated by MAD than workers (aOR: 2.21, 95% CI 1.88 to 2.58; aOR: 1.74, 95% CI 1.15 to 2.63; aOR: 1.96, 95% CI 1.11 to 3.47, respectively). Conclusions Overall, these results suggest that low

  12. STEALTH liposome-encapsulated cisplatin (SPI-77) versus carboplatin as adjuvant therapy for spontaneously arising osteosarcoma (OSA) in the dog: a randomized multicenter clinical trial.

    PubMed

    Vail, David M; Kurzman, Ilene D; Glawe, Phyllis C; O'Brien, Maura G; Chun, Ruthanne; Garrett, Laura D; Obradovich, Joyce E; Fred, Rogers M; Khanna, Chand; Colbern, Gail T; Working, Peter K

    2002-08-01

    This trial was designed to compare the efficacy of adjuvant STEALH liposome-encapsulated cisplatin (SPI-77) to "standard-of-care" carboplatin therapy in dogs with osteosarcoma (OSA) in the context of a randomized study design. The study included 40 pet dogs with spontaneously arising OSA which were randomized to receive SPI-77 (350 mg/m(2) i.v. every 3 weeks for four treatments) or carboplatin (300 mg/m(2) i.v. every 3 weeks for four treatments) along with amputation of the affected limb. Median disease-free (DFS) and overall survival (OS) were compared using standard life-table analysis. The median follow-up was 693 days (range 321-730 days). Of 38 dogs eligible for follow-up, 25 were dead of their disease, 9 were alive and disease-free (8 receiving SPI-77, 1 receiving carboplatin; P=0.02), 2 were free of disease when they were lost to follow-up at 321 and 395 days, and 2 had died of an unrelated disease. The median DFS times for dogs treated with SPI-77 and carboplatin were 156 and 123 days, respectively ( P=0.19). The median OS times for dogs treated with SPI-77 and carboplatin were 333 and 207 days, respectively ( P=0.18). While STEALTH liposome encapsulation of cisplatin allowed the safe administration of five times the maximally tolerated dose of free cisplatin to dogs without concurrent hydration protocols, this did not translate into significantly prolonged DFS or OS. However, a larger proportion of dogs receiving SPI-77 enjoyed long-term DFS when compared with dogs receiving carboplatin.

  13. Functional contribution of mandibular advancement to awake upper airway patency in obstructive sleep apnea.

    PubMed

    Tsuiki, Satoru; Ryan, C Frank; Lowe, Alan A; Inoue, Yuichi

    2007-12-01

    In the narrowed upper airway of patients with obstructive sleep apnea (OSA), a neuromuscular compensatory mechanism augments the activity of the upper airway dilator muscles in defense of upper airway patency, particularly during inspiration. We hypothesized that mechanical enlargement of the upper airway by a mandibular advancement oral appliance would permit a reduction in this neuromuscular compensation during wakefulness. To test this hypothesis, we focused on changes in the cross-sectional (CS) area of the upper airway before and after emplacement of a ventrally titrated oral appliance in 12 awake OSA patients. The CS areas at the end of tidal expiration (CS area-EET) and at the nadir of intraluminal pressure during inspiration (CS area-IN) were obtained using videoendoscopy. The median apnea-hypopnea index decreased with mandibular advancement. Before mandibular advancement, there was no difference between CS area-EET and CS area-IN in the velopharynx, oropharynx, and hypopharynx. This indicates that upper airway dilator muscle activity increased during inspiration to counteract the intraluminal negative pressure of the upper airway. After mandibular advancement, CS area-EET increased in the velopharynx, oropharynx, and hypopharynx, but CS area-IN was unchanged at any level and was less than CS area-EET in the velopharynx and oropharynx. These findings suggest that mandibular advancement enlarges the upper airway and may reduce upper airway dilator muscle activity during inspiration. We conclude that oral appliances act to return the upper airway towards a normal configuration and pattern of muscle function in OSA patients.

  14. A pilot study to compare the cerebral hemodynamics between patients with obstructive sleep apnea syndrome (OSA) and periodic limb movement syndrome (PLMS) during nocturnal sleep with near-infrared spectroscopy (NIRS)

    NASA Astrophysics Data System (ADS)

    Zhang, Zhongxing; Schneider, Maja; Laures, Marco; Fritschi, Ursula; Hügli, Gordana; Lehner, Isabella; Qi, Ming; Khatami, Ramin

    2014-03-01

    Obstructive sleep apnea syndrome (OSA) and periodic limb movement in sleep syndrome (PLMS) are two common sleep disorders. Previous studies showed that OSA and PLMS share common features, such as increased cardio-vascular risk, both apnea events and limb movements occur periodically, they are usually associated with cortical arousals, and both of them can induce declines in peripheral oxygen saturation measured with pulse oximetry. However, the question whether apnea events and limb movements also show similar characteristics in cerebral hemodynamic and oxygenation has never been addressed. In this pilot study, we will first time compare the cerebral hemodynamic changes induced by apnea events and limb movements in patients with OSA (n=4) and PLMS (n=4) with NIRS. In patients with OSA, we found periodic oscillations in HbO2, HHb, and blood volume induced by apnea/hypopnea events, HbO2 and HHb showed reverse changing trends. By contrast, the periodic oscillations linked to limb movements were only found in HbO2 and blood volume in patients with PLMS. These findings of different cerebral hemodynamics patterns between apnea events and limb movements may indicate different regulations of nervous system between these two sleep disorders.

  15. ALPhA: The Advanced Laboratory Physics Association

    NASA Astrophysics Data System (ADS)

    Black, Eric; McCann, Lowell; Reichert, Jonathan; Spalding, Gabe; Essick, John; van Baak, David; Wonnell, Steve

    2011-03-01

    The Advanced Laboratory Physics Association (ALPhA) is a group of people with a shared interest in teaching physics labs at the advanced undergraduate or graduate level. ALPhA works closely with the American Physical Society (APS), the Optical Society of America (OSA), and the American Association of Physics Teachers (AAPT) to develop new methods for teaching modern experimental physics. In the summer of 2010 we initiated the ALPhA Immersion Program, a three-day short course where instructors visit a lab, do one or more of the local experiments (home-built or commercial) with the local instructor, and learn the experiments well enough to incorporate them into their own programs. These immersions were very well received, with attendees filling up all available slots. In this talk I will describe ALPhA and the Immersions Program and solicit input from the broader community.

  16. Cephalometric analysis of modifications of the pharynx due to maxillo-mandibular advancement surgery in patients with obstructive sleep apnea.

    PubMed

    Faria, A C; Xavier, S P; Silva, S N; Trawitzki, L V Voi; de Mello-Filho, F V

    2013-05-01

    Cephalometry has been used to measure hard and soft facial tissues, as well as the pharyngeal air space for the diagnosis of obstructive sleep apnea (OSA). The changes occurring in the pharynx due to maxillo-mandibular advancement (MMA) have not been established or quantified. The objective of this study was to identify the anatomical changes of the pharynx and of hard tissues that occur in patients with OSA after MMA. 19 patients with a polysomnographic diagnosis of OSA were submitted to cephalometric analysis before and 6 months after surgery in order to evaluate the changes produced by MMA in the pharynx and soft tissues. Cephalometry was standardized in order to obtain descriptive measurements of the dimensions of the airways, the position of the hyoid bone, and maxilla-mandibular relations. The modifications of the pharynx due to MMA showed a significant relation obtained by cephalometry. For each millimeter of maxillary and mandibular bone advancement there was a 0.76mm increase in the retropalatal region and a 1.2mm increase in the pharynx in the retrolingual region. In addition, MMA promoted a significant repositioning of the hyoid bone in the cranial direction. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. A novel tongue implant for tongue advancement for obstructive sleep apnea: feasibility, safety and histology in a canine model.

    PubMed

    Hamans, E; Shih, M; Roue, C

    2010-03-01

    Obstructive sleep apnea (OSA) is a sleep related breathing disorder caused by partial or complete collapse of the upper airway during sleep. The disease is linked with important cardiovascular and cerebrovascular morbidity and mortality. Tongue base collapse is a major cause of upper airway occlusion in OSA and present surgical procedures to prevent this are invasive and inefficient. A novel implantable system to stabilize the tongue was evaluated in a canine model for feasibility, safety and histology. Successful implantation of the Advance System was performed in 21 canines and follow-up evaluations were performed at 30, 60, 90, 120 and 150 days. No technical or clinical adverse events were seen during the procedure. Minor clinical adverse events at some of the follow-up evaluations were treated successfully. Histologic evaluation of the implant was performed at different time points during follow-up and showed good biocompatibility, stability and osteointegration. The outcome of this study resulted in an implant for adjustable tongue advancement in humans with OSA.

  18. Long-Term Effectiveness and Safety of Maxillomandibular Advancement for Treatment of Obstructive Sleep Apnea.

    PubMed

    Boyd, Scott B; Walters, Arthur S; Waite, Peter; Harding, Susan M; Song, Yanna

    2015-07-15

    To determine the long-term clinical effectiveness and safety of maxillomandibular advancement (MMA) for the treatment of moderate to severe obstructive sleep apnea (OSA). A prospective two-center cohort study design was used to evaluate OSA patients who underwent MMA > 2 years ago. The primary outcome measure was the apnea-hypopnea index (AHI). Secondary outcome measures included blood pressure (BP), sleepiness (Epworth Sleepiness Scale [ESS]), and quality of life (Functional Outcomes of Sleep Questionnaire [FOSQ]). 30 adult patients (80% men, age 50.5 ± 9.6 years [mean ± SD]) participated in the study. The AHI decreased from a mean of 49 to 10.9 events/h (p < 0.0001) at the time of long-term evaluation (6.6 ± 2.8 years after MMA), with 46.7% of patients obtaining an AHI < 5 and 83.4% of patients attaining an AHI ≤ 15 events/h. The mean diastolic BP decreased from 83.7 to 79.0 mm Hg (p < 0.05). ESS decreased from a mean of 12.1 to 6.0 (p < 0.01). FOSQ increased from a mean of 12.6 to 17.3 (p < 0.05). Few long-term treatment-related adverse events occurred, which had minimal impact on quality of life (QOL). MMA is a clinically effective and safe long-term treatment for most patients with moderate-to-severe OSA as demonstrated by significant decreases in AHI, diastolic BP, and subjective sleepiness, with concomitant significant improvements in QOL. The results of this small cohort study suggest that MMA should be considered as the alternative treatment of choice for patients with severe OSA who cannot fully adhere to CPAP therapy. © 2015 American Academy of Sleep Medicine.

  19. Mandibular advancement splint improves indices of obstructive sleep apnoea and snoring but side effects are common.

    PubMed

    Neill, Alister; Whyman, Robin; Bannan, Scott; Jeffrey, Oliver; Campbell, Angela

    2002-06-21

    To assess the efficacy of a mandibular advancement splint (MAS) in the treatment of obstructive sleep apnoea syndrome (OSAS). Nineteen patients using a MAS for symptomatic OSAS underwent polysomnography, with MAS use randomised to one half of the night. Indices of snoring and OSAS were compared. Side effects, compliance and treatment response were evaluated by questionnaire. Use of the MAS improved total respiratory disturbance index (RDI) from 22.2 +/- 19.8 (SD) events per hour to 16.5 +/- 21.4/hr (p = 0.03), supine RDI (30.8 +/- 23.8/hr to 18.8 +/- 22.1/hr, p = 0.01), arousal index (25.2 +/- 18.9/hr to 19.3 +/- 14.2/hr, p = 0.01) and snoring intensity (52.7 +/- 4.1 to 50.7 +/- 2.7 dB, p = 0.02) but not total snore frequency (p > 0.05). Using polysomnographic criteria, MAS treatment was completely successful in four (21%) patients, partially successful in ten (52.6%) and a failure in five (26.3%). Treatment over a median of 6.5 weeks (range 2-48) was perceived as beneficial by ten of eleven partners. Fifteen patients (79%) reported side effects, 9 (46%) did not use the device every night and four (21%) used the device less than three nights per week. The use of the MAS resulted in significant reductions in indices of OSAS and snoring. However, a significant number of patients had difficulty tolerating and regularly using the device.

  20. The “DOC” screen: Feasible and valid screening for depression, Obstructive Sleep Apnea (OSA) and cognitive impairment in stroke prevention clinics

    PubMed Central

    Swartz, Richard H.; Cayley, Megan L.; Lanctôt, Krista L.; Murray, Brian J.; Cohen, Ashley; Thorpe, Kevin E.; Sicard, Michelle N.; Lien, Karen; Sahlas, Demetrios J.; Herrmann, Nathan

    2017-01-01

    Background Post-stroke Depression, Obstructive sleep apnea (OSA) and Cognitive impairment (“DOC”) are associated with greater mortality, worse recovery and poorer quality of life. Best practice recommendations endorse routine screening for each condition; yet, all are under-assessed, diagnosed and treated. We seek to determine the feasibility and validity of an integrated tool (“DOC” screen) to identify stroke clinic patients at high-risk of depression, OSA, and cognitive impairment. Methods All consecutive new referrals to a regional Stroke Prevention Clinic who were English-speaking and non-aphasic were eligible to be screened. Time for screen completion was logged. DOC screen results were compared to the neuropsychological battery and polysomnogram assessments using a modified receiver operator characteristic and area under the curve analysis. Data is reported to conform to STARD guidelines. Findings 1503 people were screened over 2 years. 89% of eligible patients completed the screen in 5 minutes or less (mean 4.2 minutes), less than half the time it takes to complete the Montreal Cognitive Assessment (MoCA). 437 people consented to detailed testing. Of those, 421 completed the Structured Clinical Interview for Depression within 3 months of screening, 387 completed detailed neuropsychological testing within 3 months, and 88 had overnight polysomnograms. Screening scores combined with demographic variables (age, sex, education, body mass index), had excellent validity compared to gold standard diagnoses: DOC-Mood AUC 0.90; DOC-Apnea AUC 0.80; DOC-Cog AUC 0.81. DOC screen scores can reliably categorize patients in to low-, intermediate- or high-risk groups for further action and can do so with comparable accuracy to more time-consuming screens. Conclusions Systematic screening of depression, obstructive sleep apnea, and cognitive impairment in 5 minutes or less is feasible and valid in a high volume stroke clinic using the DOC screen. The DOC screen may

  1. Advanced Science.

    ERIC Educational Resources Information Center

    Coles, Mike; Nelms, Rick

    1996-01-01

    Describes a study that explores the depth and breadth of scientific facts, principles, and procedures which are required in the Advanced General National Vocational Qualifications (GNVQ) science through comparison with GCE Advanced level. The final report takes account of the updated 1996 version of GNVQ science. (DDR)

  2. Management of severe obstructive sleep apnea using mandibular advancement devices with auto continuous positive airway pressures

    PubMed Central

    Upadhyay, Rashmi; Dubey, Abhishek; Kant, Surya; Singh, Balendra Pratap

    2015-01-01

    The use of continuous positive airway pressures (CPAP) is considered standard treatment of moderate to severe obstructive sleep apnea (OSA). Treatment of the disease poses a great challenge not only for its diagnostic purpose but also for its treatment part. In about 29-83% of the patients, treatment is difficult because of non-compliance resulting due to high pressures, air leaks and other related issues. In such situations, alternative methods of treatment need to be looked for so as to ascertain better management. Mandibular advancement devices along with CPAP may show better treatment outcome in specific situations. PMID:25814802

  3. Retinal Atherosclerosis, Ophthalmologically Reported and Documented with OSA in 1987, is now Totally Reversed, and Recorded, Photographically. The Supposition then was that Equivalent Cortical Damage could Respond to the same Healing Protocol.

    NASA Astrophysics Data System (ADS)

    Niemi, Paul N.; O., D.; Mc Leod, David M.; Mc Leod, Roger D.

    2007-10-01

    Documented retinal atherosclerosis, ``silver streaking'' of retinal capillaries, was reported and documented with OSA, in October 1987. That retinal damage, despite claims it usually progresses and is nonreversible, is now completely cleared. The original OSA presentation proposed that equivalent cortical damage was probably present throughout the brain at that time, as attested by failing short-term memory performance and transient ischemic attacks, TIAs, brief vision strokes. The supposition then was that ophthalmologic access to the retina, by some accounts the progenitor of all brain evolution, could provide a means of monitoring the actual circulatory state of inaccessible parts of the brain. To the extent that retinal health was naturopathically restored, and memory performance seems also to have significantly kept pace, is it a tenable premise that such protocols have rather general importance? Can applied optics help establish more appropriate diagnoses, and evaluate treatments for dementia and Alzheimer's disease?

  4. Advanced Microsensors

    NASA Technical Reports Server (NTRS)

    1991-01-01

    This video looks at a spinoff application of the technology from advanced microsensors -- those that monitor and determine conditions of spacecraft like the Space Shuttle. The application featured is concerned with the monitoring of the health of premature babies.

  5. Advanced Microsensors

    NASA Technical Reports Server (NTRS)

    1991-01-01

    This video looks at a spinoff application of the technology from advanced microsensors -- those that monitor and determine conditions of spacecraft like the Space Shuttle. The application featured is concerned with the monitoring of the health of premature babies.

  6. Advanced Beamformers

    DTIC Science & Technology

    2008-09-01

    Advanced Beamformers Stergios Stergiopoulos Defence R&D Canada Technical Report DRDC Toronto TR 2008-101 September 2008 Defence Research and...Development Canada Recherche et développement pour la défense Canada DEFENCE DÉFENSE & Advanced beamformers Stergios Stergiopoulos... beamformers ; and provide suggestions of how modern technology can be applied to the development of current and next generation ultrasound systems and

  7. Pre- and in-therapy predictive score models of adult OSAS patients with poor adherence pattern on nCPAP therapy

    PubMed Central

    Wang, Yeying; Geater, Alan F; Chai, Yanling; Luo, Jiahong; Niu, Xiaoqun; Hai, Bing; Qin, Jingting; Li, Yongxia

    2015-01-01

    Objectives To identify patterns of adherence to nasal continuous positive airway pressure (nCPAP) use in the first 3 months of therapy among newly diagnosed adult patients with obstructive sleep apnea/hypopnea syndrome (OSAS) and their predictors. To develop pretherapy and in-therapy scores to predict adherence pattern. Methods Newly diagnosed adult OSAS patients were consecutively recruited from March to August 2013. Baseline clinical information and measures such as Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), Zung’s Self-Rating Depression Scale (SDS), and The Pittsburgh Sleep Quality Index (PSQI) at baseline and at the end of 3rd-week therapy were collected. Twelve weeks’ adherence data were collected from the nCPAP memory card, and K-means cluster analysis was used to explore adherence patterns. Predictive scores were developed from the coefficients of cumulative logit models of adherence patterns using variables available at baseline and after 3 weeks of therapy. Performance of the score was validated using 500 bootstrap resamples. Results Seventy six patients completed a 12-week follow-up. Three patterns were revealed. Patients were identified as developing an adherence pattern that was poor (n=14, mean ± SD, 2.3±0.9 hours per night), moderate (n=19, 5.3±0.6 hours per night), or good (n=43, 6.8±0.3 hours per night). Cumulative logit regression models (good → moderate → poor) revealed independent baseline predictors to be ESS (per unit increase) (OR [95% CI], 0.763 [0.651, 0.893]), SDS (1.461 [1.238, 1.724]), and PSQI (2.261 [1.427, 3.584]); and 3-week therapy predictors to be ESS (0.554 [0.331, 0.926]), PSQI (2.548 [1.454, 4.465]), and the changes (3rd week–baseline data) in ESS (0.459 [0.243, 0.868]), FSS (3.556 [1.788, 7.070]), and PSQI (2.937 [1.273, 6.773]). Two predictive score formulas for poor adherence were developed. The area under the curve (AUC) of the receiver operating characteristics (ROC) curves for baseline and 3

  8. The impact of pasture conversion on nutrient cycles of tropical streams on the Osa Peninsula, Costa Rica: a paired catchment approach

    NASA Astrophysics Data System (ADS)

    Bringhurst, K.; Jordan, P.

    2011-12-01

    Changes in nutrient and hydrologic cycles caused by land disturbance typically lead to detrimental changes to ecosystems. This study utilized a paired, small-catchment approach to examine the effect of deforestation on nutrient transfer and hydrological discharge and the resulting impact on soils and streams of the Osa Peninsula, Costa Rica. Two first order streams were chosen, the first catchment had been cleared for pasture and the second consisted of undisturbed tropical wet forest. Soil concentrations of organic matter, total and soil available P were higher in the forested catchment with decreases of >33% of each in the deforested catchment. The effect of deforestation on stream discharge was a 59% increase in flow during the wet season and an increase in the Q5:Q95 ratio showing that the deforested stream was flashier. The deforested catchment loss of dissolved inorganic nitrogen (DIN) increased 95% over the forested catchment. Soluble reactive phosphorus (SRP) showed an increase in load of 43% in the deforested catchment compared to the forested catchment. The molar N:P ratios were lower than the Redfield ratio and both streams were well below the level at which N-limitation of lotic algal growth has been reported, therefore it is hypothesized that N is the limiting nutrient in streams in the study area. Soil nutrient depletion in the deforested catchment, accelerated by a changed hydrologic regime, is the likely trajectory of soil-water interactions in this tropical ecosystem. This will likely be among the secondary impacts should deforestation become widespread along this stretch of the Pacific coastline, with associated eutrophication of receiving transitional and coastal waters.

  9. Durability of treatment effects of the Sleep Position Trainer versus oral appliance therapy in positional OSA: 12-month follow-up of a randomized controlled trial.

    PubMed

    de Ruiter, Maurits H T; Benoist, Linda B L; de Vries, Nico; de Lange, Jan

    2017-09-15

    The Sleep Position Trainer (SPT) is a new option for treating patients with positional obstructive sleep apnea (POSA). This study investigated long-term efficacy, adherence, and quality of life during use of the SPT device compared with oral appliance therapy (OAT) in patients with POSA. This prospective, multicenter trial randomized patients with mild to moderate POSA (apnea-hypopnea index [AHI] 5-30/h) to SPT or OAT. Polysomnography was performed at baseline and after 3 and 12 months' follow-up. The primary endpoint was OSA severity; adherence, quality of life, and adverse events were also assessed. Ninety-nine patients were randomized and 58 completed the study (29 in each group). Median AHI in the SPT group decreased from 13.2/h at baseline to 7.1/h after 12 months (P < 0.001); corresponding values in the OAT group were 13.4/h and 5.0/h (P < 0.001), with no significant between-group difference (P = 1.000). Improvements throughout the study were maintained at 12 months. Long-term median adherence was also similar in the two treatment groups; the proportion of patients who used their device for ≥ 4 h for 5 days in a week was 100% in the SPT group and 97.0% in the OAT group (P = 0.598). The efficacy of SPT therapy was maintained over 12 months and was comparable to that of OAT in patients with mild to moderate POSA. Adherence was relatively high, and similar in the two groups. www.clinicaltrials.gov (NCT02045576).

  10. Physical property and Textural transition across the Unconformity and Major Seismic Reflectors in the Upper plate of the Costa Rica Subduction zone offshore Osa Peninsula

    NASA Astrophysics Data System (ADS)

    Hamahashi, M.; Screaton, E.; Tanikawa, W.; Hashimoto, Y.; Martin, K. M.; Saito, S.; Kimura, G.

    2014-12-01

    At the Costa Rica subduction zone offshore Osa Peninsula, the Cocos plate and Cocos Ridge subduct under the Caribbean plate along the Middle America Trench, creating active seismicity. In this region, the Caribbean plate is characterized by a well-consolidated, high velocity framework material beneath the slope sediments, but the nature of the upper plate material is yet unknown. During Integrated Ocean Drilling Program (IODP) Expedition 334 and 344, the unconformity between the slope sediments (Unit 1) and upper plate material (Units 2 and 3) consisting of lithic sedimentary units was penetrated at mid-slope Site 1380. In the current study, to characterize the compaction behavior of the upper plate material, we investigate the physical properties, texture and composition of the sediments at Site 1380 by conducting microstructural observations, resistivity measurements, particle size analyses, X-ray fluorescence and X-ray diffraction analyses. The microstructures of sediments observed through the microscope tend to develop dense and cohesive textures in low porosity sediments, and particle size changes across several unconformities. In particular, the small particle-sized lithic fragments compose larger bodies and form cohesive structures. The cross correlation between measured particle size and shipboard porosity show negative correlation especially at Unit 2, indicating that larger sized particles form smaller or fewer pores. From the results of XRF and XRD analyses, we found that Al, K, Ti tend to concentrate in the higher porosity sediments of Unit 1, whereas Si, Ca, P, Mg, Na, and Mn concentrate in the lower porosity sediments of Unit 2 and 3. The higher concentration in Mg, Na, Mn, Si may be due to minerals such as chlorite, serpentine, amphibole, and sodium manganese. The crossplots between porosity and element concentration show negative correlations in Mg, Na, and Mn with porosity, suggesting that the minerals rich in these elements may relate with the

  11. Risky consumption habits and safety of fluid milk available in retail sales outlets in Viçosa, Minas Gerais State, Brazil.

    PubMed

    Pieri, Fabio Alessandro; Colombo, Monique; Merhi, Carolina Milner; Juliati, Vinícius Augusto; Ferreira, Marcello Sebe; Nero, Marcelo Antônio; Nero, Luis Augusto

    2014-06-01

    This study aimed to assess raw milk consumption habits in the urban population of Viçosa, Minas Gerais, Brazil, and the microbiological safety and quality of the fluid milk available in retail sales outlets in the same region. A simplified questionnaire regarding raw milk consumption was applied to the persons responsible for food acquisition in 411 residences. The regular consumption of raw milk was observed by 18.5% of the interviewers, and lack of knowledge of possible risks related to this food product. Microbiological safety and quality were assessed for raw (n=69), pasteurized (n=80), and ultra-high-temperature (UHT)-treated milk (n=80) by analyzing the counts of mesophilic aerobes, coliforms, and Escherichia coli, and detection of Listeria monocytogenes and Salmonella spp.; raw milk samples were also subjected to enumeration of coagulase-positive Staphylococcus. Concerning raw milk, 59.4% of the samples were considered as produced in inadequate hygienic conditions, 5.8% of the samples presented counts of coagulase-positive Staphylococcus lower than 100 colony-forming units (CFU)/mL, and no samples presented with positive results for L. monocytogenes or Salmonella spp. All pasteurized and UHT milk samples presented with low counts of mesophilic aerobes and coliforms, while L. monocytogenes and Salmonella spp. were absent. The data demonstrated that raw milk was consumed by the population studied. Despite the absence of potential hazards, raw milk was of poor hygienic quality, in contrast with the processed fluid milk available in retail sales outlets that was safe and of good hygienic quality, highlighting the suitability of pasteurized and UHT milk for human consumption.

  12. Facial Mobility after Maxilla-Mandibular Advancement in Patients with Severe Obstructive Sleep Apnea Syndrome: A Three-Dimensional Study

    PubMed Central

    Bianchi, Francesca Antonella; Barla, Niccolò; Curti, Serena Maria; Gerbino, Giovanni; Ramieri, Guglielmo Amedeo

    2017-01-01

    Introduction. The functional results of surgery in terms of facial mobility are key elements in the treatment of patients. Little is actually known about changes in facial mobility following surgical treatment with maxillomandibular advancement (MMA). Objectives. The three-dimensional (3D) methods study of basic facial movements in typical OSAS patients treated with MMA was the topic of the present research. Materials and Methods. Ten patients affected by severe obstructive sleep apnea syndrome (OSAS) were engaged for the study. Their facial surface data was acquired using a 3D laser scanner one week before (T1) and 12 months after (T2) orthognathic surgery. The facial movements were frowning, grimace, smiling, and lip purse. They were described in terms of surface and landmark displacements (mm). The mean landmark displacement was calculated for right and left sides of the face, at T1 and at T2. Results. One year after surgery, facial movements were similar to presurgical registrations. No modifications of symmetry were present. Conclusions. Despite the skeletal maxilla-mandible expansion, orthognathic surgical treatment (MMA) of OSAS patients does not seem to modify facial mobility. Only an enhancement of amplitude in smiling and knitting brows was observed. These results could have reliable medical and surgical applications. PMID:28659977

  13. Maxillomandibular Advancement for Treatment of Obstructive Sleep Apnea: A Meta-analysis.

    PubMed

    Zaghi, Soroush; Holty, Jon-Erik C; Certal, Victor; Abdullatif, Jose; Guilleminault, Christian; Powell, Nelson B; Riley, Robert W; Camacho, Macario

    2016-01-01

    Maxillomandibular advancement (MMA) is an invasive yet effective surgical option for obstructive sleep apnea (OSA) that achieves enlargement of the upper airway by physically expanding the facial skeletal framework. To identify criteria associated with surgical outcomes of MMA using aggregated individual patient data from multiple studies. The Cochrane Library, Scopus, Web of Science, and MEDLINE from June 1, 2014, to March 16, 2015, using the Medical Subject Heading keywords maxillomandibular advancement, orthognathic surgery, maxillary osteotomy, mandibular advancement, sleep apnea, surgical, surgery, sleep apnea syndrome, and obstructive sleep apnea. Inclusion criteria consisted of studies in all languages of (1) adult patients who underwent MMA as treatment for OSA; (2) report of preoperative and postoperative quantitative outcomes for the apnea-hypopnea index (AHI) and/or respiratory disturbance index (RDI); and (3) report of individual patient data. Studies of patients who underwent adjunctive procedures at the time of MMA (including tonsillectomy, uvulopalatopharyngoplasty, and partial glossectomy) were excluded. Three coauthors systematically reviewed the articles and updated the review through March 16, 2015. The PRISMA statement was followed. Data were pooled using a random-effects model and analyzed from July 1, 2014, to September 23, 2015. The primary outcomes were changes in the AHI and RDI after MMA for each patient. Secondary outcomes included surgical success, defined as the percentage of patients with more than 50% reduction of the AHI to fewer than 20 events/h, and OSA cure, defined as a post-MMA AHI of fewer than 5 events/h. Forty-five studies with individual data from 518 unique patients/interventions were included. Among patients for whom data were available, 197 of 268 (73.5%) had undergone prior surgery for OSA. Mean (SD) postoperative changes in the AHI and RDI after MMA were -47.8 (25.0) and -44.4 (33.0), respectively; mean (SE) reductions

  14. Advancement Flaps.

    PubMed

    Kruter, Laura; Rohrer, Thomas

    2015-10-01

    Advancement flaps are random-pattern flaps frequently used in the reconstruction of surgical defects on the face after the removal of skin cancer. Proper design and meticulous execution is crucial in achieving reproducible esthetic results. To review the design and execution of advancement flaps in facial reconstruction. A review of the literature on the use of advancement flaps in facial reconstruction was performed and curated with the authors' experience. Many factors come into play when using local flaps to reconstruct surgical defects on the face. Close attention must be given to the tissue surrounding the surgical defect and any free margin in the area. Designing the flap closure lines along cosmetic unit junctions and or relaxed skin tension lines, preserving both the form and function of the surrounding structures, and using excellent surgical techniques during the closure will all together help in providing reproducibly outstanding results.

  15. Advancing Reflectrometry

    DTIC Science & Technology

    2013-05-21

    transmissions, was first demonstrated using Global Navigation Satellite System ( GNSS ) reflections. Recently, reflectometry has been extended to digital... GNSS +R workshop provided an opportunity for engineers and Earth scientists to assess the state of the art, demonstrate new applications, and discuss...18 Eos, Vol. 94, No. 21, 21 May 2013 MEETING -.~ Advancing Reflectometry Workshop on Renectometry Using GNSS and Other Signals of Opportunity

  16. Technological Advancements

    ERIC Educational Resources Information Center

    Kennedy, Mike

    2010-01-01

    The influx of technology has brought significant improvements to school facilities. Many of those advancements can be found in classrooms, but when students head down the hall to use the washrooms, they are likely to find a host of technological innovations that have improved conditions in that part of the building. This article describes modern…

  17. Research Advances

    ERIC Educational Resources Information Center

    King, Angela G.

    2004-01-01

    Research advances, a new feature in Journal of Chemical Engineering that brings information about innovations in current areas of research to high school and college science faculty with an intent to provide educators with timely descriptions of latest progress in research that can be integrated into existing courses to update course content and…

  18. Technological Advancements

    ERIC Educational Resources Information Center

    Kennedy, Mike

    2010-01-01

    The influx of technology has brought significant improvements to school facilities. Many of those advancements can be found in classrooms, but when students head down the hall to use the washrooms, they are likely to find a host of technological innovations that have improved conditions in that part of the building. This article describes modern…

  19. Advanced Concept

    NASA Image and Video Library

    1997-01-02

    The Advanced Space Transportation Group takes the future of space travel far into the 21st Century. Pictured is an artist's concept of a third generation Reusable Launch Vehicle (RLV). Projected for the year 2025, this third generation RLV will introduce an era of space travel not unlike air travel today.

  20. Advanced Combustion

    SciTech Connect

    Holcomb, Gordon R.

    2013-03-11

    The activity reported in this presentation is to provide the mechanical and physical property information needed to allow rational design, development and/or choice of alloys, manufacturing approaches, and environmental exposure and component life models to enable oxy-fuel combustion boilers to operate at Ultra-Supercritical (up to 650{degrees}C & between 22-30 MPa) and/or Advanced Ultra-Supercritical conditions (760{degrees}C & 35 MPa).

  1. Long-Term Effectiveness and Safety of Maxillomandibular Advancement for Treatment of Obstructive Sleep Apnea

    PubMed Central

    Boyd, Scott B.; Walters, Arthur S.; Waite, Peter; Harding, Susan M.; Song, Yanna

    2015-01-01

    Study Objective: To determine the long-term clinical effectiveness and safety of maxillomandibular advancement (MMA) for the treatment of moderate to severe obstructive sleep apnea (OSA). Methods: A prospective two-center cohort study design was used to evaluate OSA patients who underwent MMA > 2 years ago. The primary outcome measure was the apnea-hypopnea index (AHI). Secondary outcome measures included blood pressure (BP), sleepiness (Epworth Sleepiness Scale [ESS]), and quality of life (Functional Outcomes of Sleep Questionnaire [FOSQ]). Results: 30 adult patients (80% men, age 50.5 ± 9.6 years [mean ± SD]) participated in the study. The AHI decreased from a mean of 49 to 10.9 events/h (p < 0.0001) at the time of long-term evaluation (6.6 ± 2.8 years after MMA), with 46.7% of patients obtaining an AHI < 5 and 83.4% of patients attaining an AHI ≤ 15 events/h. The mean diastolic BP decreased from 83.7 to 79.0 mm Hg (p < 0.05). ESS decreased from a mean of 12.1 to 6.0 (p < 0.01). FOSQ increased from a mean of 12.6 to 17.3 (p < 0.05). Few long-term treatment-related adverse events occurred, which had minimal impact on quality of life (QOL). Conclusions: MMA is a clinically effective and safe long-term treatment for most patients with moderate-to-severe OSA as demonstrated by significant decreases in AHI, diastolic BP, and subjective sleepiness, with concomitant significant improvements in QOL. The results of this small cohort study suggest that MMA should be considered as the alternative treatment of choice for patients with severe OSA who cannot fully adhere to CPAP therapy. Citation: Boyd SB, Walters AS, Waite P, Harding SM, Song Y. Long-term effectiveness and safety of maxillomandibular advancement for treatment of obstructive sleep apnea. J Clin Sleep Med 2015;11(7):699–708. PMID:25766718

  2. Effects of CPAP-therapy on brain electrical activity in obstructive sleep apneic patients: a combined EEG study using LORETA and Omega complexity : reversible alterations of brain activity in OSAS.

    PubMed

    Toth, Marton; Faludi, Bela; Kondakor, Istvan

    2012-10-01

    Effects of initiation of continuous positive airway pressure (CPAP) therapy on EEG background activity were investigated in patients with obstructive sleep apnea syndrome (OSAS, N = 25) to test possible reversibility of alterations of brain electrical activity caused by chronic hypoxia. Normal control group (N = 14) was also examined. Two EEG examinations were done in each groups: at night and in the next morning. Global and regional (left vs. right, anterior vs. posterior) measures of spatial complexity (Omega complexity) were used to characterize the degree of spatial synchrony of EEG. Low resolution electromagnetic tomography (LORETA) was used to localize generators of EEG activity in separate frequency bands. Before CPAP-treatment, a significantly lower Omega complexity was found globally and over the right hemisphere. Due to CPAP-treatment, these significant differences vanished. Significantly decreased Omega complexity was found in the anterior region after treatment. LORETA showed a decreased activity in all of the beta bands after therapy in the right hippocampus, premotor and temporo-parietal cortex, and bilaterally in the precuneus, paracentral and posterior cingulate cortex. No significant changes were seen in control group. Comparing controls and patients before sleep, an increased alpha2 band activity was seen bilaterally in the precuneus, paracentral and posterior cingulate cortex, while in the morning an increased beta3 band activity in the left precentral and bilateral premotor cortex and a decreased delta band activity in the right temporo-parietal cortex and insula were observed. These findings indicate that effect of sleep on EEG background activity is different in OSAS patients and normal controls. In OSAS patients, significant changes lead to a more normal EEG after a night under CPAP-treatment. Compensatory alterations of brain electrical activity in regions associated with influencing sympathetic outflow, visuospatial abilities, long

  3. Impact of stepwise mandibular advancement on upper airway mechanics in obstructive sleep apnea using phrenic nerve magnetic stimulation.

    PubMed

    Gakwaya, Simon; Melo-Silva, César Augusto; Borel, Jean-Christian; Rousseau, Eric; Masse, Jean-François; Sériès, Frédéric

    2014-01-01

    Mandibular advancement devices (MAD) represent a potential treatment for obstructive sleep apnea (OSA). However, their mechanisms of actions are not completely understood. This study was aimed to explore the effects of MAD-induced mandibular protrusion on upper airway mechanics. 25 men commencing treatment for OSA with MAD were recruited. Phrenic nerve magnetic stimulation (PNMS) was used to measure flow/pressure relationship during progressive protrusion in three conditions (without MAD, MAD at minimum protrusion, and MAD at maximum tolerable protrusion). Pressures were recorded simultaneously at three different upper airway segments (naso-, velo-, and oro-pharynx). Without MAD, PNMS twitches induced flow-limitation at the velopharyngeal level in 19 subjects and six of them experienced a shift in the flow-limitation site to the lower segment with MAD at maximum protrusion. An association was found between having a velopharyngeal limitation site without MAD and the increase in maximum flow with the advanced MAD. These data suggest that mandibular advancement devices are acting predominantly at the velopharyngeal level.

  4. Advanced LIGO

    NASA Astrophysics Data System (ADS)

    LIGO Scientific Collaboration; Aasi, J.; Abbott, B. P.; Abbott, R.; Abbott, T.; Abernathy, M. R.; Ackley, K.; Adams, C.; Adams, T.; Addesso, P.; Adhikari, R. X.; Adya, V.; Affeldt, C.; Aggarwal, N.; Aguiar, O. D.; Ain, A.; Ajith, P.; Alemic, A.; Allen, B.; Amariutei, D.; Anderson, S. B.; Anderson, W. G.; Arai, K.; Araya, M. C.; Arceneaux, C.; Areeda, J. S.; Ashton, G.; Ast, S.; Aston, S. M.; Aufmuth, P.; Aulbert, C.; Aylott, B. E.; Babak, S.; Baker, P. T.; Ballmer, S. W.; Barayoga, J. C.; Barbet, M.; Barclay, S.; Barish, B. C.; Barker, D.; Barr, B.; Barsotti, L.; Bartlett, J.; Barton, M. A.; Bartos, I.; Bassiri, R.; Batch, J. C.; Baune, C.; Behnke, B.; Bell, A. S.; Bell, C.; Benacquista, M.; Bergman, J.; Bergmann, G.; Berry, C. P. L.; Betzwieser, J.; Bhagwat, S.; Bhandare, R.; Bilenko, I. A.; Billingsley, G.; Birch, J.; Biscans, S.; Biwer, C.; Blackburn, J. K.; Blackburn, L.; Blair, C. D.; Blair, D.; Bock, O.; Bodiya, T. P.; Bojtos, P.; Bond, C.; Bork, R.; Born, M.; Bose, Sukanta; Brady, P. R.; Braginsky, V. B.; Brau, J. E.; Bridges, D. O.; Brinkmann, M.; Brooks, A. F.; Brown, D. A.; Brown, D. D.; Brown, N. M.; Buchman, S.; Buikema, A.; Buonanno, A.; Cadonati, L.; Calderón Bustillo, J.; Camp, J. B.; Cannon, K. C.; Cao, J.; Capano, C. D.; Caride, S.; Caudill, S.; Cavaglià, M.; Cepeda, C.; Chakraborty, R.; Chalermsongsak, T.; Chamberlin, S. J.; Chao, S.; Charlton, P.; Chen, Y.; Cho, H. S.; Cho, M.; Chow, J. H.; Christensen, N.; Chu, Q.; Chung, S.; Ciani, G.; Clara, F.; Clark, J. A.; Collette, C.; Cominsky, L.; Constancio, M., Jr.; Cook, D.; Corbitt, T. R.; Cornish, N.; Corsi, A.; Costa, C. A.; Coughlin, M. W.; Countryman, S.; Couvares, P.; Coward, D. M.; Cowart, M. J.; Coyne, D. C.; Coyne, R.; Craig, K.; Creighton, J. D. E.; Creighton, T. D.; Cripe, J.; Crowder, S. G.; Cumming, A.; Cunningham, L.; Cutler, C.; Dahl, K.; Dal Canton, T.; Damjanic, M.; Danilishin, S. L.; Danzmann, K.; Dartez, L.; Dave, I.; Daveloza, H.; Davies, G. S.; Daw, E. J.; DeBra, D.; Del Pozzo, W.; Denker, T.; Dent, T.; Dergachev, V.; DeRosa, R. T.; DeSalvo, R.; Dhurandhar, S.; D´ıaz, M.; Di Palma, I.; Dojcinoski, G.; Dominguez, E.; Donovan, F.; Dooley, K. L.; Doravari, S.; Douglas, R.; Downes, T. P.; Driggers, J. C.; Du, Z.; Dwyer, S.; Eberle, T.; Edo, T.; Edwards, M.; Edwards, M.; Effler, A.; Eggenstein, H.-B.; Ehrens, P.; Eichholz, J.; Eikenberry, S. S.; Essick, R.; Etzel, T.; Evans, M.; Evans, T.; Factourovich, M.; Fairhurst, S.; Fan, X.; Fang, Q.; Farr, B.; Farr, W. M.; Favata, M.; Fays, M.; Fehrmann, H.; Fejer, M. M.; Feldbaum, D.; Ferreira, E. C.; Fisher, R. P.; Frei, Z.; Freise, A.; Frey, R.; Fricke, T. T.; Fritschel, P.; Frolov, V. V.; Fuentes-Tapia, S.; Fulda, P.; Fyffe, M.; Gair, J. R.; Gaonkar, S.; Gehrels, N.; Gergely, L. Á.; Giaime, J. A.; Giardina, K. D.; Gleason, J.; Goetz, E.; Goetz, R.; Gondan, L.; González, G.; Gordon, N.; Gorodetsky, M. L.; Gossan, S.; Goßler, S.; Gräf, C.; Graff, P. B.; Grant, A.; Gras, S.; Gray, C.; Greenhalgh, R. J. S.; Gretarsson, A. M.; Grote, H.; Grunewald, S.; Guido, C. J.; Guo, X.; Gushwa, K.; Gustafson, E. K.; Gustafson, R.; Hacker, J.; Hall, E. D.; Hammond, G.; Hanke, M.; Hanks, J.; Hanna, C.; Hannam, M. D.; Hanson, J.; Hardwick, T.; Harry, G. M.; Harry, I. W.; Hart, M.; Hartman, M. T.; Haster, C.-J.; Haughian, K.; Hee, S.; Heintze, M.; Heinzel, G.; Hendry, M.; Heng, I. S.; Heptonstall, A. W.; Heurs, M.; Hewitson, M.; Hild, S.; Hoak, D.; Hodge, K. A.; Hollitt, S. E.; Holt, K.; Hopkins, P.; Hosken, D. J.; Hough, J.; Houston, E.; Howell, E. J.; Hu, Y. M.; Huerta, E.; Hughey, B.; Husa, S.; Huttner, S. H.; Huynh, M.; Huynh-Dinh, T.; Idrisy, A.; Indik, N.; Ingram, D. R.; Inta, R.; Islas, G.; Isler, J. C.; Isogai, T.; Iyer, B. R.; Izumi, K.; Jacobson, M.; Jang, H.; Jawahar, S.; Ji, Y.; Jiménez-Forteza, F.; Johnson, W. W.; Jones, D. I.; Jones, R.; Ju, L.; Haris, K.; Kalogera, V.; Kandhasamy, S.; Kang, G.; Kanner, J. B.; Katsavounidis, E.; Katzman, W.; Kaufer, H.; Kaufer, S.; Kaur, T.; Kawabe, K.; Kawazoe, F.; Keiser, G. M.; Keitel, D.; Kelley, D. B.; Kells, W.; Keppel, D. G.; Key, J. S.; Khalaidovski, A.; Khalili, F. Y.; Khazanov, E. A.; Kim, C.; Kim, K.; Kim, N. G.; Kim, N.; Kim, Y.-M.; King, E. J.; King, P. J.; Kinzel, D. L.; Kissel, J. S.; Klimenko, S.; Kline, J.; Koehlenbeck, S.; Kokeyama, K.; Kondrashov, V.; Korobko, M.; Korth, W. Z.; Kozak, D. B.; Kringel, V.; Krishnan, B.; Krueger, C.; Kuehn, G.; Kumar, A.; Kumar, P.; Kuo, L.; Landry, M.; Lantz, B.; Larson, S.; Lasky, P. D.; Lazzarini, A.; Lazzaro, C.; Le, J.; Leaci, P.; Leavey, S.; Lebigot, E. O.; Lee, C. H.; Lee, H. K.; Lee, H. M.; Leong, J. R.; Levin, Y.; Levine, B.; Lewis, J.; Li, T. G. F.; Libbrecht, K.; Libson, A.; Lin, A. C.; Littenberg, T. B.; Lockerbie, N. A.; Lockett, V.; Logue, J.; Lombardi, A. L.; Lormand, M.; Lough, J.; Lubinski, M. J.; Lück, H.; Lundgren, A. P.; Lynch, R.; Ma, Y.; Macarthur, J.; MacDonald, T.; Machenschalk, B.; MacInnis, M.; Macleod, D. M.; Magaña-Sandoval, F.; Magee, R.; Mageswaran, M.; Maglione, C.; Mailand, K.; Mandel, I.; Mandic, V.; Mangano, V.; Mansell, G. L.; Márka, S.; Márka, Z.; Markosyan, A.; Maros, E.; Martin, I. W.; Martin, R. M.; Martynov, D.; Marx, J. N.; Mason, K.; Massinger, T. J.; Matichard, F.; Matone, L.; Mavalvala, N.; Mazumder, N.; Mazzolo, G.; McCarthy, R.; McClelland, D. E.; McCormick, S.; McGuire, S. C.; McIntyre, G.; McIver, J.; McLin, K.; McWilliams, S.; Meadors, G. D.; Meinders, M.; Melatos, A.; Mendell, G.; Mercer, R. A.; Meshkov, S.; Messenger, C.; Meyers, P. M.; Miao, H.; Middleton, H.; Mikhailov, E. E.; Miller, A.; Miller, J.; Millhouse, M.; Ming, J.; Mirshekari, S.; Mishra, C.; Mitra, S.; Mitrofanov, V. P.; Mitselmakher, G.; Mittleman, R.; Moe, B.; Mohanty, S. D.; Mohapatra, S. R. P.; Moore, B.; Moraru, D.; Moreno, G.; Morriss, S. R.; Mossavi, K.; Mow-Lowry, C. M.; Mueller, C. L.; Mueller, G.; Mukherjee, S.; Mullavey, A.; Munch, J.; Murphy, D.; Murray, P. G.; Mytidis, A.; Nash, T.; Nayak, R. K.; Necula, V.; Nedkova, K.; Newton, G.; Nguyen, T.; Nielsen, A. B.; Nissanke, S.; Nitz, A. H.; Nolting, D.; Normandin, M. E. N.; Nuttall, L. K.; Ochsner, E.; O'Dell, J.; Oelker, E.; Ogin, G. H.; Oh, J. J.; Oh, S. H.; Ohme, F.; Oppermann, P.; Oram, R.; O'Reilly, B.; Ortega, W.; O'Shaughnessy, R.; Osthelder, C.; Ott, C. D.; Ottaway, D. J.; Ottens, R. S.; Overmier, H.; Owen, B. J.; Padilla, C.; Pai, A.; Pai, S.; Palashov, O.; Pal-Singh, A.; Pan, H.; Pankow, C.; Pannarale, F.; Pant, B. C.; Papa, M. A.; Paris, H.; Patrick, Z.; Pedraza, M.; Pekowsky, L.; Pele, A.; Penn, S.; Perreca, A.; Phelps, M.; Pierro, V.; Pinto, I. M.; Pitkin, M.; Poeld, J.; Post, A.; Poteomkin, A.; Powell, J.; Prasad, J.; Predoi, V.; Premachandra, S.; Prestegard, T.; Price, L. R.; Principe, M.; Privitera, S.; Prix, R.; Prokhorov, L.; Puncken, O.; Pürrer, M.; Qin, J.; Quetschke, V.; Quintero, E.; Quiroga, G.; Quitzow-James, R.; Raab, F. J.; Rabeling, D. S.; Radkins, H.; Raffai, P.; Raja, S.; Rajalakshmi, G.; Rakhmanov, M.; Ramirez, K.; Raymond, V.; Reed, C. M.; Reid, S.; Reitze, D. H.; Reula, O.; Riles, K.; Robertson, N. A.; Robie, R.; Rollins, J. G.; Roma, V.; Romano, J. D.; Romanov, G.; Romie, J. H.; Rowan, S.; Rüdiger, A.; Ryan, K.; Sachdev, S.; Sadecki, T.; Sadeghian, L.; Saleem, M.; Salemi, F.; Sammut, L.; Sandberg, V.; Sanders, J. R.; Sannibale, V.; Santiago-Prieto, I.; Sathyaprakash, B. S.; Saulson, P. R.; Savage, R.; Sawadsky, A.; Scheuer, J.; Schilling, R.; Schmidt, P.; Schnabel, R.; Schofield, R. M. S.; Schreiber, E.; Schuette, D.; Schutz, B. F.; Scott, J.; Scott, S. M.; Sellers, D.; Sengupta, A. S.; Sergeev, A.; Serna, G.; Sevigny, A.; Shaddock, D. A.; Shahriar, M. S.; Shaltev, M.; Shao, Z.; Shapiro, B.; Shawhan, P.; Shoemaker, D. H.; Sidery, T. L.; Siemens, X.; Sigg, D.; Silva, A. D.; Simakov, D.; Singer, A.; Singer, L.; Singh, R.; Sintes, A. M.; Slagmolen, B. J. J.; Smith, J. R.; Smith, M. R.; Smith, R. J. E.; Smith-Lefebvre, N. D.; Son, E. J.; Sorazu, B.; Souradeep, T.; Staley, A.; Stebbins, J.; Steinke, M.; Steinlechner, J.; Steinlechner, S.; Steinmeyer, D.; Stephens, B. C.; Steplewski, S.; Stevenson, S.; Stone, R.; Strain, K. A.; Strigin, S.; Sturani, R.; Stuver, A. L.; Summerscales, T. Z.; Sutton, P. J.; Szczepanczyk, M.; Szeifert, G.; Talukder, D.; Tanner, D. B.; Tápai, M.; Tarabrin, S. P.; Taracchini, A.; Taylor, R.; Tellez, G.; Theeg, T.; Thirugnanasambandam, M. P.; Thomas, M.; Thomas, P.; Thorne, K. A.; Thorne, K. S.; Thrane, E.; Tiwari, V.; Tomlinson, C.; Torres, C. V.; Torrie, C. I.; Traylor, G.; Tse, M.; Tshilumba, D.; Ugolini, D.; Unnikrishnan, C. S.; Urban, A. L.; Usman, S. A.; Vahlbruch, H.; Vajente, G.; Valdes, G.; Vallisneri, M.; van Veggel, A. A.; Vass, S.; Vaulin, R.; Vecchio, A.; Veitch, J.; Veitch, P. J.; Venkateswara, K.; Vincent-Finley, R.; Vitale, S.; Vo, T.; Vorvick, C.; Vousden, W. D.; Vyatchanin, S. P.; Wade, A. R.; Wade, L.; Wade, M.; Walker, M.; Wallace, L.; Walsh, S.; Wang, H.; Wang, M.; Wang, X.; Ward, R. L.; Warner, J.; Was, M.; Weaver, B.; Weinert, M.; Weinstein, A. J.; Weiss, R.; Welborn, T.; Wen, L.; Wessels, P.; Westphal, T.; Wette, K.; Whelan, J. T.; Whitcomb, S. E.; White, D. J.; Whiting, B. F.; Wilkinson, C.; Williams, L.; Williams, R.; Williamson, A. R.; Willis, J. L.; Willke, B.; Wimmer, M.; Winkler, W.; Wipf, C. C.; Wittel, H.; Woan, G.; Worden, J.; Xie, S.; Yablon, J.; Yakushin, I.; Yam, W.; Yamamoto, H.; Yancey, C. C.; Yang, Q.; Zanolin, M.; Zhang, Fan; Zhang, L.; Zhang, M.; Zhang, Y.; Zhao, C.; Zhou, M.; Zhu, X. J.; Zucker, M. E.; Zuraw, S.; Zweizig, J.

    2015-04-01

    The Advanced LIGO gravitational wave detectors are second-generation instruments designed and built for the two LIGO observatories in Hanford, WA and Livingston, LA, USA. The two instruments are identical in design, and are specialized versions of a Michelson interferometer with 4 km long arms. As in Initial LIGO, Fabry-Perot cavities are used in the arms to increase the interaction time with a gravitational wave, and power recycling is used to increase the effective laser power. Signal recycling has been added in Advanced LIGO to improve the frequency response. In the most sensitive frequency region around 100 Hz, the design strain sensitivity is a factor of 10 better than Initial LIGO. In addition, the low frequency end of the sensitivity band is moved from 40 Hz down to 10 Hz. All interferometer components have been replaced with improved technologies to achieve this sensitivity gain. Much better seismic isolation and test mass suspensions are responsible for the gains at lower frequencies. Higher laser power, larger test masses and improved mirror coatings lead to the improved sensitivity at mid and high frequencies. Data collecting runs with these new instruments are planned to begin in mid-2015.

  5. Advanced Pacemaker

    NASA Technical Reports Server (NTRS)

    1990-01-01

    Synchrony, developed by St. Jude Medical's Cardiac Rhythm Management Division (formerly known as Pacesetter Systems, Inc.) is an advanced state-of-the-art implantable pacemaker that closely matches the natural rhythm of the heart. The companion element of the Synchrony Pacemaker System is the Programmer Analyzer APS-II which allows a doctor to reprogram and fine tune the pacemaker to each user's special requirements without surgery. The two-way communications capability that allows the physician to instruct and query the pacemaker is accomplished by bidirectional telemetry. APS-II features 28 pacing functions and thousands of programming combinations to accommodate diverse lifestyles. Microprocessor unit also records and stores pertinent patient data up to a year.

  6. Advanced stellarators

    NASA Astrophysics Data System (ADS)

    Schlüter, Arnulf

    1983-03-01

    Toroidal confinement of a plasma by an external magnetic field is not compatible with axisymmetry, in contrast to confinement by the pinch effect of induced electric currents as in a tokomak or by the reversed field pinch configuration. The existence of magnetic surfaces throughout the region in which grad p ≠ 0 is therefore not guaranteed in such configurations, though it is necessary for MHD-equilibrium when the lines of force possess a finite twist (or "rotational transform"). These twisted equilibria are called stellarators. The other type of external confinement requires all lines of force to be closed upon themselves and p to be function of the well defined quantity Q = φ d l/ B only. The resulting "bumpy" tori are sometimes also referred to as being M + S like. By discussing specific examples it is shown that stellarator configurations exist which retain as much as possible the properties of M + S like configurations, combine these with the magnetic well, and with an approximation to the isodynamic requirement of D. Palumbo. These so-called Advanced Stellarators shown an improvement in predicted particle confinement and beta-limit compared to the classical stellarators. They can also be viewed as forming a system of linked stabilized mirrors of small mirror ratio. These fields can be produced by modular coils. A prototype of such a configuration is being designed by the stellarator division of IPP under the name of Wendelstein VII-AS. Expected physical data and technical details of W VII-AS are given.

  7. Bimaxillary Advancement as the Initial Treatment of Obstructive Sleep Apnea: Five Years Follow-Up of the Pori Experience

    PubMed Central

    Raunio, Antti; Rauhala, Esa; Kiviharju, Minna; Lehmijoki, Ossi; Sándor, George K. B.

    2012-01-01

    ABSTRACT Objectives Bimaxillary advancement surgery has proven to be effective treatment of obstructive sleep apnea syndrome. According to the Stanford protocol upper airway soft tissue surgery or advancement of tongue by chin plastic surgery is first carried out and if obstructive sleep apnea persists, then bimaxillary advancement is done. This study describes the 5 year outcome of 13 obstructive sleep apnea patients in whom the Stanford protocol was omitted and bimaxillary advancement was carried out as initial surgical treatment. Material and Methods Patients were divided in two groups. Group A comprised patients with obstructive sleep apnea (OSAS) confirmed by polysomnography in whom ODI-4 (oxygen desaturation index) was 5 or more. Group B consisted of patients with occlusal problems needing orthognathic surgery and with OSAS symptoms but no clear disease on polysomnography, where the ODI-4 index was less than 5. Both groups were treated with bimaxillary advancement surgery (BAS) as initial therapy. Results In the group A mean ODI-4 was 17.8 (SD 12) before treatment and 3.5 (SD 3.4) at 5-year follow-up (P = 0.018 in paired differences t-test). In group B the ODI-4 remained below 5. In group A mean saturation improved from 94.3% (SD 1.6) to 96.3% (SD 2), P = 0.115 and in group B from 96.3% (SD 1.2) to 97.8% (SD 1.7), P = 0.056 (in paired differences t-test). The static charge sensitive bed evaluation showed improvement in all patients except one. Conclusions Bimaxillary advancement surgery is safe and reliable as an initial surgical treatment of obstructive sleep apnea syndrome. PMID:24422007

  8. Bimaxillary advancement as the initial treatment of obstructive sleep apnea: five years follow-up of the pori experience.

    PubMed

    Raunio, Antti; Rauhala, Esa; Kiviharju, Minna; Lehmijoki, Ossi; Sándor, George K B; Oikarinen, Kyösti

    2012-01-01

    Bimaxillary advancement surgery has proven to be effective treatment of obstructive sleep apnea syndrome. According to the Stanford protocol upper airway soft tissue surgery or advancement of tongue by chin plastic surgery is first carried out and if obstructive sleep apnea persists, then bimaxillary advancement is done. This study describes the 5 year outcome of 13 obstructive sleep apnea patients in whom the Stanford protocol was omitted and bimaxillary advancement was carried out as initial surgical treatment. Patients were divided in two groups. Group A comprised patients with obstructive sleep apnea (OSAS) confirmed by polysomnography in whom ODI-4 (oxygen desaturation index) was 5 or more. Group B consisted of patients with occlusal problems needing orthognathic surgery and with OSAS symptoms but no clear disease on polysomnography, where the ODI-4 index was less than 5. Both groups were treated with bimaxillary advancement surgery (BAS) as initial therapy. In the group A mean ODI-4 was 17.8 (SD 12) before treatment and 3.5 (SD 3.4) at 5-year follow-up (P = 0.018 in paired differences t-test). In group B the ODI-4 remained below 5. In group A mean saturation improved from 94.3% (SD 1.6) to 96.3% (SD 2), P = 0.115 and in group B from 96.3% (SD 1.2) to 97.8% (SD 1.7), P = 0.056 (in paired differences t-test). The static charge sensitive bed evaluation showed improvement in all patients except one. Bimaxillary advancement surgery is safe and reliable as an initial surgical treatment of obstructive sleep apnea syndrome.

  9. Advanced Concept

    NASA Image and Video Library

    2002-01-01

    An artist's rendering of the air-breathing, hypersonic X-43B, the third and largest of NASA's Hyper-X series flight demonstrators, which could fly later this decade. Revolutionizing the way we gain access to space is NASA's primary goal for the Hypersonic Investment Area, managed for NASA by the Advanced Space Transportation Program at the Marshall Space Flight Center in Huntsville, Alabama. The Hypersonic Investment area, which includes leading-edge partners in industry and academia, will support future generation reusable vehicles and improved access to space. These technology demonstrators, intended for flight testing by decade's end, are expected to yield a new generation of vehicles that routinely fly about 100,000 feet above Earth's surface and reach sustained speeds in excess of Mach 5 (3,750 mph), the point at which "supersonic" flight becomes "hypersonic" flight. The flight demonstrators, the Hyper-X series, will be powered by air-breathing rocket or turbine-based engines, and ram/scramjets. Air-breathing engines, known as combined-cycle systems, achieve their efficiency gains over rocket systems by getting their oxygen for combustion from the atmosphere, as opposed to a rocket that must carry its oxygen. Once a hypersonic vehicle has accelerated to more than twice the speed of sound, the turbine or rockets are turned off, and the engine relies solely on oxygen in the atmosphere to burn fuel. When the vehicle has accelerated to more than 10 to 15 times the speed of sound, the engine converts to a conventional rocket-powered system to propel the craft into orbit or sustain it to suborbital flight speed. NASA's series of hypersonic flight demonstrators includes three air-breathing vehicles: the X-43A, X-43B and X-43C.

  10. SCIENCE BRIEF: ADVANCED CONCEPTS

    EPA Science Inventory

    Research on advanced concepts will evaluate and demonstrate the application of innovative infrastructure designs, management procedures and operational approaches. Advanced concepts go beyond simple asset management. The infusion of these advanced concepts into established wastew...

  11. SCIENCE BRIEF: ADVANCED CONCEPTS

    EPA Science Inventory

    Research on advanced concepts will evaluate and demonstrate the application of innovative infrastructure designs, management procedures and operational approaches. Advanced concepts go beyond simple asset management. The infusion of these advanced concepts into established wastew...

  12. Advancing advanced practice - clarifying the conceptual confusion.

    PubMed

    Stasa, Helen; Cashin, Andrew; Buckley, Thomas; Donoghue, Judith

    2014-03-01

    In recent years, there has been a substantial increase in the number of nurses holding advanced practice nursing positions. However, the lack of clarity regarding key terms such as 'advanced practice nursing', 'advanced nursing practice', 'scope of practice' and 'extended practice', and international variability in how these terms are used has created significant confusion. This lack of clarity is problematic for nurses, other health professionals, health service consumers, educators and policy makers, particularly given the global mobility of the nursing workforce. 1) To highlight the significant international variability in how advanced practice nursing, and associated terms such as extended and expanded practice, are defined and regulated across a variety of different English speaking countries, including the US, UK, New Zealand, Canada and Australia. 2) To propose innovative formulations for how the nursing profession may attempt to ensure greater precision and agreement around advanced practice terminology. Discursive paper. It was found that there is a considerable lack of clarity regarding the precise definitions of key terms surrounding the discussion of advanced practice. Additionally, there are large disparities in how the five chosen countries regulate advanced practice nursing, and roles such as that of the nurse practitioner. It is suggested that the confusion regarding advanced practice terminology can be reduced definitionally by minimising the use of the term 'expanded practice'; defining advanced practice nursing to refer to the type of practice in defined and regulated advanced practice nursing scopes; and defining advanced nursing practice as expert practice within a regulated nursing scope. © 2013.

  13. The Effect of mandible advancement splints in mild, moderate, and severe obstructive sleep apnea-the need for sleep registrations during follow up.

    PubMed

    Palotie, Tuula; Riekki, Siru; Mäkitie, Antti; Bachour, Adel; Arte, Sirpa; Bäck, Leif

    2017-10-01

    Our aim was to evaluate the effect of mandible advancement splint (MAS) in mild, moderate, and severe obstructive sleep apnea (OSA). We also determined, if and in which OSA-groups the adequate forward movement in MAS could be quantified without sleep registration for different OSA levels. A retrospective study. The effect of MAS was measured with clinical methods and by sleep registration. The series consisted of 103 patients, 75 males and 28 females (mean age 52 years) suffering from mild (32 per cent), moderate (32 per cent), or severe (36 per cent) OSA, who were treated with MAS at Helsinki University Hospital, Finland during the years 2011-2012. Seventy per cent of the patients had tried continuous positive airway pressure (CPAP) before MAS. The lower the body mass index (BMI) was the bigger the probability was to get apnea/hypopnea index (AHI) values <5 per hour with MAS (P < 0.01). The total AHI decreased significantly from the baseline with MAS: 23 per hour (range 5-89) to 6 per hour (range 0.3-54), (P < 0.001). The mean oxygen desaturation index (ODI4%) improved significantly from 16 per hour (range 1-76) to 5.3 per hour (range 0.2-49), (P < 0.01), and the minimum oxygen saturation improved significantly from 84 per cent (67-91) to 87 per cent (68-93), (P < 0.01). The reduction of AHI with MAS was significantly bigger in patients with a previous CPAP experience (73 per cent) than those who did not tried CPAP therapy. The positive correlation was found between the decrease in AHI and the increase of the protrusion in MAS. Both sleep recordings and subjective indicators demonstrated that MAS therapy was successful in OSA based on ESS, total AHI, ODI4%, and minimum oxygen saturation values. It seems useful to increase the protrusion at its maximal clinical tolerance. An experienced dentist could make therapeutically decision concerning the follow up of MAS efficacy regardless of the result of sleep study. We suggest that MAS is a valuable treatment alternative

  14. Frequency Agile Transceiver for Advanced Vehicle Data Links

    NASA Technical Reports Server (NTRS)

    Freudinger, Lawrence C.; Macias, Filiberto; Cornelius, Harold

    2009-01-01

    Emerging and next-generation test instrumentation increasingly relies on network communication to manage complex and dynamic test scenarios, particularly for uninhabited autonomous systems. Adapting wireless communication infrastructure to accommodate challenging testing needs can benefit from reconfigurable radio technology. Frequency agility is one characteristic of reconfigurable radios that to date has seen only limited progress toward programmability. This paper overviews an ongoing project to validate a promising chipset that performs conversion of RF signals directly into digital data for the wireless receiver and, for the transmitter, converts digital data into RF signals. The Software Configurable Multichannel Transceiver (SCMT) enables four transmitters and four receivers in a single unit, programmable for any frequency band between 1 MHz and 6 GHz.

  15. Treatment success with titratable thermoplastic mandibular advancement devices for obstructive sleep apnea: A comparison of patient characteristics.

    PubMed

    Wang, Tang-Chuan; Tsou, Yung-An; Wu, Yi-Fan; Huang, Chia-Chang; Lin, Wesley Wen-Yang; Li, Yu-Fen; Chen, Michael Yuan-Chien; Tai, Chih-Jaan; Tsai, Ming-Hsui

    2017-03-01

    A titratable thermoplastic mandibular advancement device (MAD) is clearly an effective treatment option in some patients with obstructive sleep apnea (OSA). Determining which patients may be more likely to respond to treatment with thermoplastic MADs and to adhere to treatment would be of obvious clinical relevance. This was an experimental descriptive study (N = 60). Patients with OSA were instructed to wear a titratable thermoplastic MAD for 3 months. Treatment success was defined as a ≥50% reduction from baseline in the apnea-hypopnea index (AHI) or AHI <10 when wearing MAD. Adherence was defined as MAD use ≥5 nights/week. Treatment was successful in 66.7% of patients and 60.0% were adherent. All polysomnographic parameters and visual analogue scale scores (sleep quality, snoring, waking refreshed) were significantly improved after treatment. The patients in whom treatment failed had significantly higher neck circumferences (39.3 cm vs. 37.5 cm, p = 0.014), higher baseline AHI values (26.6 vs. 18.0, p = 0.016), and smaller AHI reduction (-31.8 vs -53.1, p < 0.001) than those in the group in whom treatment succeeded. There were no significant differences in polysomnographic, cephalometric, or visual analogue scale measures between patients for whom treatment was and was not successful, regardless of baseline values or the change rates after the MAD was placed. Titratable thermoplastic MADs can improve indicators of sleep quality, even in patients in whom treatment is considered to have failed.

  16. Computational Fluid Dynamic Analysis of the Posterior Airway Space After Maxillomandibular Advancement For Obstructive Sleep Apnea Syndrome

    PubMed Central

    Sittitavornwong, Somsak; Waite, Peter D.; Shih, Alan M.; Cheng, Gary C.; Koomullil, Roy; Ito, Yasushi; Cure, Joel K; Harding, Susan M.; Litaker, Mark

    2013-01-01

    Purpose Evaluate the soft tissue change of the upper airway after maxillomandibular advancement (MMA) by computational fluid dynamics (CFD). Materials and Methods Eight OSAS patients who required MMA were recruited into this study. All participants had pre- and post-operative computed tomography (CT) and underwent MMA by a single oral and maxillofacial surgeon. Upper airway CT data sets for these 8 participants were created with high-fidelity 3-D numerical models for computational fluid dynamics (CFD). The 3-D models were simulated and analyzed to study how changes in airway anatomy affects pressure effort required for normal breathing. Airway dimensions, skeletal changes, Apnea-Hypopnea Index (AHI), and pressure efforts of pre- and post-operative 3-D models were compared and correlations interpreted. Results After MMA, laminar and turbulent air flow was significantly decreased at every level of the airway. The cross-sectional areas at the soft palate and tongue base were significantly increased. Conclusions This study shows that MMA increases airway dimensions by the increasing the occipital base (Base) - pogonion (Pg) distance. An increase of the Base-Pg distance showed a significant correlation with an AHI improvement and a decreased pressure effort of the upper airway. Decreasing the pressure effort will decrease the breathing workload. This improves the condition of OSAS. PMID:23642544

  17. ADVANCED MANUFACTURING TEAM

    NASA Image and Video Library

    2014-01-16

    ZACK JONES AND JIM LYDON OF MSFC’S ADVANCED MANUFACTURING TEAM, WITH MSFC’S M2 SELECTIVE LASER MELTING SYSTEM. THE M2 IS CURRENTLY DEDICATED TO ADVANCED COPPER MATERIAL DEVELOPMENT FOR THE LOW COST UPPER STAGE PROGRAM.

  18. Advances in forefoot trauma.

    PubMed

    Clements, J Randolph; Schopf, Robert

    2013-07-01

    Forefoot traumas, particularly involving the metatarsals, are commonly occurring injuries. There have been several advances in management of these injuries. These advances include updates in operative technique, internal fixation options, plating constructs, and external fixation. In addition, the advances of soft tissue management have improved outcomes. This article outlines these injuries and provides an update on techniques, principles, and understanding of managing forefoot trauma.

  19. Advanced planetary studies

    NASA Technical Reports Server (NTRS)

    1977-01-01

    Results of planetary advanced studies and planning support are summarized. The scope of analyses includes cost estimation research, planetary mission performance, penetrator advanced studies, Mercury mission transport requirements, definition of super solar electric propulsion/solar sail mission discriminators, and advanced planning activities.

  20. Advances in Serials Management. Volume 6.

    ERIC Educational Resources Information Center

    Hepfer, Cindy, Ed.; Gammon, Julia, Ed.; Malinowski, Teresa, Ed.

    In order to further discussion and support constructive change, this volume presents the following eight papers on various dimensions of serials management: (1) "CD-ROMs, Surveys, and Sales: The OSA [Optical Society of America] Experience" (Frank E. Harris and Alan Tourtlotte); (2) "Management and Integration of Electronic Journals into the…

  1. Advances in Serials Management. Volume 6.

    ERIC Educational Resources Information Center

    Hepfer, Cindy, Ed.; Gammon, Julia, Ed.; Malinowski, Teresa, Ed.

    In order to further discussion and support constructive change, this volume presents the following eight papers on various dimensions of serials management: (1) "CD-ROMs, Surveys, and Sales: The OSA [Optical Society of America] Experience" (Frank E. Harris and Alan Tourtlotte); (2) "Management and Integration of Electronic Journals into the…

  2. Session: CSP Advanced Systems -- Advanced Overview (Presentation)

    SciTech Connect

    Mehos, M.

    2008-04-01

    The project description is: (1) it supports crosscutting activities, e.g. advanced optical materials, that aren't tied to a single CSP technology and (2) it supports the 'incubation' of new concepts in preliminary stages of investigation.

  3. 77 FR 66481 - Certain Integrated Circuits, Chipsets, and Products Containing Same Including Televisions; Notice...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-05

    ..., California; Amtran Technology Co., Ltd. of Xinbei City, Taiwan; and Amtran Logistics, Inc. of Irvine... the following as respondents: MediaTek Inc. of Hsinchu City, Taiwan; Zoran Corporation of Sunnyvale... Corporation of San Diego, California; Sanyo Manufacturing Corporation of Forrest City, Arizona; TPV Technology...

  4. Custom chipset and compact module design for a 75-110 GHz laboratory signal source

    NASA Astrophysics Data System (ADS)

    Morgan, Matthew A.; Boyd, Tod A.; Castro, Jason J.

    2016-12-01

    We report on the development and characterization of a compact, full-waveguide bandwidth (WR-10) signal source for general-purpose testing of mm-wave components. The monolithic microwave integrated circuit (MMIC) based multichip module is designed for compactness and ease-of-use, especially in size-constrained test sets such as a wafer probe station. It takes as input a cm-wave continuous-wave (CW) reference and provides a factor of three frequency multiplication as well as amplification, output power adjustment, and in situ output power monitoring. It utilizes a number of custom MMIC chips such as a Schottky-diode limiter and a broadband mm-wave detector, both designed explicitly for this module, as well as custom millimeter-wave multipliers and amplifiers reported in previous papers.

  5. Very high speed integrated circuit /VHSIC/ antijam communications chipset and brassboard demonstration

    NASA Astrophysics Data System (ADS)

    Bowers, G. F.

    1982-10-01

    Three Hughes VHSIC chips for use in digital anti-jam communications systems are described. These chips will be produced in CMOS/SOS using the Hughes 1.25 micron SOS III process. Common features of four digital communications system applications are reviewed. The advantage of spread spectrum signal processing in a jamming environment is identified. The paper then describes the architecture of each signal processing chip type, their performance design goals, and their use in a demonstration with the Army's PLRS/JTIDS Hybrid System as a prototype battlefield information distribution system.

  6. VLSI chip-set for data compression using the Rice algorithm

    NASA Technical Reports Server (NTRS)

    Venbrux, J.; Liu, N.

    1990-01-01

    A full custom VLSI implementation of a data compression encoder and decoder which implements the lossless Rice data compression algorithm is discussed in this paper. The encoder and decoder reside on single chips. The data rates are to be 5 and 10 Mega-samples-per-second for the decoder and encoder respectively.

  7. Drug-induced sleep endoscopy as a selection tool for mandibular advancement therapy by oral device in patients with mild to moderate obstructive sleep apnoea.

    PubMed

    De Corso, E; Bastanza, G; Della Marca, G; Grippaudo, C; Rizzotto, G; Marchese, M R; Fiorita, A; Sergi, B; Meucci, D; Di Nardo, W; Paludetti, G; Scarano, E

    2015-12-01

    Nowadays oral appliance therapy is recognised as an effective therapy for many patients with primary snoring and mild to moderate obstructive sleep apnoea (OSA), as well as those with more severe OSA who cannot tolerate positive airway pressure (PAP) therapies. For this reason, it is important to focus on objective criteria to indicate which subjects may benefit from treatment with a mandibular advancement device (MAD). Various anthropometric and polysomnographic predictors have been described in the literature, whereas there are still controversies about the role of drug-induced sleep endoscopy (DISE) and advancement bimanual manoeuvre as predictor factors of treatment outcome by oral device. Herein, we report our experience in treatment of mild moderate OSA by oral appliance selected by DISE. We performed a single institution, longitudinal prospective evaluation of a consecutive group of mild moderate patients with obstructive sleep apnoea syndrome who underwent DISE. During sleep endoscopy, gentle manoeuvre of mandibular advancement less than 5 mm was performed. In 30 of 65 patients (46.2%) we obtained an unsuccessful improvement of airway patency whereas in 35 of 65 patients (53.8%) the improvement was successful and patients were considered suitable for oral device application. Because 7 of 35 patients were excluded due to conditions interfering with oral appliance therapy, we finally treated 28 patients. After 3 months of treatment, we observed a significant improvement in the Epworth medium index [(7.35 ± 2.8 versus 4.1 ± 2.2 (p < 0.05)], in mean AHI [(21.4 ± 6 events per hour versus 8.85 ± 6.9 (p < 0.05)] and in mean ODI [(18.6 ± 8 events per hour to 7 ± 5.8 (p < 0.05)]. We observed that the apnoea/hypopnoea index (AHI) improved by up to 50% from baseline in 71.4% of patients selected after DISE for MAD therapy. In the current study, mandibular advancement splint therapy was successfully prescribed on the basis not only of severity of disease, as

  8. Long-term side effects on the temporomandibular joints and oro-facial function in patients with obstructive sleep apnoea treated with a mandibular advancement device.

    PubMed

    Knappe, S W; Bakke, M; Svanholt, P; Petersson, A; Sonnesen, L

    2017-01-17

    Patients with obstructive sleep apnoea (OSA) in long-term treatment with a mandibular advancement device (MAD) to increase the upper airway space may develop changes in the temporomandibular joint (TMJ) and the oro-facial function due to the protruded jaw position during sleep. The aim was to investigate the influence of long-term MAD treatment on the TMJs, oro-facial function and occlusion. This prospective study included 30 men and 13 women (median age 54) with OSA [Apnoea-Hypopnoea Index (AHI): 7-57]. They were examined with the Nordic Orofacial Test Screening (NOT-S), the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and cone beam computed tomography (CBCT) of the TMJs. The examination was performed before MAD treatment (T0), and 3-6 months (T1, no CBCT), 1 year (T2) and 3 years (T3) after treatment start. The results were analysed as long term (T0-T3, n = 14) and short term (T0-T2, n = 24) by t-test, Fisher's exact test and anova. Both long- and short-term analyses revealed a reduction in AHI (P < 0·002). Significant long term were increased scores in the NOT-S Interview (P < 0·045), reduced vertical overbite (P < 0·031) and increased jaw protrusive movement (P < 0·027). TMJ changes were found as joint sounds in terms of reciprocal clicking and crepitus, short term as a decrease and subsequent recurrence (P < 0·053; P < 0·037). No significant radiological changes were found. In conclusion, MAD treatment is beneficial to some OSA patients, but might induce changes in the TMJs, the oro-facial function and the occlusion. However, these changes seemed to be less harmful than previously reported with careful adaptation, control and follow-ups.

  9. Advanced data compression promises the next big leap in network performance

    NASA Astrophysics Data System (ADS)

    Holtz, Klaus E.; Holtz, Eric S.; Kalienky, Diana

    1998-09-01

    Three recently introduced technologies: a new Autosophy information theory; fast Content Addressable Memories; and Packet Switching protocols, are combined in data compression chipsets to improve network throughput with real-time lossless text and image compression. Compared with the cost of putting new cables into the ground or launching new satellites, data compression chipsets offer a much less expensive alternative for improving the bandwidth of broadband communication networks. Data compression is based on a new Autosophy information theory in which, in contrast to Shannon's theory, communication is determined only by the data content. In addition to high lossless data compression, this also provides virtually unbreakable 'codebook' encryption and easier communication via packet switching networks. The Autosophy theories provide eight known classes of self-learning Omni Dimensional Networks. Only the serial network is explained here for use in compressed text and video communications. A new Content Addressable Read Only Memory (CAROM) may increase data compression speed to more than 20 Million symbols per second, fast enough for virtually any network speed.

  10. Advance Care Planning.

    PubMed

    Stallworthy, Elizabeth J

    2013-04-16

    Advance care planning should be available to all patients with chronic kidney disease, including end-stage kidney disease on renal replacement therapy. Advance care planning is a process of patient-centred discussion, ideally involving family/significant others, to assist the patient to understand how their illness might affect them, identify their goals and establish how medical treatment might help them to achieve these. An Advance Care Plan is only one useful outcome from the Advance Care Planning process, the education of patient and family around prognosis and treatment options is likely to be beneficial whether or not a plan is written or the individual loses decision making capacity at the end of life. Facilitating Advance Care Planning discussions requires an understanding of their purpose and communication skills which need to be taught. Advance Care Planning needs to be supported by effective systems to enable the discussions and any resulting Plans to be used to aid subsequent decision making.

  11. Generalization of color-difference formulas for any illuminant and any observer by assuming perfect color constancy in a color-vision model based on the OSA-UCS system.

    PubMed

    Oleari, Claudio; Melgosa, Manuel; Huertas, Rafael

    2011-11-01

    The most widely used color-difference formulas are based on color-difference data obtained under D65 illumination or similar and for a 10° visual field; i.e., these formulas hold true for the CIE 1964 observer adapted to D65 illuminant. This work considers the psychometric color-vision model based on the Optical Society of America-Uniform Color Scales (OSA-UCS) system previously published by the first author [J. Opt. Soc. Am. A 21, 677 (2004); Color Res. Appl. 30, 31 (2005)] with the additional hypothesis that complete illuminant adaptation with perfect color constancy exists in the visual evaluation of color differences. In this way a computational procedure is defined for color conversion between different illuminant adaptations, which is an alternative to the current chromatic adaptation transforms. This color conversion allows the passage between different observers, e.g., CIE 1964 and CIE 1931. An application of this color conversion is here made in the color-difference evaluation for any observer and in any illuminant adaptation: these transformations convert tristimulus values related to any observer and illuminant adaptation to those related to the observer and illuminant adaptation of the definition of the color-difference formulas, i.e., to the CIE 1964 observer adapted to the D65 illuminant, and then the known color-difference formulas can be applied. The adaptations to the illuminants A, C, F11, D50, Planckian and daylight at any color temperature and for CIE 1931 and CIE 1964 observers are considered as examples, and all the corresponding transformations are given for practical use.

  12. Constraining Source Locations of Shallow Subduction Megathrust Earthquakes in 1-D and 3-D Velocity Models - A Case Study of the 2002 Mw=6.4 Osa Earthquake, Costa Rica

    NASA Astrophysics Data System (ADS)

    Grevemeyer, I.; Arroyo, I. G.

    2015-12-01

    Earthquake source locations are generally routinely constrained using a global 1-D Earth model. However, the source location might be associated with large uncertainties. This is definitively the case for earthquakes occurring at active continental margins were thin oceanic crust subducts below thick continental crust and hence large lateral changes in crustal thickness occur as a function of distance to the deep-sea trench. Here, we conducted a case study of the 2002 Mw 6.4 Osa thrust earthquake in Costa Rica that was followed by an aftershock sequence. Initial relocations indicated that the main shock occurred fairly trenchward of most large earthquakes along the Middle America Trench off central Costa Rica. The earthquake sequence occurred while a temporary network of ocean-bottom-hydrophones and land stations 80 km to the northwest were deployed. By adding readings from permanent Costa Rican stations, we obtain uncommon P wave coverage of a large subduction zone earthquake. We relocated this catalog using a nonlinear probabilistic approach using a 1-D and two 3-D P-wave velocity models. The 3-D model was either derived from 3-D tomography based on onshore stations and a priori model based on seismic refraction data. All epicentres occurred close to the trench axis, but depth estimates vary by several tens of kilometres. Based on the epicentres and constraints from seismic reflection data the main shock occurred 25 km from the trench and probably along the plate interface at 5-10 km depth. The source location that agreed best with the geology was based on the 3-D velocity model derived from a priori data. Aftershocks propagated downdip to the area of a 1999 Mw 6.9 sequence and partially overlapped it. The results indicate that underthrusting of the young and buoyant Cocos Ridge has created conditions for interpolate seismogenesis shallower and closer to the trench axis than elsewhere along the central Costa Rica margin.

  13. Advances in pediatric anesthesia.

    PubMed

    Burns, L S

    1997-03-01

    Advances in many aspects of pediatric anesthesia have resulted in a significant reduction in morbidity and mortality in children. Research and development have created vast improvements in pharmacology. Sophisticated monitoring and improvements in equipment evolved from advances made in scientific technology. Recognition of the psychological needs of children of all ages likely has reduced the incidence of lasting psychological effects after hospitalization. Finally, these important advances have made pediatric anesthesia a safer and more compassionate specialty.

  14. Advanced echocardiographic techniques

    PubMed Central

    Perry, Rebecca

    2015-01-01

    Abstract Echocardiography has advanced significantly since its first clinical use. The move towards more accurate imaging and quantification has driven this advancement. In this review, we will briefly focus on three distinct but important recent advances, three‐dimensional (3D) echocardiography, contrast echocardiography and myocardial tissue imaging. The basic principles of these techniques will be discussed as well as current and future clinical applications. PMID:28191159

  15. Hydromechanical Advanced Coal Excavator

    NASA Technical Reports Server (NTRS)

    Estus, Jay M.; Summers, David

    1990-01-01

    Water-jet cutting reduces coal dust and its hazards. Advanced mining system utilizes full-face, hydromechanical, continuous miner. Coal excavator uses high-pressure water-jet lances, one in each of cutting heads and one in movable lance, to make cuts across top, bottom and middle height, respectively, of coal face. Wedge-shaped cutting heads advance into lower and upper cuts in turn, thereby breaking coal toward middle cut. Thrust cylinders and walking pads advance excavator toward coal face.

  16. Advancing the educational agenda.

    PubMed

    Baker, Cynthia

    2010-12-01

    This timely paper provides a thought-provoking analysis of current advanced practice nursing education in Canada. It comes at a critical juncture in the evolution of Canadian healthcare services and the redefinition of nursing roles. Increasingly, multiple sectors of society are calling for more nurses with advanced practice preparation and for a wider range of advanced practice nursing specialties. Advanced practice nurses (APNs) are being proposed as a solution to a financially overburdened national healthcare system, the increasing complexity of healthcare services, and a crisis in access to primary healthcare. Thus, governments seeking greater fiscal efficiency, medical specialists needing sophisticated collaborative support, and healthcare consumers see APNs as the way forward.

  17. OSA Imaging and Applied Optics Congress Support

    DTIC Science & Technology

    2017-02-16

    and Computational Optical Sensing and Imaging (COSI) .The meetings exposed attendees to in-depth learning of optical sensing and imaging and their...were supported by this grant. The meetings exposed attendees to in-depth learning of optical sensing and imaging and their applications from...Participants can hear about the latest products and services, but more importantly, learn about entrepreneurial opportunities and how scientific

  18. Advanced Manufacturing Technologies

    NASA Technical Reports Server (NTRS)

    Fikes, John

    2016-01-01

    Advanced Manufacturing Technologies (AMT) is developing and maturing innovative and advanced manufacturing technologies that will enable more capable and lower-cost spacecraft, launch vehicles and infrastructure to enable exploration missions. The technologies will utilize cutting edge materials and emerging capabilities including metallic processes, additive manufacturing, composites, and digital manufacturing. The AMT project supports the National Manufacturing Initiative involving collaboration with other government agencies.

  19. Kansas Advanced Semiconductor Project

    SciTech Connect

    Baringer, P.; Bean, A.; Bolton, T.; Horton-Smith, G.; Maravin, Y.; Ratra, B.; Stanton, N.; von Toerne, E.; Wilson, G.

    2007-09-21

    KASP (Kansas Advanced Semiconductor Project) completed the new Layer 0 upgrade for D0, assumed key electronics projects for the US CMS project, finished important new physics measurements with the D0 experiment at Fermilab, made substantial contributions to detector studies for the proposed e+e- international linear collider (ILC), and advanced key initiatives in non-accelerator-based neutrino physics.

  20. Advanced planetary studies

    NASA Technical Reports Server (NTRS)

    1976-01-01

    Results of planetary advanced studies and planning support are summarized. The scope of analyses includes cost estimation research, planetary mission performance, penetrator mission concepts for airless planets/satellites, geology orbiter payload adaptability, lunar mission performance, and advanced planning activities. Study reports and related publications are included in a bibliography section.

  1. Advanced Network Security Project

    DTIC Science & Technology

    2005-12-01

    network. The network observed was the Abilene network of the University Consortium for Advanced Internet Development (UCAID), often known as “ Internet2 ...for Advanced Internet Development (UCAID), often known as “ Internet2 .” This contract was heavily operational in nature, as opposed to a contract

  2. Advanced Life Support

    NASA Technical Reports Server (NTRS)

    Chambliss, Joe

    2004-01-01

    Viewgraphs on Advanced Life Support (ALS) Systems are presented. The topics include: 1) Fundamental Need for Advanced Life Support; 2) ALS organization; 3) Requirements and Rationale; 4) Past Integrated tests; 5) The need for improvements in life support systems; 6) ALS approach to meet exploration goals; 7) ALS Projects showing promise to meet exploration goals; and 9) GRC involvement in ALS.

  3. ADVANCED MANUFACTURING TEAM

    NASA Image and Video Library

    2014-01-16

    QUINCY BEAN, JIM LYDON, AND ZACK JONES OF MSFC’S ADVANCED MANUFACTURING TEAM, WITH MSFC’S M2 SELECTIVE LASER MELTING SYSTEM. THE M2 IS CURRENTLY DEDICATED TO ADVANCED COPPER MATERIAL DEVELOPMENT FOR THE LOW COST UPPER STAGE PROGRAM.

  4. Advances in dental materials.

    PubMed

    Fleming, Garry J P

    2014-05-01

    The dental market is replete with new resorative materials marketed on the basis of novel technological advances in materials chemistry, bonding capability or reduced operator time and/or technique sensitivity. This paper aims to consider advances in current materials, with an emphasis on their role in supporting contemporary clinical practice.

  5. Advanced Ceramic Armor Materials

    DTIC Science & Technology

    1990-05-11

    materials, toughened alumina, fiber -reinforced glass matrix composites, and multilayer-gradient materials for ballistic testing. Fabrication and...material systems: Multilayer advanced armor materials consisting of a hard ceramic faceplate bonded to a graphite fiber -reinforced glass matrix...toughened alumina, and fiber - applied studies of advanced reinforced ceramic matrix glass and glass -ceramic composites for ballistic testing. technologies

  6. Advanced Engineering Fibers.

    ERIC Educational Resources Information Center

    Edie, Dan D.; Dunham, Michael G.

    1987-01-01

    Describes Clemson University's Advanced Engineered Fibers Laboratory, which was established to provide national leadership and expertise in developing the processing equipment and advance fibers necessary for the chemical, fiber, and textile industries to enter the composite materials market. Discusses some of the laboratory's activities in…

  7. Advances in tissue engineering.

    PubMed

    Langer, Robert; Vacanti, Joseph

    2016-01-01

    Nearly 30 years ago, we reported on a concept now known as Tissue Engineering. Here, we report on some of the advances in this now thriving area of research. In particular, significant advances in tissue engineering of skin, liver, spinal cord, blood vessels, and other areas are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Advances in Tissue Engineering

    PubMed Central

    Vacanti, Joseph

    2016-01-01

    Nearly 30 years ago, we reported on a concept now known as Tissue Engineering. Here, we report on some of the advances in this now thriving area of research. In particular, significant advances in tissue engineering of skin, liver, spinal cord, blood vessels, and other areas are discussed. PMID:26711689

  9. Advanced Engineering Fibers.

    ERIC Educational Resources Information Center

    Edie, Dan D.; Dunham, Michael G.

    1987-01-01

    Describes Clemson University's Advanced Engineered Fibers Laboratory, which was established to provide national leadership and expertise in developing the processing equipment and advance fibers necessary for the chemical, fiber, and textile industries to enter the composite materials market. Discusses some of the laboratory's activities in…

  10. Drilling at Advanced Levels

    ERIC Educational Resources Information Center

    Case, Doug

    1977-01-01

    Instances where drilling is useful for advanced language are discussed. Several types of drills are recommended, with the philosophy that advanced level drills should have a lighter style and be regarded as a useful, occasional means of practicing individual new items. (CHK)

  11. Advanced Chemical Propulsion Study

    NASA Technical Reports Server (NTRS)

    Woodcock, Gordon; Byers, Dave; Alexander, Leslie A.; Krebsbach, Al

    2004-01-01

    A study was performed of advanced chemical propulsion technology application to space science (Code S) missions. The purpose was to begin the process of selecting chemical propulsion technology advancement activities that would provide greatest benefits to Code S missions. Several missions were selected from Code S planning data, and a range of advanced chemical propulsion options was analyzed to assess capabilities and benefits re these missions. Selected beneficial applications were found for higher-performing bipropellants, gelled propellants, and cryogenic propellants. Technology advancement recommendations included cryocoolers and small turbopump engines for cryogenic propellants; space storable propellants such as LOX-hydrazine; and advanced monopropellants. It was noted that fluorine-bearing oxidizers offer performance gains over more benign oxidizers. Potential benefits were observed for gelled propellants that could be allowed to freeze, then thawed for use.

  12. Soluble Receptor for Advanced Glycation End Product Ameliorates Chronic Intermittent Hypoxia Induced Renal Injury, Inflammation, and Apoptosis via P38/JNK Signaling Pathways

    PubMed Central

    Wu, Xu; Gu, Wenyu; Lu, Huan; Liu, Chengying; Yu, Biyun; Xu, Hui; Tang, Yaodong

    2016-01-01

    Obstructive sleep apnea (OSA) associated chronic kidney disease is mainly caused by chronic intermittent hypoxia (CIH) triggered tissue damage. Receptor for advanced glycation end product (RAGE) and its ligand high mobility group box 1 (HMGB1) are expressed on renal cells and mediate inflammatory responses in OSA-related diseases. To determine their roles in CIH-induced renal injury, soluble RAGE (sRAGE), the RAGE neutralizing antibody, was intravenously administered in a CIH model. We also evaluated the effect of sRAGE on inflammation and apoptosis. Rats were divided into four groups: (1) normal air (NA), (2) CIH, (3) CIH+sRAGE, and (4) NA+sRAGE. Our results showed that CIH accelerated renal histological injury and upregulated RAGE-HMGB1 levels involving inflammatory (NF-κB, TNF-α, and IL-6), apoptotic (Bcl-2/Bax), and mitogen-activated protein kinases (phosphorylation of P38, ERK, and JNK) signal transduction pathways, which were abolished by sRAGE but p-ERK. Furthermore, sRAGE ameliorated renal dysfunction by attenuating tubular endothelial apoptosis determined by immunofluorescence staining of CD31 and TUNEL. These findings suggested that RAGE-HMGB1 activated chronic inflammatory transduction cascades that contributed to the pathogenesis of the CIH-induced renal injury. Inhibition of RAGE ligand interaction by sRAGE provided a therapeutic potential for CIH-induced renal injury, inflammation, and apoptosis through P38 and JNK pathways. PMID:27688824

  13. Advancing Ethical Neuroscience Research.

    PubMed

    Borah, B Rashmi; Strand, Nicolle K; Chillag, Kata L

    2016-12-01

    As neuroscience research advances, researchers, clinicians, and other stakeholders will face a host of ethical challenges. The Presidential Commission for the Study of Bioethical Issues (Bioethics Commission) has published two reports that provide recommendations on how to advance research endeavors ethically. The commission addressed, among other issues, how to prioritize different types of neuroscience research and how to include research participants who have impaired consent capacity. The Bioethics Commission's recommendations provide a foundation for ethical guidelines as neuroscience research advances and progresses. © 2016 American Medical Association. All Rights Reserved.

  14. Advanced information society(7)

    NASA Astrophysics Data System (ADS)

    Chiba, Toshihiro

    Various threats are hiding in advanced informationalized society. As we see car accident problems in motorization society light aspects necessarily accompy shady ones. Under the changing circumstances of advanced informationalization added values of information has become much higher. It causes computer crime, hacker, computer virus to come to the surface. In addition it can be said that infringement of intellectual property and privacy are threats brought by advanced information. Against these threats legal, institutional and insurance measures have been progressed, and newly security industry has been established. However, they are not adequate individually or totally. The future vision should be clarified, and countermeasures according to the visions have to be considered.

  15. The ADvanced SEParation (ADSEP)

    NASA Technical Reports Server (NTRS)

    1998-01-01

    The ADvanced SEParation (ADSEP) commercial payload is making use of major advances in separation technology: The Phase Partitioning Experiment (PPE); the Micorencapsulation experiment; and the Hemoglobin Separation Experiment (HSE). Using ADSEP, commercial researchers will attempt to determine the partition coefficients for model particles in a two-phase system. With this information, researchers can develop a higher resolution, more effective cell isolation procedure that can be used for many different types of research and for improved health care. The advanced separation technology is already being made available for use in ground-based laboratories.

  16. Advanced biostack experiment

    NASA Technical Reports Server (NTRS)

    Buecker, H.

    1981-01-01

    The Advanced Biostack Experiment is described. The objectives are: (1) to confirm, complement, and enlarge the information obtained from the previous experiments by applying improved and advanced methods of localization and physical and biological evaluation, performing advanced experiments based on these data, and including additional biological specimens and additional radiation detectors; (2) to determine the biological importance of nuclear disintegration stars; (3) to determine the interference of HZE particle induced effects with those of other space flight factors (e.g., weightlessness); and (4) to determine the distribution of HZE particles and of disintegration stars at different locations inside the module and on the pallet.

  17. Advanced biostack experiment

    SciTech Connect

    Buecker, H.

    1981-11-01

    The Advanced Biostack Experiment is described. The objectives are: (1) to confirm, complement, and enlarge the information obtained from the previous experiments by applying improved and advanced methods of localization and physical and biological evaluation, performing advanced experiments based on these data, and including additional biological specimens and additional radiation detectors (2) to determine the biological importance of nuclear disintegration stars (3) to determine the interference of HZE particle induced effects with those of other space flight factors (e.g., weightlessness) and (4) to determine the distribution of HZE particles and of disintegration stars at different locations inside the module and on the pallet.

  18. Advanced houses guide

    SciTech Connect

    1995-12-31

    Section 1 of this report describes the R-2000 and Advanced Houses programs, and reviews the technical requirements of Advanced Houses with regard to purchased energy, environmental features, and indoor comfort/health. Subsequent sections describe design considerations, construction issues, existing installations, and alternate approaches used in the following components of Advanced Houses: Foundation systems, wall systems, windows and exterior doors, interior finishes and indoor air quality, environmental materials, mechanical systems, home automation, lights and appliances, renewable energy and heat recovery systems, and environmental management.

  19. Advanced Computer Typography.

    DTIC Science & Technology

    1981-12-01

    ADVANCED COMPUTER TYPOGRAPHY .(U) DEC 81 A V HERSHEY UNCLASSIFIED NPS012-81-005 M MEEEIEEEII IIUJIL15I.4 MICROCQP RE SO.JjI ON ft R NPS012-81-005...NAVAL POSTGRADUATE SCHOOL 0Monterey, California DTIC SELECTEWA APR 5 1982 B ADVANCED COMPUTER TYPOGRAPHY by A. V. HERSHEY December 1981 OApproved for...Subtitle) S. TYPE Or REPORT & PERIOD COVERED Final ADVANCED COMPUTER TYPOGRAPHY Dec 1979 - Dec 1981 S. PERFORMING ORG. REPORT NUMBER 7. AUTHOR(s) S CONTRACT

  20. Advanced Electronic Technology.

    DTIC Science & Technology

    1978-11-15

    It AD AObS 062 MASSACHUSETTS INST OF TECH LEXINGTON LINCOLN LAB F/S 9/S ADVANCED ELECTRONIC TECHNOLOGY .(U) NOV 78 A J MCLAUGHLIN. A L MCWHORTER...T I T U T E OF T E C H N O L O G Y L I N C O L N L A B O R A T O R Y ADVANCED ELECTRONIC TECHNOLOGY QUARTERLY TECKNICAL SUMMAR Y REPORT TO THE AIR...Division 8 (Solid State) on the Advanced Electronic Technology Program. Hi

  1. The ADvanced SEParation (ADSEP)

    NASA Technical Reports Server (NTRS)

    1998-01-01

    The ADvanced SEParation (ADSEP) commercial payload is making use of major advances in separation technology: The Phase Partitioning Experiment (PPE); the Micorencapsulation experiment; and the Hemoglobin Separation Experiment (HSE). Using ADSEP, commercial researchers will attempt to determine the partition coefficients for model particles in a two-phase system. With this information, researchers can develop a higher resolution, more effective cell isolation procedure that can be used for many different types of research and for improved health care. The advanced separation technology is already being made available for use in ground-based laboratories.

  2. Advanced biostack experiment

    NASA Technical Reports Server (NTRS)

    Buecker, H.

    1981-01-01

    The Advanced Biostack Experiment is described. The objectives are: (1) to confirm, complement, and enlarge the information obtained from the previous experiments by applying improved and advanced methods of localization and physical and biological evaluation, performing advanced experiments based on these data, and including additional biological specimens and additional radiation detectors; (2) to determine the biological importance of nuclear disintegration stars; (3) to determine the interference of HZE particle induced effects with those of other space flight factors (e.g., weightlessness); and (4) to determine the distribution of HZE particles and of disintegration stars at different locations inside the module and on the pallet.

  3. Efficacy of mandibular advancement device in the treatment of obstructive sleep apnea syndrome: A randomized controlled crossover clinical trial

    PubMed Central

    Crovetto-Martínez, Rafael; Alkhraisat, Mohammad-Hamdan; Crovetto, Miguel; Municio, Antonio; Kutz, Ramón; Aizpuru, Felipe; Miranda, Erika; Anitua, Eduardo

    2015-01-01

    Background Evaluation of the efficacy and safety of a mandibular advancement device (MAD) (KlearwayTM) in the treatment of mild-to-moderate obstructive sleep apnea and chronic roncopathy. Material and Methods A randomized, placebo-controlled, double blinded, and crossover clinical trial was conducted. Placebo device (PD) defined as a splint in the centric occlusion that did not induce a mandibular advancement served as a control. The mandible was advanced to the maximum tolerable distance or to a minimum of 65% of the maximum protrusion. After each sequence of treatment, patients were assessed by questionnaires, conventional polysomnography, and objective measurement of snoring at the patient’s own home. Results Forty two patients participated in the study and 38 completed the study. Patients mean age was 46 ±9 years and the 79% were males. The mean mandibular advancement was 8.6 ±2.8 mm. Patients used the MAD and the PD for 6.4 +2.4 hours and 6.2 +2.0 hours, respectively. Secondary effects (mostly mild) occurred in the 85.7% and the 86.8% of the users of MAD and PD, respectively. The MAD induced a decrease in the apnea-hypopnea index (AHI) from 15.3 +10.2 to 11.9 +15.5. The 50% reduction in the AHI was achieved in the 46.2% and the 18.4% of the patients treated with MAD and PD, respectively. The use of the MAD induced a reduction in the AHI by 3.4 +15.9 while the PD induced an increase by 10.6 +26.1. The subjective evaluation of the roncopathy indicated an improvement by the MAD and an increase in the perceptive quality of sleep. However, the objective evaluation of the roncopathy did not show significant improvements. Conclusions The use of MAD is efficient to reduce the AHI and improve subjectively the roncopathy. MAD could be considered in the treatment of mild-to-moderate OSA and chronic roncopathy. Key words:Obstructive sleep apnea (OSA), mandibular advance device, treatment, efficacy, clinical assay. PMID:26241460

  4. Dyspnea during Advanced Cancer

    MedlinePlus

    ... important in planning treatment. Treatment may be to control signs and symptoms of pleural effusion and improve quality of life. A malignant pleural effusion often occurs in cancer that is advanced , cannot be removed by surgery , or continues to ...

  5. Advanced care directives

    MedlinePlus

    ... you want no matter how ill you are. Writing an advance care directive may be hard. You ... wishes usually replace those you made previously in writing. Additional Information Write your living will or health ...

  6. Advances in Process Control.

    ERIC Educational Resources Information Center

    Morrison, David L.; And Others

    1982-01-01

    Advances in electronics and computer science have enabled industries (pulp/paper, iron/steel, petroleum/chemical) to attain better control of their processes with resulting increases in quality, productivity, profitability, and compliance with government regulations. (JN)

  7. Advanced Welding Concepts

    NASA Technical Reports Server (NTRS)

    Ding, Robert J.

    2010-01-01

    Four advanced welding techniques and their use in NASA are briefly reviewed in this poster presentation. The welding techniques reviewed are: Solid State Welding, Friction Stir Welding (FSW), Thermal Stir Welding (TSW) and Ultrasonic Stir Welding.

  8. Advanced information society(2)

    NASA Astrophysics Data System (ADS)

    Masuyama, Keiichi

    Our modern life is full of information and information infiltrates into our daily life. Networking of the telecommunication is extended to society, company, and individual level. Although we have just entered the advanced information society, business world and our daily life have been steadily transformed by the advancement of information network. This advancement of information brings a big influence on economy, and will play they the main role in the expansion of domestic demands. This paper tries to view the image of coming advanced information society, focusing on the transforming businessman's life and the situation of our daily life, which became wealthy by the spread of daily life information and the visual information by satellite system, in the development of the intelligent city.

  9. Advanced Lab Consortium ``Conspiracy''

    NASA Astrophysics Data System (ADS)

    Reichert, Jonathan F.

    2006-03-01

    Advanced Laboratory instruction is a time-honored and essential element of an undergraduate physics education. But, from my vantage point, it has been neglected by the two major professional societies, APS and AAPT. At some schools, it has been replaced by ``research experiences,'' but I contend that very few of these experiences in the research lab, particularly in the junior year, deliver what they promise. It is time to focus the attention of APS, AAPT, and the NSF on the advanced lab. We need to create an Advanced Lab Consortium (ALC) of faculty and staff to share experiments, suppliers, materials, pedagogy, ideas, in short to build a professional network for those committed to advanced lab instruction. The AAPT is currently in serious discussions on this topic and my company stands ready with both financial and personnel resources to support the effort. This talk is a plea for co-conspirators.

  10. Advance Identification (ADID)

    EPA Pesticide Factsheets

    Advance identification of disposal areas (ADID), a planning process used to identify wetlands and other waters that are generally suitable or unsuitable for the discharge of dredged and fill material.

  11. Advanced Electron Linacs

    SciTech Connect

    Siemann, R.

    2005-02-14

    The research into advanced acceleration concepts for electron linear accelerators being pursued at SLAC is reviewed. This research includes experiments in laser acceleration, plasma wakefield acceleration, and mmwavelength RF driven accelerators.

  12. Advanced Electrochemical Waste Forms

    SciTech Connect

    Riley, Brian J.; Crum, Jarrod V.; McCloy, John S.; Matyas, Josef

    2011-12-01

    This is a brief description of PNNL's efforts in FY2011 towards developing advanced electrochemical waste forms. This is a short section that will become part of a larger document being put together by INL.

  13. Advance Control Measures & Programs

    EPA Pesticide Factsheets

    As areas develop their path forward or action plan, they should consider a variety of voluntary and mandatory measures and programs. The resources on this page can help, and participants are also encouraged to talk with their EPA Advance contact

  14. Advance Directives - Multiple Languages

    MedlinePlus

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Advance Directives URL of this page: https://medlineplus.gov/languages/advancedirectives.html Other topics A-Z Expand Section ...

  15. Advances in Process Control.

    ERIC Educational Resources Information Center

    Morrison, David L.; And Others

    1982-01-01

    Advances in electronics and computer science have enabled industries (pulp/paper, iron/steel, petroleum/chemical) to attain better control of their processes with resulting increases in quality, productivity, profitability, and compliance with government regulations. (JN)

  16. Advanced Heart Failure

    MedlinePlus

    ... doctors, making good decisions requires teamwork. Through shared decision making, doctors and patients consider both the options and ... care you want to receive. What is shared decision making? When heart failure progresses to an advanced stage, ...

  17. Advances in cell culture

    SciTech Connect

    Maramorosch, K. )

    1987-01-01

    This book presents papers on advances in cell culture. Topics covered include: Genetic changes in the influenza viruses during growth in cultured cells; The biochemistry and genetics of mosquito cells in culture; and Tree tissue culture applications.

  18. Advanced urology nursing practice.

    PubMed

    Crowe, Helen

    2014-03-01

    Urology nursing has developed as a specialty over the past few decades in response to several factors, workload demands being a prime reason. Nurses are taking on additional roles and activities including procedures such as cystoscopy and prostate biopsy, and running nurse-led clinics for a variety of urological conditions. Audits of advanced urological nursing practice have shown this care to be of a high standard and investigative procedures performed by these nurses match the diagnostic quality of existing services. Professional urological nursing organizations support the professional needs of these nurses, but the provision of education and training for advanced practice activities remains an unaddressed need. A range of confusing advanced urology nursing titles exists, and uncertainty regarding the roles and scope of practice for these nurses remains a concern. Acceptance and support from medical colleagues is required for the success of advanced urological nursing practice, but opinions on these roles remain divided.

  19. Advanced planetary studies

    NASA Technical Reports Server (NTRS)

    1982-01-01

    Results of planetary advanced studies and planning support provided by Science Applications, Inc. staff members to Earth and Planetary Exploration Division, OSSA/NASA, for the period 1 February 1981 to 30 April 1982 are summarized. The scope of analyses includes cost estimation, planetary missions performance, solar system exploration committee support, Mars program planning, Galilean satellite mission concepts, and advanced propulsion data base. The work covers 80 man-months of research. Study reports and related publications are included in a bibliography section.

  20. Advanced Welding Applications

    NASA Technical Reports Server (NTRS)

    Ding, Robert J.

    2010-01-01

    Some of the applications of advanced welding techniques are shown in this poster presentation. Included are brief explanations of the use on the Ares I and Ares V launch vehicle and on the Space Shuttle Launch vehicle. Also included are microstructural views from four advanced welding techniques: Variable Polarity Plasma Arc (VPPA) weld (fusion), self-reacting friction stir welding (SR-FSW), conventional FSW, and Tube Socket Weld (TSW) on aluminum.

  1. Advanced Usability Evaluation Methods

    DTIC Science & Technology

    2007-04-01

    tracking in usability evaluation : A practitioner’s guide. In J. Hyönä, R. Radach, & H. Deubel. (Eds.), The mind’s eye: Cognitive and applied...Advanced Usability Evaluation Methods Terence S. Andre, Lt Col, USAF Margaret Schurig, Human Factors Design Specialist, The Boeing Co...TITLE AND SUBTITLE Advanced Usability Evaluation Methods 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT

  2. Psychiatric Advance Directives: Getting Started

    MedlinePlus

    ... More... Home Getting Started National Resource Center on Psychiatric Advance Directives - Getting Started Getting Started Psychiatric advance directives (PADs) are relatively new legal instruments ...

  3. The effect of oral appliances that advanced the mandible forward and limited mouth opening in patients with obstructive sleep apnea: a systematic review and meta-analysis of randomised controlled trials.

    PubMed

    Okuno, K; Sato, K; Arisaka, T; Hosohama, K; Gotoh, M; Taga, H; Sasao, Y; Hamada, S

    2014-07-01

    Oral appliances (OAs) have demonstrated efficacy in treating obstructive sleep apnea (OSA), but many different OA devices are available. The Japanese Academy of Dental Sleep Medicine supported the use of OAs that advanced the mandible forward and limited mouth opening and suggested an evaluation of their effects in comparison with untreated or CPAP. A systematic search was undertaken in 16 April 2012. The outcome measures of interest were as follows: Apnea Hypopnea Index (AHI), lowest SpO2 , arousal index, Epworth Sleepiness Scale (ESS), the SF-36 Health Survey. We performed this meta-analysis using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Five studies remained eligible after applying the exclusion criteria. Comparing OA and control appliance, OA significantly reduced the weighted mean difference (WMD) in both AHI and the arousal index (favouring OA, AHI: -7.05 events h(-1) ; 95% CI, -12.07 to -2.03; P = 0.006, arousal index: -6.95 events h(-1) ; 95% CI, -11.75 to -2.15; P = 0.005). OAs were significantly less effective at reducing the WMD in AHI and improving lowest SpO2 and SF-36 than CPAP, (favouring OA, AHI: 6.11 events h(-1) ; 95% CI, 3.24 to 8.98; P = 0.0001, lowest SpO2 : -2.52%; 95% CI, -4.81 to -0.23; P = 0.03, SF-36: -1.80; 95% CI, -3.17 to -042; P = 0.01). Apnea Hypopnea Index and arousal index were significantly improved by OA relative to the untreated disease. Apnea Hypopnea Index, lowest SpO2 and SF-36 were significantly better with CPAP than with OA. The results of this study suggested that OAs improve OSA compared with untreated. CPAP appears to be more effective in improving OSA than OAs.

  4. The Use of Remotely Controlled Mandibular Positioner as a Predictive Screening Tool for Mandibular Advancement Device Therapy in Patients with Obstructive Sleep Apnea through Single-Night Progressive Titration of the Mandible: A Systematic Review.

    PubMed

    Kastoer, Chloé; Dieltjens, Marijke; Oorts, Eline; Hamans, Evert; Braem, Marc J; Van de Heyning, Paul H; Vanderveken, Olivier M

    2016-10-15

    To perform a review of the current evidence regarding the use of a remotely controlled mandibular positioner (RCMP) and to analyze the efficacy of RCMP as a predictive selection tool in the treatment of obstructive sleep apnea (OSA) with oral appliances that protrude the mandible (OAm), exclusively relying on single-night RCMP titration. An extensive literature search is performed through PubMed.com, Thecochranelibrary.com (CENTRAL only), Embase.com, and recent conference meeting abstracts in the field. A total of 254 OSA patients from four full-text articles and 5 conference meeting abstracts contribute data to the review. Criteria for successful RCMP test and success with OAm differed between studies. Study populations were not fully comparable due to range-difference in baseline apneahypopnea index (AHI). However, in all studies elimination of airway obstruction events during sleep by RCMP titration predicted OAm therapy success by the determination of the most effective target protrusive position (ETPP). A statistically significant association is found between mean AHI predicted outcome with RCMP and treatment outcome with OAm on polysomnographic or portable sleep monitoring evaluation (p < 0.05). The existing evidence regarding the use of RCMP in patients with OSA indicates that it might be possible to protrude the mandible progressively during sleep under poly(somno)graphic observation by RCMP until respiratory events are eliminated without disturbing sleep or arousing the patient. ETPP as measured by the use of RCMP was significantly associated with success of OAm therapy in the reported studies. RCMP might be a promising instrument for predicting OAm treatment outcome and targeting the degree of mandibular advancement needed.

  5. Recruit and ADVANCE

    NASA Astrophysics Data System (ADS)

    Rosser, Sue V.

    2007-04-01

    Beginning in 2001, the National Science Foundation launched the ADVANCE Initiative, which has now awarded more than 70 million to some thirty institutions for transformations to advance women. Results of studies on how to attract and retain women students and faculty underpinned our ADVANCE Institutional Transformation grant funded by the NSF for 3.7 million for five years, beginning in 2001. As co-principal investigator on this grant, I insured that this research informed the five major threads of the grant: 1) Four termed ADVANCE professors to mentor junior women faculty in each college; 2) Collection of MIT-Report-like data indicators to assess whether advancement of women really occurs during and after the institutional transformation undertaken through ADVANCE; 3) Family-friendly policies and practices to stop the tenure clock and provide active service, modified duties, lactation stations and day care; 4) Mini-retreats to facilitate access for tenure-track women faculty to male decision-makers and administrators for informal conversations and discussion on topics important to women faculty; 5) Removal of subtle gender, racial, and other biases in promotion and tenure. The dynamic changes resulting from the grant in quality of mentoring, new understanding of promotion and tenure, numbers of women retained and given endowed chairs, and emergence of new family friendly policies gave me hope for genuine diversification of leadership in science and technology. As the grant funding ends, the absence of NSF prestige and monitoring, coupled with a change in academic leadership at the top, provide new challenges for institutionalization, recruitment, and advancement of women into leadership positions in science and engineering.

  6. Effect of Mandibular Advancement Device Therapy on the Signs and Symptoms of Temporomandibular Disorders

    PubMed Central

    Raunio, Antti; Sipilä, Kirsi; Raustia, Aune

    2012-01-01

    ABSTRACT Objectives Mandibular advancement device therapy is effectively used in the treatment of obstructive sleep apnea, but also several side effects in the masticatory system have been reported. The aim of this study was to evaluate the subjective symptoms and clinical signs of temporomandibular disorders connected to mandibular advancement device therapy. Material and Methods The material consisted of 15 patients (9 men and 6 women, mean age 51.1 years, range 21 to 70 years) diagnosed with obstructive sleep apnea (OSA). Subjective symptoms and clinical temporomandibular disorders (TMD) signs were recorded at the beginning of the treatment (baseline) and at 1-month, 3-month, 6-month and 24-month follow-ups. The degree of TMD was assessed using the anamnestic (Ai) and the clinical dysfunction index (Di) of Helkimo. For assessing the effect of TMD the patients were divided in discontinuing and continuing groups. Results According to Ai and Di, the severity of TMD remained unchanged during the follow-up in most of the patients. Temporomandibular joint (TMJ) crepitation was found more frequently in discontinuing patients at all follow-ups. The difference was statistically significant (P < 0.05) at the six-month follow-up. Masticatory muscle pain during palpation was a frequent clinical sign at the baseline and during the follow-up period but the difference between discontinuing and continuing patients was not significant. Conclusions It seems that signs and symptoms of temporomandibular disorders do not necessarily increase during long-term mandibular advancement device therapy. However, it seems that patients with clinically assessed temporomandibular joint crepitation may discontinue their mandibular advancement device therapy due to temporomandibular disorders. PMID:24422023

  7. Do Advance Directives Direct?

    PubMed

    Shapiro, Susan P

    2015-06-01

    Resolution of long-standing debates about the role and impact of advance directives - living wills and powers of attorney for health care - has been hampered by a dearth of appropriate data, in particular data that compare the process and outcomes of end-of-life decision making on behalf of patients with and without advance directives. Drawing on a large ethnographic study of patients in two intensive care units in a large urban teaching hospital, this article compares aspects of the medical decision-making process and outcomes by advance-directive status. Controlling for demographic characteristics and severity of illness, the study finds few significant differences between patients without advance directives and those who claim to have them. Surprisingly, these few differences hold only for those whose directives are in their hospital chart. There are no significant differences between those with no directive and those claiming to have a copy at home or elsewhere. The article considers the implications if directives seemingly must be in hand to show even modest effects. Do advance directives direct? The intensive care unit data provide far more support for the growing body of literature that casts doubt on their impact than studies that promote the use of them.

  8. Advanced access appointments

    PubMed Central

    Hudec, John C.; MacDougall, Steven; Rankin, Elaine

    2010-01-01

    ABSTRACT OBJECTIVE To examine the effects of advanced access (same-day physician appointments) on patient and provider satisfaction and to determine its association with other variables such as physician income and patient emergency department use. DESIGN Patient satisfaction survey and semistructured interviews with physicians and support staff; analysis of physician medical insurance billings and patient emergency department visits. SETTING Cape Breton, NS. PARTICIPANTS Patients, physicians, and support staff of 3 comparable family physician practices that had not implemented advanced access and an established advanced access practice. MAIN OUTCOME MEASURES Self-reported provider and patient satisfaction, physician office income, and patients’ emergency department use. RESULTS The key benefits of implementation of advanced access were an increase in provider and patient satisfaction levels, same or greater physician office income, and fewer less urgent (triage level 4) and nonurgent (triage level 5) emergency department visits by patients. CONCLUSION Currently within the Central Cape Breton Region, 33% of patients wait 4 or more days for urgent appointments. Findings from this study can be used to enhance primary care physician practice redesign. This research supports many benefits of transitioning to an advanced access model of patient booking. PMID:20944024

  9. Advanced transmission studies

    NASA Technical Reports Server (NTRS)

    Coy, John J.; Bill, Robert C.

    1988-01-01

    The NASA Lewis Research Center and the U.S. Army Aviation Systems Command share an interest in advancing the technology for helicopter propulsion systems. In particular, this paper presents highlights from that portion of the program in drive train technology and the related mechanical components. The major goals of the program are to increase the life, reliability, and maintainability; reduce the weight, noise, and vibration; and maintain the relatively high mechanical efficiency of the gear train. The current activity emphasizes noise reduction technology and analytical code development followed by experimental verification. Selected significant advances in technology for transmissions are reviewed, including advanced configurations and new analytical tools. Finally, the plan for future transmission research is presented.

  10. Advanced Hydrogen Turbine Development

    SciTech Connect

    Marra, John

    2015-09-30

    Under the sponsorship of the U.S. Department of Energy (DOE) National Energy Technology Laboratories, Siemens has completed the Advanced Hydrogen Turbine Development Program to develop an advanced gas turbine for incorporation into future coal-based Integrated Gasification Combined Cycle (IGCC) plants. All the scheduled DOE Milestones were completed and significant technical progress was made in the development of new technologies and concepts. Advanced computer simulations and modeling, as well as subscale, full scale laboratory, rig and engine testing were utilized to evaluate and select concepts for further development. Program Requirements of: A 3 to 5 percentage point improvement in overall plant combined cycle efficiency when compared to the reference baseline plant; 20 to 30 percent reduction in overall plant capital cost when compared to the reference baseline plant; and NOx emissions of 2 PPM out of the stack. were all met. The program was completed on schedule and within the allotted budget

  11. Advanced thermionic energy conversion

    NASA Technical Reports Server (NTRS)

    Britt, E. J.; Fitzpatrick, G. D.; Hansen, L. K.; Rasor, N. S.

    1974-01-01

    Basic analytical and experimental exploration was conducted on several types of advanced thermionic energy converters, and preliminary analysis was performed on systems utilizing advanced converter performance. The Pt--Nb cylindrical diode which exhibited a suppressed arc drop, as described in the preceding report, was reassembled and the existence of the postulated hydrid mode of operation was tentatively confirmed. Initial data obtained on ignited and unignited triode operation in the demountable cesium vapor system essentially confirmed the design principles developed in earlier work, with a few exceptions. Three specific advanced converter concepts were selected as candidates for concentrated basic study and for practical evaluation in fixed-configuration converters. Test vehicles and test stands for these converters and a unique controlled-atmosphere station for converter assembly and processing were designed, and procurement was initiated.

  12. Advanced rocket propulsion

    NASA Technical Reports Server (NTRS)

    Obrien, Charles J.

    1993-01-01

    Existing NASA research contracts are supporting development of advanced reinforced polymer and metal matrix composites for use in liquid rocket engines of the future. Advanced rocket propulsion concepts, such as modular platelet engines, dual-fuel dual-expander engines, and variable mixture ratio engines, require advanced materials and structures to reduce overall vehicle weight as well as address specific propulsion system problems related to elevated operating temperatures, new engine components, and unique operating processes. High performance propulsion systems with improved manufacturability and maintainability are needed for single stage to orbit vehicles and other high performance mission applications. One way to satisfy these needs is to develop a small engine which can be clustered in modules to provide required levels of total thrust. This approach should reduce development schedule and cost requirements by lowering hardware lead times and permitting the use of existing test facilities. Modular engines should also reduce operational costs associated with maintenance and parts inventories.

  13. Advanced Worker Protection System

    SciTech Connect

    1996-04-01

    The Advanced Worker Protection System (AWPS) is a liquid-air-based, self-contained breathing and cooling system with a duration of 2 hrs. AWPS employs a patented system developed by Oceaneering Space Systems (OSS), and was demonstrated at their facility in Houston, TX as well as at Kansas State University, Manhattan. The heart of the system is the life-support backpack that uses liquid air to provide cooling as well as breathing gas to the worker. The backpack is combined with advanced protective garments, an advanced liquid cooling garment (LCG), a respirator, and communications and support equipment. The prototype unit development and testing under Phase 1 has demonstrated that AWPS has the ability to meet performance criteria. These criteria were developed with an understanding of both the AWPS capabilities and the DOE decontamination and decommissioning (D and D) activities protection needs.

  14. [Advanced Composites Technology Initiatives

    NASA Technical Reports Server (NTRS)

    Julian, Mark R.

    2002-01-01

    This final report closes out the W02 NASA Grant #NCC5-646. The FY02 grant for advanced technology initiatives through the Advanced Composites Technology Institute in Bridgeport, WV, at the Robert C. Byrd Institute (RCBI) Bridgeport Manufacturing Technology Center, is complete; all funding has been expended. RCBI continued to expand access to technology; develop and implement a workforce-training curriculum; improve material development; and provide prototyping and demonstrations of new and advanced composites technologies for West Virginia composites firms. The FY 02 efforts supported workforce development, technical training and the HST development effort of a super-lightweight composite carrier prototype and expanded the existing technical capabilities of the growing aerospace industry across West Virginia to provide additional support for NASA missions. Additionally, the Composites Technology and Training Center was awarded IS0 9001 - 2000 certification and Cleanroom Class 1000 certification during this report period.

  15. Advances in diagnostic radiology.

    PubMed

    Runge, Val M

    2010-12-01

    Recent advances in diagnostic radiology are discussed on the basis of current publications in Investigative Radiology. Publications in the journal during 2009 and 2010 are reviewed, evaluating developments by modality and anatomic region. Technological advances continue to play a major role in the evolution and clinical practice of diagnostic radiology, and as such constitute a major publication focus. In the past 2 years, this includes advances in both magnetic resonance and computed tomography (in particular, the advent of dual energy computed tomography). An additional major focus of publications concerns contrast media, and in particular continuing research involving nephrogenic systemic fibrosis, its etiology, and differentiation of the gadolinium chelates on the basis of in vivo stability.

  16. Advanced servomanipulator development

    SciTech Connect

    Kuban, D.P.

    1985-01-01

    The Advanced Servomanipulator (ASM) System consists of three major components: the ASM slave, the dual arm master controller (DAMC) or master, and the control system. The ASM is remotely maintainable force-reflecting servomanipulator developed at the Oak Ridge National Laboratory (ORNL) as part of the Consolidated Fuel Reprocessing Program. This new manipulator addresses requirements of advanced nuclear fuel reprocessing with emphasis on force reflection, remote maintainability, reliability, radiation tolerance, and corrosion resistance. The advanced servomanipulator is uniquely subdivided into remotely replaceable modules which will permit in situ manipulator repair by spare module replacement. Manipulator modularization and increased reliability are accomplished through a force transmission system that uses gears and torque tubes. Digital control algorithms and mechanical precision are used to offset the increased backlash, friction, and inertia resulting from the gear drives. This results in the first remotely maintainable force-reflecting servomanipulator in the world.

  17. Advanced ramjet concepts program

    NASA Technical Reports Server (NTRS)

    Leingang, J. L.

    1992-01-01

    Uniquely advantageous features, on both the performance and weight sides of the ledger, can be achieved through synergistic design integration of airbreathing and rocket technologies in the development of advanced orbital space transport propulsion systems of the combined cycle type. In the context of well understood advanced airbreathing and liquid rocket propulsion principles and practices, this precept of synergism is advanced mainly through six rather specific examples. These range from the detailed component level to the overall vehicle system level as follows: using jet compression; achieving a high area ratio rocket nozzle; ameliorating gas generator cycle rocket system deficiencies; using the in-duct special rocket thrust chamber assembly as the principal scramjet fuel injection operation; using the unstowed, covered fan as a duct closure for effecting high area ratio rocket mode operation; and creating a unique airbreathing rocket system via the onboard, cryogenic hydrogen induced air liquefaction process.

  18. Advanced Aerodynamic Control Effectors

    NASA Technical Reports Server (NTRS)

    Wood, Richard M.; Bauer, Steven X. S.

    1999-01-01

    A 1990 research program that focused on the development of advanced aerodynamic control effectors (AACE) for military aircraft has been reviewed and summarized. Data are presented for advanced planform, flow control, and surface contouring technologies. The data show significant increases in lift, reductions in drag, and increased control power, compared to typical aerodynamic designs. The results presented also highlighted the importance of planform selection in the design of a control effector suite. Planform data showed that dramatic increases in lift (greater than 25%) can be achieved with multiple wings and a sawtooth forebody. Passive porosity and micro drag generator control effector data showed control power levels exceeding that available from typical effectors (moving surfaces). Application of an advanced planform to a tailless concept showed benefits of similar magnitude as those observed in the generic studies.

  19. Advanced fuel chemistry for advanced engines.

    SciTech Connect

    Taatjes, Craig A.; Jusinski, Leonard E.; Zador, Judit; Fernandes, Ravi X.; Miller, James A.

    2009-09-01

    Autoignition chemistry is central to predictive modeling of many advanced engine designs that combine high efficiency and low inherent pollutant emissions. This chemistry, and especially its pressure dependence, is poorly known for fuels derived from heavy petroleum and for biofuels, both of which are becoming increasingly prominent in the nation's fuel stream. We have investigated the pressure dependence of key ignition reactions for a series of molecules representative of non-traditional and alternative fuels. These investigations combined experimental characterization of hydroxyl radical production in well-controlled photolytically initiated oxidation and a hybrid modeling strategy that linked detailed quantum chemistry and computational kinetics of critical reactions with rate-equation models of the global chemical system. Comprehensive mechanisms for autoignition generally ignore the pressure dependence of branching fractions in the important alkyl + O{sub 2} reaction systems; however we have demonstrated that pressure-dependent 'formally direct' pathways persist at in-cylinder pressures.

  20. Education in advanced disease.

    PubMed

    Flemming, Kate; Closs, S José; Foy, Robbie; Bennett, Michael I

    2012-05-01

    In advanced disease, the management of symptoms and lifestyle are essential for the maintenance of patients' quality of life. Appropriate education by health professionals can help patients to better manage their disease. Although the provision of education by health professionals for patients with advanced cancer is reasonably well documented, much less is known about how health professionals facilitate education with patients with other advanced progressive diseases. The aim of this review was to synthesize qualitative research examining health professionals' knowledge of, attitudes toward, and ability to deliver educational interventions for symptom and disease management to patients with advanced progressive diseases other than cancer. The synthesis was conducted using meta-ethnography. Systematic searching of five electronic databases (CINAHL, Medline, PsycInfo, Web of Science Social Science Citation Index, and EMBASE) was performed. Included studies were data extracted and assessed for quality. Systematic searching of four electronic databases identified 911 records; 17 studies met review inclusion criteria and underwent data extraction and quality appraisal. Three key factors were identified that influenced the delivery of education by health professionals to patients with advanced disease: capacity (to educate and aid decision making), context (of educational delivery), and timing (of education). Health professionals identify and acknowledge a range of factors that influence their ability to deliver education to patients with advanced disease. The types of circumstantial factors identified in this review can influence the successful delivery of educational interventions and need to be considered when such interventions are being developed. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  1. Advanced sensors technology survey

    NASA Technical Reports Server (NTRS)

    Cooper, Tommy G.; Costello, David J.; Davis, Jerry G.; Horst, Richard L.; Lessard, Charles S.; Peel, H. Herbert; Tolliver, Robert

    1992-01-01

    This project assesses the state-of-the-art in advanced or 'smart' sensors technology for NASA Life Sciences research applications with an emphasis on those sensors with potential applications on the space station freedom (SSF). The objectives are: (1) to conduct literature reviews on relevant advanced sensor technology; (2) to interview various scientists and engineers in industry, academia, and government who are knowledgeable on this topic; (3) to provide viewpoints and opinions regarding the potential applications of this technology on the SSF; and (4) to provide summary charts of relevant technologies and centers where these technologies are being developed.

  2. Advanced flight software reconfiguraton

    NASA Technical Reports Server (NTRS)

    Porcher, Bryan

    1991-01-01

    Information is given in viewgraph form on advanced flight software reconfiguration. Reconfiguration is defined as identifying mission and configuration specific requirements, controlling mission and configuration specific data, binding this information to the flight software code to perform specific missions, and the release and distribution of the flight software. The objectives are to develop, demonstrate, and validate advanced software reconfiguration tools and techniques; to demonstrate reconfiguration approaches on Space Station Freedom (SSF) onboard systems displays; and to interactively test onboard systems displays, flight software, and flight data.

  3. Advanced Solar Power Systems

    NASA Technical Reports Server (NTRS)

    Atkinson, J. H.; Hobgood, J. M.

    1984-01-01

    The Advanced Solar Power System (ASPS) concentrator uses a technically sophisticated design and extensive tooling to produce very efficient (80 to 90%) and versatile energy supply equipment which is inexpensive to manufacture and requires little maintenance. The advanced optical design has two 10th order, generalized aspheric surfaces in a Cassegrainian configuration which gives outstanding performance and is relatively insensitive to temperature changes and wind loading. Manufacturing tolerances also have been achieved. The key to the ASPS is the direct absorption of concentrated sunlight in the working fluid by radiative transfers in a black body cavity. The basic ASPS design concepts, efficiency, optical system, and tracking and focusing controls are described.

  4. Advanced Monitoring systems initiative

    SciTech Connect

    R.J. Venedam; E.O. Hohman; C.F. Lohrstorfer; S.J. Weeks; J.B. Jones; W.J. Haas

    2004-09-30

    The Advanced Monitoring Systems Initiative (AMSI) actively searches for promising technologies and aggressively moves them from the research bench into DOE/NNSA end-user applications. There is a large unfulfilled need for an active element that reaches out to identify and recruit emerging sensor technologies into the test and evaluation function. Sensor research is ubiquitous, with the seeds of many novel concepts originating in the university systems, but at present these novel concepts do not move quickly and efficiently into real test environments. AMSI is a widely recognized, self-sustaining ''business'' accelerating the selection, development, testing, evaluation, and deployment of advanced monitoring systems and components.

  5. MR Neurography: Advances

    PubMed Central

    Chhabra, Avneesh; Zhao, Lianxin; Carrino, John A.; Trueblood, Eo; Koceski, Saso; Shteriev, Filip; Lenkinski, Lionel; Sinclair, Christopher D. J.; Andreisek, Gustav

    2013-01-01

    High resolution and high field magnetic resonance neurography (MR neurography, MRN) is shown to have excellent anatomic capability. There have been considerable advances in the technology in the last few years leading to various feasibility studies using different structural and functional imaging approaches in both clinical and research settings. This paper is intended to be a useful seminar for readers who want to gain knowledge of the advancements in the MRN pulse sequences currently used in clinical practice as well as learn about the other techniques on the horizon aimed at better depiction of nerve anatomy, pathology, and potential noninvasive evaluation of nerve degeneration or regeneration. PMID:23589774

  6. Advanced Neuroimaging of Tinnitus.

    PubMed

    Raghavan, Prashant; Steven, Andrew; Rath, Tanya; Gandhi, Dheeraj

    2016-05-01

    Although tinnitus may originate in damage to the peripheral auditory apparatus, its perception and distressing symptomatology are consequences of alterations to auditory, sensory, and limbic neural networks. This has been described in several studies, some using advanced structural MR imaging techniques such as diffusion tensor imaging. An understanding of these complex changes could enable development of targeted treatment. New MR imaging techniques enabling detailed depiction of the labyrinth may be useful when diagnosis of Meniere disease is equivocal. Advances in computed tomography and MR imaging have enabled noninvasive diagnosis of dural arteriovenous fistulae.

  7. Advanced concepts for acceleration

    SciTech Connect

    Keefe, D.

    1986-07-01

    Selected examples of advanced accelerator concepts are reviewed. Such plasma accelerators as plasma beat wave accelerator, plasma wake field accelerator, and plasma grating accelerator are discussed particularly as examples of concepts for accelerating relativistic electrons or positrons. Also covered are the pulsed electron-beam, pulsed laser accelerator, inverse Cherenkov accelerator, inverse free-electron laser, switched radial-line accelerators, and two-beam accelerator. Advanced concepts for ion acceleration discussed include the electron ring accelerator, excitation of waves on intense electron beams, and two-wave combinations. (LEW)

  8. Advanced Containment System

    DOEpatents

    Kostelnik, Kevin M.; Kawamura, Hideki; Richardson, John G.; Noda, Masaru

    2005-02-08

    An advanced containment system for containing buried waste and associated leachate. The advanced containment system comprises a plurality of casing sections with each casing section interlocked to an adjacent casing section. Each casing section includes a complementary interlocking structure that interlocks with the complementary interlocking structure on an adjacent casing section. A barrier filler substantially fills the casing sections and may substantially fill the spaces of the complementary interlocking structure to form a substantially impermeable barrier. Some of the casing sections may include sensors so that the casing sections and the zone of interest may be remotely monitored after the casing sections are emplaced in the ground.

  9. Advanced Imaging Tracker

    DTIC Science & Technology

    1982-06-01

    document requires that it 1e returncd: ADVANCED IMACINGC TRACKER Dr . L. E. Schmutz Contractor: Adaptive Optics Associates, Inc. Contt-ict Number: F30602-80...Code Number: IE20 Period of Worl: Covered: jun 80 - D’:c 81 Principal Investigator: Dr . Larry Schmut~z Phone: 617 547-2786 Project Engineer: Captaia...yaJPODCVR~ ADVANCED IMAGING TRACKER 10Jun 80 - ’,’ Dec 81 𔄃 PiRFORMiNO7 01G. REPORT NUMBER 7 ATII~(. ONTPA OR GRANTY NUMDERf.) Dr . 1L. E. Schiiut

  10. Advancing cardiovascular tissue engineering

    PubMed Central

    Truskey, George A.

    2016-01-01

    Cardiovascular tissue engineering offers the promise of biologically based repair of injured and damaged blood vessels, valves, and cardiac tissue. Major advances in cardiovascular tissue engineering over the past few years involve improved methods to promote the establishment and differentiation of induced pluripotent stem cells (iPSCs), scaffolds from decellularized tissue that may produce more highly differentiated tissues and advance clinical translation, improved methods to promote vascularization, and novel in vitro microphysiological systems to model normal and diseased tissue function. iPSC technology holds great promise, but robust methods are needed to further promote differentiation. Differentiation can be further enhanced with chemical, electrical, or mechanical stimuli. PMID:27303643

  11. Advancing cytometry for immunology.

    PubMed

    Cossarizza, Andrea; Nolan, John; Radbruch, Andreas; Tárnok, Attila

    2012-12-01

    Cytometry is a key technology for immunology. It allows researchers to scrutinize the cells of the immune system in molecular detail, and to assess phenotype and function at the level of individual cells, no matter how rare these cells may be. The International Society for the Advancement of Cytometry, ISAC, by way of its meetings, online resources and publications (e.g. Cytometry Part A and Current Protocols in Cytometry, which are all published by Wiley) track the ever advancing developments regarding cytometry instrumentation and reagents, and the analysis of complex data sets. In June this year in Leipzig, Germany, ISAC held its annual conference "CYTO 2012", a marketplace of innovation in cytometry.

  12. Avionics advanced development strategy

    NASA Technical Reports Server (NTRS)

    Dyer, D.

    1990-01-01

    Discussed here is the problem of how to put together an integrated, phased, and affordable avionics advanced development program that links and applies to operational, evolving, and developing programs/vehicles, as well as those in the planning phases. Collecting technology needs from individual programs/vehicles and proposed technology items from individual developers usually results in a mismatch and something that is unaffordable. A strategy to address this problem is outlined with task definitions which will lead to avionics advanced development items that will fit within an overall framework, prioritized to support budgeting, and support the scope of NASA space transportations needs.

  13. Advances in attosecond science

    NASA Astrophysics Data System (ADS)

    Calegari, Francesca; Sansone, Giuseppe; Stagira, Salvatore; Vozzi, Caterina; Nisoli, Mauro

    2016-03-01

    Attosecond science offers formidable tools for the investigation of electronic processes at the heart of important physical processes in atomic, molecular and solid-state physics. In the last 15 years impressive advances have been obtained from both the experimental and theoretical points of view. Attosecond pulses, in the form of isolated pulses or of trains of pulses, are now routinely available in various laboratories. In this review recent advances in attosecond science are reported and important applications are discussed. After a brief presentation of various techniques that can be employed for the generation and diagnosis of sub-femtosecond pulses, various applications are reported in atomic, molecular and condensed-matter physics.

  14. Advances in periodontology.

    PubMed

    Tonetti, M S

    2000-10-01

    Advances in periodontal science and practice over the last decade have radically changed the understanding of periodontal diseases and have opened new, exciting prospects for both medical and surgical therapy of periodontal diseases. Establishment of the aetiology and pathogenesis of periodontitis, understanding of the unique genetic and environmental susceptibility profile of affected subjects, and recognition of the systemic implications of periodontal infections are the key research findings. The use of randomised, controlled, clinical trials has allowed the development of evidence-based periodontology. Adjunctive antimicrobial therapy, regenerative periodontal surgery, periodontal plastic surgery, bone regeneration surgery in the light of implant treatment, and advanced soft tissue management at implant sites have radically changed practice.

  15. Advanced engine study program

    NASA Technical Reports Server (NTRS)

    Masters, A. I.; Galler, D. E.; Denman, T. F.; Shied, R. A.; Black, J. R.; Fierstein, A. R.; Clark, G. L.; Branstrom, B. R.

    1993-01-01

    A design and analysis study was conducted to provide advanced engine descriptions and parametric data for space transfer vehicles. The study was based on an advanced oxygen/hydrogen engine in the 7,500 to 50,000 lbf thrust range. Emphasis was placed on defining requirements for high-performance engines capable of achieving reliable and versatile operation in a space environment. Four variations on the expander cycle were compared, and the advantages and disadvantages of each were assessed. Parametric weight, envelope, and performance data were generated over a range of 7,500 to 50,000 lb thrust and a wide range of chamber pressure and nozzle expansion ratio.

  16. Retroauricular cutaneous advancement flap.

    PubMed

    Kim, Peter; Lee, Kwan Stephen

    2012-08-01

    Excisional surgery of the ear, such as that following a skin cancer excision, often produces a smaller ear postoperatively. This article describes the various uses of a retroauricular cutaneous advancement flap to repair surgical defects of the ear following a skin cancer excision, without miniaturising the ear. A retroauricular cutaneous advancement flap is an option for patients who require cosmetically satisfying reconstruction of the ear post skin cancer excision. The technique can avoid the miniaturisation of the ear that may occur with other techniques.

  17. The Advanced Virgo detector

    NASA Astrophysics Data System (ADS)

    Acernese, F.; Adams, T.; Agathos, M.; Agatsuma, K.; Allocca, A.; Astone, P.; Ballardin, G.; Barone, F.; Barsuglia, M.; Basti, A.; Bauer, Th S.; Bavigadda, V.; Bejger, M.; Belczynski, C.; Bersanetti, D.; Bertolini, A.; Bitossi, M.; Bizouard, M. A.; Bloemen, S.; Boer, M.; Bogaert, G.; Bondu, F.; Bonelli, L.; Bonnand, R.; Boschi, V.; Bosi, L.; Bradaschia, C.; Branchesi, M.; Briant, T.; Brillet, A.; Brisson, V.; Bulik, T.; Bulten, H. J.; Buskulic, D.; Buy, C.; Cagnoli, G.; Calloni, E.; Carbognani, F.; Cavalier, F.; Cavalieri, R.; Cella, G.; Cesarini, E.; Chassande-Mottin, E.; Chincarini, A.; Chiummo, A.; Chua, S.; Cleva, F.; Coccia, E.; Cohadon, P.-F.; Colla, A.; Colombini, M.; Conte, A.; Coulon, J.-P.; Cuoco, E.; D'Antonio, S.; Dattilo, V.; Davier, M.; Day, R.; Debreczeni, G.; Degallaix, J.; De Laurentis, M.; Deléglise, S.; Del Pozzo, W.; Dereli, H.; De Rosa, R.; Di Fiore, L.; Di Lieto, A.; Di Virgilio, A.; Dolique, V.; Drago, M.; Ducrot, M.; Endrőczi, G.; Fafone, V.; Farinon, S.; Ferrante, I.; Ferrini, F.; Fidecaro, F.; Fiori, I.; Flaminio, R.; Fournier, J.-D.; Franco, S.; Frasca, S.; Frasconi, F.; Gammaitoni, L.; Garufi, F.; Gatto, A.; Gemme, G.; Gendre, B.; Genin, E.; Gennai, A.; Ghosh, S.; Giazotto, A.; Gouaty, R.; Granata, M.; Greco, G.; Groot, P.; Guidi, G. M.; Harms, J.; Heidmann, A.; Heitmann, H.; Hello, P.; Hemming, G.; Hofman, D.; Jonker, R. J. G.; Kasprzack, M.; Kéfélian, F.; Królak, A.; Kutynia, A.; Lazzaro, C.; Lebigot, E.; Leonardi, M.; Leroy, N.; Letendre, N.; Lorenzini, M.; Loriette, V.; Losurdo, G.; Majorana, E.; Maksimovic, I.; Malvezzi, V.; Man, N.; Mangano, V.; Mantovani, M.; Marchesoni, F.; Marion, F.; Marque, J.; Martelli, F.; Martinelli, L.; Masserot, A.; Meacher, D.; Meidam, J.; Mezzani, F.; Michel, C.; Milano, L.; Minenkov, Y.; Moggi, A.; Mohan, M.; Mours, B.; Nagy, M. F.; Nardecchia, I.; Naticchioni, L.; Nelemans, G.; Neri, I.; Neri, M.; Nocera, F.; Palomba, C.; Paoletti, F.; Pasqualetti, A.; Passaquieti, R.; Passuello, D.; Pichot, M.; Piergiovanni, F.; Pillant, G.; Pinard, L.; Poggiani, R.; Prijatelj, M.; Prodi, G. A.; Punturo, M.; Puppo, P.; Rabeling, D. S.; Rácz, I.; Rapagnani, P.; Razzano, M.; Re, V.; Regimbau, T.; Ricci, F.; Robinet, F.; Rocchi, A.; Rolland, L.; Romano, R.; Ruggi, P.; Sassolas, B.; Sentenac, D.; Sequino, V.; Shah, S.; Siellez, K.; Straniero, N.; Swinkels, B.; Tacca, M.; Tonelli, M.; Travasso, F.; Vajente, G.; van Bakel, N.; van Beuzekom, M.; van den Brand, J. F. J.; Van Den Broeck, C.; van der Sluys, M. V.; van Heijningen, J.; Vasúth, M.; Vedovato, G.; Veitch, J.; Verkindt, D.; Vetrano, F.; Viceré, A.; Vinet, J.-Y.; Vocca, H.; Wei, L.-W.; Yvert, M.; Zadrożny, A.; Zendri, J.-P.

    2015-05-01

    The Advanced Virgo interferometer is the upgraded version of the Virgo detector having the goal to extend by a factor 10 the observation horizon in the universe and consequently increase the detection rate by three orders of magnitude. Its installation is in progress and is expected to be completed in late 2015. In this proceeding we will present the scheme and the main challenging technical features of the detector and we will give an outline of the installation status and the foreseen time schedule which will bring Advanced Virgo to its full operation.

  18. Advanced Teleprocessing Systems

    DTIC Science & Technology

    1979-09-30

    Research in Distributed Communications. Advanced studies in --n-ternetting, flow ontrol, distribted access , fundamental capacity dafin- itions and contours...OCUENTTIO PAE BEFORE COMPLETING FORM I.REP0R NUNpp N . GOVT ACCESSION 010 3. NECIP111IS CATALOG NUMMER 4. TIYLIE (and IUwiIDCI.) .yK _ C"I"" 40VANCED...ADcRNSS Defense Advanced Research Projects Agency jel ON OM 1400 Wilson Boulevard_______________ Arlington, VA 22209 10______________ r t’ ONITORtIN8

  19. Advanced solar dynamic technology program

    NASA Technical Reports Server (NTRS)

    Calogeras, James

    1990-01-01

    Viewgraphs and discussion on Advanced Solar Dynamic Technology Program are presented. Topics covered include: advanced solar dynamic technology program; advanced concentrators; advanced heat receivers; power conversion systems; dished all metal honeycomb sandwich panels; Stirling cavity heat pipe receiver; Brayton solar receiver; and thermal energy storage technology.

  20. Improvement of Cognitive and Psychomotor Performance in Patients with Mild to Moderate Obstructive Sleep Apnea Treated with Mandibular Advancement Device: A Prospective 1-Year Study

    PubMed Central

    Galic, Tea; Bozic, Josko; Pecotic, Renata; Ivkovic, Natalija; Valic, Maja; Dogas, Zoran

    2016-01-01

    Study Objectives: This study aimed to provide the evidence on effect of mandibular advancement device (MAD) therapy on long-term cognitive and psychomotor performance, excessive daytime sleepiness, and quality of life in patients with mild to moderate obstructive sleep apnea (OSA). Methods: A total of 15 patients with mild to moderate OSA were treated with MAD therapy and they were followed up after 3 mo and 1 y of therapy. The patients were tested on three different tests of cognitive and psychomotor performance using the computer-based system Complex Reactionmeter Drenovac (CRD-series) at baseline and at the time of follow-up, and the 36-Item Short Form Health Survey (SF-36) questionnaire and Epworth Sleepiness Scale were used to assess their quality of life and excessive daytime sleepiness, respectively. Results: The mean apnea-hypopnea index (AHI) decreased significantly from 22.9 ± 5.9 events/h at baseline, to 9.7 ± 4.5 events/h after 1 y of MAD therapy (p < 0.001). There was significant improvement on all three CRD-series tests used after 1 y of MAD therapy, considering total test solving time (TTST) and minimal single task solving time (MinT), whereas total number of errors committed during the tests (TE) remained unchanged. Self-reported measures, excessive daytime sleepiness, and three domains of quality of life, social functioning, general health perception, and health change following MAD therapy showed significant improvements after 1 y of MAD therapy. Conclusions: This study demonstrates significant improvements in cognitive and psychomotor performance, particularly in the domain of perceptive abilities, convergent thinking (constructing and solving simple mathematical tasks) and psychomotor reaction times, excessive daytime sleepiness, and quality of life in patients with mild to moderate OSA following MAD therapy. Citation: Galic T, Bozic J, Pecotic R, Ivkovic N, Valic M, Dogas Z. Improvement of cognitive and psychomotor performance in patients

  1. Advanced Cardiac Life Support.

    ERIC Educational Resources Information Center

    Kirkwood Community Coll., Cedar Rapids, IA.

    This document contains materials for an advanced college course in cardiac life support developed for the State of Iowa. The course syllabus lists the course title, hours, number, description, prerequisites, learning activities, instructional units, required text, six references, evaluation criteria, course objectives by units, course…

  2. Interfaces for Advanced Computing.

    ERIC Educational Resources Information Center

    Foley, James D.

    1987-01-01

    Discusses the coming generation of supercomputers that will have the power to make elaborate "artificial realities" that facilitate user-computer communication. Illustrates these technological advancements with examples of the use of head-mounted monitors which are connected to position and orientation sensors, and gloves that track finger and…

  3. Technological advances transforming rheumatology

    PubMed Central

    Robinson, William H.; Mao, Rong

    2016-01-01

    Technological advances over the past decade have revolutionized many areas of rheumatology, ranging from diagnosis, prognosis and therapeutic development to the mechanistic understanding of rheumatic diseases. This overview highlights key technological innovations and discusses the major impact that these developments are having on research and clinical practice. PMID:26439404

  4. Advanced proteomic liquid chromatography

    SciTech Connect

    Xie, Fang; Smith, Richard D.; Shen, Yufeng

    2012-10-26

    Liquid chromatography coupled with mass spectrometry is the predominant platform used to analyze proteomics samples consisting of large numbers of proteins and their proteolytic products (e.g., truncated polypeptides) and spanning a wide range of relative concentrations. This review provides an overview of advanced capillary liquid chromatography techniques and methodologies that greatly improve separation resolving power and proteomics analysis coverage, sensitivity, and throughput.

  5. Advanced Polymer Network Structures

    DTIC Science & Technology

    2016-02-01

    it is no longer needed. Do not return it to the originator. ARL-TR-7612 ● FEB 2016 US Army Research Laboratory Advanced Polymer...penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR

  6. Preliminary Advanced Colloids Experiment

    NASA Image and Video Library

    2011-09-29

    ISS029-E-011867 (29 Sept. 2011) --- NASA astronaut Mike Fossum, Expedition 29 commander, works with the Light Microscopy Module (LMM) control box in the Destiny laboratory of the International Space Station in preparation for another session with the Preliminary Advanced Colloids Experiment (PACE) hardware.

  7. Advancing Student Achievement

    ERIC Educational Resources Information Center

    Walberg, Herbert J.

    2010-01-01

    For the last half century, higher spending and many modern reforms have failed to raise the achievement of students in the United States to the levels of other economically advanced countries. A possible explanation, says Herbert Walberg, is that much current education theory is ill informed about scientific psychology, often drawing on fads and…

  8. Advanced Mirror Technology Development

    NASA Technical Reports Server (NTRS)

    Stahl, H. Philip

    2017-01-01

    The Advanced Mirror Technology Development (AMTD) project matures critical technologies required to enable ultra-stable 4-m-or-larger monolithic or segmented ultraviolet, optical, and infrared (UVOIR) space telescope primary-mirror assemblies for general astrophysics and ultra-high-contrast observations of exoplanets.

  9. Advanced propeller aerodynamic analysis

    NASA Technical Reports Server (NTRS)

    Bober, L. J.

    1980-01-01

    The analytical approaches as well as the capabilities of three advanced analyses for predicting propeller aerodynamic performance are presented. It is shown that two of these analyses use a lifting line representation for the propeller blades, and the third uses a lifting surface representation.

  10. Advanced Civilian Aeronautical Concepts

    NASA Technical Reports Server (NTRS)

    Bushnell, Dennis M.

    1996-01-01

    Paper discusses alternatives to currently deployed systems which could provide revolutionary improvements in metrics applicable to civilian aeronautics. Specific missions addressed include subsonic transports, supersonic transports and personal aircraft. These alternative systems and concepts are enabled by recent and envisaged advancements in electronics, communications, computing and Designer Fluid Mechanics in conjunction with a design approach employing extensive synergistic interactions between propulsion, aerodynamics and structures.

  11. Advanced Test Reactor Tour

    SciTech Connect

    Miley, Don

    2011-01-01

    The Advanced Test Reactor at Idaho National Laboratory is the foremost nuclear materials test reactor in the world. This virtual tour describes the reactor, how experiments are conducted, and how spent nuclear fuel is handled and stored. For more information about INL research, visit http://www.facebook.com/idahonationallaboratory.

  12. Advanced Test Reactor Tour

    ScienceCinema

    Miley, Don

    2016-07-12

    The Advanced Test Reactor at Idaho National Laboratory is the foremost nuclear materials test reactor in the world. This virtual tour describes the reactor, how experiments are conducted, and how spent nuclear fuel is handled and stored. For more information about INL research, visit http://www.facebook.com/idahonationallaboratory.

  13. Advances in Distance Learning.

    ERIC Educational Resources Information Center

    1999

    This document contains three symposium papers on advances in distance learning. "The Adoption of Computer Technology and Telecommunications: A Case Study" (Larry M. Dooley, Teri Metcalf, Ann Martinez) reports on a study of the possible applications of two theoretical models (Rogers' Diffusion of Innovations model and the Concerns-Based…

  14. Advanced Gas Turbine (AGT)

    NASA Technical Reports Server (NTRS)

    1983-01-01

    The development and progress of the Advanced Gas Turbine engine program is examined. An analysis of the role of ceramics in the design and major engine components is included. Projected fuel economy, emissions and performance standards, and versatility in fuel use are also discussed.

  15. Advancing beyond AP Courses

    ERIC Educational Resources Information Center

    Hammond, Bruce G.

    2009-01-01

    A quiet revolution is picking up steam in the nation's private secondary schools, with broad implications for college admissions and for teaching and learning on both sides of the transition from high school to college. About 50 of the nation's leading college-preparatory schools have opted out of the College Board's Advanced Placement (AP)…

  16. Advanced nuclear propulsion concepts

    SciTech Connect

    Howe, S.D.

    1994-12-31

    A preliminary analysis has been carried out for two potential advanced nuclear propulsion systems: a contained pulsed nuclear propulsion engine and an antiproton initiated ICF system. The results of these studies indicate that both concepts have a high potential to help enable manned planetary exploration but require substantial development.

  17. Advances in Planetary Geology

    NASA Technical Reports Server (NTRS)

    Woronow, A. (Editor)

    1982-01-01

    Advances in Planetary Geology is a new series intended to serve the planetary geology community with a form for quick and thorough communications. There are no set lists of acceptable topics or formats, and submitted manuscripts will not undergo a formal review. All submissions should be in a camera ready form, preferably spaced, and submitted to the editor.

  18. Cartoons as Advance Organizers

    ERIC Educational Resources Information Center

    Kovalik, Cindy L.; Williams, Matthew A.

    2011-01-01

    This exploratory study investigated student reaction to the use of cartoons as advance organizers for online discussions in an online course. A convenience sample of 15 students participated in the study by contributing cartoons, participating in online discussions, and completing a survey. Overall, survey results indicated student reaction to the…

  19. Advancing Student Achievement

    ERIC Educational Resources Information Center

    Walberg, Herbert J.

    2010-01-01

    For the last half century, higher spending and many modern reforms have failed to raise the achievement of students in the United States to the levels of other economically advanced countries. A possible explanation, says Herbert Walberg, is that much current education theory is ill informed about scientific psychology, often drawing on fads and…

  20. Advanced turbine systems program

    SciTech Connect

    Wilkes, C.; Mukavetz, D.W.; Knickerbocker, T.K.; Ali, S.A.

    1992-01-01

    In accordance with the goals of the DOE program, improvements in the gas turbine are the primary focus of Allison activity during Phase I. To this end Allison conducted a survey of potentially applicable gas turbine cycles and selected the advanced combined cycle as reference system. Extensive analysis of two versions of the advanced combined cycle was performed against the requirement for a 60% thermal efficiency (LHV) utility-sized, natural gas fired system. This analysis resulted in technology requirements for this system. Additional analysis determined emissions potential for the system, established a coal-fueled derivative system and a commercialization plan. This report deals with the technical requirements for a system that meets the thermal efficiency goal. Allison initially investigated four basic thermodynamic cycles: Humid air turbine, intercalate-recuperated systems, advanced combined cycle, chemically recuperated cycle. Our survey and cycle analysis indicated that au had the potential of reaching 60% thermal efficiency. We also concluded that engine hot section technology would be a critical technology regardless of which cycle was chosen. Based on this result Allison chose to concentrate on the advanced combined cycle. This cycle is well known and understood by the utility turbine user community and is therefore likely to be acceptable to users.

  1. Advanced turbine systems program

    SciTech Connect

    Wilkes, C.; Mukavetz, D.W.; Knickerbocker, T.K.; Ali, S.A.

    1992-12-31

    In accordance with the goals of the DOE program, improvements in the gas turbine are the primary focus of Allison activity during Phase I. To this end Allison conducted a survey of potentially applicable gas turbine cycles and selected the advanced combined cycle as reference system. Extensive analysis of two versions of the advanced combined cycle was performed against the requirement for a 60% thermal efficiency (LHV) utility-sized, natural gas fired system. This analysis resulted in technology requirements for this system. Additional analysis determined emissions potential for the system, established a coal-fueled derivative system and a commercialization plan. This report deals with the technical requirements for a system that meets the thermal efficiency goal. Allison initially investigated four basic thermodynamic cycles: Humid air turbine, intercalate-recuperated systems, advanced combined cycle, chemically recuperated cycle. Our survey and cycle analysis indicated that au had the potential of reaching 60% thermal efficiency. We also concluded that engine hot section technology would be a critical technology regardless of which cycle was chosen. Based on this result Allison chose to concentrate on the advanced combined cycle. This cycle is well known and understood by the utility turbine user community and is therefore likely to be acceptable to users.

  2. Advanced Chemical Propulsion

    NASA Technical Reports Server (NTRS)

    Alexander, Leslie, Jr.

    2006-01-01

    Advanced Chemical Propulsion (ACP) provides near-term incremental improvements in propulsion system performance and/or cost. It is an evolutionary approach to technology development that produces useful products along the way to meet increasingly more demanding mission requirements while focusing on improving payload mass fraction to yield greater science capability. Current activities are focused on two areas: chemical propulsion component, subsystem, and manufacturing technologies that offer measurable system level benefits; and the evaluation of high-energy storable propellants with enhanced performance for in-space application. To prioritize candidate propulsion technology alternatives, a variety of propulsion/mission analyses and trades have been conducted for SMD missions to yield sufficient data for investment planning. They include: the Advanced Chemical Propulsion Assessment; an Advanced Chemical Propulsion System Model; a LOx-LH2 small pumps conceptual design; a space storables propellant study; a spacecraft cryogenic propulsion study; an advanced pressurization and mixture ratio control study; and a pump-fed vs. pressure-fed study.

  3. Advanced Plant Habitat (APH)

    NASA Technical Reports Server (NTRS)

    Richards, Stephanie E. (Compiler); Levine, Howard G.; Reed, David W.

    2016-01-01

    The Advanced Plant Habitat (APH) hardware will be a large growth volume plant habitat, capable of hosting multigenerational studies, in which environmental variables (e.g., temperature, relative humidity, carbon dioxide level light intensity and spectral quality) can be tracked and controlled in support of whole plant physiological testing and Bio-regenerative Life Support System investigations.

  4. Advances in satellite oceanography

    NASA Technical Reports Server (NTRS)

    Brown, O. B.; Cheney, R. E.

    1983-01-01

    Technical advances and recent applications of active and passive satellite remote sensing techniques to the study of oceanic processes are summarized. The general themes include infrared and visible radiometry, active and passive microwave sensors, and buoy location systems. The surface parameters of sea surface temperature, windstream, sea state, altimetry, color, and ice are treated as applicable under each of the general methods.

  5. Advances in statistics

    Treesearch

    Howard Stauffer; Nadav Nur

    2005-01-01

    The papers included in the Advances in Statistics section of the Partners in Flight (PIF) 2002 Proceedings represent a small sample of statistical topics of current importance to Partners In Flight research scientists: hierarchical modeling, estimation of detection probabilities, and Bayesian applications. Sauer et al. (this volume) examines a hierarchical model...

  6. ISE advanced technology

    NASA Technical Reports Server (NTRS)

    Fox, Barry R.

    1991-01-01

    Information on Space Station Freedom scheduling problems and techniques are presented in viewgraph form. Topics covered include automated scheduling systems, user interface standards, benefits of interactive scheduling systems, incremental scheduling, software engineering, computer graphics interface, distributed resource management, and advanced applications.

  7. Oklahoma's Advanced School Funding.

    ERIC Educational Resources Information Center

    Green, Gary

    A new means of funding school operations known as advanced school funding allows Oklahoma schools financing during the temporary cash shortfalls. The program consists of the Oklahoma Development Authority issuing revenue bonds purchased by E. F. Hutton and Company, Inc., which then sells the tax free bonds to investors throughout the country. A…

  8. Advances in fuzzy theory.

    PubMed

    Sadegh-Zadeh, K

    1999-03-01

    Recent advances in the foundations of fuzzy theory facilitated by Bart Kosko's discovery of the fuzzy hypercube are of high relevance to artificial intelligence in medicine research. The new concepts of set inclusion, equality, and similarity are therefore reported in this paper. A unifying notion of a Lotfi Zadeh space is also introduced to show that Bart Kosko's fuzzy hypercube is a Zadeh space.

  9. Introduction to advanced biologics.

    PubMed

    Inumaru, Shigeki

    2012-07-15

    The changing structure and environment of the animal industry have brought about the need for new-generation vaccines, therapeutic methods, and diagnostic methods. This review briefly explains the present situation and future prospects of advanced biologics. Copyright © 2012 Elsevier B.V. All rights reserved.

  10. Advanced fossil energy utilization

    SciTech Connect

    Shekhawat, D.; Berry, D.; Spivey, J.; Pennline, H.; Granite, E.

    2010-01-01

    This special issue of Fuel is a selection of papers presented at the symposium ‘Advanced Fossil Energy Utilization’ co-sponsored by the Fuels and Petrochemicals Division and Research and New Technology Committee in the 2009 American Institute of Chemical Engineers (AIChE) Spring National Meeting Tampa, FL, on April 26–30, 2009.

  11. Advanced Learning Environments.

    ERIC Educational Resources Information Center

    Hubal, Robert C.; Helms, Robert F.; Triplett, Suzanne E.

    Leading-edge technologies, integrated with emerging educational methodologies, make the Advanced Learning Environment (ALE) model cost effective and efficient for learning. The ALE integrates virtual reality and other enabling technologies such as natural language processing, animation, video, courseware, sound, projection, CD-ROM, and distance…

  12. Advances in Qualitative Research.

    ERIC Educational Resources Information Center

    1998

    This document contains five papers from a symposium on advances in qualitative research in human resource development (HRD). "Case Study and Its Virtuoso Possibilities" (Verna J. Willis) asserts that the case study method is particularly well suited for research in HRD because its creative and investigative possibilities have not yet…

  13. Advanced Mathematical Thinking

    ERIC Educational Resources Information Center

    Dubinsky, Ed; McDonald, Michael A.; Edwards, Barbara S.

    2005-01-01

    In this article we propose the following definition for advanced mathematical thinking: Thinking that requires deductive and rigorous reasoning about mathematical notions that are not entirely accessible to us through our five senses. We argue that this definition is not necessarily tied to a particular kind of educational experience; nor is it…

  14. Rewriting in Advanced Composition.

    ERIC Educational Resources Information Center

    Stone, William B.

    A college English instructor made an informal comparison of rewriting habits of students in a freshman composition course and two advanced composition courses. Notes kept on student rewriting focused on this central question: given peer and instructor response to their papers and a choice as to what and how to rewrite, what will students decide to…

  15. The Teacher Advancement Program.

    ERIC Educational Resources Information Center

    Schiff, Tamara W.

    2002-01-01

    This publication contains two essays discussing the Teacher Advancement Program (TAP) and a criticism of merit pay for teachers. Today's schools are larger, often overcrowded, and frequently staffed by temporary or inexperienced teachers. TAP was created in response to the need for teacher-quality reform. It addresses challenges of teacher quality…

  16. Oklahoma's Advanced School Funding.

    ERIC Educational Resources Information Center

    Green, Gary

    A new means of funding school operations known as advanced school funding allows Oklahoma schools financing during the temporary cash shortfalls. The program consists of the Oklahoma Development Authority issuing revenue bonds purchased by E. F. Hutton and Company, Inc., which then sells the tax free bonds to investors throughout the country. A…

  17. ADVANCED MANUFACTURING TEAM

    NASA Image and Video Library

    2016-03-17

    KEN COOPER, TEAM LEAD OF MSFC’S ADVANCED MANUFACTURING TEAM, WITH NICKEL ALLOY 718 PARTS FABRICATED USING THE M1 SELECTIVE LASER MELTING SYSTEM. THE M1 MACHINE IS DEDICATED TO BUILDING QUALIFICATION SAMPLES AND HARDWARE DEMONSTRATORS FOR THE RS25 ENGINE PROJECT.

  18. ADVANCED MANUFACTURING TEAM

    NASA Image and Video Library

    2016-03-17

    JOHNNIE CLARK, BRIAN WEST, AND ZACK JONES OF MSFC’S ADVANCED MANUFACTURING TEAM, WITH MSFC’S XLINE SELECTIVE LASER MELTING SYSTEM. CURRENTLY ONE OF THE LARGEST METAL 3D PRINTERS, THE XLINE AT MARSHALL IS BEING USED TO DEVELOP AND CERTIFY NICKEL ALLOY 718 MATERIAL PROPERTIES AND LARGE MANUFACTURING TECH DEMOS FOR THE RS25 ENGINE AND THE COMMERCIAL CREWED VEHICLE PROJECTS.

  19. Advancement's Sticky Issues

    ERIC Educational Resources Information Center

    Jackson, Patricia

    2011-01-01

    The author did not expect to be surprised or disturbed by the data from the latest Council for Advancement and Support of Education (CASE) salary survey; however, she was. CASE has been conducting the survey since 1982, so she assumed the findings would mirror her own salary history and those of her peers. While she suspected that older women…

  20. Advances in fetal surgery

    PubMed Central

    Pedreira, Denise Araujo Lapa

    2016-01-01

    ABSTRACT This paper discusses the main advances in fetal surgical therapy aiming to inform health care professionals about the state-of-the-art techniques and future challenges in this field. We discuss the necessary steps of technical evolution from the initial open fetal surgery approach until the development of minimally invasive techniques of fetal endoscopic surgery (fetoscopy). PMID:27074241

  1. Advanced intrarenal ureteroscopic procedures.

    PubMed

    Monga, Manoj; Beeman, William W

    2004-02-01

    The role of flexible ureteroscopy in the management of intrarenal pathology has undergone a dramatic evolution, powered by improvements in flexible ureteroscope design; deflection and image quality; diversification of small, disposable instrumentation; and the use of holmium laser lithotripsy. This article reviews the application of flexible ureteroscopy for advanced intrarenal procedures.

  2. Advanced Concept Modeling

    NASA Technical Reports Server (NTRS)

    Chaput, Armand; Johns, Zachary; Hodges, Todd; Selfridge, Justin; Bevirt, Joeben; Ahuja, Vivek

    2015-01-01

    Advanced Concepts Modeling software validation, analysis, and design. This was a National Institute of Aerospace contract with a lot of pieces. Efforts ranged from software development and validation for structures and aerodynamics, through flight control development, and aeropropulsive analysis, to UAV piloting services.

  3. Advanced planetary studies

    NASA Technical Reports Server (NTRS)

    1978-01-01

    Eleven study tasks are described and key results are discussed for the following: advanced planning activity; cost estimation research; planetary missions performance handbooks-revisions; multiple discipline science assessment; asteroid workshop; galilean lander mission strategies; asteroid exploration study; ion drive transport capabilities; Mars strategy study; Venus surface sample return; and ion drive/solar sail assessment study.

  4. Infant Development: Recent Advances.

    ERIC Educational Resources Information Center

    Bremner, Gavin, Ed.; Slater, Alan, Ed.; Butterworth, George, Ed.

    Noting that the last 30 years have seen enormous increases in the understanding of infancy, this book examines the current state of knowledge regarding infant development. The book's contents stem from meetings of the British Infancy Research Group. Although the book was intended for advanced undergraduates, it would also be useful for advanced…

  5. Advances in Calorimetry

    SciTech Connect

    Brau, James E.; Jaros, John A.; Ma, Hong

    2010-11-23

    We review recent advances in calorimetry for high-energy physics. We provide an overview of the fundamentals of calorimetry, then survey calorimeters used in recent experiments, which represent the current state of the art. We conclude with descriptions of several research and development efforts and discuss future directions of the field.

  6. Advanced Distribution Management System

    NASA Astrophysics Data System (ADS)

    Avazov, Artur R.; Sobinova, Liubov A.

    2016-02-01

    This article describes the advisability of using advanced distribution management systems in the electricity distribution networks area and considers premises of implementing ADMS within the Smart Grid era. Also, it gives the big picture of ADMS and discusses the ADMS advantages and functionalities.

  7. Advanced geometries and regimes

    SciTech Connect

    Bulanov, S. S.; Bulanov, S. V.; Turchetti, G.; Limpouch, J.; Klimo, O.; Psikal, J.; Margarone, D.; Korn, G.

    2013-07-26

    We review and discuss different schemes of laser ion acceleration as well as advanced target geometries in connection with the development of the laser-driven proton source for hadron therapy of oncological diseases, which is a part of the ELIMED project.

  8. Infant Development: Recent Advances.

    ERIC Educational Resources Information Center

    Bremner, Gavin, Ed.; Slater, Alan, Ed.; Butterworth, George, Ed.

    Noting that the last 30 years have seen enormous increases in the understanding of infancy, this book examines the current state of knowledge regarding infant development. The book's contents stem from meetings of the British Infancy Research Group. Although the book was intended for advanced undergraduates, it would also be useful for advanced…

  9. Coping with Advanced Cancer

    MedlinePlus

    ... of palliative care Coping with your feelings and getting support Advanced planning How to talk with friends and family about your cancer Looking for meaning in your life The booklet is meant to provide you with information and ways you can still have a control of your ...

  10. Labour analgesia: Recent advances

    PubMed Central

    Pandya, Sunil T

    2010-01-01

    Advances in the field of labour analgesia have tread a long journey from the days of ether and chloroform in 1847 to the present day practice of comprehensive programme of labour pain management using evidence-based medicine. Newer advances include introduction of newer techniques like combined spinal epidurals, low-dose epidurals facilitating ambulation, pharmacological advances like introduction of remifentanil for patient-controlled intravenous analgesia, introduction of newer local anaesthetics and adjuvants like ropivacaine, levobupivacaine, sufentanil, clonidine and neostigmine, use of inhalational agents like sevoflourane for patient-controlled inhalational analgesia using special vaporizers, all have revolutionized the practice of pain management in labouring parturients. Technological advances like use of ultrasound to localize epidural space in difficult cases minimizes failed epidurals and introduction of novel drug delivery modalities like patient-controlled epidural analgesia (PCEA) pumps and computer-integrated drug delivery pumps have improved the overall maternal satisfaction rate and have enabled us to customize a suitable analgesic regimen for each parturient. Recent randomized controlled trials and Cochrane studies have concluded that the association of epidurals with increased caesarean section and long-term backache remains only a myth. Studies have also shown that the newer, low-dose regimes do not have a statistically significant impact on the duration of labour and breast feeding and also that these reduce the instrumental delivery rates thus improving maternal and foetal safety. Advances in medical technology like use of ultrasound for localizing epidural space have helped the clinicians to minimize the failure rates, and many novel drug delivery modalities like PCEA and computer-integrated PCEA have contributed to the overall maternal satisfaction and safety. PMID:21189877

  11. Advanced Space Propulsion

    NASA Technical Reports Server (NTRS)

    Frisbee, Robert H.

    1996-01-01

    This presentation describes a number of advanced space propulsion technologies with the potential for meeting the need for dramatic reductions in the cost of access to space, and the need for new propulsion capabilities to enable bold new space exploration (and, ultimately, space exploitation) missions of the 21st century. For example, current Earth-to-orbit (e.g., low Earth orbit, LEO) launch costs are extremely high (ca. $10,000/kg); a factor 25 reduction (to ca. $400/kg) will be needed to produce the dramatic increases in space activities in both the civilian and government sectors identified in the Commercial Space Transportation Study (CSTS). Similarly, in the area of space exploration, all of the relatively 'easy' missions (e.g., robotic flybys, inner solar system orbiters and landers; and piloted short-duration Lunar missions) have been done. Ambitious missions of the next century (e.g., robotic outer-planet orbiters/probes, landers, rovers, sample returns; and piloted long-duration Lunar and Mars missions) will require major improvements in propulsion capability. In some cases, advanced propulsion can enable a mission by making it faster or more affordable, and in some cases, by directly enabling the mission (e.g., interstellar missions). As a general rule, advanced propulsion systems are attractive because of their low operating costs (e.g., higher specific impulse, ISD) and typically show the most benefit for relatively 'big' missions (i.e., missions with large payloads or AV, or a large overall mission model). In part, this is due to the intrinsic size of the advanced systems as compared to state-of-the-art (SOTA) chemical propulsion systems. Also, advanced systems often have a large 'infrastructure' cost, either in the form of initial R&D costs or in facilities hardware costs (e.g., laser or microwave transmission ground stations for beamed energy propulsion). These costs must then be amortized over a large mission to be cost-competitive with a SOTA

  12. Piecing Together Phenotypes of Brain Injury and Dysfunction in Obstructive Sleep Apnea

    PubMed Central

    Veasey, Sigrid C.

    2012-01-01

    Obstructive sleep apnea (OSA) is a highly prevalent condition that is associated with significant neurobehavioral impairments. Cognitive abnormalities identified in individuals with OSA include impaired verbal memory, planning, reasoning, vigilance, and mood. Therapy for OSA improves some but not all neurobehavioral outcomes, supporting a direct role for OSA in brain dysfunction and raising the question of irreversible injury from OSA. Recent clinical studies have refined the neurobehavioral, brain imaging, and electrophysiological characteristics of OSA, highlighting findings shared with aging and some unique to OSA. This review summarizes the cognitive, brain metabolic and structural, and peripheral nerve conduction changes observed in OSA that collectively provide a distinct phenotype of OSA brain injury and dysfunction. Findings in animal models of OSA provide insight into molecular mechanisms underlying OSA neuronal injury that can be related back to human neural injury and dysfunction. A comprehensive phenotype of brain function and injury in OSA is essential for advancing diagnosis, prevention, and treatment of this common disorder. PMID:23087666

  13. Advances in Norovirus Biology

    PubMed Central

    Karst, Stephanie M.; Wobus, Christiane E.; Goodfellow, Ian G.; Green, Kim Y.

    2014-01-01

    Human noroviruses are a major cause of epidemic and sporadic gastroenteritis worldwide, and can chronically infect immunocompromised patients. Efforts to develop effective vaccines and antivirals have been hindered by the uncultivable nature and extreme genetic diversity of human noroviruses. Although they remain a particularly challenging pathogen to study, recent advances in norovirus animal models and in vitro cultivation systems have led to an increased understanding of norovirus molecular biology and replication, pathogenesis, cell tropism, and innate and adaptive immunity. Furthermore, clinical trials of vaccines consisting of nonreplicating virus-like particles have shown promise. In this review, we summarize these recent advances and discuss controversies in the field, which is rapidly progressing towards generation of antiviral agents and increasingly effective vaccines. PMID:24922570

  14. Advanced life support study

    NASA Technical Reports Server (NTRS)

    1991-01-01

    Summary reports on each of the eight tasks undertaken by this contract are given. Discussed here is an evaluation of a Closed Ecological Life Support System (CELSS), including modeling and analysis of Physical/Chemical Closed Loop Life Support (P/C CLLS); the Environmental Control and Life Support Systems (ECLSS) evolution - Intermodule Ventilation study; advanced technologies interface requirements relative to ECLSS; an ECLSS resupply analysis; the ECLSS module addition relocation systems engineering analysis; an ECLSS cost/benefit analysis to identify rack-level interface requirements of the alternate technologies evaluated in the ventilation study, with a comparison of these with the rack level interface requirements for the baseline technologies; advanced instrumentation - technology database enhancement; and a clean room survey and assessment of various ECLSS evaluation options for different growth scenarios.

  15. Advanced Ablative TPS

    NASA Technical Reports Server (NTRS)

    Gasch, Matthew J.

    2011-01-01

    Early NASA missions (Gemini, Apollo, Mars Viking) employed new ablative TPS that were tailored for the entry environment. After 40 years, heritage ablative TPS materials using Viking or Pathfinder era materials are at or near their performance limits and will be inadequate for future exploration missions. Significant advances in TPS materials technology are needed in order to enable any subsequent human exploration missions beyond Low Earth Orbit. This poster summarizes some recent progress at NASA in developing families of advanced rigid/conformable and flexible ablators that could potentially be used for thermal protection in planetary entry missions. In particular the effort focuses technologies required to land heavy (approx.40 metric ton) masses on Mars to facilitate future exploration plans.

  16. Advanced information society(5)

    NASA Astrophysics Data System (ADS)

    Tanizawa, Ippei

    Based on the advancement of information network technology information communication forms informationalized society giving significant impact on business activities and life style in it. The information network has been backed up technologically by development of computer technology and has got great contribution by enhanced computer technology and communication equipments. Information is transferred by digital and analog methods. Technical development which has brought out multifunctioned modems of communication equipments in analog mode, and construction of advanced information communication network which has come out by joint work of computer and communication under digital technique, are described. The trend in institutional matter and standardization of electrical communication is also described showing some examples of value-added network (VAN).

  17. Recent Advances in Voltammetry.

    PubMed

    Batchelor-McAuley, Christopher; Kätelhön, Enno; Barnes, Edward O; Compton, Richard G; Laborda, Eduardo; Molina, Angela

    2015-06-01

    Recent progress in the theory and practice of voltammetry is surveyed and evaluated. The transformation over the last decade of the level of modelling and simulation of experiments has realised major advances such that electrochemical techniques can be fully developed and applied to real chemical problems of distinct complexity. This review focuses on the topic areas of: multistep electrochemical processes, voltammetry in ionic liquids, the development and interpretation of theories of electron transfer (Butler-Volmer and Marcus-Hush), advances in voltammetric pulse techniques, stochastic random walk models of diffusion, the influence of migration under conditions of low support, voltammetry at rough and porous electrodes, and nanoparticle electrochemistry. The review of the latter field encompasses both the study of nanoparticle-modified electrodes, including stripping voltammetry and the new technique of 'nano-impacts'.

  18. Advanced Life Support Systems

    NASA Technical Reports Server (NTRS)

    Barta, Daniel J.

    2004-01-01

    This presentation is planned to be a 10-15 minute "catalytic" focused presentation to be scheduled during one of the working sessions at the TIM. This presentation will focus on Advanced Life Support technologies key to future human Space Exploration as outlined in the Vision, and will include basic requirements, assessment of the state-of-the-art and gaps, and include specific technology metrics. The presentation will be technical in character, lean heavily on data in published ALS documents (such as the Baseline Values and Assumptions Document) but not provide specific technical details or build to information on any technology mentioned (thus the presentation will be benign from an export control and a new technology perspective). The topics presented will be focused on the following elements of Advanced Life Support: air revitalization, water recovery, waste management, thermal control, habitation systems, food systems and bioregenerative life support.

  19. Advanced Separation Consortium

    SciTech Connect

    2006-01-01

    The Center for Advanced Separation Technologies (CAST) was formed in 2001 under the sponsorship of the US Department of Energy to conduct fundamental research in advanced separation and to develop technologies that can be used to produce coal and minerals in an efficient and environmentally acceptable manner. The CAST consortium consists of seven universities - Virginia Tech, West Virginia University, University of Kentucky, Montana Tech, University of Utah, University of Nevada-Reno, and New Mexico Tech. The consortium brings together a broad range of expertise to solve problems facing the US coal industry and the mining sector in general. At present, a total of 60 research projects are under way. The article outlines some of these, on topics including innovative dewatering technologies, removal of mercury and other impurities, and modelling of the flotation process. 1 photo.

  20. Advanced light source

    NASA Astrophysics Data System (ADS)

    Sah, R. C.

    1983-03-01

    The Advanced Light Source (ALS) is a new synchrotron radiation source which was proposed by Lawrence Berkeley Laboratory. The ALS will be a key component in a major new research facility, the National Center for Advanced Materials. The ALS will consist of an electron linear accelerator, a booster synchrotron, a 1.3-GeV electron storage ring, and a number of photon beam lines. Most of all photon beam lines will originate from wiggler and undulator magnets placed in the 12 long straight sections of the ALS. A very low electron beam emittance will provide photon beams of unsurpassed spectral brilliance from specially-designed undulators, and a high radiofrequency will produce very short pulse lengths.

  1. Recent Advances in Voltammetry

    PubMed Central

    Batchelor-McAuley, Christopher; Kätelhön, Enno; Barnes, Edward O; Compton, Richard G; Laborda, Eduardo; Molina, Angela

    2015-01-01

    Recent progress in the theory and practice of voltammetry is surveyed and evaluated. The transformation over the last decade of the level of modelling and simulation of experiments has realised major advances such that electrochemical techniques can be fully developed and applied to real chemical problems of distinct complexity. This review focuses on the topic areas of: multistep electrochemical processes, voltammetry in ionic liquids, the development and interpretation of theories of electron transfer (Butler–Volmer and Marcus–Hush), advances in voltammetric pulse techniques, stochastic random walk models of diffusion, the influence of migration under conditions of low support, voltammetry at rough and porous electrodes, and nanoparticle electrochemistry. The review of the latter field encompasses both the study of nanoparticle-modified electrodes, including stripping voltammetry and the new technique of ‘nano-impacts’. PMID:26246984

  2. CADC Advanced Search

    NASA Astrophysics Data System (ADS)

    Jenkins, D. N.

    2012-09-01

    The Canadian Astronomy Data Centre's (CADC) Advanced Search web application is a modern search tool to access data across the CADC archives. It allows searching in different units, and is well averse in wild card characters and numeric operations. Search results are displayed in a sortable and filterable manner allowing quick and accurate access to downloadable data. The Advanced Search interface makes extremely good use of the Astronomical Data Query Language (ADQL) to scour the Common Archive Observation Model (CAOM) Table Access Protocol (TAP) query service and the vast CADC Archive Data (AD) storage system. A new tabular view of the query form and the results data makes it easy to view the query, then return to the query form to make further changes, or, alternatively, filter the data from the paginated table. Results are displayed using a rich, open-source, JavaScript-based VOTable viewer called voview.

  3. Advanced Rotorcraft Transmission Program

    NASA Technical Reports Server (NTRS)

    Bill, Robert C.

    1990-01-01

    The U.S. Army/NASA Advanced Rotorcraft Transmission (ART) program is charged with developing and demonstrating a light, quiet, and durable drivetrain for next-generation rotorcraft in two classes: a 10,000-20,000 Future Attack Air Vehicle capable of both tactical ground support and air-to-air missions, and a 60,000-80,000 lb Advanced Cargo Aircraft, for heavy-lift field-support operations. Specific ART objectives encompass a 25-percent reduction in drivetrain weight, a 10-dB noise level reduction at the transmission source, and the achievement of a 5000-hr MTBF. Four candidate drivetrain systems have been carried to a conceptual design stage, together with projections of their mission performance and life-cycle costs.

  4. Advanced information processing system

    NASA Technical Reports Server (NTRS)

    Lala, J. H.

    1984-01-01

    Design and performance details of the advanced information processing system (AIPS) for fault and damage tolerant data processing on aircraft and spacecraft are presented. AIPS comprises several computers distributed throughout the vehicle and linked by a damage tolerant data bus. Most I/O functions are available to all the computers, which run in a TDMA mode. Each computer performs separate specific tasks in normal operation and assumes other tasks in degraded modes. Redundant software assures that all fault monitoring, logging and reporting are automated, together with control functions. Redundant duplex links and damage-spread limitation provide the fault tolerance. Details of an advanced design of a laboratory-scale proof-of-concept system are described, including functional operations.

  5. Advanced ground station architecture

    NASA Technical Reports Server (NTRS)

    Zillig, David; Benjamin, Ted

    1994-01-01

    This paper describes a new station architecture for NASA's Ground Network (GN). The architecture makes efficient use of emerging technologies to provide dramatic reductions in size, operational complexity, and operational and maintenance costs. The architecture, which is based on recent receiver work sponsored by the Office of Space Communications Advanced Systems Program, allows integration of both GN and Space Network (SN) modes of operation in the same electronics system. It is highly configurable through software and the use of charged coupled device (CCD) technology to provide a wide range of operating modes. Moreover, it affords modularity of features which are optional depending on the application. The resulting system incorporates advanced RF, digital, and remote control technology capable of introducing significant operational, performance, and cost benefits to a variety of NASA communications and tracking applications.

  6. Advanced far infrared detectors

    SciTech Connect

    Haller, E.E.

    1993-05-01

    Recent advances in photoconductive and bolometric semiconductor detectors for wavelength 1 mm > {lambda} > 50 {mu}m are reviewed. Progress in detector performance in this photon energy range has been stimulated by new and stringent requirements for ground based, high altitude and space-borne telescopes for astronomical and astrophysical observations. The paper consists of chapters dealing with the various types of detectors: Be and Ga doped Ge photoconductors, stressed Ge:Ga devices and neutron transmutation doped Ge thermistors. Advances in the understanding of basic detector physics and the introduction of modern semiconductor device technology have led to predictable and reliable fabrication techniques. Integration of detectors into functional arrays has become feasible and is vigorously pursued by groups worldwide.

  7. Advanced steel reheat furnace

    SciTech Connect

    Moyeda, D.; Sheldon, M.; Koppang, R.; Lanyi, M.; Li, X.; Eleazer, B.

    1997-10-01

    Energy and Environmental Research Corp. (EER) under a contract from the Department of Energy is pursuing the development and demonstration of an Advanced Steel Reheating Furnace. This paper reports the results of Phase 1, Research, which has evaluated an advanced furnace concept incorporating two proven and commercialized technologies previously applied to other high temperature combustion applications: EER`s gas reburn technology (GR) for post combustion NOx control; and Air Product`s oxy-fuel enrichment air (OEA) for improved flame heat transfer in the heating zones of the furnace. The combined technologies feature greater production throughput with associated furnace efficiency improvements; lowered NOx emissions; and better control over the furnace atmosphere, whether oxidizing or reducing, leading to better control over surface finish.

  8. Advances in norovirus biology.

    PubMed

    Karst, Stephanie M; Wobus, Christiane E; Goodfellow, Ian G; Green, Kim Y; Virgin, Herbert W

    2014-06-11

    Human noroviruses are a major cause of epidemic and sporadic gastroenteritis worldwide and can chronically infect immunocompromised patients. Efforts to develop effective vaccines and antivirals have been hindered by the uncultivable nature and extreme genetic diversity of human noroviruses. Although they remain a particularly challenging pathogen to study, recent advances in norovirus animal models and in vitro cultivation systems have led to an increased understanding of norovirus molecular biology and replication, pathogenesis, cell tropism, and innate and adaptive immunity. Furthermore, clinical trials of vaccines consisting of nonreplicating virus-like particles have shown promise. In this review, we summarize these recent advances and discuss controversies in the field, which is rapidly progressing toward generation of antiviral agents and increasingly effective vaccines. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Advanced Technology Vehicle Testing

    SciTech Connect

    James Francfort

    2004-06-01

    The goal of the U.S. Department of Energy's Advanced Vehicle Testing Activity (AVTA) is to increase the body of knowledge as well as the awareness and acceptance of electric drive and other advanced technology vehicles (ATV). The AVTA accomplishes this goal by testing ATVs on test tracks and dynamometers (Baseline Performance testing), as well as in real-world applications (Fleet and Accelerated Reliability testing and public demonstrations). This enables the AVTA to provide Federal and private fleet managers, as well as other potential ATV users, with accurate and unbiased information on vehicle performance and infrastructure needs so they can make informed decisions about acquiring and operating ATVs. The ATVs currently in testing include vehicles that burn gaseous hydrogen (H2) fuel and hydrogen/CNG (H/CNG) blended fuels in internal combustion engines (ICE), and hybrid electric (HEV), urban electric, and neighborhood electric vehicles. The AVTA is part of DOE's FreedomCAR and Vehicle Technologies Program.

  10. Technical advances power neuroscience

    SciTech Connect

    Barinaga, M.

    1991-01-01

    New techniques are helping researchers study the development of nerve cells in cell cultures and in vivo. These new methods are offering insights into the brain that were not available even a couple of years ago. Among the new advances discussed are imaging technology for evaluating the thinking human brain. One area in which researchers have made recent progress is the quest for ways to create immortal cell lines from specific types of nerve cells. Other projects using genetically engineered retroviruses and tumor-inducing genes, as well as gene regulation are discussed. Recent advances in neuroscience techniques apply not only to neurons, but also to whole brains as well. One example is a high-resulution electroencephalogram (EEG). Although the EEG cannot pin down the actual sites of activity as precisely as static brain imaging methods, it complements them with real-time recording that can keep up with the very rapid pace of brain activity.

  11. Advanced CCD camera developments

    SciTech Connect

    Condor, A.

    1994-11-15

    Two charge coupled device (CCD) camera systems are introduced and discussed, describing briefly the hardware involved, and the data obtained in their various applications. The Advanced Development Group Defense Sciences Engineering Division has been actively designing, manufacturing, fielding state-of-the-art CCD camera systems for over a decade. These systems were originally developed for the nuclear test program to record data from underground nuclear tests. Today, new and interesting application for these systems have surfaced and development is continuing in the area of advanced CCD camera systems, with the new CCD camera that will allow experimenters to replace film for x-ray imaging at the JANUS, USP, and NOVA laser facilities.

  12. Advanced Clothing System

    NASA Technical Reports Server (NTRS)

    Broyan, James; Orndoff, Evelyne

    2014-01-01

    The goal of the Advanced Clothing System (ACS) is to use advanced commercial off-the-shelf fibers and antimicrobial treatments with the goal of directly reducing the mass and volume of a logistics item. The current clothing state-of-the-art on the International Space Station (ISS) is disposable, mostly cotton-based, clothing with no laundry provisions. Each clothing article has varying use periods and will become trash. The goal is to increase the length of wear of the clothing to reduce the logistical mass and volume. The initial focus has been exercise clothing since the use period is lower. Various ground studies and an ISS technology demonstration have been conducted to evaluate clothing preference and length of wear. The analysis indicates that use of ACS selected garments (e.g. wool, modacrylic, polyester) can increase the breakeven point for laundry to 300 days.

  13. Advanced Clothing System

    NASA Technical Reports Server (NTRS)

    Schlesinger, Thilini; Broyan, James; Orndoff, Evelyne

    2014-01-01

    The goal of the Advanced Clothing System (ACS) is to use advanced commercial off-theshelf fibers and antimicrobial treatments with the goal of directly reducing the mass and volume of a logistics item. The current clothing state-of-the-art on the International Space Station (ISS) is disposable, mostly cotton-based, clothing with no laundry provisions. Each clothing article has varying use periods and will become trash. The goal is to increase the length of wear of the clothing to reduce the logistical mass and volume. The initial focus has been exercise clothing since the use period is lower. Various ground studies and an ISS technology demonstration have been conducted to evaluate clothing preference and length of wear. The analysis indicates that use of ACS selected garments (e.g. wool, modacrylic, polyester) can increase the breakeven point for laundry to 300 days.

  14. [Research advances in dendrochronology].

    PubMed

    Fang, Ke-Yan; Chen, Qiu-Yan; Liu, Chang-Zhi; Cao, Chun-Fu; Chen, Ya-Jun; Zhou, Fei-Fei

    2014-07-01

    Tree-ring studies in China have achieved great advances since the 1990s, particularly for the dendroclimatological studies which have made some influence around the world. However, because of the uneven development, limited attention has been currently paid on the other branches of dendrochronology. We herein briefly compared the advances of dendrochronology in China and of the world and presented suggestions on future dendrochronological studies. Large-scale tree-ring based climate reconstructions in China are highly needed by employing mathematical methods and a high quality tree-ring network of the ring-width, density, stable isotope and wood anatomy. Tree-ring based field climate reconstructions provide potentials on explorations of climate forcings during the reconstructed periods via climate diagnosis and process simulation.

  15. Advanced Polymer Processing Facility

    SciTech Connect

    Muenchausen, Ross E.

    2012-07-25

    Some conclusions of this presentation are: (1) Radiation-assisted nanotechnology applications will continue to grow; (2) The APPF will provide a unique focus for radiolytic processing of nanomaterials in support of DOE-DP, other DOE and advanced manufacturing initiatives; (3) {gamma}, X-ray, e-beam and ion beam processing will increasingly be applied for 'green' manufacturing of nanomaterials and nanocomposites; and (4) Biomedical science and engineering may ultimately be the biggest application area for radiation-assisted nanotechnology development.

  16. ADVANCED CHEMISTRY BASINS MODEL

    SciTech Connect

    William Goddard III; Lawrence Cathles III; Mario Blanco; Paul Manhardt; Peter Meulbroek; Yongchun Tang

    2004-05-01

    The advanced Chemistry Basin Model project has been operative for 48 months. During this period, about half the project tasks are on projected schedule. On average the project is somewhat behind schedule (90%). Unanticipated issues are causing model integration to take longer then scheduled, delaying final debugging and manual development. It is anticipated that a short extension will be required to fulfill all contract obligations.

  17. Advanced Lightplane Wing

    NASA Technical Reports Server (NTRS)

    1987-01-01

    Neico Aviation, Inc.'s tubular fuselage frame of Prescott Pusher is heliarc welded at the factory. Wings, tail, and control surfaces are of traditional aluminum. A rear mounted 180 horsepower engine with a four bladed pusher propeller allows speeds up to 200 miles per hour; an advanced rotary engine and other powerplants being tested are expected to boost cruise speed above 200 miles per hour.

  18. Advances in Strapdown Sensors

    DTIC Science & Technology

    1984-04-01

    axis laser gyro sensor assembly (1, 24) in a single Zerodur structure using interleaved laser paths to reduce net size/weight. If advances in mirror ...laser gyros, special design considerations - associated with mechanically dithered laaer gyros, the state-of-the-art in magnetic mirror and...from the lasing action of a helium-noon gas discharge within the optical cavity. The reflecting surfaces are die- lectric mirrors designed to

  19. The advanced neutron source

    SciTech Connect

    Raman, S.; Hayter, J.B.

    1990-01-01

    The Advanced Neutron Source (ANS) is a new user experimental facility planned to be operational at Oak Ridge in the late 1990's. The centerpiece of the ANS will be a steady-state research reactor of unprecedented thermal neutron flux ({phi}{sub th} {approx} 8 {times} 10{sup 19} m{sup {minus}2} {center dot}s{sup {minus}1}) accompanied by extensive and comprehensive equipment and facilities for neutron-based research.

  20. The Advanced Neutron Source

    SciTech Connect

    Hayter, J.B.

    1989-01-01

    The Advanced Neutron Source (ANS) is a new user experimental facility planned to be operational at Oak Ridge in the late 1990's. The centerpiece of the ANS will be a steady-state research reactor of unprecedented thermal neutron flux ({phi}{sub th} {approx} 9{center dot}10{sup 19} m{sup -2}{center dot}s{sup -1}) accompanied by extensive and comprehensive equipment and facilities for neutron-based research. 5 refs., 5 figs.

  1. Recent advances in epilepsy.

    PubMed

    Manford, Mark

    2017-08-01

    This paper reviews advances in epilepsy in recent years with an emphasis on therapeutics and underlying mechanisms, including status epilepticus, drug and surgical treatments. Lessons from rarer epilepsies regarding the relationship between epilepsy type, mechanisms and choice of antiepileptic drugs (AED) are explored and data regarding AED use in pregnancy are reviewed. Concepts evolving towards a move from treating seizures to treating epilepsy are discussed, both in terms of the mechanisms of epileptogenesis, and in terms of epilepsy's broader comorbidity, especially depression.

  2. STIR: Advanced Quantum Sensing

    DTIC Science & Technology

    2014-07-18

    STIR: Advanced Quantum Sensing Recycling unmeasured photons in a system utilizing weak measurements can substantially improve the signal-to- noise...Quantum Sensing Report Title Recycling unmeasured photons in a system utilizing weak measurements can substantially improve the signal-to-noise ratio. We...Kevin Lyons, Andrew N. Jordan, Trent M. Graham, Paul G. Kwiat. Strengthening weak- value amplification with recycled photons , Physical Review A, (08

  3. Recent advances in neotectonics

    NASA Astrophysics Data System (ADS)

    Vita-Finzi, Claudio

    Recent advances in neotectonics was the focus of some seventy delegates from sixteen countries who met at the Geological Society of London in Piccadilly from June 15-16. The meeting, convened by Nils-Axel Mörner, Lewis Owen, Ian Stewart, and Claudio Vita-Finzi, was sponsored by the Neotectonics Commission of the International Union for Quaternary Research (INQUA), the Quaternary Research Association, and the Tectonic Studies Group of the Geological Society of London.

  4. Advanced turboprop vibratory characteristics

    NASA Technical Reports Server (NTRS)

    Srinivasan, A. V.; Fulton, G. B.

    1984-01-01

    The assembly of SR5 advanced turboprop blades to develop a structural dynamic data base for swept props is reported. Steady state blade deformation under centrifugal loading and vibratory characteristics of the rotor assembly were measured. Vibration was induced through a system of piezoelectric crystals attached to the blades. Data reduction procedures are used to provide deformation, mode shape, and frequencies of the assembly at predetermined speeds.

  5. Advanced Triangulation Displacement Sensors

    NASA Technical Reports Server (NTRS)

    Poteet, Wade M.; Cauthen, Harold K.

    1996-01-01

    Advanced optoelectronic triangulation displacement sensors undergoing development. Highly miniaturized, more stable, more accurate, and relatively easy to use. Incorporate wideband electronic circuits suitable for real-time monitoring and control of displacements. Measurements expected to be accurate to within nanometers. In principle, sensors mass-produced at relatively low unit cost. Potential applications numerous. Possible industrial application in measuring runout of rotating shaft or other moving part during fabrication in "zero-defect" manufacturing system, in which measured runout automatically corrected.

  6. Advanced Environmental Monitoring Technologies

    NASA Technical Reports Server (NTRS)

    Jan, Darrell

    2004-01-01

    Viewgraphs on Advanced Environmental Monitoring Technologies are presented. The topics include: 1) Monitoring & Controlling the Environment; 2) Illustrative Example: Canary 3) Ground-based Commercial Technology; 4) High Capability & Low Mass/Power + Autonomy = Key to Future SpaceFlight; 5) Current Practice: in Flight; 6) Current Practice: Post Flight; 7) Miniature Mass Spectrometer for Planetary Exploration and Long Duration Human Flight; 8) Hardware and Data Acquisition System; 9) 16S rDNA Phylogenetic Tree; and 10) Preview of Porter.

  7. Polarized advanced fuel reactors

    SciTech Connect

    Kulsrud, R.M.

    1987-07-01

    The d-/sup 3/He reaction has the same spin dependence as the d-t reaction. It produces no neutrons, so that if the d-d reactivity could be reduced, it would lead to a neutron-lean reactor. The current understanding of the possible suppression of the d-d reactivity by spin polarization is discussed. The question as to whether a suppression is possible is still unresolved. Other advanced fuel reactions are briefly discussed. 11 refs.

  8. Advanced worker protection system

    SciTech Connect

    Caldwell, B.; Duncan, P.; Myers, J.

    1995-12-01

    The Department of Energy (DOE) is in the process of defining the magnitude and diversity of Decontamination and Decommissioning (D&D) obligations at its numerous sites. The DOE believes that existing technologies are inadequate to solve many challenging problems such as how to decontaminate structures and equipment cost effectively, what to do with materials and wastes generated, and how to adequately protect workers and the environment. Preliminary estimates show a tremendous need for effective use of resources over a relatively long period (over 30 years). Several technologies are being investigated which can potentially reduce D&D costs while providing appropriate protection to DOE workers. The DOE recognizes that traditional methods used by the EPA in hazardous waste site clean up activities are insufficient to provide the needed protection and worker productivity demanded by DOE D&D programs. As a consequence, new clothing and equipment which can adequately protect workers while providing increases in worker productivity are being sought for implementation at DOE sites. This project will result in the development of an Advanced Worker Protection System (AWPS). The AWPS will be built around a life support backpack that uses liquid air to provide cooling as well as breathing gas to the worker. The backpack will be combined with advanced protective garments, advanced liquid cooling garment, respirator, communications, and support equipment to provide improved worker protection, simplified system maintenance, and dramatically improve worker productivity through longer duration work cycles. Phase I of the project has resulted in a full scale prototype Advanced Worker Protection Ensemble (AWPE, everything the worker will wear), with sub-scale support equipment, suitable for integrated testing and preliminary evaluation. Phase II will culminate in a full scale, certified, pre-production AWPS and a site demonstration.

  9. Advanced concentrator panels

    NASA Technical Reports Server (NTRS)

    Bell, D. M.; Bedard, R. J., Jr.

    1981-01-01

    The prototype fabrication of a lightweight, high-quality cellular glass substrate reflective panel for use in an advanced point-focusing solar concentrator was completed. The reflective panel is a gore shaped segment of an 11-m paraboloidal dish. The overall concentrator design and the design of the reflective panels are described. prototype-specific panel design modifications are discussed and the fabrication approach and procedure outlined.

  10. Advances in epilepsy surgery

    PubMed Central

    Nowell, Mark; Miserocchi, Anna; McEvoy, Andrew W; Duncan, John S

    2014-01-01

    This review summarises exciting recent and forthcoming advances that will impact on the surgical management of epilepsy in the near future. This does not cover the current accepted diagnostic methodologies or surgical treatments that are routinely practiced today. The content of this review was derived from a PubMed literature search, using the key words ‘Epilepsy Surgery’, ‘Neuromodulation’, ‘Neuroablation’, ‘Advances’, between 2010 and November 2013. PMID:24719180

  11. Advanced geothermal technologies

    SciTech Connect

    Whetten, J.T.; Murphy, H.D.; Hanold, R.J.; Myers, C.W.; Dunn, J.C.

    1988-01-01

    Research and development in advanced technologies for geothermal energy production continue to increase the energy production options for the Nation. The high-risk investment over the past few years by the US Department of Energy in geopressured, hot dry rock, and magma energy resources is producing new means to lower production costs and to take advantage of these resources. The Nation has far larger and more regionally extensive geothermal resources than heretofore realized. At the end of a short 30-day closed-loop flow test, the manmade hot dry rock reservoir at Fenton Hill, New Mexico, was producing 10 MW thermal - and still climbing - proving the technical feasibility of this new technology. The scientific feasibility of magma energy extraction has been demonstrated, and new field tests to evaluate this technology are planned. Analysis and field tests confirm the viability of geopressured-geothermal energy and the prospect that many dry-hole or depleted petroleum wells can be turned into producing geopressured-geothermal wells. Technological advances achieved through hot dry rock, magma, geopressured, and other geothermal research are making these resources and conventional hydrothermal resources more competitive. Noteworthy among these technological advances are techniques in computer simulation of geothermal reservoirs, new means for well stimulation, new high-temperature logging tools and packers, new hard-rock penetration techniques, and new methods for mapping fracture flow paths across large underground areas in reservoirs. In addition, many of these same technological advances can be applied by the petroleum industry to help lower production costs in domestic oil and gas fields. 5 refs., 4 figs.

  12. Silicene: Recent theoretical advances

    NASA Astrophysics Data System (ADS)

    Lew Yan Voon, L. C.; Zhu, Jiajie; Schwingenschlögl, Udo

    2016-12-01

    Silicene is a two-dimensional allotrope of silicon with a puckered hexagonal structure closely related to the structure of graphene and that has been predicted to be stable. To date, it has been successfully grown in solution (functionalized) and on substrates. The goal of this review is to provide a summary of recent theoretical advances in the properties of both free-standing silicene as well as in interaction with molecules and substrates, and of proposed device applications.

  13. Advanced Multifunctional Coating

    DTIC Science & Technology

    2011-08-17

    and UV durability of then current chrome free TT-P-2756 SPTC • Leverage APC technology into SPTC • Coating uses same fluoropolyurethane technology...as APC currently used on C-17 • Leverage recent advances in chrome free corrosion inhibitor technology • State of the art chrome free corrosion...coat exposed metal Aluminum Base Metal Original Finish System Aged APC Topcoat Conversion Coat Chromic Acid Anodize Aluminum Cladding Original Primer

  14. Advances in Doppler OCT

    PubMed Central

    Liu, Gangjun; Chen, Zhongping

    2014-01-01

    We review the principle and some recent applications of Doppler optical coherence tomography (OCT). The advances of the phase-resolved Doppler OCT method are described. Functional OCT algorithms which are based on an extension of the phase-resolved scheme are also introduced. Recent applications of Doppler OCT for quantification of flow, imaging of microvasculature and vocal fold vibration, and optical coherence elastography are briefly discussed. PMID:24443649

  15. Advanced nuclear propulsion technologies

    SciTech Connect

    Cassenti, B.N. )

    1991-01-01

    Advanced nuclear propulsion can take on several forms. Radioactive thrust sheets directly use the decay of radioactive nuclei to provide propulsion. The fissioning of nuclei has been extensively studied for propulsion both analytically and experimentally. Fusion has been analytically examined as a means of providing propulsion during the last few decades. In the last decade, serious attention has been given to the direct annihilation of matter. Each of these technologies is discussed in this paper with the greatest emphasis on antiproton annihilation propulsion.

  16. Advanced Triangulation Displacement Sensors

    NASA Technical Reports Server (NTRS)

    Poteet, Wade M.; Cauthen, Harold K.

    1996-01-01

    Advanced optoelectronic triangulation displacement sensors undergoing development. Highly miniaturized, more stable, more accurate, and relatively easy to use. Incorporate wideband electronic circuits suitable for real-time monitoring and control of displacements. Measurements expected to be accurate to within nanometers. In principle, sensors mass-produced at relatively low unit cost. Potential applications numerous. Possible industrial application in measuring runout of rotating shaft or other moving part during fabrication in "zero-defect" manufacturing system, in which measured runout automatically corrected.

  17. Recent advances in dermoscopy

    PubMed Central

    Russo, Teresa; Piccolo, Vincenzo; Lallas, Aimilios; Argenziano, Giuseppe

    2016-01-01

    The use of dermoscopy has offered a new morphological dimension of skin lesions and has provided an effective diagnostic tool to differentiate melanoma from other benign or malignant skin tumors but also to support the clinical diagnosis in general dermatology. The aim of this article is to provide an overview of the most recent and important advances in the rising world of dermoscopy. PMID:26949523

  18. Advanced Doppler tracking experiments

    NASA Technical Reports Server (NTRS)

    Armstrong, J. W.

    1989-01-01

    The Doppler tracking method is currently the only technique available for broadband gravitational wave searches in the approx. 10(exp -4) to 10(exp -1) Hz low frequency band. A brief review is given of the Doppler method, a discussion of the main noise sources, and a review of experience with current spacecraft and the prospects for sensitivity improvements in an advanced Doppler tracking experiment.

  19. Advanced gearbox technology

    NASA Technical Reports Server (NTRS)

    Anderson, N. E.; Cedoz, R. W.; Salama, E. E.; Wagner, D. A.

    1987-01-01

    An advanced 13,000 HP, counterrotating (CR) gearbox was designed and successfully tested to provide a technology base for future designs of geared propfan propulsion systems for both commercial and military aircraft. The advanced technology CR gearbox was designed for high efficiency, low weight, long life, and improved maintainability. The differential planetary CR gearbox features double helical gears, double row cylindrical roller bearings integral with planet gears, tapered roller prop support bearings, and a flexible ring gear and diaphragm to provide load sharing. A new Allison propfan back-to-back gearbox test facility was constructed. Extensive rotating and stationary instrumentation was used to measure temperature, strain, vibration, deflection and efficiency under representative flight operating conditions. The tests verified smooth, efficient gearbox operation. The highly-instrumented advanced CR gearbox was successfully tested to design speed and power (13,000 HP), and to a 115 percent overspeed condition. Measured CR gearbox efficiency was 99.3 percent at the design point based on heat loss to the oil. Tests demonstrated low vibration characteristics of double helical gearing, proper gear tooth load sharing, low stress levels, and the high load capacity of the prop tapered roller bearings. Applied external prop loads did not significantly affect gearbox temperature, vibration, or stress levels. Gearbox hardware was in excellent condition after the tests with no indication of distress.

  20. Are Advanced Potentials Anomalous?

    NASA Astrophysics Data System (ADS)

    Ibison, Michael

    2006-10-01

    Advanced electromagnetic potentials are indigenous to the classical Maxwell theory. Generally however they are deemed undesirable and are forcibly excluded, destroying the theory's inherent time-symmetry. We investigate the reason for this, pointing out that it is not necessary and in some cases is counter-productive. We then focus on the direct-action theory in which the advanced and retarded contributions are present symmetrically, with no opportunity supplement the particular integral solution of the wave equation with an arbitrary complementary function. One then requires a plausible explanation for the observed broken symmetry that, commonly, is understood cannot be met by the Wheeler-Feynman mechanism because the necessary boundary condition cannot be satisfied in acceptable cosmologies. We take this opportunity to argue that the boundary condition is already met by all expanding cosmologies simply as a result of cosmological red-shift. A consequence is that the cosmological and thermodynamic arrows of time can be equated, the direct action version of EM is preferred, and that advanced potentials are ubiquitous.

  1. Advanced scale conditioning agents

    SciTech Connect

    Davis, Jeff; Battaglia, Philip J.

    2004-06-01

    A technical description of Advanced Scale Conditioning Agents (ASCA) technology was published in the May-June 2003 edition of the Nuclear Plant Journal. That article described the development of programs of advanced scale conditioning agents and specific types to maintain the secondary side of steam generators within a pressurized water reactor free of deposited corrosion products and corrosion-inducing contaminants to ensure their long-term operation. This article describes the first two plant applications of advanced scale conditioning agents implemented at Southern Nuclear Operating Company's Vogtle Units 1 and 2 during their 2002 scheduled outages to minimize tube degradation and maintain full power operation using the most effective techniques while minimizing outage costs. The goal was to remove three to four fuel cycles of deposits from each steam generator so that after future chemical cleaning activities, ASCAs could be used to maintain the cleanliness of the steam generators without the need for additional chemical cleaning efforts. The goal was achieved as well as several other benefits that resulted in cost savings to the plant.

  2. Advanced Microturbine Systems

    SciTech Connect

    Lindberg, Laura

    2005-04-29

    Dept. of Energy (DOE) Cooperative Agreement DE-FC02-00-CH11061 was originally awarded to Honeywell International, Inc. Honeywell Power Systems Inc. (HPSI) division located in Albuquerque, NM in October 2000 to conduct a program titled Advanced Microturbine Systems (AMS). The DOE Advanced Microturbines Systems Program was originally proposed as a five-year program to design and develop a high efficiency, low emissions, durable microturbine system. The period of performance was to be October 2000 through September 2005. Program efforts were underway, when one year into the program Honeywell sold the intellectual property of Honeywell Power Systems Inc. and HPSI ceased business operations. Honeywell made an internal decision to restructure the existing program due to the HPSI shutdown and submitted a formal request to DOE on September 24, 2001 to transfer the Cooperative Agreement to Honeywell Engines, Systems and Services (HES&S) in Phoenix, AZ in order to continue to offer support for DOE's Advanced Microturbine Program. Work continued on the descoped program under Cooperative Agreement No. DE-FC26-00-CH11061 and has been completed.

  3. Advanced Subsonic Combustion Rig

    NASA Technical Reports Server (NTRS)

    Lee, Chi-Ming

    1998-01-01

    Researchers from the NASA Lewis Research Center have obtained the first combustion/emissions data under extreme future engine operating conditions. In Lewis' new world-class 60-atm combustor research facility--the Advanced Subsonic Combustion Rig (ASCR)--a flametube was used to conduct combustion experiments in environments as extreme as 900 psia and 3400 F. The greatest challenge for combustion researchers is the uncertainty of the effects of pressure on the formation of nitrogen oxides (NOx). Consequently, U.S. engine manufacturers are using these data to guide their future combustor designs. The flametube's metal housing has an inside diameter of 12 in. and a length of 10.5 in. The flametube can be used with a variety of different flow paths. Each flow path is lined with a high-temperature, castable refractory material (alumina) to minimize heat loss. Upstream of the flametube is the injector section, which has an inside diameter of 13 in. and a length of 0.5-in. It was designed to provide for quick changeovers. This flametube is being used to provide all U.S. engine manufacturers early assessments of advanced combustion concepts at full power conditions prior to engine production. To date, seven concepts from engine manufacturers have been evaluated and improved. This collaborated development can potentially give U.S. engine manufacturers the competitive advantage of being first in the market with advanced low-emission technologies.

  4. Advanced Subsonic Combustion Rig

    NASA Technical Reports Server (NTRS)

    Lee, Chi-Ming

    1998-01-01

    Researchers from the NASA Lewis Research Center have obtained the first combustion/emissions data under extreme future engine operating conditions. In Lewis' new world-class 60-atm combustor research facility--the Advanced Subsonic Combustion Rig (ASCR)--a flametube was used to conduct combustion experiments in environments as extreme as 900 psia and 3400 F. The greatest challenge for combustion researchers is the uncertainty of the effects of pressure on the formation of nitrogen oxides (NOx). Consequently, U.S. engine manufacturers are using these data to guide their future combustor designs. The flametube's metal housing has an inside diameter of 12 in. and a length of 10.5 in. The flametube can be used with a variety of different flow paths. Each flow path is lined with a high-temperature, castable refractory material (alumina) to minimize heat loss. Upstream of the flametube is the injector section, which has an inside diameter of 13 in. and a length of 0.5-in. It was designed to provide for quick changeovers. This flametube is being used to provide all U.S. engine manufacturers early assessments of advanced combustion concepts at full power conditions prior to engine production. To date, seven concepts from engine manufacturers have been evaluated and improved. This collaborated development can potentially give U.S. engine manufacturers the competitive advantage of being first in the market with advanced low-emission technologies.

  5. Advanced Rigid Ablative TPS

    NASA Technical Reports Server (NTRS)

    Gasch, Matthew J.

    2011-01-01

    NASA Exploration Systems Mission Directorate s (ESMD) Entry, Descent, and Landing (EDL) Technology Development Project (TDP) and the NASA Aeronautics Research Mission Directorate s (ARMD) Hypersonics Project are developing new advanced rigid ablators in an effort to substantially increase reliability, decrease mass, and reduce life cycle cost of rigid aeroshell-based entry systems for multiple missions. Advanced Rigid Ablators combine ablation resistant top layers capable of high heat flux entry and enable high-speed EDL with insulating mass-efficient bottom that, insulate the structure and lower the areal weight. These materials may benefit Commercial Orbital Transportation Services (COTS) vendors and may potentially enable new NASA missions for higher velocity returns (e.g. asteroid, Mars). The materials have been thermally tested to 400-450 W/sq cm at the Laser Hardened Materials Evaluation Lab (LHMEL), Hypersonics Materials Evaluation Test System (HyMETS) and in arcjet facilities. Tested materials exhibit much lower backface temperatures and reduced recession over the baseline materials (PICA). Although the EDL project is ending in FY11, NASA in-house development of advanced ablators will continue with a focus on varying resin systems and fiber/resin interactions.

  6. Advances in thermal engineering

    SciTech Connect

    Kitto, J.B.; Fiveland, W.A.; Latham, C.E.; Peterson, G.P.

    1995-03-01

    Heat transfer--more broadly, thermal engineering--is playing an increasingly critical role in the development and successful application of advanced technology in virtually all fields. From space stations to hazardous-waste destruction to high-speed transport, from ozone-protecting refrigerants to ``night vision`` goggles, a vast range of technologies depend on energy management, heat-flow control, and temperature control to successfully meet their design objectives and attain commercial success. Meeting the continually escalating demand for electricity and ``cheap`` process that will remain a challenge. Environmental protection can depend not only on using energy more efficiently, but on changing the energy conversion process to reduce initial pollutant formation. Further advances in electronics, materials processing, and manufacturing will depend in part on more precise energy management and temperature control. The scale of thermal engineering is quite broad, extending from the very large to the near-molecular level, and from very high temperatures of thousands of degrees to very low ones approaching absolute zero. This breadth of application is illustrated by a review of three specific areas: application of advanced numerical modeling to large boiler furnaces (approaching 100 m in height) in order to improve environmental performance; application of microscale ({approximately}100 {micro}) heat pipes to cool high-performance electronic circuits; and a look at some of the manufacturing processes where heat transfer and thermal analysis improve quality, performance and cost.

  7. Advanced Technology Vehicle Testing

    SciTech Connect

    James Francfort

    2003-11-01

    The light-duty vehicle transportation sector in the United States depends heavily on imported petroleum as a transportation fuel. The Department of Energy’s Advanced Vehicle Testing Activity (AVTA) is testing advanced technology vehicles to help reduce this dependency, which would contribute to the economic stability and homeland security of the United States. These advanced technology test vehicles include internal combustion engine vehicles operating on 100% hydrogen (H2) and H2CNG (compressed natural gas) blended fuels, hybrid electric vehicles, neighborhood electric vehicles, urban electric vehicles, and electric ground support vehicles. The AVTA tests and evaluates these vehicles with closed track and dynamometer testing methods (baseline performance testing) and accelerated reliability testing methods (accumulating lifecycle vehicle miles and operational knowledge within 1 to 1.5 years), and in normal fleet environments. The Arizona Public Service Alternative Fuel Pilot Plant and H2-fueled vehicles are demonstrating the feasibility of using H2 as a transportation fuel. Hybrid, neighborhood, and urban electric test vehicles are demonstrating successful applications of electric drive vehicles in various fleet missions. The AVTA is also developing electric ground support equipment (GSE) test procedures, and GSE testing will start during the fall of 2003. All of these activities are intended to support U.S. energy independence. The Idaho National Engineering and Environmental Laboratory manages these activities for the AVTA.

  8. Advances in Irrigation

    NASA Astrophysics Data System (ADS)

    Gardner, W. R.

    This is the first volume of Advances in Irrigation, a new serial publication by the publishers of Advances in Agronomy and Advances in Hydroscience and designed to follow the same format. The editor is a well-known researcher and writer on irrigation and related subjects and has assembled a collection of highly regarded and respected authors for the initial volume. The readership for this volume will probably be mainly specialists and students interested in irrigation and an occasional design engineer.The seven contributions in this volume fall roughly into two classes: research and practice. Three papers (“Conjunctive Use of Rainfall and Irrigation in Semi-arid Regions,” by Stewart and Musik, “Irrigation Scheduling Using Soil Moisture Measurements: Theory and Practice,” by G. S. and M. D. Campbell, and “Use of Solute Transport Models to Estimate Salt Balance Below Irrigated Cropland,” by Jury) cover topics that have been the subject of a number of reviews. The contributions here provide brief, well-written, and authoritative summaries of the chosen topics and serve as good introductions or reviews. They should lend themselves well to classroom use in various ways. They also should be helpful to the nonspecialist interested in getting a sense of the subject without going into great detail.

  9. Accelerating advanced-materials commercialization

    NASA Astrophysics Data System (ADS)

    Maine, Elicia; Seegopaul, Purnesh

    2016-05-01

    Long commercialization times, high capital costs and sustained uncertainty deter investment in innovation for advanced materials. With appropriate strategies, technology and market uncertainties can be reduced, and the commercialization of advanced materials accelerated.

  10. Buildings energy technology advancement plan

    SciTech Connect

    1993-12-31

    The Buildings Energy Technology Advancement (BETA) Plan is an integrated set of programs dedicated to the advancement and commercialization of energy-efficient and passive solar technologies for residential and commercial buildings in Canada. This bulletin begins with an overview of the BETA plan and barriers to more energy-efficient buildings. It then outlines the BETA technology advancement strategy and some BETA programs including the Passive Solar Program and Advanced Houses Program. Highlights of some BETA program achievements are also included.

  11. Advances in ice mechanics - 1987

    SciTech Connect

    Chung, J.S.; Hallam, S.D.; Maatanen, M.; Sinha, N.K.; Sodhi, D.S.

    1987-01-01

    This book presents the papers given at a symposium on the interaction of icebergs with offshore platforms. Topics considered at the symposium included advances in ice mechanics in the United Kingdom, ice mechanics in Finland, recent advances in ice mechanics in Canada, advances in sea ice mechanics in the USA, foundations, monitoring, hazards, risk assessment, and deformation.

  12. TIMSS Advanced 2008 Assessment Frameworks

    ERIC Educational Resources Information Center

    Garden, Robert A.; Lie, Svein; Robitaille, David F.; Angell, Carl; Martin, Michael O.; Mullis, Ina V.S.; Foy, Pierre; Arora, Alka

    2006-01-01

    Developing the Trends in International Mathematics and Science Study (TIMSS) Advanced 2008 Assessment Frameworks was a collaborative venture involving mathematics and physics experts from around the world. The document contains two frameworks for implementing TIMSS Advanced 2008--one for advanced mathematics and one for physics. It also contains…

  13. TIMSS Advanced 2015 Assessment Frameworks

    ERIC Educational Resources Information Center

    Mullis, Ina V. S., Ed.; Martin, Michael O., Ed.

    2014-01-01

    The "TIMSS Advanced 2015 Assessment Frameworks" provides the foundation for the two international assessments to take place as part of the International Association for the Evaluation of Educational Achievement's TIMSS (Trends in International Mathematics and Science Study) Advanced 2015--Advanced Mathematics and Physics. Chapter 1 (Liv…

  14. Advancing therapy for hypercholesterolemia.

    PubMed

    Toutouzas, Konstantinos; Drakopoulou, Maria; Skoumas, Ioannis; Stefanadis, Christodoulos

    2010-07-01

    Hypercholesterolemia holds a key role in the development and progression of atherosclerosis and is a causative factor of coronary artery disease. Current guidelines for cholesterol treatment target low-density cholesterol (LDL-C) as the primary goal of therapy. Despite advances in the pharmacotherapy of atherosclerosis, the most successful agents used to treat this disease--HMG CoA reductase inhibitors--remain ineffective for the primary or secondary prevention of myocardial infarction in 50-60% of patients. Advancing therapy for hypercholesterolemia with new-emerging drugs either as monotherapy or in combination will hopefully improve cardiovascular outcomes. The two major sources of cholesterol in the human body are: i) biosynthesis of cholesterol by the liver; and ii) absorption by the intestines. Both play a pivotal role in the overall balance of cholesterol. A recent and more effective therapeutic strategy is to treat both sources of cholesterol simultaneously with a complementary mechanism of action. The present article presents cholesterol metabolism and reviews new emerging lipid-lowering drugs and therapies that: i) lower LDL-C; ii) lower triglycerides; and iii) increase high-density lipoprotein cholesterol. This review summarizes the pivotal role of both the liver and intestine in the overall balance of cholesterol in the body and describe the clinical impact and relevance of using new emerging lipid-lowering drugs either alone or co-administered with statins in controlling cholesterol levels. An elevated concentration of LDL-C plays a causal role in the development of cardiovascular disease. The new aggressive cholesterol treatment goals call for a more advanced therapeutic approach to maximize the cardiovascular benefits associated with lower LDL-C levels.

  15. Advanced education in prosthodontics.

    PubMed

    McGivney, G P

    1990-09-01

    1. The ADA Council on Dental Education Commission on Accreditation, using the Standards for undergraduate education and current National Board scores, does not believe there has been a deemphasis in prosthodontic knowledge and skill. This opinion is not shared by program Directors or representatives of the laboratory industry. The Council on Dental Education has a mechanism for periodic review in place. State Boards of Dental Examiners did not respond. 2. Teaching experience for residents or graduate students should be encouraged in advanced education programs in prosthodontics as an elective or be limited to no more than 10% of the curriculum time. 3. The American Board of Prosthodontics would not comment on any changes regarding the clinical or didactic knowledge of candidates. 4. Meaningful research is not possible within the current minimum 22-month program duration. 5. Accredited advanced education programs in prosthodontics are currently meeting the standard guidelines for clinical and didactic experiences. 6. Accredited advanced education programs in prosthodontics are currently satisfying the requirements on supervision and faculty; however, the data from the annual reports suggest a marked decrease in staff support and amount of time that program directors are devoting to the program. 7. Expanding the curriculum to include implant prosthodontics will require lengthening the curriculum time. 8. TMJ therapy and geriatric dentistry need to be better defined in the educational guidelines. 9. The criterion-based examination currently given by the American Board of Prosthodontics clearly delineates acceptable, marginal, and unacceptable levels of performance. 10. Program directors desire more "feedback" from the American Board of Prosthodontics on the performance of candidates.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. ADVANCED SULFUR CONTROL CONCEPTS

    SciTech Connect

    Apostolos A. Nikolopoulos; Santosh K. Gangwal; William J. McMichael; Jeffrey W. Portzer

    2003-01-01

    Conventional sulfur removal in integrated gasification combined cycle (IGCC) power plants involves numerous steps: COS (carbonyl sulfide) hydrolysis, amine scrubbing/regeneration, Claus process, and tail-gas treatment. Advanced sulfur removal in IGCC systems involves typically the use of zinc oxide-based sorbents. The sulfides sorbent is regenerated using dilute air to produce a dilute SO{sub 2} (sulfur dioxide) tail gas. Under previous contracts the highly effective first generation Direct Sulfur Recovery Process (DSRP) for catalytic reduction of this SO{sub 2} tail gas to elemental sulfur was developed. This process is currently undergoing field-testing. In this project, advanced concepts were evaluated to reduce the number of unit operations in sulfur removal and recovery. Substantial effort was directed towards developing sorbents that could be directly regenerated to elemental sulfur in an Advanced Hot Gas Process (AHGP). Development of this process has been described in detail in Appendices A-F. RTI began the development of the Single-step Sulfur Recovery Process (SSRP) to eliminate the use of sorbents and multiple reactors in sulfur removal and recovery. This process showed promising preliminary results and thus further process development of AHGP was abandoned in favor of SSRP. The SSRP is a direct Claus process that consists of injecting SO{sub 2} directly into the quenched coal gas from a coal gasifier, and reacting the H{sub 2}S-SO{sub 2} mixture over a selective catalyst to both remove and recover sulfur in a single step. The process is conducted at gasifier pressure and 125 to 160 C. The proposed commercial embodiment of the SSRP involves a liquid phase of molten sulfur with dispersed catalyst in a slurry bubble-column reactor (SBCR).

  17. Advanced satellite communication system

    NASA Technical Reports Server (NTRS)

    Staples, Edward J.; Lie, Sen

    1992-01-01

    The objective of this research program was to develop an innovative advanced satellite receiver/demodulator utilizing surface acoustic wave (SAW) chirp transform processor and coherent BPSK demodulation. The algorithm of this SAW chirp Fourier transformer is of the Convolve - Multiply - Convolve (CMC) type, utilizing off-the-shelf reflective array compressor (RAC) chirp filters. This satellite receiver, if fully developed, was intended to be used as an on-board multichannel communications repeater. The Advanced Communications Receiver consists of four units: (1) CMC processor, (2) single sideband modulator, (3) demodulator, and (4) chirp waveform generator and individual channel processors. The input signal is composed of multiple user transmission frequencies operating independently from remotely located ground terminals. This signal is Fourier transformed by the CMC Processor into a unique time slot for each user frequency. The CMC processor is driven by a waveform generator through a single sideband (SSB) modulator. The output of the coherent demodulator is composed of positive and negative pulses, which are the envelopes of the chirp transform processor output. These pulses correspond to the data symbols. Following the demodulator, a logic circuit reconstructs the pulses into data, which are subsequently differentially decoded to form the transmitted data. The coherent demodulation and detection of BPSK signals derived from a CMC chirp transform processor were experimentally demonstrated and bit error rate (BER) testing was performed. To assess the feasibility of such advanced receiver, the results were compared with the theoretical analysis and plotted for an average BER as a function of signal-to-noise ratio. Another goal of this SBIR program was the development of a commercial product. The commercial product developed was an arbitrary waveform generator. The successful sales have begun with the delivery of the first arbitrary waveform generator.

  18. Advanced rotorcraft transmission program

    NASA Technical Reports Server (NTRS)

    Bill, Robert C.

    1990-01-01

    The Advanced Rotorcraft Transmission (ART) program is an Army-funded, joint Army/NASA program to develop and demonstrate lightweight, quiet, durable drivetrain systems for next generation rotorcraft. ART addresses the drivetrain requirements of two distinct next generation aircraft classes: Future Air Attack Vehicle, a 10,000 to 20,000 lb. aircraft capable of undertaking tactical support and air-to-air missions; and Advanced Cargo Aircraft, a 60,000 to 80,000 lb. aircraft capable of heavy life field support operations. Both tiltrotor and more conventional helicopter configurations are included in the ART program. Specific objectives of ART include reduction of drivetrain weight by 25 percent compared to baseline state-of-the-art drive systems configured and sized for the next generation aircraft, reduction of noise level at the transmission source by 10 dB relative to a suitably sized and configured baseline, and attainment of at least a 5000 hr mean-time-between-removal. The technical approach for achieving the ART goals includes application of the latest available component, material, and lubrication technology to advanced concept drivetrains that utilize new ideas in gear configuration, transmission layout, and airframe/drivetrain integration. To date, candidate drivetrain systems were carried to a conceptual design stage, and tradeoff studies were conducted resulting in selection of an ART transmission configuration for each of the four contractors. The final selection was based on comparative weight, noise, and reliability studies. A description of each of the selected ART designs is included. Preliminary design of each of the four selected ART transmission was completed, as have mission impact studies wherein comparisons of aircraft mission performance and life cycle costs are undertaken for the next generation aircraft with ART and with the baseline transmission.

  19. Advanced satellite communication system

    NASA Astrophysics Data System (ADS)

    Staples, Edward J.; Lie, Sen

    1992-05-01

    The objective of this research program was to develop an innovative advanced satellite receiver/demodulator utilizing surface acoustic wave (SAW) chirp transform processor and coherent BPSK demodulation. The algorithm of this SAW chirp Fourier transformer is of the Convolve - Multiply - Convolve (CMC) type, utilizing off-the-shelf reflective array compressor (RAC) chirp filters. This satellite receiver, if fully developed, was intended to be used as an on-board multichannel communications repeater. The Advanced Communications Receiver consists of four units: (1) CMC processor, (2) single sideband modulator, (3) demodulator, and (4) chirp waveform generator and individual channel processors. The input signal is composed of multiple user transmission frequencies operating independently from remotely located ground terminals. This signal is Fourier transformed by the CMC Processor into a unique time slot for each user frequency. The CMC processor is driven by a waveform generator through a single sideband (SSB) modulator. The output of the coherent demodulator is composed of positive and negative pulses, which are the envelopes of the chirp transform processor output. These pulses correspond to the data symbols. Following the demodulator, a logic circuit reconstructs the pulses into data, which are subsequently differentially decoded to form the transmitted data. The coherent demodulation and detection of BPSK signals derived from a CMC chirp transform processor were experimentally demonstrated and bit error rate (BER) testing was performed. To assess the feasibility of such advanced receiver, the results were compared with the theoretical analysis and plotted for an average BER as a function of signal-to-noise ratio. Another goal of this SBIR program was the development of a commercial product. The commercial product developed was an arbitrary waveform generator. The successful sales have begun with the delivery of the first arbitrary waveform generator.

  20. Advanced composite fuselage technology

    NASA Technical Reports Server (NTRS)

    Ilcewicz, Larry B.; Smith, Peter J.; Horton, Ray E.

    1993-01-01

    Boeing's ATCAS program has completed its third year and continues to progress towards a goal to demonstrate composite fuselage technology with cost and weight advantages over aluminum. Work on this program is performed by an integrated team that includes several groups within The Boeing Company, industrial and university subcontractors, and technical support from NASA. During the course of the program, the ATCAS team has continued to perform a critical review of composite developments by recognizing advances in metal fuselage technology. Despite recent material, structural design, and manufacturing advancements for metals, polymeric matrix composite designs studied in ATCAS still project significant cost and weight advantages for future applications. A critical path to demonstrating technology readiness for composite transport fuselage structures was created to summarize ATCAS tasks for Phases A, B, and C. This includes a global schedule and list of technical issues which will be addressed throughout the course of studies. Work performed in ATCAS since the last ACT conference is also summarized. Most activities relate to crown quadrant manufacturing scaleup and performance verification. The former was highlighted by fabricating a curved, 7 ft. by 10 ft. panel, with cocured hat-stiffeners and cobonded J-frames. In building to this scale, process developments were achieved for tow-placed skins, drape formed stiffeners, braided/RTM frames, and panel cure tooling. Over 700 tests and supporting analyses have been performed for crown material and design evaluation, including structural tests that demonstrated limit load requirements for severed stiffener/skin failsafe damage conditions. Analysis of tests for tow-placed hybrid laminates with large damage indicates a tensile fracture toughness that is higher than that observed for advanced aluminum alloys. Additional recent ATCAS achievements include crown supporting technology, keel quadrant design evaluation, and

  1. Horizontal Advanced Tensiometer

    SciTech Connect

    Hubbell, Joel M.; Sisson, James B.

    2004-06-22

    An horizontal advanced tensiometer is described that allows the monitoring of the water pressure of soil positions, particularly beneath objects or materials that inhibit the use of previous monitoring wells. The tensiometer includes a porous cup, a pressure transducer (with an attached gasket device), an adaptive chamber, at least one outer guide tube which allows access to the desired horizontal position, a transducer wire, a data logger and preferably an inner guide tube and a specialized joint which provides pressure on the inner guide tube to maintain the seal between the gasket of the transducer and the adaptive chamber.

  2. Advances in fetal surgery

    PubMed Central

    Maselli, Kathryn M.

    2016-01-01

    Historically, the gold standard for the treatment of congenital malformations has been planned delivery at tertiary care center with attempted post-natal repair or amelioration of the lesion. Over the last few decades however, rapid advances in imaging and instrumentation technology combined with superior knowledge of fetal pathophysiology has led to the development of novel intrauterine interventions for most common fetal anomalies. Great success has already been seen the treatment of previous devastating anomalies such as myelomeningocele (MMC), congenital cystic malformations of the lung, twin-twin transfusion, and sacrococcygeal teratomas. Although still limited, these innovative techniques have unique potential to improve outcomes in the most devastating fetal anomalies. PMID:27867946

  3. Advanced Resistive Exercise Device

    NASA Technical Reports Server (NTRS)

    Raboin, Jasen; Niebuhr, Jason; Cruz, Santana; Lamoreaux, chris

    2007-01-01

    The advanced resistive exercise device (ARED), now at the prototype stage of development, is a versatile machine that can be used to perform different customized exercises for which, heretofore, it has been necessary to use different machines. Conceived as a means of helping astronauts and others to maintain muscle and bone strength and endurance in low-gravity environments, the ARED could also prove advantageous in terrestrial settings (e.g., health clubs and military training facilities) in which many users are exercising simultaneously and there is heavy demand for use of exercise machines.

  4. Advanced turboprop project

    SciTech Connect

    Hager, R.D.; Vrabel, D.

    1988-01-01

    At the direction of Congress, a task force headed by NASA was organized in 1975 to identify potential fuel saving concepts for aviation. The result was the Aircraft Energy Efficiency (ACEE) Program implemented in 1976. An important part of the program was the development of advanced turboprop technology for Mach 0.65 to 0.85 applications having the potential fuel saving of 30 to 50 percent relative to existing turbofan engines. A historical perspective is presented of the development and the accomplishments that brought the turboprop to successful flight tests in 1986 and 1987.

  5. Advanced Turboprop Project

    NASA Technical Reports Server (NTRS)

    Hager, Roy D.; Vrabel, Deborah

    1988-01-01

    At the direction of Congress, a task force headed by NASA was organized in 1975 to identify potential fuel saving concepts for aviation. The result was the Aircraft Energy Efficiency (ACEE) Program implemented in 1976. An important part of the program was the development of advanced turboprop technology for Mach 0.65 to 0.85 applications having the potential fuel saving of 30 to 50 percent relative to existing turbofan engines. A historical perspective is presented of the development and the accomplishments that brought the turboprop to successful flight tests in 1986 and 1987.

  6. Horizontal Advanced Tensiometer

    DOEpatents

    Hubbell, Joel M.; Sisson, James B.

    2004-06-22

    An horizontal advanced tensiometer is described that allows the monitoring of the water pressure of soil positions, particularly beneath objects or materials that inhibit the use of previous monitoring wells. The tensiometer includes a porous cup, a pressure transducer (with an attached gasket device), an adaptive chamber, at least one outer guide tube which allows access to the desired horizontal position, a transducer wire, a data logger and preferably an inner guide tube and a specialized joint which provides pressure on the inner guide tube to maintain the seal between the gasket of the transducer and the adaptive chamber.

  7. Advances in viral oncology

    SciTech Connect

    Klein, G.

    1987-01-01

    Volume 6 of Advances in Viral Oncology presents experimental approaches to multifactorial interactions in tumor development. Included are in-depth analyses of malignant phenotypes by oncogene complementation, as well as studies of complementary interactions among DNA viral oncogenes; multiple cell-derived sequences in single retroviral genomes; and sequences that influence the transforming activity and expression of the mos oncogene. The genetic regulation of tumorigenic expression in somatic cell hybrids, the inhibition of oncogenes by cellular genes, and the interaction of genes that favor and genes that suppress tumorigenesis are examined in detail. The book concludes with a study of the relationship of oncogenes to the evolution of the metastatic phenotype.

  8. Cryptosporidium infections: molecular advances.

    PubMed

    Lendner, Matthias; Daugschies, Arwid

    2014-09-01

    Cryptosporidium host cell interaction remains fairly obscure compared with other apicomplexans such as Plasmodium or Toxoplasma. The reason for this is probably the inability of this parasite to complete its life cycle in vitro and the lack of a system to genetically modify Cryptosporidium. However, there is a substantial set of data about the molecules involved in attachment and invasion and about the host cell pathways involved in actin arrangement that are altered by the parasite. Here we summarize the recent advances in research on host cell infection regarding the excystation process, attachment and invasion, survival in the cell, egress and the available data on omics.

  9. Advanced thermionic converter development

    NASA Technical Reports Server (NTRS)

    Huffman, F. N.; Lieb, D.; Briere, T. R.; Sommer, A. H.; Rufeh, F.

    1976-01-01

    Recent progress at Thermo Electron in developing advanced thermionic converters is summarized with particular attention paid to the development of electrodes, diodes, and triodes. It is found that one class of materials (ZnO, BaO and SrO) provides interesting cesiated work functions (1.3-1.4 eV) without additional oxygen. The second class of materials studied (rare earth oxides and hexaborides) gives cesiated/oxygenated work functions of less than 1.2 eV. Five techniques of oxygen addition to thermionic converters are discussed. Vapor deposited tungsten oxide collector diodes and the reflux converter are considered.

  10. Advances in aptamers.

    PubMed

    Syed, Muhammad Ali; Pervaiz, Saima

    2010-10-01

    Aptamers are nucleic acid sequences synthesized through in vitro selection and amplification technique, possessing a broader range of applications in therapeutics, biosensing, diagnostics, and research. Aptamers offer a number of advantages over their antibodies counterpart, one of them is their ability to undergo chemical derivatization to increase their life in the body fluids and bioavailability in animals. Although aptamers were discovered in 1990s, they have become one of the most widely investigated molecules, with a huge number of publications in the last decade. This article presents an overview of the advancements that have been made in aptamers. We mainly focused on articles published since 2005.

  11. Advanced space transportation systems

    NASA Technical Reports Server (NTRS)

    Disher, J. H.; Hethcoat, J. P.; Page, M. A.

    1981-01-01

    Projected growth in space transportation capabilities beyond the initial Space Shuttle is discussed in terms of earth-to-low-orbit launch vehicles as well as transportation beyond low orbit (orbit transfer vehicles). Growth versions of the Shuttle and heavy-lift derivatives of the Shuttle are shown conceptually. More advanced launch vehicle concepts are also shown, based on rocket propulsion or combinations of rocket and air-breathing propulsion. Orbit transfer vehicle concepts for personnel transport and for cargo transport are discussed, including chemical rocket as well as electric propulsion. Finally, target levels of capability and efficiencies for later time periods are discussed and compared with the prospective vehicle concepts mentioned earlier.

  12. Advanced Software Quality Assurance

    DTIC Science & Technology

    1977-03-01

    ment Head, General Research Corporation reports are subject to Independent review by a staff member not connected with the project. This report...ö CR^-72,0 / y < BwKmTö^RoTi T^W^n TNÖ^RcTN^rTlON NAME AND ADDRESS General Research Corporation / P.O. Box 3587 / Santa Barbara, CA...Idrnlily tt* block numb«" This is a report of the work performed by General Research Corporation during the Advanced Software Quality Assurance contract

  13. Advances in hematology analyzers.

    PubMed

    DeNicola, Dennis B

    2011-05-01

    The complete blood count is one of the basic building blocks of the minimum database in veterinary medicine. Over the past 20 years, there has been a tremendous advancement in the technology of hematology analyzers and their availability to the general practitioner. There are 4 basic methodologies that can be used to generate data for a complete blood count: manual methods, quantitative buffy coat analysis, automated impedance analysis, and flow cytometric analysis. This article will review the principles of these methodologies, discuss some of their advantages and disadvantages, and describe some of the hematology analyzers that are available for the in-house veterinary laboratory. Copyright © 2011. Published by Elsevier Inc.

  14. Advanced Plant Habitat

    NASA Image and Video Library

    2016-11-17

    A test unit, or prototype, of NASA's Advanced Plant Habitat (APH) was delivered to the Space Station Processing Facility at the agency's Kennedy Space Center in Florida. Inside a laboratory, Engineering Services Contract engineers set up test parameters on computers. From left, are Glenn Washington, ESC quality engineer; Claton Grosse, ESC mechanical engineer; and Jeff Richards, ESC project scientist. The APH is the largest plant chamber built for the agency. It will have 180 sensors and four times the light output of Veggie. The APH will be delivered to the International Space Station in March 2017.

  15. Advanced Plant Habitat

    NASA Image and Video Library

    2016-11-17

    A test unit, or prototype, of NASA's Advanced Plant Habitat (APH) was delivered to the Space Station Processing Facility at the agency's Kennedy Space Center in Florida. The APH is the largest plant chamber built for the agency. The unit is being prepared for engineering development tests to see how the science will integrate with the various systems of the plant habitat. It will have 180 sensors and four times the light output of Veggie. The APH will be delivered to the International Space Station in March 2017.

  16. Advanced Plant Habitat

    NASA Image and Video Library

    2016-11-17

    A test unit, or prototype, of NASA's Advanced Plant Habitat (APH) was delivered to the Space Station Processing Facility at the agency's Kennedy Space Center in Florida. The APH is the largest plant chamber built for the agency. The base of the APH is being prepared for engineering development tests to see how the science will integrate with the various systems of the plant habitat. It will have 180 sensors and four times the light output of Veggie. The APH will be delivered to the International Space Station in March 2017.

  17. Advanced Plant Habitat

    NASA Image and Video Library

    2016-11-17

    A test unit, or prototype, of NASA's Advanced Plant Habitat (APH) was delivered to the Space Station Processing Facility at the agency's Kennedy Space Center in Florida. The APH is the largest plant chamber built for the agency. Oscar Monje, a scientist on the Engineering Services Contract, prepares the base of the APH for engineering development tests to see how the science will integrate with the various systems of the plant habitat. The APH will have about 180 sensors and fourt times the light output of Veggie. The APH will be delivered to the International Space Station in March 2017.

  18. Advanced Plant Habitat (APH)

    NASA Image and Video Library

    2017-03-16

    A test unit, or prototype, of NASA's Advanced Plant Habitat (APH) with its first initial grow test in the Space Station Processing Facility at the agency's Kennedy Space Center in Florida. The taller plants pictured are dwarf wheat and the smaller plants are Arabidopsis. Developed by NASA and ORBITEC of Madison, Wisconsin, the APH is the largest plant chamber built for the agency. It is a fully automated plant growth facility that will be used to conduct bioscience research on the International Space Station. The APH will be delivered to the space station aboard future Commercial Resupply Services missions.

  19. Advanced imaging system

    NASA Technical Reports Server (NTRS)

    1992-01-01

    This document describes the Advanced Imaging System CCD based camera. The AIS1 camera system was developed at Photometric Ltd. in Tucson, Arizona as part of a Phase 2 SBIR contract No. NAS5-30171 from the NASA/Goddard Space Flight Center in Greenbelt, Maryland. The camera project was undertaken as a part of the Space Telescope Imaging Spectrograph (STIS) project. This document is intended to serve as a complete manual for the use and maintenance of the camera system. All the different parts of the camera hardware and software are discussed and complete schematics and source code listings are provided.

  20. Advanced Propulsion Study

    DTIC Science & Technology

    2004-02-01

    G . L ., Forward, R. L . and Frisbee, R. H. (1995a), “Report on the NASA/JPL Workshop on Advanced Quantum/Relativity Theory Propulsion,” AIAA-95-2599...31st AIAA/ASME/SAE/ASEE Joint Propulsion Conference and Exhibit, San Diego, CA 19. Bennett, G . L ., Forward, R. L . and Frisbee, R. H. (1995b...Propulsion Conference, Indianapolis, IN 169. Mead, F. B., Myrabo, L . N., and Messitt, D. G . (1998), “Flight and Ground Tests of a Laser-Boosted Vehicle