Mandibular advancement devices in the treatment of obstructive sleep apnea syndrome

La apnea del sueño es un trastorno respiratorio, con consecuencias no deseables para la salud, que ocurre durante el sueño cuando se obstruyen o colapsan las vías aéreas superiores. El fenómeno es bien conocido clínicamente, con diagnosis y tratamientos médicos contrastados, pero no existe una metodología sencilla ni los instrumentos y técnicas de análisis necesarias para conocer y valorar cualitativa y cuantitativamente la respuesta física y clínica de una actuación mandibular concreta. En este trabajo se muestra como las técnicas digitales de tratamiento de imágenes, la dinámica de fluidos y la implementación de criterios ingenieriles de diseño importados de otros campos de actividad permiten, a partir de unas imágenes médicas convencionales, establecer una metodología de análisis sencilla útil clínicamente para decidir las actuaciones, de presión o mecánicas, mandibulares más convenientes. La metodología se aplica a un paciente que sufre el síndrome y se estudia el efecto de un dispositivo mandibular (DAM® ), especialmente innovador, premiado científica y empresarialmente en varias ocasiones, que por medio de un avance de la mandíbula, variable y distinto para cada paciente según las necesidades clínicas, provoca una apertura significativa de las vías aéreas superiores.Obstructive sleep apnea syndrome (OSAS) consists in the occurrence of recurrent episodes of airflow limitation during sleep, with undesirable consequences for the health. The phenomenon is well known from a medical point of view (prognosis, diagnosis and treatment), but there is not a methodology or analysis tools for the quantification of the clinical response using Mandibular Advancement Devices (MAD). This paper shows how combining image processing, fluid dynamics and engineering design criteria, imported from other fields, allow to establish a simple analysis method clinically useful to decide the more convenient positioning of the MAD based on the pressure or mechanical movement of the jaw. This methodology is applied to a patient suffering OSAS which the objective to evaluate the changes provoked in the upper-airways due to an innovative mandibular device.Peer Reviewe

Effects of Extracellular Matrix on the Morphology and Behaviour of Rabbit Auricular Chondrocytes in Culture

Isolated chondrocytes dedifferentiate to a fibroblast-like shape on plastic substrata and proliferate extensively, but rarely form nodules. However, when dissociation is not complete and some cartilage remnants are included in the culture, proliferation decreases and cells grow in a reticular pattern with numerous nodules, which occasionally form small cartilage-like fragments. In an attempt to reproduce this stable chondrogenic state, we added a cartilage protein extract, a sugar extract, and hyaluronan to the medium of previously dedifferentiated chondrocytes. When protein extract was added, many cartilaginous nodules appeared. Hyaluronan produced changes in cell phenotype and behaviour, but not nodule formation. Protein extract has positive effects on the differentiation of previously proliferated chondrocytes and permits nodule formation and the extensive production of type-II collagen. A comparison with incompletely dissociated chondrocyte cultures suggests that the presence of some living cells anchored to their natural extracellular matrix provides some important additional factors for the phenotypical stability of chondrocytes on plastic surfaces. In order to elucidate if it is possible that the incidence of apoptosis is related to the results, we also characterized the molecular traits of apoptosis

Supercritical CO2 technology for one-pot foaming and sterilization of polymeric scaffolds for bone regeneration

Sterilization is a quite challenging step in the development of novel polymeric scaffolds for regenerative medicine since conventional sterilization techniques may significantly alter their morphological and physicochemical properties. Supercritical (sc) sterilization, i.e. the use of scCO2 as a sterilizing agent, emerges as a promising sterilization method due to the mild operational conditions and excellent penetration capability. In this work, a scCO2 protocol was implemented for the one-pot preparation and sterilization of poly(-caprolactone) (PCL)/poly(lactic-co-glycolic acid) (PLGA) scaffolds. The sterilization conditions were established after screening against both Gram-positive (Staphylococcus aureus) and Gram-negative (Escherichia coli, Pseudomonas aeruginosa) vegetative bacteria and spores of Bacillus stearothermophilus, Bacillus pumilus and Bacillus atrophaeus. The transition from the sterilization conditions (140 bar, 39 °C) to the compressed foaming (60 bar, 26 °C) was performed through controlled depressurization (3.2 bar/min) and CO2 liquid flow. Controlled depressurization/pressurization cycles were subsequently applied. Using this scCO2 technology toolbox, sterile scaffolds of well-controlled pore architecture were obtained. This sterilization procedure successfully achieved not only SAL-6 against well-known resistant bacteria endospores but also improved the scaffold morphologies compared to standard gamma radiation sterilization proceduresThis work was supported by Xunta de Galicia [ED431F 2016/01, ED431C 2020/17], MCIUN [RTI2018-094131-A-I00], MINECO [SAF2017-83118-R], Consellería de Sanidade, Servizo Galego de Saúde, Axencia de Coñecemento e Saúde (ACIS, CT850A-G), Agencia Estatal de Investigación [AEI] and FEDER funds. V. Santos-Rosales acknowledges to Xunta de Galicia (Consellería de Cultura, Educación e Ordenación Universitaria) for a predoctoral research fellowship [ED481A-2018/014]. C.A. García-González acknowledges to MINECO for a Ramón y Cajal Fellowship [RYC2014-15239]S

The HADES RV Programme with HARPS-N@TNG IV. Time resolved analysis of the Ca ii H&K and H{\alpha} chromospheric emission of low-activity early-type M dwarfs

M dwarfs are prime targets for planet search programs, particularly of those focused on the detection and characterization of rocky planets in the habitable zone. Understanding their magnetic activity is important because it affects our ability to detect small planets, and it plays a key role in the characterization of the stellar environment. We analyze observations of the Ca II H&K and H{\alpha} lines as diagnostics of chromospheric activity for low-activity early-type M dwarfs. We analyze the time series of spectra of 71 early-type M dwarfs collected for the HADES project for planet search purposes. The HARPS-N spectra provide simultaneously the H&K doublet and the H{\alpha} line. We develop a reduction scheme able to correct the HARPS-N spectra for instrumental and atmospheric effects, and to provide flux-calibrated spectra in units of flux at the stellar surface. The H&K and H{\alpha} fluxes are compared with each other, and their variability is analyzed. We find that the H and K flux excesses are strongly correlated with each other, while the H{\alpha} flux excess is generally less correlated with the H&K doublet. We also find that H{\alpha} emission does not increase monotonically with the H&K line flux, showing some absorption before being filled in by chromospheric emission when H&K activity increases. Analyzing the time variability of the emission fluxes, we derive a tentative estimate of the rotation period (of the order of a few tens of days) for some of the program stars, and the typical lifetime of chromospheric active regions (a few stellar rotations). Our results are in good agreement with previous studies. In particular, we find evidence that the chromospheres of early-type M dwarfs could be characterized by different filaments coverage, affecting the formation mechanism of the H{\alpha} line. We also show that chromospheric structure is likely related to spectral type

Epigenetic Mechanisms Regulate MHC and Antigen Processing Molecules in Human Embryonic and Induced Pluripotent Stem Cells

Background Human embryonic stem cells (hESCs) are an attractive resource for new therapeutic approaches that involve tissue regeneration. hESCs have exhibited low immunogenicity due to low levels of Mayor Histocompatibility Complex (MHC) class-I and absence of MHC class-II expression. Nevertheless, the mechanisms regulating MHC expression in hESCs had not been explored. Methodology/Principal Findings We analyzed the expression levels of classical and non-classical MHC class-I, MHC class-II molecules, antigen-processing machinery (APM) components and NKG2D ligands (NKG2D-L) in hESCs, induced pluripotent stem cells (iPSCs) and NTera2 (NT2) teratocarcinoma cell line. Epigenetic mechanisms involved in the regulation of these genes were investigated by bisulfite sequencing and chromatin immunoprecipitation (ChIP) assays. We showed that low levels of MHC class-I molecules were associated with absent or reduced expression of the transporter associated with antigen processing 1 (TAP-1) and tapasin (TPN) components in hESCs and iPSCs, which are involved in the transport and load of peptides. Furthermore, lack of β2-microglobulin (β2m) light chain in these cells limited the expression of MHC class I trimeric molecule on the cell surface. NKG2D ligands (MICA, MICB) were observed in all pluripotent stem cells lines. Epigenetic analysis showed that H3K9me3 repressed the TPN gene in undifferentiated cells whilst HLA-B and β2m acquired the H3K4me3 modification during the differentiation to embryoid bodies (EBs). Absence of HLA-DR and HLA-G expression was regulated by DNA methylation. Conclusions/Significance Our data provide fundamental evidence for the epigenetic control of MHC in hESCs and iPSCs. Reduced MHC class I and class II expression in hESCs and iPSCs can limit their recognition by the immune response against these cells. The knowledge of these mechanisms will further allow the development of strategies to induce tolerance and improve stem cell allograft acceptance

Effect of Fish Oil Parenteral Emulsion Supplementation on Inflammatory Parameters after Esophagectomy

(Background) Esophagectomy (EPG) presents high morbidity and mortality. Omega-3 fatty acids (omega-3FA) are a pharmaconutrient with benefits for postoperative morbidity. Studies of omega-3FA administered parenterally after esophagectomy are scarce. This study proposes to investigate the effect of combining fish oil lipid emulsions (LE) administered parenterally with enteral nutrition support. (Methods) Randomization was 1:1:1 in three groups: Group A received a LE mixture of 0.4 g/kg/day of fish oil and 0.4 g/kg/day of LCT/MCT 50:50, Group B received 0.8 g/kg/day of fish oil LE, and Group C received 0.8 g/kg/day of LCT/MCT 50:50. Variables were measured at recruitment time and day +1, +3, and +5. Inflammatory variables studied were Interlukin-6, C-reactive protein (CRP), tumoral necrosis factor-alpha (TNF-alpha), IL-10, IL-8 and CD25s. Safety, nutritional parameters and complications were analyzed. (Results) Administration of omega-3LE in the immediate postoperative period did not modulate the earlier inflammatory response. Statistically significant differences were found in IL-6 and CRP overall temporal evolution but were not found when studying the type of LE administered or in patients needing critical care. Administration of omega-3 resulted in safe and improved hypertriglyceridemia, depending on the dose. (Conclusions) omega-3FA has no impact on the early inflammatory postoperative response assessed for a short period but was safe. More studies for longer periods are needed

The Imaging Magnetograph eXperiment (IMaX) for the Sunrise balloon-borne solar observatory

The Imaging Magnetograph eXperiment (IMaX) is a spectropolarimeter built by four institutions in Spain that flew on board the Sunrise balloon-borne telesocope in June 2009 for almost six days over the Arctic Circle. As a polarimeter IMaX uses fast polarization modulation (based on the use of two liquid crystal retarders), real-time image accumulation, and dual beam polarimetry to reach polarization sensitivities of 0.1%. As a spectrograph, the instrument uses a LiNbO3 etalon in double pass and a narrow band pre-filter to achieve a spectral resolution of 85 mAA. IMaX uses the high Zeeman sensitive line of Fe I at 5250.2 AA and observes all four Stokes parameters at various points inside the spectral line. This allows vector magnetograms, Dopplergrams, and intensity frames to be produced that, after reconstruction, reach spatial resolutions in the 0.15-0.18 arcsec range over a 50x50 arcsec FOV. Time cadences vary between ten and 33 seconds, although the shortest one only includes longitudinal polarimetry. The spectral line is sampled in various ways depending on the applied observing mode, from just two points inside the line to 11 of them. All observing modes include one extra wavelength point in the nearby continuum. Gauss equivalent sensitivities are four Gauss for longitudinal fields and 80 Gauss for transverse fields per wavelength sample. The LOS velocities are estimated with statistical errors of the order of 5-40 m/s. The design, calibration and integration phases of the instrument, together with the implemented data reduction scheme are described in some detail.Comment: 17 figure

The second flight of the SUNRISE balloon-borne solar observatory: overview of instrument updates, the flight, the data and first results

The SUNRISE balloon-borne solar observatory, consisting of a 1~m aperture telescope that provided a stabilized image to a UV filter imager and an imaging vector polarimeter, carried out its second science flight in June 2013. It provided observations of parts of active regions at high spatial resolution, including the first high-resolution images in the Mg~{\sc ii}~k line. The obtained data are of very high quality, with the best UV images reaching the diffraction limit of the telescope at 3000~\AA\ after Multi-Frame Blind Deconvolution reconstruction accounting for phase-diversity information. Here a brief update is given of the instruments and the data reduction techniques, which includes an inversion of the polarimetric data. Mainly those aspects that evolved compared with the first flight are described. A tabular overview of the observations is given. In addition, an example time series of a part of the emerging active region NOAA AR~11768 observed relatively close to disk centre is described and discussed in some detail. The observations cover the pores in the trailing polarity of the active region, as well as the polarity inversion line where flux emergence was ongoing and a small flare-like brightening occurred in the course of the time series. The pores are found to contain magnetic field strengths ranging up to 2500~G and, while large pores are clearly darker and cooler than the quiet Sun in all layers of the photosphere, the temperature and brightness of small pores approach or even exceed those of the quiet Sun in the upper photosphere.Comment: Accepted for publication in The Astrophysical Journa

Infraestructura tecnológica de servicios semánticos para la Web Semántica

This project aims at creating a network of distributed interoperable semantic services for building more complex ones. These services will be available in semantic Web service libraries, so that they can be invoked by other systems (e.g., semantic portals, software agents, etc.). Thus, to accomplish this objective, the project proposes: a) To create specific technology for developing and composing Semantic Web Services. b) To migrate the WebODE ontology development workbench to this new distributed interoperable semantic service architecture. c) To develop new semantic services (ontology learning, ontology mappings, incremental ontology evaluation, and ontology evolution). d) To develop technological support that eases semantic portal interoperability, using Web services and Semantic Web Services. The project results will be open source, so as to improve their technological transfer. The quality of these results is ensured by a benchmarking process. Keywords: Ontologies and Semantic We