New organisation for follow-up and assessment of treatment efficacy in sleep apnoea

Obstructive sleep apnoea (OSA) is a highly prevalent disease, and there is an increased demand for OSA diagnosis and treatment. However, resources are limited compared with the growing needs for OSA diagnosis and management, and alternative strategies need to be developed to optimise the OSA clinical pathway. In this review, we propose a management strategy for OSA, and in general for sleep-disordered breathing, to be implemented from diagnosis to follow-up. For this purpose, the best current options seem to be: 1) networking at different levels of care, from primary physicians to specialised sleep laboratories; and 2) use of telemedicine. Telemedicine can contribute to the improved cost-effectiveness of OSA management during both the diagnostic and therapeutic phases. However, although the technology is already in place and different commercial platforms are in use, it is still unclear how to use telemedicine effectively in the sleep field. Application of telemedicine for titration of positive airway pressure treatment, follow-up to improve compliance to treatment through early identification and solution of problems, and teleconsultation all appear to be promising areas for improved OSA management

Embarazo a término en mujer con trasplante renal previo

En esta comunicación se presenta la evolución de un embarazo, con parto prematuro de 33-34 semanas, en una enferma que previamente había recibido un trasplante renal

Role of redox environment on the oligomerization of higher molecular weight adiponectin

<p>Abstract</p> <p>Background</p> <p>Adiponectin is an adipocyte-secreted hormone with insulin-sensitizing and anti-inflammatory actions. The assembly of trimeric, hexameric, and higher molecular weight (HMW) species of adiponectin is a topic of significant interest because physiological actions of adiponectin are oligomer-specific. In addition, adiponectin assembly is an example of oxidative oligomerization of multi-subunit protein complexes in endoplasmic reticulum (ER).</p> <p>Results</p> <p>We previously reported that trimers assemble into HMW adiponectin <it>via </it>intermediates stabilized by disulfide bonds, and complete oxidation of available cysteines locks adiponectin in hexameric conformation. In this study, we examined the effects of redox environment on the rate of oligomer formation and the distribution of oligomers. Reassembly of adiponectin under oxidizing conditions accelerated disulfide bonding but favored formation of hexamers over the HMW species. Increased ratios of HMW to hexameric adiponectin could be achieved rapidly under oxidizing conditions by promoting disulfide rearrangement.</p> <p>Conclusions</p> <p>Based upon these observations, we propose oxidative assembly of multi-subunit adiponectin complexes in a defined and stable redox environment is favored under oxidizing conditions coupled with high rates of disulfide rearrangement.</p

Ancient Egypt 1923 Part 2

Part 2 of the 1923 Ancient Egypt books. Contents include the tomb at Byblos, a tomb with Aramaic inscriptions, the British school at Qau, the magic skin, Apries and the possibility of royal blood, and obelisks at Pylon VII.https://knowledge.e.southern.edu/kweeks_coll/1023/thumbnail.jp

Lophomonas blattarum and bronchopulmonary disease

The natural habitat of the multiflagellate protozoon Lophomonas blattarum is as an endocommensal in the hindgut of insects such as cockroaches. However, it also causes bronchopulmonary disease in humans. The aim of this paper was to review the literature on this organism in the context of respiratory disease. The biology epidemiology, route of transmission, pathogenic mechanisms and diagnosis methods are also described. A total of 61 cases were identified in the literature. The majority of these reports were from China, with some cases from Peru and Spain. Most cases were adult males, although paediatric cases were reported in Peru. Clinical presentation was non-specific, including symptoms such as fever, cough and breathless. Antiprotozoal therapy was generally effective

Mechanical durability of hydrophobic surfaces fabricated by injection moulding of laser-induced textures

YesThe paper reports an investigation on the mechanical durability of textured thermoplastic surfaces together with their respective wetting properties. A range of laser-induced topographies with different aspect ratios from micro to nanoscale were fabricated on tool steel inserts using an ultrashort pulsed near infrared laser. Then, through micro-injection moulding the topographies were replicated onto polypropylene surfaces and their durability was studied systematically. In particular, the evolution of topographies on textured thermoplastic surfaces together with their wetting properties were investigated after undergoing a controlled mechanical abrasion, i.e. reciprocating dry and wet cleaning cycles. The obtained empirical data was used both to study the effects of cleaning cycles and also to identify cleaning procedures with a minimal impact on textured thermoplastic surfaces and their respective wetting properties. In addition, the use of 3D areal parameters that are standardised and could be obtained readily with any state-of-the-art surface characterisation system are discussed for monitoring the surfaces' functional response.European Commission H2020 ITN programme “European ESRs Network on Short Pulsed Laser Micro/Nanostructuring of Surfaces for Improved Functional Applications” (Laser4Fun) under the Marie Skłodowska-Curie grant agreement No. 675063 (www.laser4fun.eu) and the UKIERI DST programme “Surface functionalisation for food, packaging, and healthcare applications”. In addition, the work was supported by three other H2020 programmes, i.e. the projects on “Modular laser based additive manufacturing platform for large scale industrial applications” (MAESTRO), “High-Impact Injection Moulding Platform for mass-production of 3D and/or large micro-structured surfaces with Antimicrobial, Self-cleaning, Anti-scratch, Anti-squeak and Aesthetic functionalities” (HIMALAIA) and “Process Fingerprint for Zero-defect Net-shape Micromanufacturing” (MICROMAN)

Projeto tecnologias sociais para a gestão da água ? TSGA: contribuição para a gestão participativa da água.

Projeto: 06.09.06.001

An International Prospective Cohort Study To Validate 2 Prediction Rules for Infections Caused by Third-generation Cephalosporin-resistant Enterobacterales

Background The possibility of bloodstream infections caused by third-generation cephalosporin-resistant Enterobacterales (3GC-R-BSI) leads to a trade-off between empiric inappropriate treatment (IAT) and unnecessary carbapenem use (UCU). Accurately predicting 3GC-R-BSI could reduce IAT and UCU. We externally validate 2 previously derived prediction rules for community-onset (CO) and hospital-onset (HO) suspected bloodstream infections. Methods In 33 hospitals in 13 countries we prospectively enrolled 200 patients per hospital in whom blood cultures were obtained and intravenous antibiotics with coverage for Enterobacterales were empirically started. Cases were defined as 3GC-R-BSI or 3GC-R gram-negative infection (3GC-R-GNI) (analysis 2); all other outcomes served as a comparator. Model discrimination and calibration were assessed. Impact on carbapenem use was assessed at several cutoff points. Results 4650 CO infection episodes were included and the prevalence of 3GC-R-BSI was 2.1% (n = 97). IAT occurred in 69 of 97 (71.1%) 3GC-R-BSI and UCU in 398 of 4553 non–3GC-R-BSI patients (8.7%). Model calibration was good, and the AUC was .79 (95% CI, .75–.83) for 3GC-R-BSI. The prediction rule potentially reduced IAT to 62% (60/97) while keeping UCU comparable at 8.4% or could reduce UCU to 6.3% (287/4553) while keeping IAT equal. IAT and UCU in all 3GC-R-GNIs (analysis 2) improved at similar percentages. 1683 HO infection episodes were included and the prevalence of 3GC-R-BSI was 4.9% (n = 83). Here model calibration was insufficient. Conclusions A prediction rule for CO 3GC-R infection was validated in an international cohort and could improve empirical antibiotic use. Validation of the HO rule yielded suboptimal performance

Enhancing visual motion discrimination by desynchronizing bifocal oscillatory activity

Visual motion discrimination involves reciprocal interactions in the alpha band between the primary visual cortex (V1) and mediotemporal areas (V5/MT). We investigated whether modulating alpha phase synchronization using individualized multisite transcranial alternating current stimulation (tACS) over V5 and V1 regions would improve motion discrimination. We tested 3 groups of healthy subjects with the following conditions: (1) individualized In-Phase V1alpha-V5alpha tACS (0° lag), (2) individualized Anti-Phase V1alpha-V5alpha tACS (180° lag) and (3) sham tACS. Motion discrimination and EEG activity were recorded before, during and after tACS. Performance significantly improved in the Anti-Phase group compared to the In-Phase group 10 and 30Â min after stimulation. This result was explained by decreases in bottom-up alpha-V1 gamma-V5 phase-amplitude coupling. One possible explanation of these results is that Anti-Phase V1alpha-V5alpha tACS might impose an optimal phase lag between stimulation sites due to the inherent speed of wave propagation, hereby supporting optimized neuronal communication