Upper airway muscle exercises outcome in patients with obstructive sleep apnea syndrome

AbstractBackgroundObstructive sleep apnea syndrome (OSAS) is an important disease that represent a challenge for both patients and physicians to reach optimum choice for treatment mostly because genesis of OSAS is multifactorial. Upper airway muscle function plays a major role in maintenance of the upper airway patency especially during sleep. Oropharyngeal exercises may be an effective treatment option for OSAS.ObjectiveAim of this study was to evaluate upper airway muscle exercise as method to treat OSAS.Patients and methods30 patients divided into 2 groups; Group I moderate OSAS and Group II: severe OSAS patients. Follow up, as regard ESS, AHI, oxygen saturation and snoring was done after 3months of oropharyngeal exercises.ResultsAfter end of study, daytime sleepiness and AHI improved significantly in group I (moderate OSA) 13 out of 15 patients shifted from moderate to mild OSAS. There was significant decrease in oxygen desaturation and snoring index. As for group II, there was decrease but not significant change in same parameters. Only for moderate OSAS, there was, significant decrease in neck circumference, which inversely correlated with changes in AHI (r=0.582; P<0.001).ConclusionUpper airways exercises can be a novel easy non invasive technique to improve AHI, O2 saturation and snoring thus used in treatment of OSAS patients mainly moderate type

Effects of Grain Refining on Columnar-to-Equiaxed Transition in Aluminum Alloys

The effects of grain refining in ultra-pure aluminum, commercially pure aluminum (1050), and Al-7%Si binary alloy were investigated, using different additions of Al-10%Ti, Al-5%Ti-1%B, and Al-4%B master alloys. Thermal analysis and metallography were used to assess the variations in microstructure resulting from these additions, at solidification rates of 0.8°C/s and ~10°C/s. The results revealed that addition of Al-4%B to ultra-pure aluminum forms AlB12 and AlB2 which have no grain-refining effect. Without grain refiner addition, the pure aluminum microstructure exhibits a mixture of columnar and equiaxed grains. Addition of 30ppm Ti is sufficient to promote equiaxed grains at ~10°C/s but requires addition of 1000 ppm B to obtain similar results at 0.8°C/s. Increasing the Si content to 7% reduces the initial grain size of pure aluminum from 2800 μm to ~1850 μm, and further to 450 μm with ddition of ~500ppm B. In commercial aluminum, the B reacts with traces of Ti forming Al3Ti and TiB2 phases which are active grain-refiners. In Al-7%Si, Ti reacts with Si forming (Al,Si)2Ti phase, which is a poor refining agent. This phenomenon is termed poisoning. No interaction between B and Si is observed in the commercial aluminum or Al-7%Si alloy when B is added

Associations Between Radiation Oncologist Demographic Factors and Segmentation Similarity Benchmarks: Insights From a Crowd-Sourced Challenge Using Bayesian Estimation

PURPOSE: The quality of radiotherapy auto-segmentation training data, primarily derived from clinician observers, is of utmost importance. However, the factors influencing the quality of clinician-derived segmentations are poorly understood; our study aims to quantify these factors. METHODS: Organ at risk (OAR) and tumor-related segmentations provided by radiation oncologists from the Contouring Collaborative for Consensus in Radiation Oncology data set were used. Segmentations were derived from five disease sites: breast, sarcoma, head and neck (H&N), gynecologic (GYN), and GI. Segmentation quality was determined on a structure-by-structure basis by comparing the observer segmentations with an expert-derived consensus, which served as a reference standard benchmark. The Dice similarity coefficient (DSC) was primarily used as a metric for the comparisons. DSC was stratified into binary groups on the basis of structure-specific expert-derived interobserver variability (IOV) cutoffs. Generalized linear mixed-effects models using Bayesian estimation were used to investigate the association between demographic variables and the binarized DSC for each disease site. Variables with a highest density interval excluding zero were considered to substantially affect the outcome measure. RESULTS: Five hundred seventy-four, 110, 452, 112, and 48 segmentations were used for the breast, sarcoma, H&N, GYN, and GI cases, respectively. The median percentage of segmentations that crossed the expert DSC IOV cutoff when stratified by structure type was 55% and 31% for OARs and tumors, respectively. Regression analysis revealed that the structure being tumor-related had a substantial negative impact on binarized DSC for the breast, sarcoma, H&N, and GI cases. There were no recurring relationships between segmentation quality and demographic variables across the cases, with most variables demonstrating large standard deviations. CONCLUSION: Our study highlights substantial uncertainty surrounding conventionally presumed factors influencing segmentation quality relative to benchmarks

Valorization of Rice Husk and Straw Agriculture Wastes of Eastern Saudi Arabia: Production of Bio-Based Silica, Lignocellulose, and Activated Carbon

Bio-based silica, lignocellulose, and activated carbon were simply produced via the recycling of Hassawi rice biomass waste of Al-Ahsa governorate in the eastern Saudi Arabia region using a fast chemical treatment procedure. Rice husk and rice straw wastes were collected, ground, and chemically treated with sodium hydroxide to extract silica/silicate from the dried plant tissues. The liquid extract is then treated with acid solutions in order to precipitate silica/silicate at neutral medium. Lowering the pH of the supernatant to 2 resulted in the precipitation of lignocellulose. Thermal treatment of the biomass residue under N2 gas stream resulted in activated carbon production. Separated products were dried/treated and characterized using several physical examination techniques, such as FT-IR, SEM/EDX, XRD, and Raman spectroscopy in order to study their structure and morphology. Silica and lignocelluloses products were then preliminarily used in the treatment of wastewaters and water-desalination processes

Informal Cairo: Between Islamist Insurgency & the Neglectful State?

From the late 1980s, Islamist militants established a ‘state within the state’ in the Egyptian capital Cairo, situated in ‘informal’ neighbourhoods developed without official authorization, planning or public services. After government security forces in late 1992 crushed these efforts in the neighbourhood of Munira Gharbiyya, informal Cairo became pathologized in public discourse as ashwa’iyyat (‘random’ or ‘haphazard’ areas), a zone of socio-spatial disorder threatening Egypt as a whole and demanding state intervention. However, this securitizing move did not lead to heavy-handed intervention against informal Cairo more generally. Following the suppression of the militants, the Mubarak government instead returned to long-term patterns of indifference and neglect that had allowed informal neighbourhoods to flourish since the 1960s. In part, the absence of intervention can be explained in terms of resource constraints and risk avoidance. More profoundly, however, it reflects numerous linkages between informal urbanization and the Egyptian state. The ashwa’iyyat are, to a significant degree, both a consequence of an authoritarian political order and embedded in the informal control stratagems used by Egyptian governments to bolster their rule. Informal Cairo should thus not be understood as a disorderly zone of subaltern dissidence. Rather, the Egyptian state is best seen as facing its own oblique reflection