773 research outputs found

    Snoring in Early Childhood

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    Taustaa: Unenaikaiset hengityshäiriöt, jotka käsittävät sekä kuorsauksen että obstruktiivisen uniapnean, ovat lapsilla varsin yleisiä, joskin raportoidut esiintyvyydet vaihtelevat suuresti. Vaikka kuorsaus on obstruktiivista uniapneaa lievempi unenaikainen hengityshäiriö, myös siihen on osoitettu liittyvän lisääntynyt riski kohonneeseen verenpaineeseen, neurokognitiivisiin ja käyttäytymisongelmiin sekä haitallisiin muutoksiin lasten aineenvaihdunnan mittareissa. Imeväisten ja taaperoiden unenaikaisia hengityshäiriöitä koskeva tutkimustieto on rajallista verrattuna kouluikäisiin lapsiin. Tavoitteet: Tässä etenevässä tutkimuksessa tarkasteltiin kuorsauksen esiintyvyyttä imeväisiässä, sekä kuorsaukseen liittyviä riskitekijöitä ennen ja jälkeen syntymän. Lisäksi tavoitteena oli arvioida kuorsauksen esiintyvyyttä ja pysyvyyttä kahden ensimmäisen elinvuoden aikana kahdessa suomalaisessa syntymäkohortissa. Tutkimuksessa tarkasteltiin myös varhaislapsuuden kuorsauksen ja kasvun välistä yhteyttä sekä sydän- ja verisuonisairauksien ja aineenvaihduntahäiriöiden riskitekijöitä verinäytteiden avulla. Menetelmät: Ensimmäinen tutkimusväestö koostui 1388 imeväisestä, jotka rekrytoitiin CHILD SLEEP (CS) -syntymäkohortista Pirkanmaan sairaanhoitopiirissä vuosina 2011–2013. Vanhemmille osoitetut kyselyt täytettiin ennen lapsen syntymää sekä lapsen ollessa kolmen ja kahdeksan kuukauden ikäinen. Toinen tutkimusaineisto sisälsi 947 lasta CS-kohortista sekä 1393 lasta FinnBrain (FB) -syntymäkohortista. Molemmat vanhemmat täyttivät kyselylomakkeet lapsen ollessa 24 kuukauden ikäinen, jotka sisälsivät osiot lapsen unesta sekä ympäristötekijöistä. Kolmas tutkimusjoukko koostui 78 lapsesta CS-kohortista, joille tehtiin yhden yön polysomnografiatutkimus (PSG), ja joiden vanhemmat olivat täyttäneet uni- ja ympäristötekijöitä koskevan kyselylomakkeen 24 kuukauden kohdalla. Kasvutiedot kerättiin neuvoloista, ja aineenvaihduntaverinäytteet otetiin 31 lapselta. Tulokset: Tutkimuksen mukaan vauvojen kuorsauksen esiintyvyys oli 3,2 % kolmen kuukauden iässä ja 3,0 % kahdeksan kuukauden iässä. Imeväisiällä kuorsaavilla lapsilla oli enemmän univaikeuksia. Lisäksi kolmen kuukauden iässä kuorsaavien vauvojen uni oli levottomampaa ja kestoltaan lyhyempää kuin muilla lapsilla. Vauvojen kuorsauksen riskitekijöitä olivat äidin tupakointi sekä vanhempien kuorsaus. Lisäksi korvikeruokinta ja tutinkäyttö lisäsivät vauvan kuorsauksen riskiä kolmen kuukauden iässä. Kuorsauksen yhdistetty esiintyvyys kahdessa syntymäkohortissa 24 kuukauden iässä havaittiin olevan 2,3 %, joka on merkittävästi vähäisempi kuin aiemmissa tutkimuksissa on raportoitu. Lasten, joilla oli toistuvia infektioita tai diagnosoitu astma, kuorsasivat muita todennäköisemmin säännöllisesti. Lisäksi riski lapsen kuorsaamisesta kasvoi tavallisesti, jos molemmat vanhemmat kuorsasivat joka yö. Lapsen kuorsauksen havaittiin liittyvän myös äidin alhaisempaan koulutustasoon ja alhaisempiin kuukausituloihin. Kahden ensimmäisen elinvuoden aikana kuorsanneiden lasten ja kontrolliryhmän kasvussa ei havaittu merkittäviä eroja. Kuitenkin lapsien, joiden PSG:n rekisteröimä kuorsausaika oli jakauman ylimmässä neljänneksessä, HDL-arvot olivat alhaisemmat verrattuna lapsiin, joiden kuorsausaika oli alimmassa neljännessä. Lineaariset regressiomallit paljastivat, että kuorsausaika ennusti merkittävästi alhaisempia HDL- ja ApoA1-tasoja sekä korkeampia hs-CRP-tasoja. Johtopäätökset: Yhteenvetona voidaan todeta, että säännöllisen kuorsauksen esiintyvyys suomalaisissa syntymäkohorteissa oli aiemmin raportoitua pienempi. Tässä tutkimuksessa havaittiin, että vanhempien kuorsaus ja äitien tupakointi olivat kuorsauksen riskitekijöitä vauvaiässä, ja kuorsaavilla vauvoilla oli myös enemmän univaikeuksia. Riskitekijöitä kuorsaukselle kaksivuotiaana olivat vanhempien kuorsaus, äidin alhaiset tulot sekä alhainen koulutustaso. Suomalaisilla lapsilla PSG- tutkimuksessa rekisteröity kuorsausaika liittyi negatiivisiin muutoksiin seerumin metabolisissa merkkiainetasoissa. Nämä havainnot viittaavat siihen, että kuorsaus varhaislapsuudessa voi lisätä sydän- ja verisuonisairauksien riskiä aikuisiässä.Background: Sleep disordered breathing (SDB) includes snoring and obstructive sleep apnea (OSA) and is common in children, with reported prevalence rates varying widely. Snoring, though less severe than OSA, can have detrimental effects on children’s health. Left untreated. it can lead to elevated blood pressure, neurocognitive and behavioral problems, and adverse impacts on metabolic profiles. Research on infants’ and toddlers’ SDB is limited compared to data on snoring in school-aged children. Objectives: This prospective study examined the prevalence of snoring during early childhood and the prenatal and postnatal risk factors for this condition. A further aim was to evaluate the prevalence and persistence of snoring during the first two years of life in two Finnish birth cohorts. Additionally, the association between snoring and growth during early childhood and the risk factors for cardiovascular and metabolic disorders, as measured by blood samples at age two, was examined. Methods: The first study population consisted of 1388 infants who were recruited from the CHILD SLEEP (CS) birth cohort in the Pirkanmaa Hospital District, Finland between 2011 and 2013. Parents completed questionnaires on sleep and background factors prenatally, as well as when the infants were three and eight months old. The second study included 947 children from the CS and 1393 children from the FinnBrain (FB) birth cohorts. At 24 months of age, both parents were given questionnaires that included sections on the child’s sleep and environmental factors. The third sample consisted of 78 children from the CS cohort who underwent full-night polysomnography (PSG) and whose parents completed a questionnaire on sleep and environmental factors at 24 months. Growth charts were obtained from well-baby clinics, and metabolic blood samples were taken from 31 children. Results: According to the study, the prevalence of habitual snoring in infants was 3.2% at three months and 3.0% at eight months. Infants who snored at these ages experienced more sleeping difficulties. At three months, snoring infants had shorter sleep duration and more restless sleep than other infants. The risk factors for infants’ snoring were maternal smoking and parental snoring. Additionally, formula feeding, and pacifier use added to the risk of an infant’s snoring at the age of three months. The combined prevalence of habitual snoring in two birth cohorts at the age of 24 months was found to be 2.3%, which is significantly lower than that reported in previous studies. Children who experienced recurrent infections or asthma were found to be more likely to snore habitually. Moreover, the risk of a child snoring habitually increased when both parents snored every night. A child’s likelihood of habitual snoring was found to be associated with a mother with lower level of education and a lower monthly income. During the first two years of life, there were no significant differences in growth parameters between the children who snored and the control group. However, children whose total sleep snoring time recorded by PSG was in the highest quartile had lower levels of high-density lipoprotein (HDL) compared to those in the lowest quartile. Linear regression models revealed that snoring time significantly predicted lower HDL and apolipoprotein A1 (ApoA1) levels and higher levels of high- sensitivity C-reactive protein (hs-CRP). Conclusions: In conclusion, the prevalence of habitual snoring in the Finnish birth cohort was lower than previously reported. Parental snoring, maternal smoking, and socioeconomic factors were linked to infant snoring. Snoring infants were reported to face more sleep difficulties, and independent risk factors included parental snoring, low maternal income, and low maternal education levels. In Finnish children, snoring was associated with adverse effects on the serum metabolic profile. These findings suggest that snoring during early childhood may increase the risk of cardiovascular disease in adulthood

    A novel optogenetics-based therapy for obstructive sleep apnoea

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    Obstructive sleep apnoea (OSA) is characterised by repeat upper airway narrowing and/or collapse during sleep. Many patients are sub-optimally treated due to poor tolerance or incomplete response to established therapies. We propose a novel, optogenetics-based therapy, that enables light-stimulation induced upper airway dilator muscle contractions to maintain airway patency. The primary aims of this thesis were to determine feasibility in a rodent model of OSA, and identify effective optogenetic constructs for activating upper airway muscles. Chapters 2 and 3 outline the development of a novel construct for the expression of light-sensitive proteins (opsins) in upper airway muscles, comparing two promotors and two recombinant adeno-associated virus capsids (rAAV) for optogenetic gene transfer. Results show that a muscle-specific promotor (tMCK) was superior to a non-specific promotor (CAG). With tMCK, opsin expression in the tongue was 470% greater (p=0.013, RM-ANOVA), brainstem expression was abolished, and light stimulation facilitated a 66% increase in muscle activity from that recorded during unstimulated breaths in an acute model of OSA (p<0.001, linear mixed model) (Chapter 2). Moreover, a novel, highly myotropic rAAV serotype, AAVMYO, was superior to a wild-type serotype, AAV9. The AAVMYO serotype driven by tMCK facilitated a further increase in muscle activity with light stimulation to 194% of that recorded during unstimulated breaths (p<0.001, linear mixed model) (Chapter 3). Finally, ultrasound imaging confirmed that the optimised construct was able to generate effective light-induced muscle contractions and airway dilation (Chapter 4). A secondary aim was to advance preclinical trials for the proposed therapy. To this end, a surgical protocol for chronic implantation of light delivery hardware and recording electrodes in rodents was developed (Chapter 5). The final protocol will allow us to determine the effects of acute and chronic light stimulation on opsin-expressing upper airway muscles during natural sleep. In summary, Chapters 2 to 4 provide proof-of-concept for a non-invasive optogenetics-based OSA therapy. The combination of a muscle-specific promotor and a muscle-specific viral vector presents a novel and highly effective method of inducing light sensitivity into skeletal muscle and facilitating light-evoked airway dilation. Finally, Chapter 5 commences the development of a surgical protocol that will aid ongoing preclinical trials

    Physical activity and pulmonary rehabilitation in difficult-to-treat asthma associated with elevated body mass index

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    This thesis studies physical activity levels, pulmonary rehabilitation and their effects in participants with difficult-to-treat asthma associated with elevated body mass index (BMI). The three results chapters present the original research which I conducted during my period of study. All three chapters are presented as contracted papers, two of which have been peer-reviewed and published in scientific journals. This thesis has been approved for submission as an ‘alternative format’ thesis by the Higher Degrees Committee of the University of Glasgow. The focus of the thesis is exercise in participants with difficult-to-treat asthma associated with elevated body mass index. There are two research questions addressed by the thesis, do asthma severity or body mass index affect physical activity levels in asthma? The first results chapter concludes that they both do. Secondly, does pulmonary rehabilitation improve asthma control in this group of participants? The results of the work suggest that it may lead to some improvements in asthma control, but not to a clinically significant degree. “Physical activity levels in asthma: relationship with disease severity, body mass index and novel accelerometer-derived metrics” was published in the Journal of Asthma, online version published 2nd August 2022. This paper reports physical activity (PA) levels in participants with varying degrees of asthma severity and body mass index (BMI). It incorporates the use of two novel accelerometerbased metrics and how they correlate with asthma control. This paper provides an introduction into how difficult-to-treat asthma and elevated BMI affect physical activity and leads onto the main work in pulmonary rehabilitation. “A pragmatic randomised controlled trial of tailored pulmonary rehabilitation in participants with difficult-to-control asthma and elevated body mass index” was published in BMC Pulmonary Medicine, online version published 24th September 2022. This paper presents the initial outcomes at completion of an eight-week asthma-tailored pulmonary rehabilitation programme, comparing participants who completed PR with a control group who had usual care. The final results chapter, “Immediate and longer-term effects of an asthma tailored pulmonary rehabilitation programme in overweight and obese participants with difficult-to-treat asthma” has been submitted to Respiratory Medicine, to be considered for publication. This paper presents wider results of the above trial in a prospective observational format, as everyone who was randomised to usual care was invited to participate in PR after completion of the initial 8-week observation period. Here we consider the immediate and longerterm outcomes of a larger group of participants undergoing PR, and look at possible predictors of response

    Monitoring the critical newborn:Towards a safe and more silent neonatal intensive care unit

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    New advances in the neurobiological mechanisms regulating fear extinction.

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    24th Nordic Conference on Computational Linguistics (NoDaLiDa)

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    Changing Priorities. 3rd VIBRArch

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    In order to warrant a good present and future for people around the planet and to safe the care of the planet itself, research in architecture has to release all its potential. Therefore, the aims of the 3rd Valencia International Biennial of Research in Architecture are: - To focus on the most relevant needs of humanity and the planet and what architectural research can do for solving them. - To assess the evolution of architectural research in traditionally matters of interest and the current state of these popular and widespread topics. - To deepen in the current state and findings of architectural research on subjects akin to post-capitalism and frequently related to equal opportunities and the universal right to personal development and happiness. - To showcase all kinds of research related to the new and holistic concept of sustainability and to climate emergency. - To place in the spotlight those ongoing works or available proposals developed by architectural researchers in order to combat the effects of the COVID-19 pandemic. - To underline the capacity of architectural research to develop resiliency and abilities to adapt itself to changing priorities. - To highlight architecture's multidisciplinarity as a melting pot of multiple approaches, points of view and expertise. - To open new perspectives for architectural research by promoting the development of multidisciplinary and inter-university networks and research groups. For all that, the 3rd Valencia International Biennial of Research in Architecture is open not only to architects, but also for any academic, practitioner, professional or student with a determination to develop research in architecture or neighboring fields.Cabrera Fausto, I. (2023). Changing Priorities. 3rd VIBRArch. Editorial Universitat Politècnica de València. https://doi.org/10.4995/VIBRArch2022.2022.1686

    2009 GREAT Day Program

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    SUNY Geneseo’s Third Annual GREAT Day.https://knightscholar.geneseo.edu/program-2007/1003/thumbnail.jp
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