Assessment of the prevalence of obstructive sleep apnea in patients with stable uncontrolled asthma, impact of continuous positive airway pressure treatment

AbstractThere are increasing data about the association between bronchial asthma and obstructive sleep apnea (OSA) is an important contributor to asthma control and can aggravate asthma exacerbation, continuous positive airway pressure (CPAP) which is the main line of treatment in OSA can improve asthma outcomes.Aim of the present studyTo assess the prevalence of OSA in patients with stable uncontrolled asthma and to study the effect of CPAP treatment on the asthma condition.Subjects and methodsSixty subjects with uncontrolled bronchial asthma were included in the study, mean age was 46±13years, there were female predominance (75%), all patients were not smokers, pregnancy and patients in acute exacerbation were excluded, after detailed history taking and physical examination pulmonary function tests and asthma control test were applied to all patients to assess the asthma control, then polysomnography was done to all patients and those proved to have OSA were offered CPAP treatment and followed up for 6weeks then assessed again for asthma control test, pulmonary function tests and day – time sleepiness.ResultsFifteen patients out of the 60 patients included in the study proved to have OSA, Apnea Hypopnea Index (AHI) was 23.5±10.9/h of sleep, CPAP treatment improved significantly the AHI (from 23.5±10.9 to 2.3±2.1/h of sleep, p<0.01), but there was no significant improvement in asthma control test or in the pulmonary functions (ACT was 13.97±3.52 before CPAP and became 14.1±3.97, p>0.05 after CPAP, FEV1% pred. was 60.1±6.9 before CPAP and became 61.2±6.2, p>0.05 after CPAP.ConclusionObstructive sleep apnea should be screened for in all patients with uncontrolled bronchial asthma, CPAP treatment may improve asthma quality of life but not improving the pulmonary function tests. Larger studies are needed to fully address the impact of CPAP on asthma condition in patient with both asthma and OSA

The role of financial intermediaries in Saudi Arabia’s development with particular reference to the national commercial bank

The purpose of this thesis is to examine the role of financial intermediaries in Saudi Arabia’s development with particular reference to the experience of the National Commercial Bank, the oldest bank in the Kingdom and the largest in the Middle East. The objective of the work was to reveal to what extent financial intermediation was involved in the development process of Saudi Arabia? Were commercial banks a prerequisite for development or was their growth a consequence of it? Was the development financed through Saudi Arabian financial intermediaries or was it funded from elsewhere, namely, revenues from crude oil disbursed through government spending? As a result, was the financial system permitted to deepen its financing or merely widen its activities? Was the Saudi Arabian government's role in development so great that commercial banks experienced crowding out? These issues were explored by examining the overall position of the commercial banks, and the National Commercial Bank in particular. The case study of the National Commercial Bank's financial statements and financial ratios over a period of two decades revealed its unfolding role within the economy. An investigation was made of the competitive position of the National Commercial Bank vis-a-vis other banks, and the fluctuations in its market share of deposits and loans was assessed. Finally, interviews and surveys revealed the bank's new managerial strategies and its plans for future business development to serve the needs of its clients. It was found that the liberalisation of the Saudi Arabian financial system had contributed to the Kingdom's economic development, and resulted in changes in institutions such as the National Commercial Bank which meant they could play an increasing role in the funding of industrialisation

A genetic basis for a postmeiotic X versus Y chromosome intragenomic conflict in the mouse.

Intragenomic conflicts arise when a genetic element favours its own transmission to the detriment of others. Conflicts over sex chromosome transmission are expected to have influenced genome structure, gene regulation, and speciation. In the mouse, the existence of an intragenomic conflict between X- and Y-linked multicopy genes has long been suggested but never demonstrated. The Y-encoded multicopy gene Sly has been shown to have a predominant role in the epigenetic repression of post meiotic sex chromatin (PMSC) and, as such, represses X and Y genes, among which are its X-linked homologs Slx and Slxl1. Here, we produced mice that are deficient for both Sly and Slx/Slxl1 and observed that Slx/Slxl1 has an opposite role to that of Sly, in that it stimulates XY gene expression in spermatids. Slx/Slxl1 deficiency rescues the sperm differentiation defects and near sterility caused by Sly deficiency and vice versa. Slx/Slxl1 deficiency also causes a sex ratio distortion towards the production of male offspring that is corrected by Sly deficiency. All in all, our data show that Slx/Slxl1 and Sly have antagonistic effects during sperm differentiation and are involved in a postmeiotic intragenomic conflict that causes segregation distortion and male sterility. This is undoubtedly what drove the massive gene amplification on the mouse X and Y chromosomes. It may also be at the basis of cases of F1 male hybrid sterility where the balance between Slx/Slxl1 and Sly copy number, and therefore expression, is disrupted. To the best of our knowledge, our work is the first demonstration of a competition occurring between X and Y related genes in mammals. It also provides a biological basis for the concept that intragenomic conflict is an important evolutionary force which impacts on gene expression, genome structure, and speciation

The multicopy gene Sly represses the sex chromosomes in the male mouse germline after meiosis.

Studies of mice with Y chromosome long arm deficiencies suggest that the male-specific region (MSYq) encodes information required for sperm differentiation and postmeiotic sex chromatin repression (PSCR). Several genes have been identified on MSYq, but because they are present in more than 40 copies each, their functions cannot be investigated using traditional gene targeting. Here, we generate transgenic mice producing small interfering RNAs that specifically target the transcripts of the MSYq-encoded multicopy gene Sly (Sycp3-like Y-linked). Microarray analyses performed on these Sly-deficient males and on MSYq-deficient males show a remarkable up-regulation of sex chromosome genes in spermatids. SLY protein colocalizes with the X and Y chromatin in spermatids of normal males, and Sly deficiency leads to defective repressive marks on the sex chromatin, such as reduced levels of the heterochromatin protein CBX1 and of histone H3 methylated at lysine 9. Sly-deficient mice, just like MSYq-deficient mice, have severe impairment of sperm differentiation and are near sterile. We propose that their spermiogenesis phenotype is a consequence of the change in spermatid gene expression following Sly deficiency. To our knowledge, this is the first successful targeted disruption of the function of a multicopy gene (or of any Y gene). It shows that SLY has a predominant role in PSCR, either via direct interaction with the spermatid sex chromatin or via interaction with sex chromatin protein partners. Sly deficiency is the major underlying cause of the spectrum of anomalies identified 17 y ago in MSYq-deficient males. Our results also suggest that the expansion of sex-linked spermatid-expressed genes in mouse is a consequence of the enhancement of PSCR that accompanies Sly amplification

Issues of Cost & Access in Canada’s Health Care System: Lessons for the Civil Justice System

There are numerous examples of rethinking costs in the Canadian health care system. Three of these provide us with a sense of why there might be useful lessons for the civil justice system

Issues of Cost & Access in Canadian’s Social Investment: Lessons for the Civil Justice System

Historically, the dominant discourse within the welfare state was one of redistribution and the paternalistic protection of citizens against social risks such as unemployment, illness, disability and retirement. Over the past few decades, changes in social policy have been introduced which are directed towards “social investment” and empowering citizens rather than protecting them. The social investment model focuses on investing public money and time in social programs such as housing, healthcare, employment insurance, child benefits and education with an eye to providing all citizens with opportunities that will enable them to take responsibility for themselves and their families. In practice, social investment targets marginalized peoples because they are the ones who are believed to benefit the most from small investments in their human capital and are the least likely to generate their own human capital investment. Public funds for social investment are raised through progressive taxation that has the double effect of generating funds for investing in marginal peoples and having a redistributive effect

IN SITU LOCALIZATION OF GLOBIN MESSENGER RNA FORMATION : I. During Mouse Fetal Liver Development

Globin mRNA levels in 11–15-day mouse fetal liver cells have been estimated by in situ hybridization of a highly labeled DNA copy (cDNA) of adult globin messenger RNAs (mRNAs) (globin cDNA) to fixed preparations of cells. Under the conditions employed, no significant in situ hybridization occurred to lymphoma cells (L 51787), mouse L cells, or hepatocytes; whereas reticulocytes from phenyl hydrazine-treated mice showed extensive in situ hybridization. The proportion of fetal liver cells showing predominantly cytoplasmic in situ hybridization increased from about 30% at the 11th day of development to 80–85% by days 13–15. Unlike more mature cells, proerythroblasts did not show in situ hybridization, except to a slight extent at later stages of development. These studies therefore indicate that globin mRNAs begin to accumulate during or shortly after the proerythroblastbasophilic erythroblast transition. The fact that certain immature erythroid cells from 14-day fetal liver contain substantial amounts of globin mRNAs has been confirmed by comparing the hybridization in solution of globin cDNA to cytoplasmic RNA extracted from total fetal liver cells or from immature erythroid cells obtained by treatment of fetal liver cells with an antiserum raised against erythrocytes

Issues of Cost & Access in Canada’s Early Childhood Education System: Lessons for the Civil Justice System

In recent years in Canada, there has been growing appreciation that early childhood education (ECE) is a basic foundation for building a successful education system, competitive global economy, and a well functioning democracy. A policy of publicly funding ECE programming is, in other words, seen as a smart investment in the future. This new appreciation of ECE is evident from the fact that ECE is now integrated into our school system and early childhood educators are recognized as trained professionals, not mere childcare workers. ECE policies in Ontario are now a model of evidence-based decision-making. Early learning initiatives such as full-day kindergartens and seamless days are based on new innovative research on child development that shows the long term benefits of skills such as early literacy and self-regulation for young children. ECE is also an effective compensatory vehicle for children from disadvantaged socio-economic backgrounds