Nasal pathologies in patients with obstructive sleep apnoea

Nasal obstruction is a frequent condition in patients with obstructive sleep apnoea (OSA). Nasal obstruction leads to mouth breathing, which is thought to destabilise the upper airway to aggravate the condition. Three conditions could be considered as the cause of the nasal breathing obstruction: anatomical conditions of the nose (septum deviation, hypertrophy of the inferior turbinates), chronic rhinosinusitis (CRS) and chronic nasal inflammation caused by allergic rhinitis or non-allergic cellular rhinitis. In this prospective study, we present an evaluation of all these possible rhino-sinusal aspects in OSA patients to correlate different nasal pathologies with nasal obstruction. Fifty patients with a diagnosis of OSA were enrolled in the study. In 70% of OSA patients, nasal obstruction was confirmed by clinical evaluation and rhinomanometry testing. Normal rhino-sinus aspects were present in only 20% of OSAS patients, whereas one or more pathological rhino-sinus conditions were present in the remaining 80%. The percentage of OSA patients with a diagnosis of allergic rhinitis and non-allergic rhinitis was 18% and 26% respectively. Non-allergic rhinitis with neutrophils (NARNE) was the most frequent type of cellular rhinitis diagnosed in OSA patients (20% of cases). The results of the present study support and extend the observation that rhinitis is present in OSA patients. Mucosal inflammation caused by these conditions could be the cause of upper airway patency impairment inducing nasal mucosa swellin

Micromixing and microchannel design: Vortex shape and entropy

This paper was presented at the 2nd Micro and Nano Flows Conference (MNF2009), which was held at Brunel University, West London, UK. The conference was organised by Brunel University and supported by the Institution of Mechanical Engineers, IPEM, the Italian Union of Thermofluid dynamics, the Process Intensification Network, HEXAG - the Heat Exchange Action Group and the Institute of Mathematics and its Applications.In very recent years microdevices, due to their potency in replacing large-scale conventional laboratory instrumentation, are becoming a fast and low cost technology for the treatment of several chemical and biological processes. In particular microfluidics has been massively investigated, aiming at improving the performance of chemical reactors. This is because of the fact that reaction is often an interface phenomenon where the greater the surface to volume ratio, the higher the reaction speed, and microscale mixing increases the interfacial area (in terms of mixing-induced-by-vortices generation). However, microfluidic systems suffer from the limitation that they are characterized mostly by very low Reynolds numbers, with the consequence that (i) they cannot take advantage from the turbulence mixing support, and (ii) viscosity hampers proper vortex detection. Therefore, the proper design of micro-channels (MCs) becomes essential. In this framework, several geometries have been proposed to induce mixing vortices in MCs. However a quantitative comparison between proposed geometries in terms of their passive mixing potency can be done only after proper definition of vortex formation (topology, size) and mixing performance. The objective of this study is to test the ability of different fluid dynamic metrics in vortex detection and mixing effectiveness in micromixers. This is done numerically solving different conditions for the flow in a classic passive mixer, a ring shaped MC. We speculate that MCs design could take advantage from fluidic metrics able to rank properly flow related mixing

Physico-chemical and sensory characterization of a fruit beer obtained with the addition of cv. Lambrusco grapes must

In 2015, Italian Grape Ale (IGA) beers have been included as a new provisional sub-category of special-type fruit beers by the Beer Judge Certification Program, including those products whose brewing process is carried out in presence of determined quantities of grape must. However, information on the effects of these additions on the composition of final beers are still scarce. This work is hence focused on the chromatic, volatile, phenolic and sensory characterization of IGA beers obtained with the addition of grape musts during brewing process. To this aim, different amounts of must (5, 10 and 20%) from cv. Lambrusco red grapes were added to a lager wort before primary fermentation. Beers were then characterized by HPLC-MS, GC-MS and sensory analysis in order to determine phenolic and aroma compounds along with their sensory attributes. Results confirmed the addition of must from cv. Lambrusco grapes capable to enrich beers in color, acids, phenolic (up to 7-folded increased) and volatile compounds, while giving complexity to beers. These results, which were confirmed by a trained sensory panel, are among the very first insights on the impact of red grape must in brewing, both from a compositional and sensory point of view

Superconducting properties of mesoscopic cylinders with enhanced surface superconductivity

The superconducting state of an infinitely long superconducting cylinder surrounded by a medium which enhances its superconductivity near the boundary is studied within the nonlinear Ginzburg-Landau theory. This enhancement can be due to the proximity of another superconductor or due to surface treatment. Quantities like the free energy, the magnetization and the Cooper-pair density are calculated. Phase diagrams are obtained to investigate how the critical field and the critical temperature depend on this surface enhancement for different values of the Ginzburg-Landau parameter \kappa. Increasing the superconductivity near the surface leads to higher critical fields and critical temperatures. For small cylinder diameters only giant vortex states nucleate, while for larger cylinders multivortices can nucleate. The stability of these multivortex states also depends on the surface enhancement. For type-I superconductors we found the remarkable result that for a range of values of the surface extrapolation length the superconductor can transit from the Meissner state into superconducting states with vorticity L > 1. Such a behaviour is not found for the case of large \kappa, i.e. type-II superconductivity.Comment: submitted to Phys. Rev.

Phenomenological theory of the 3 Kelvin phase in Sr2RuO4

We model the 3K-phase of Sr2RuO4 with Ru-metal inclusion as interface state with locally enhanced transition temperatures. The resulting 3K-phase must have a different pairing symmetry than the bulk phase of Sr2RuO4, because the symmetry at the interface is lower than in the bulk. It is invariant under time reversal and a second transition, in general, above the onset of bulk superconductivity is expected where time reversal symmetry is broken. The nucleation of the 3K-phase exhibits a ``capillary effect'' which can lead to frustration phenomena for the superconducting states on different Ru-inclusions. Furthermore, the phase structure of the pair wave function gives rise to zero-energy quasiparticle states which would be visible in quasiparticle tunneling spectra. Additional characteristic properties are associated with the upper critical field Hc2. The 3K-phase has a weaker anisotropy of Hc2 between the inplane and z-axis orientation than the bulk superconducting phase. This is connected with the more isotropic nature Ru-metal which yields a stronger orbital depairing effect for the inplane magnetic field than in the strongly layered Sr$_2RuO4. An anomalous temperature dependence for the z-axis critical field is found due to the coupling of the magnetic field to the order parameter texture at the interface. Various other experiments are discussed and new measurements are suggested.Comment: 10 pages, 5 figure

Trans-oral robotic surgery for the management of oropharyngeal carcinomas: A 9-year institutional experience

Trans-oral robotic surgery (TORS) has changed surgical management of patients with oropharyngeal squamous cell carcinomas (OPSCC). In this study we present surgical and oncologic outcomes of patients with oropharyngeal squamous cell carcinomas, treated using TORS, with and without an adjuvant therapy. Sixty patients with oropharyngeal squamous cell carcinomas treated with TORS between January 2008 and December 2017 have been retrospectively evaluated considering clinicopathologic features, disease characteristics, adjuvant treatments and oncological outcomes. TORS was performed for OPSCC to the base of tongue in 41.7%, tonsils in 46.7%, soft palate and posterior pharyngeal wall in 3.3% and 5%, respectively. Neck dissection was performed in 43.3% of patients. Management strategies included surgery alone in 30%, TORS and adjuvant radiotherapy in 33.3%, and TORS plus adjuvant chemotherapy in 36.7%. The 5-year overall survival of the total group was 77.6%, the 5-year disease-free survival rate was 85.2%, and the 5-year local recurrence-free survival rate was 90.6%. Finally, in selected patients TORS appears to yield similar oncologic outcomes and functional outcomes to traditional techniques and non-operative treatment with a possible benefit on long-term quality of life. The future offers exciting opportunities to combine TORS and radiotherapy in unique ways. However, further research is urgently needed to clarify the indications for adjuvant therapy following TORS resections

Does nasal surgery improve multilevel surgical outcome in obstructive sleep apnea:A multicenter study on 735 patients

Objective Does nasal surgery affect multilevel surgical success outcome. Methods Prospective eight country nonrandomized trial of 735 obstructive sleep apnea (OSA) patients, who had multilevel palate and/or tongue surgery, divided into two groups, with or without nose surgery. Results There were 575 patients in nose group, 160 patients in no nose group. The mean age for nose group 44.6 ± 11.4, no nose group 44.2 ± 11.8. Mean preoperative BMI for nose group 27.5 ± 3.6, no nose group 27.5 ± 4.1, mean postoperative BMI nose group 26.3 ± 3.7, no nose group 27.1 ± 3.8 (P = .006). Mean preoperative AHI nose group 32.7 ± 19.4, no nose group 34.3 ± 25.0 (P = .377); and mean postoperative AHI nose group 13.5 ± 10.2, no nose group 17.1 ± 16.0 (P = .001). Mean preoperative ESS nose group was 11.3 ± 4.7, no nose group was 10.4 ± 5.4 (P = .051); and mean postoperative ESS nose group was 5.3 ± 3.2, no nose group was 6.7 ± 2.8 (P = .001). The nose group had higher percentage change (adjusted for age, gender, BMI) in AHI (33.7%, 95% CI 14% to 53.5%) compared to the no nose group (P = .001); the nose group also had more percentage change in ESS (37%, 95% CI 23.6% to 50.3%) compared to the no nose group (P < .001). Change in BMI did not affect AHI nor ESS change (Cohen effect 0.03 and 0.14, respectively). AHI change in both groups were also statistically significant in the mild OSA (P = .008) and the severe OSA (P = .01). Success rate of surgery for the nose group 68.2%, while the no nose group 55.0% (P = .002). Conclusion Combining nose surgery in multilevel surgery improves surgical success. Level of evidence IIC

Sottoprodotti agroalimentari valorizzati con le mosche soldato

Le strategie di gestione degli scarti alimentari si sono finora concentrate principalmente sulla riduzione dei rifiuti, tuttavia la ricerca di nuove forme di valorizzazione rappresenta un\u2019alternativa concreta che apre nuovi scenari di mercato. La capacit\ue0 di alcune specie di insetti di utilizzare un\u2019ampia gamma di substrati organici comunemente considerati come sottoprodotti e rifiuti, rappresenta una delle soluzioni pi\uf9 promettenti per attuare il principio fondante dell\u2019economia circolare. Tra questi vi \ue8 la \u201cmosca soldato nera\u201d (Hermetia illucens, Diptera: Stratiomyidae), una mosca non infestante (gli adulti vivono pochi giorni, non si nutrono e non trasmettono patogeni), le cui larve sono in grado di svilupparsi su un\u2019ampia variet\ue0 di substrati organici ad elevato contenuto di umidit\ue0. Per sfruttare le potenzialit\ue0 delle mosche soldato nel ricavare nutrienti ad alto valore energetico utilizzabili sia in ambito alimentare/mangimistico, sia come combustibili, sia come ammendanti per l\u2019agricoltura \ue8 stato creato, nel solco dei Gruppi Operativi per l\u2019Innovazione (GOI) del partenariato PEI AGRI, il progetto BIOECO-FLIES, un gruppo di ricerca coordinato da CRPV (Centro Ricerche Produzioni Vegetali) e finanziato dalla Regione Emilia Romagna (PSR 2014-2020 Mis. 16.01 Focus Area 5C), che vede coinvolti diversi enti di ricerca pubblici e privati: Universit\ue0 di Modena e Reggio Emilia (UNIMORE), Universit\ue0 di Parma (UNIPR) e la societ\ue0 Astra Innovazione e Sviluppo. Partendo dai sottoprodotti della lavorazione di prodotti ortofrutticoli e olivicoli forniti dalle imprese agricole del GOI quali Consorzio Agribologna, C.A.B. Cooperativa agricola Brisighellese, Conserve Italia, ed altre aziende agricole del territorio Emiliano-Romagnolo, il progetto ha ottimizzato le caratteristiche quali-quantitative delle mosche soldato allevate in relazione alla stagionalit\ue0 dei sottoprodotti; inoltre, sono stati valutati i processi estrattivi applicabili per ottenere una separazione efficiente delle frazioni, le possibilit\ue0 di impiego di tali frazioni, e la sostenibilit\ue0 ambientale ed economica dell\u2019intero process

Albatrosses Following Fishing Vessels: How Badly Hooked Are They on an Easy Meal?

Fisheries have major impacts on seabirds, both by changing food availability and by causing direct mortality of birds during trawling and longline setting. However, little is known about the nature and the spatial-temporal extent of the interactions between individual birds and vessels. By studying a system in which we had fine-scale data on bird movements and activity, and near real-time information on vessel distribution, we provide new insights on the association of a threatened albatross with fisheries. During early chick-rearing, black-browed albatrosses Thalassarche melanophris from two different colonies (separated by only 75 km) showed significant differences in the degree of association with fisheries, despite being nearly equidistant to the Falklands fishing fleet. Most foraging trips from either colony did not bring tracked individuals close to vessels, and proportionally little time and foraging effort was spent near ships. Nevertheless, a few individuals repeatedly visited fishing vessels, which may indicate they specialise on fisheries-linked food sources and so are potentially more vulnerable to bycatch. The evidence suggests that this population has little reliance on fisheries discards at a critical stage of its nesting cycle, and hence measures to limit fisheries waste on the Patagonian shelf that also reduce vessel attractiveness and the risk of incidental mortality, would be of high overall conservation benefit