Randomised short-term trial of high-span versus low-span APAP for treating sleep apnoea

PURPOSE: Auto-titrating continuous positive airway pressure (APAP) devices were developed to improve treatment efficacy and compliance in patients with obstructive sleep apnoea syndrome (OSAS). Since there are insufficient data on the optimal pressure range setting, we aimed to compare the adherence, efficacy and tolerability of treatment with high-span versus low-span APAP. METHODS: Seventy-six newly diagnosed OSAS patients fulfilling the treatment criteria were randomised to receive high-span (HS, range 4-15cmH2O, n?=?38) or low-span (LS, range 8-12cmH2O, n?=?38) APAP. Patients were assessed at 1 and 3 months. RESULTS: Median Epworth sleepiness scale (ESS) was 13 (IQR, 6-16) and median apnoea-hypopnoea index (AHI) was 35.9 (IQR, 27.6-56.3). There were no significant differences in baseline demographic and clinical characteristics between groups. Overall, no significant differences were found at the first month assessment. After 3 months of therapy, we found again no differences in residual AHI or ESS. However, the group HS proved less adherent than group LS, respectively, with median 87 % (IQR, 60.5-97.5) versus 94 % (IQR, 80.0-98.3) of the nights using =4 h (P?=?0.014) and mean (±SD) usage 5.7?±?1.6 versus 6.4?±?1.2 h/night (P?=?0.049). The group HS reported more frequently nasal congestion, excessive oronasal dryness and nocturnal awakenings of at least moderate intensity, the latter with statistical significance (P?=?0.005). CONCLUSIONS: Both pressure ranges appear to be equally effective to correct AHI and to improve symptoms. Though, patients with high-span APAP were less compliant to treatment, raising issues about the tolerability of wide pressure range settings of these devices.T Pinto has received financial support from Linde and Vitalaire (Healthcare Providers) for attending symposia and honoraria for speaking at symposia from Philips. After the conclusion of the study, JC Winck has started working in a global position for Linde. The remaining authors declare that they have no conflict of interest

A factorially-designed study of physico-chemical reactive dye colour removal from simulated cotton textile processing wastewaters

The process performance of coagulation to remove reactive dyes from dyehouse effluent is affected by multiple factors, which can be best examined in factorially-designed experiments. A preliminary jar-test procedure was used to select coagulants and the optimal pH and coagulant dosage ranges. An inorganic salt (ferrous sulphate) and an organic polymer (DEC 50) were selected for further studies. Factorially-designed jar-test experiments were performed with different compositions of a synthetic cotton processing wastewater to determine which factors most affected colour removal and highlight interactions between them. Some additives, such as an oxidative desizing agent and a peroxide stabiliser, favoured colour removal within specific concentration ranges. The presence of sizing agents and surfactants reduced process efficiency. Increasing concentration of ferrous sulphate could counteract this, but would result in higher sludge disposal costs

Studies on activated sludge response to variations in the composition of a synthetic surfactant-containing feed effluent

Laboratory batch and sequencing-batch reactors and closed respirometry techniques were used to study the response of activated sludge to non-ionic synthetic surfactants. Two laboratory-grade and three commercial surfactant mixtures used in the textile industry (alkyl- and alkylphenol-ethoxylate types) were tested. Respirometric profiles during degradation experiments were complemented with titrimetric surfactant measurements and TOC determinations, representing primary and ultimate biodegradation, respectively. Though non-acclimatized sludge was apparently not inhibited by the surfactant products, total degradation took at least 20 hours with S/X values in the 0.24-0.86 range. Respiration rate profiles (respirograms) showed several peaks, suggesting stepwise primary-ultimate degradation of the surfactant molecules. Acclimatization shortened degradation times and produced repirograms with a single peak. Biomass adaptation, response to load increases and memory loss was faster for primary than for ultimate degradation. Alkyl ethoxylate-adapted biomass was apparently more capable of adaptation to alkylphenol ethoxylate than the inverse.Laboratory batch and sequencing-batch reactors and closed respirometry techniques were used to study the response of activated sludge to non-ionic synthetic surfactants. Two laboratory-grade and three commercial surfactant mixtures used in the textile industry (alkyl- and alkylphenol-ethoxylate types) were tested. Respirometric profiles during degradation experiments were complemented with titrimetric surfactant measurements and TOC determinations, representing primary and ultimate biodegradation, respectively. Though non-acclimatized sludge was apparently not inhibited by the surfactant products, total degradation took at least 20 hours with S/X values in the 0.24-0.86 range. Respiration rate profiles (respirograms) showed several peaks, suggesting stepwise primary-ultimate degradation of the surfactant molecules. Acclimatization shortened degradation times and produced repirograms with a single peak. Biomass adaptation, response to load increases and memory loss was faster for primary than for ultimate degradation. Alkyl ethoxylate-adapted biomass was apparently more capable of adaptation to alkylphenol ethoxylate than the inverse