Protocol of the SOMNIA project : an observational study to create a neurophysiological database for advanced clinical sleep monitoring

Introduction Polysomnography (PSG) is the primary tool for sleep monitoring and the diagnosis of sleep disorders. Recent advances in signal analysis make it possible to reveal more information from this rich data source. Furthermore, many innovative sleep monitoring techniques are being developed that are less obtrusive, easier to use over long time periods and in the home situation. Here, we describe the methods of the Sleep and Obstructive Sleep Apnoea Monitoring with Non-Invasive Applications (SOMNIA) project, yielding a database combining clinical PSG with advanced unobtrusive sleep monitoring modalities in a large cohort of patients with various sleep disorders. The SOMNIA database will facilitate the validation and assessment of the diagnostic value of the new techniques, as well as the development of additional indices and biomarkers derived from new and/or traditional sleep monitoring methods. Methods and analysis We aim to include at least 2100 subjects (both adults and children) with a variety of sleep disorders who undergo a PSG as part of standard clinical care in a dedicated sleep centre. Full-video PSG will be performed according to the standards of the American Academy of Sleep Medicine. Each recording will be supplemented with one or more new monitoring systems, including wrist-worn photoplethysmography and actigraphy, pressure sensing mattresses, multimicrophone recording of respiratory sounds including snoring, suprasternal pressure monitoring and multielectrode electromyography of the diaphragm

Endoscopic Versus Surgical Step-Up Approach for Infected Necrotizing Pancreatitis (ExTENSION):Long-term Follow-up of a Randomized Trial

Background & Aims: Previous randomized trials, including the Transluminal Endoscopic Step-Up Approach Versus Minimally Invasive Surgical Step-Up Approach in Patients With Infected Pancreatic Necrosis (TENSION) trial, demonstrated that the endoscopic step-up approach might be preferred over the surgical step-up approach in patients with infected necrotizing pancreatitis based on favorable short-term outcomes. We compared long-term clinical outcomes of both step-up approaches after a period of at least 5 years. Methods: In this long-term follow-up study, we reevaluated all clinical data on 83 patients (of the originally 98 included patients) from the TENSION trial who were still alive after the initial 6-month follow-up. The primary end point, similar to the TENSION trial, was a composite of death and major complications. Secondary end points included individual major complications, pancreaticocutaneous fistula, reinterventions, pancreatic insufficiency, and quality of life. Results: After a mean follow-up period of 7 years, the primary end point occurred in 27 patients (53%) in the endoscopy group and in 27 patients (57%) in the surgery group (risk ratio [RR], 0.93; 95% confidence interval [CI], 0.65–1.32; P = .688). Fewer pancreaticocutaneous fistulas were identified in the endoscopy group (8% vs 34%; RR, 0.23; 95% CI, 0.08–0.83). After the initial 6-month follow-up, the endoscopy group needed fewer reinterventions than the surgery group (7% vs 24%; RR, 0.29; 95% CI, 0.09–0.99). Pancreatic insufficiency and quality of life did not differ between groups. Conclusions: At long-term follow-up, the endoscopic step-up approach was not superior to the surgical step-up approach in reducing death or major complications in patients with infected necrotizing pancreatitis. However, patients assigned to the endoscopic approach developed overall fewer pancreaticocutaneous fistulas and needed fewer reinterventions after the initial 6-month follow-up. Netherlands Trial Register no: NL8571

Impact of the synthesis route of supported copper catalysts on the performance in the methanol synthesis reaction

Two Cu/SiO2 methanol synthesis catalysts were synthesized, one via precipitation and one via impregnation. The copper particle size distribution and local copper weight loading were similar for both catalysts. Electron tomography revealed for the precipitated catalyst a plate-like silica structure with copper particles partially entrapped, whereas for the impregnated catalyst the copper particles were located in the pores between the primary particles of a silica gel. The precipitated catalyst displayed a lower initial copper weight normalized activity and a higher stability in the methanol synthesis reaction (40 bar, 260 ??C). Copper particle growth during reaction, as determined by transmission electron microscopy, was more limited for the precipitated catalyst, in line with the higher catalyst stability, possibly due to the partial entrapment of the copper particles. In addition to copper particle growth, deactivation of both catalysts was ascribed to restructuring of the silica resulting in partial coverage of the copper surface

Recurrent neural network for classification of snoring and non-snoring sound events

Obstructive sleep apnea (OSA) is a disorder that affects up to 38% of the western population. It is characterized by repetitive episodes of partial or complete collapse of the upper airway during sleep. These episodes are almost always accompanied by loud snoring. Questionnaires such as STOP-BANG exploit snoring to screen for OSA. However, they are not quantitative and thus do not exploit its full potential. A method for automatic detection of snoring in whole-night recordings is required to enable its quantitative evaluation. In this study, we propose such a method. The centerpiece of the proposed method is a recurrent neural network for modeling of sequential data with variable length. Mel-frequency cepstral coefficients, which were extracted from snoring and non-snoring sound events, were used as inputs to the proposed network. A total of 20 subjects referred to clinical sleep recording were also recorded by a microphone that was placed 70 cm from the top end of the bed. These recordings were used to assess the performance of the proposed method. When it comes to the detection of snoring events, our results show that the proposed method has an accuracy of 95%, sensitivity of 92%, and specificity of 98%. In conclusion, our results suggest that the proposed method may improve the process of snoring detection and with that the process of OSA screening. Follow-up clinical studies are required to confirm this potential

Support Functionalization To Retard Ostwald Ripening in Copper Methanol Synthesis Catalysts

A main reason for catalyst deactivation in supported catalysts for methanol synthesis is copper particle growth. We have functionalized the support surface in order to suppress the formation and/or transport of mobile copper species and thereby catalyst deactivation. A Stöber silica support was functionalized by treatment with aminopropyltriethoxysilane, which introduces aminopropyl groups on the surface. Copper was deposited on both unfunctionalized and functionalized Stöber silica via incipient wetness impregnation with aqueous copper nitrate solutions followed by drying and calcination. Similar particle size distributions (1−5 nm) were obtained for both supports by changing the flow of N2 to a flow of 2% NO/N2 during calcination of the unfunctionalized and amine functionalized silica, respectively. The effect of support functionalization with aminopropyl groups was an increased stability in the methanol synthesis reaction (40 bar, 260 °C, 23% CO/7% CO2/60% H2/10% Ar, 3% COx conversion) due to more limited copper particle growth as determined by transmission electron microscopy (TEM). Changing the interparticle distance did not have an influence on the deactivation rate, while the addition of few very large copper particles did, indicating that Ostwald ripening was most probably the dominant particle growth mechanism for these samples. In situ TEM images showed the contact angle between the reduced copper particles and the support. As shape and size was similar on silica as on amine-functionalized silica, the thermodynamic stability of the copper particles was unaltered. The driving force for copper particle growth was thus unchanged upon functionalization. We therefore suggest that Ostwald ripening in methanol synthesis catalysts was retarded by inhibiting the transport of copper species over the support surface. Diffuse reflectance infrared Fourier transform spectroscopy (DRIFTS) revealed a decrease in the number of surface groups (hydroxyl, methoxy, and aminopropyl) upon functionalization because aminopropyltriethoxysilane reacted with multiple hydroxyl groups. Because of that, the distance between neighboring functional groups was increased, suppressing the mobility of Ostwald ripening species from one copper particle to another

Recurrent neural network for classification of snoring and non-snoring sound events

\u3cp\u3eObstructive sleep apnea (OSA) is a disorder that affects up to 38% of the western population. It is characterized by repetitive episodes of partial or complete collapse of the upper airway during sleep. These episodes are almost always accompanied by loud snoring. Questionnaires such as STOP-BANG exploit snoring to screen for OSA. However, they are not quantitative and thus do not exploit its full potential. A method for automatic detection of snoring in whole-night recordings is required to enable its quantitative evaluation. In this study, we propose such a method. The centerpiece of the proposed method is a recurrent neural network for modeling of sequential data with variable length. Mel-frequency cepstral coefficients, which were extracted from snoring and non-snoring sound events, were used as inputs to the proposed network. A total of 20 subjects referred to clinical sleep recording were also recorded by a microphone that was placed 70 cm from the top end of the bed. These recordings were used to assess the performance of the proposed method. When it comes to the detection of snoring events, our results show that the proposed method has an accuracy of 95%, sensitivity of 92%, and specificity of 98%. In conclusion, our results suggest that the proposed method may improve the process of snoring detection and with that the process of OSA screening. Follow-up clinical studies are required to confirm this potential.\u3c/p\u3

Support Functionalization To Retard Ostwald Ripening in Copper Methanol Synthesis Catalysts

A main reason for catalyst deactivation in supported catalysts for methanol synthesis is copper particle growth. We have functionalized the support surface in order to suppress the formation and/or transport of mobile copper species and thereby catalyst deactivation. A Stober silica support was functionalized by treatment with aminopropyltriethoxysilane, which introduces aminopropyl groups on the surface. Copper was deposited on both unfunctionalized and functionalized Stober silica via incipient wetness impregnation with aqueous copper nitrate solutions followed by drying and calcination. Similar particle size distributions (1-5 nm) were obtained for both supports by changing the flow of N-2 to a flow of 2% NO/N-2 during calcination of the unfunctionalized and amine-functionalized silica, respectively. The effect of support functionalization with aminopropyl groups was an increased stability in the methanol synthesis reaction (40 bar, 260 degrees C, 23% CO/7% CO2/60% H-2/10% Ar, 3% COx conversion) due to more limited copper particle growth as determined by transmission electron microscopy (TEM). Changing the interparticle distance did not have an influence on the deactivation rate, while the addition of few very large copper particles did, indicating that Ostwald ripening was most probably the dominant particle growth mechanism for these samples. In situ TEM images showed the contact angle between the reduced copper particles and the support. As shape and size was similar on silica as on amine-functionalized silica, the thermodynamic stability of the copper particles was unaltered. The driving force for copper particle growth was thus unchanged upon functionalization. We therefore suggest that Ostwald ripening in methanol synthesis catalysts was retarded by inhibiting the transport of copper species over the support surface. Diffuse reflectance infrared Fourier transform spectroscopy (DRIFTS) revealed a decrease in the number of surface groups (hydroxyl, methoxy, and aminopropyl) upon functionalization because aminopropyltriethoxysilane reacted with multiple hydroxyl groups. Because of that, the distance between neighboring functional groups was increased, suppressing the mobility of Ostwald ripening species from one copper particle to another

Reversibility of the hydrogen desorption from nabh(4) by confinement in nanoporous carbon

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