Long-term prediction of adherence to continuous positive air pressure therapy for the treatment of moderate/severe obstructive sleep apnea syndrome

BACKGROUND: Continuous positive airway pressure (CPAP) therapy is a highly effective treatment for obstructive sleep apnea syndrome (OSAS). However, poor adherence is a limiting factor, and a significant proportion of patients are unable to tolerate CPAP. The aim of this study was to determine predictors of long-term non-compliance with CPAP. METHODS: CPAP treatment was prescribed to all consecutive patients with moderate or severe OSAS (AHI ≥15 events/h) (n = 295) who underwent a full-night CPAP titration study at home between February 1, 2002 and December 1, 2016. Adherence was defined as CPAP use for at least 4 h per night and five days per week. Subjects had periodical follow-up visits including clinical and biochemical evaluation and assessment of adherence to CPAP. RESULTS: Median follow-up observation was 74.8 (24.2/110.9) months. The percentage of OSAS patients adhering to CPAP was 41.4% (42.3% in males and 37.0% in females), and prevalence was significantly higher in severe OSAS than in moderate (51.8% vs. 22.1%; p < 0.001; respectively). At multivariate analysis, lower severity of OSAS (HR = 0.66; CI 95 0.46-0.94) p < 0.023), cigarette smoking (HR = 1.72; CI 95 1.13-2.61); p = 0.011), and previous cardiovascular events (HR = 1.95; CI 95 1.03-3.70; p = 0.04) were the only independent predictors of long-term non-adherence to CPAP after controlling for age, gender, and metabolic syndrome. CONCLUSIONS: In our cohort of patients with moderate/severe OSAS who were prescribed CPAP therapy, long-term compliance to treatment was present in less than half of the patients. Adherence was positively associated with OSAS severity and negatively associated with cigarette smoking and previous cardiovascular events at baseline

Floristic composition of weeds in different winter and summer covers.

The usage of cover crops is an adopted cultural measure that shows positive effects when associated with the no-till system and weed management. During the cycle of the plants there might be competition within them for water, solar radiation and nutrients and effects of allelopathic substances released by leaching, volatilization and/or root exudation in the environment might also coexist. The study aimed to quantify the floristic composition of weed species in an cultivated area with cover crops during winter and summer, for two years, 2011/12 and 2012/13, in an experimental area of UFSM, Campus of Frederico Westphalen ? RS state, Brazil. The treatments consisted of Italian ryegrass, wild radish, black oat, vetch, wheat and uncultivated, in winter, and, sorghum, sunflower, black velvet bean, dwarf velvet bean, gray velvet bean and green velvet bean in the summer. In the first year of the experiment, a diversity of weeds in winter was observed, especially occuring Stellaria media and Bowlesia incana. In summer, the weeds of higher importance were Ipomoea spp. and Bidens spp., both of utter importance in agricultural systems. Winter cover crops of wild radish and Italian ryegrass and summer cover crops of sorghum and sunflower provided a lower weed infestatio

Relative yield of wheat in coexistence with concurrent plants as indicator of competitiveness.

One of the factors that limit the yield of wheat is the weed competition, being the competitive potential of plants affected by their morphophysiological characteristics. The objective of this study was to determine the competitiveness of wheat when in coexistence with Italian ryegrass (Lolium multiflorum) and radish (Raphanus sativus) competitive plants or with wheat as simulator competition plant. There were realized four experiments in the greenhouse of the Agricultural Department of Environmental Sciences of the UFSM, Campus of Frederico Westphalen ? RS, during July to September, 2012. The treatments were arranged in a replacement series, in the proportions of 100:00 (wheat monoculture), 75:25, 50:50, 25:75 and 100:00 (competitor plant monoculture) for wheat plants (cv. Fundacep Cristalino) and for Italian ryegrass, radish and wheat (cv. BRS Guamirim) as competitor plants. The wheat is more competitive than Italian ryegrass in initial coexistence, even in the smallest proportion of plants. The radish when intercropped with wheat demonstrates similar competitive potential for environmental resources to the crop. There is mutual beneficial effect when wheat cultivars Fundacep Cristalino and BRS Guamirim coexisted, and each cultivar seems to have mechanism to avoid competition

Evaluating visitor experiences with interactive art

The Music Room is an interactive installation that allows visitor to compose classical music by moving throughout a space. The distance between them and their average speed maps the emotionality of music: in particular, distance influences the pleasantness of the music, while speed influences its intensity. This paper focuses on the evaluation of visitors' experience with The Music Room by examining log-data, video footages, interviews, and questionnaires, as collected in two public exhibitions of the installation. We examined this data to the identify the factors that fostered the engagement and to understand how players appropriated the original design idea. Reconsidering our design assumptions against behavioural data, we noticed a number of unexpected behaviours, which induced us to make some considerations on design and evaluation of interactive art

The pricing behaviour of firms in the euro area : new survey evidence

This study investigates the pricing behaviour of firms in the euro area on the basis of surveys conducted by nine Eurosystem national central banks. Overall, more than 11,000 firms participated in the survey. The results are very robust across countries. Firms operate in monopolistically competitive markets, where prices are mostly set following mark-up rules and where price discrimination is a common practice. Our evidence suggests that both time- and state-dependent pricing strategies are applied by firms in the euro area: around one-third of the companies follow mainly time-dependent pricing rules while two-thirds use pricing rules with some element of state-dependence. Although the majority of firms take into account a wide range of information, including past and expected economic developments, about one-third adopts a purely backward-looking behaviour. The pattern of results lends support to the recent wave of estimations of hybrid versions of the New Keynesian Phillips Curve. Price stickiness arises both at the stage when firms review their prices and again when they actually change prices. The most relevant factors underlying price rigidity are customer relationships - as expressed in the theories about explicit and implicit contracts - and thus, are mainly found at the price changing (second) stage of the price adjustment process. Finally, we provide evidence that firms adjust prices asymmetrically in response to shocks, depending on the direction of the adjustment and the source of the shock: while cost shocks have a greater impact when prices have to be raised than when they have to be reduced, reductions in demand are more likely to induce a price change than increases in demand.price setting, nominal rigidity, real rigidity, inflation persistence, survey data.

Mutations within the hepatitis C virus genotype 1b E2-PePHD domain do not correlate with treatment outcome.

The hepatitis C virus (HCV) envelope protein 2 (E2) interacts in vitro with the interferon alpha (IFN-alpha)-inducible double-stranded RNA-activated protein kinase, suggesting a possible mechanism by which HCV may evade the antiviral effects of IFN-alpha. Variability in the part of the HCV E2 gene encoding the carboxy-terminal part of the protein, which includes the interaction domain (E2-PePHD), was explored in 25 patients infected with HCV genotype 1b and receiving IFN-alpha therapy. PCR products were generated and sequenced for 15 patients with a sustained response and for 10 patients with no virological response after treatment with IFN-alpha and ribavirin. PePHD amino acid sequences were obtained for isolates from serum collected before and during treatment, after 2 months in responders, and after 6 months in nonresponders. Quasispecies analysis of the pretreatment PePHD region was performed for isolates from patients displaying amino acid substitutions in this domain on direct sequencing. The E2-PePHD sequence was highly conserved in both resistant and susceptible genotype 1b strains and was identical to the prototype HCV type J sequence. No significant emergence of PePHD mutants during therapy was observed in our clonal analysis, and sporadic mutations and treatment outcomes were not found to be correlated. The PePHD sequence before or during treatment cannot be used to predict reliably the outcome of treatment in HCV type 1b-infected patients

Integrazione di rilievi batimetrici e laser scanner aereo nell'area dei Colli Albani

The Colli Albani are a Quaternary volcanic complex located about 15 km SE of Rome, comprised in an area of latitudes 41.6-41.9 N and longitudes 12.5-12.9 E. It has recently developed particular interest in the geophysical community for some peculiar characteristics imputable to a residual volcanic activity. In the framework of a project financed by the Department of the Civil Protection devoted to the study of the Colli Albani deformations, we have recently realized a bathymetric survey of the Albano lake and an airborne laser scanner survey of the Albano and Nemi craters. The present work is composed by two phases. In a first phase the accuracy of the DEM achieved by the laser scanner is verified through a comparison with a GPS kinematic survey. In particular, our aim is to test if the use of DEM in different formats, TIN or Grid, could lead to meaningful differences in terms of accuracy and precision. In a second phase of the work, we merged the LIDAR and bathymetric data with the purpose to achieve a complete digital terrain model of the area that could allow in the next future geo-morphological analyses of the whole volcanic structure

Spectral and polarimetric characterization of the Gas Pixel Detector filled with dimethyl ether

The Gas Pixel Detector belongs to the very limited class of gas detectors optimized for the measurement of X-ray polarization in the emission of astrophysical sources. The choice of the mixture in which X-ray photons are absorbed and photoelectrons propagate, deeply affects both the energy range of the instrument and its performance in terms of gain, track dimension and ultimately, polarimetric sensitivity. Here we present the characterization of the Gas Pixel Detector with a 1 cm thick cell filled with dimethyl ether (DME) at 0.79 atm, selected among other mixtures for the very low diffusion coefficient. Almost completely polarized and monochromatic photons were produced at the calibration facility built at INAF/IASF-Rome exploiting Bragg diffraction at nearly 45 degrees. For the first time ever, we measured the modulation factor and the spectral capabilities of the instrument at energies as low as 2.0 keV, but also at 2.6 keV, 3.7 keV, 4.0 keV, 5.2 keV and 7.8 keV. These measurements cover almost completely the energy range of the instrument and allows to compare the sensitivity achieved with that of the standard mixture, composed of helium and DME.Comment: 20 pages, 11 figures, 5 tables. Accepted for publication by NIM

Nanofibrous piezoelectric structures for composite materials to be used in electrical and electronic components

This paper deals with realization of multifunctional composite materials, having piezoelectric effect. First of all polymeric mats of electrospun piezoelectric nanofibers were realized with different geometries. Such effect has been maximized by designing properly the electrospinning apparatus in order to enhance the electric field in the interelectrodic space which polarize the dipolar moments. The mats are then integrated in a silicon rubber matrix and measurements of the electromechanical response of the composite materials thus manufactured are performed. A good integration of nanofibers inside the host material is evidenced by electron microscopy images, allowing delaminations, which could occur using piezoelectric films, to be avoided. A large electrical response to both impact and vibration stimuli has been finally demonstrated