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

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.

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.

Perubahan Sensitivitas Indera Perasa pada Anak dengan Obesitas

Obesity is one of the most serious international health problems. According to WHO, obesity in Asia Pacific is defined by a body mass index of 23–24.9 kg m−2.1. Children are categorized as under 18 years of age. Obesity in children is a global health problem that has a negative impact on children's growth and development, and can even increase comorbidities in later life. In obesity, it is suspected that there is a change in the sensitivity of the sense of taste which can cause changes in diet and weight. This literature study aims to determine changes in the sensitivity of the sense of taste in obese children. The method used in this study is by searching journals that were conducted on 3 journal databases, namely PubMed, Google Scholar and Cochrane Library. Obtained 5 journals that meet the research criteria. Based on the study, obese subjects had more difficulty in correctly identifying different taste than normal weight kontrols resulting in a lower total score overall. Concluded that there is a change in the sensitivity of the sense of taste in children with obesity where the child has a lack of ability to taste sour, salty (umami) and sweet.Obesitas adalah salah satu masalah kesehatan internasional yang paling serius. Berdasarkan WHO, kondisi obesitas pada Asia Pasifik didefinisikan oleh indeks massa tubuh 23-24.9 kg m-2. Anak-anak dikategorikan berusia dibawah 18 tahun. Obesitas pada anak merupakan masalah kesehatan dunia yang berdampak buruk pada pertumbuhan dan perkembangan anak, bahkan dapat meningkatkan komobiditas di kemudian hari. Pada obesitas diduga terjadi perubahan sensitivitas indera perasa yang dapat menyebabkan perubahan pola makan dan berat badan. Studi literatur ini bertujuan untuk mengetahui perubahan sensitivitas indera perasa pada anak obesitas. Metode pada literatur ini merupakan pencarian jurnal penelitian yang dilakukan pada 3 database jurnal yaitu PubMed, Google Scholar dan Chocrane Library. Diperoleh 5 jurnal yang memenuhi kriteria penelitian. Hasil yang didapatkan adalah subjek obesitas memiliki lebih banyak kesulitan dalam mengidentifikasi kualitas rasa yang berbeda dengan benar daripada kontrol berat badan normal sehingga menghasilkan skor total yang lebih rendah secara keseluruhan. Terdapat satu penelitian yang menyatakan perbedaan yang kecil/tidak signifikan tetapi dapat dipengaruhi oleh kuantitas peserta yang lebih kecil dan jarak umur yang lebih sempit. Dari hasil review literatur ini dapat disimpulkan terdapat perubahan sensitivitas indera perasa pada anak dengan obesitas dimana anak tersebut memiliki kurangnya kemampuan merasakan asam, asin (umami) dan manis

Effect of long-term fluorination on surface electrical performance of ethylene propylene rubber

To investigate the effect of fluorination on surface electrical performance of ethylene propylene rubber (EPR), four pieces of EPR specimens are prepared and fluorinated for different duration ranging from 120 min to 480 min. The surface morphology and element compositions of experimental specimens are tested. The surface potential decay and complex permittivity are measured. The tracking discharge property and the erosion properties after tracking test are investigated. The surface charge transport and electrical property tailoring mechanism are discussed. The results show that when the fluorination duration is from 120 min to 360 min, the surface morphology gradually becomes flat and compact with time, and the surface resistance to electrical tracking is improved. While an excessive fluorination with the duration of 480 min leads to a significant increase in surface conductivity and a weakening in the resistance to electrical tracking, which is mainly due to a change in surface morphology. The recommended fluorination duration for an optimised surface property is between 240 and 360 min for EPR specimen

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

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

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 demonstrate

Résultats de trois méthodes pour la détection de la mutation précore G1896A du virus de l’hépatite B chez les donneurs de sang français : PCR temps réel, séquençage et test Inno-LIPA

AIM: To screen hepatitis B virus (HBV) genotypes and associated basal core promoter (BCP; T1762A/A1764) and precore (PC; A1896) mutations among the 100 HBV surface antigen (HBsAg) positive voluntary blood donors in France. METHODS: HBV genotypes were determined by using direct sequence analysis. Three methods were used to detect G1896A mutation: non-commercial real-time PCR (PCRTR°, line probe assay (InnoLiPA HBV PreCore, INNOGENETICS(®)) and direct sequencing of precore gene. HBV viral load was quantified with two commercial real-time PCR (COBAS(®) AmpliPrep/COBAS(®) TaqMan(®) HBV Test/Roche and Real Time HBV/M2000/Abbott). RESULTS: The mean age of donors was 30 (18-64). Patients were from Africa (42%), Europa (50%), and Asia (8%). HBV/D was the most predominant (37%) genotype followed by HBV/A (31%) and HBV/E (22%). PC and BCP mutants were found in 57% with Inno-LIPA HBV test and 59% with both PCRTR and sequencing methods. A significant difference in the viral load of blood donors with wild and PC mutants was observed with the Taqman Cobas real time PCR (3,19 Log(10) UI/ml versus 4,93 Log(10) UI/ml, p < 0.05). Precore phenotype determination was in agreement with the three PC mutation detection methods in 56% of cases. CONCLUSIONS: Non-Caucasian genotype E was present in the French blood donors. PC mutation was more common than BCP mutations in this study. As HBV infected blood donors were more often asymptomatic carriers, we could speculate that the G1896A mutation may favour the asymptomatic state, supporting previous observations

Diabetes Mellitus Due to Liver Cirrhosis in 33-Year-Old Female

Impaired glucose metabolism can occur in patient with chronic liver disease, either it is impaired glucose tolerance or diabetes mellitus (DM). DM due to liver cirrhosis is known as hepatogenous diabetes (HD). HDis different from type 2 DM in clinical signs and management.A 33-year-old female came with chief complaint of fatigue since three days before admission. Patient also complained of nausea, vomiting, and increased abdominal circumference since one year ago. Patient wasdiagnosed with DM two months ago. From physical examination, anemic and ascites without signs of cirrhosis were obtained. Laboratory test showed mild anemia with hemoglobin levels 6.5 g/dL, elevated serum bilirubinand liver enzymes, decreased serum albumin, prolonged prothrombin time and elevated random blood glucose. Serologic test showed chronic hepatitis B with HBV DNA 1.61 x 104 copy/mL. The abdominal ultrasound resultshowed liver cirrhosis with ascites.The patient was diagnosed with hepatogenous diabetes in liver cirrhosis due to chronic hepatitis B infection and anemia of chronic disease. The management of this patient was quite complex especially in administrationof oral antidiabetic agent which could affect the liver function