The Effects of Nocturnal Hypoxemia on Cognitive Performance in Andean Highlanders.

Many Andean highlanders exposed to chronic hypoxemia are susceptible to excessive erythrocytosis (EE) and chronic mountain sickness (CMS). Nocturnal hypoxemia is more marked than diurnal hypoxemia and includes sustained and intermittent components. The potential for cognitive impairments related to nocturnal hypoxemia in this population has not been extensively studied, but improved understanding may provide opportunities for the prevention of long-term effects of EE and CMS.

Combination Drug Therapy with Acetazolamide, Eszopiclone +/- Venlafaxine for Obstructive Sleep Apnea (RESCUE-Combo): A Randomized, Double-blind, Placebo-controlled Trial.

Introduction: Acetazolamide, eszopiclone, and venlafaxine may target different underlying mechanisms of obstructive sleep apnea (OSA) and individually may partially improve OSA severity in select patients. We tested whether acetazolamide+eszopiclone (DualRx) improves OSA severity. We further explored whether addition of venlafaxine (TripleRx) improves OSA in patients who do not fully respond to DualRx.

Enhanced production of Fe in massive stars.

Massive stars are a major source of chemical elements in the cosmos, ejecting freshly produced nuclei through winds and core-collapse supernova explosions into the interstellar medium. Among the material ejected, long-lived radioisotopes, such as Fe (iron) and Al (aluminum), offer unique signs of active nucleosynthesis in our galaxy. There is a long-standing discrepancy between the observed Fe/Al ratio by γ-ray telescopes and predictions from supernova models.

First Study of the ^{139}Ba(n,γ)^{140}Ba Reaction to Constrain the Conditions for the Astrophysical i Process.

New astronomical observations point to a nucleosynthesis picture that goes beyond what was accepted until recently. The intermediate "i" process was proposed as a plausible scenario to explain some of the unusual abundance patterns observed in metal-poor stars. The most important nuclear physics properties entering i-process calculations are the neutron-capture cross sections and they are almost exclusively not known experimentally.

Performance of a commercial smart watch compared to polysomnography reference for overnight continuous oximetry measurement and sleep apnea evaluation.

Study Objectives: We evaluated the accuracy and precision of continuous overnight oxygen saturation (SpO) measurement by a commercial wrist device (WD) incorporating high-grade sensors and investigated WD estimation of sleep-disordered breathing by quantifying overnight oxygen desaturation index compared to polysomnography (PSG) oxygen desaturation index and apnea-hypopnea index (AHI) with and without sleep questionnaire data to assess the WD's ability to detect obstructive sleep apnea and determine its severity.

Methods: Participants completed sleep questionnaires, had a WD (Samsung Galaxy Watch 4) placed on their wrist, and underwent attended, in-laboratory overnight PSG (Nihon Kohden) with a pulse oximetry probe secured either to a finger or an ear lobe. PSG data were scored by a single experienced registered PSG technologist.

Upper airway imaging and function in obstructive sleep apnea in people with and without HIV.

Obstructive sleep apnea (OSA) is common in people living with human immunodeficiency virus (HIV) (PLWH), but the underlying mechanisms are unclear. With improved long-term survival among PLWH, aging and obesity are increasingly prevalent in this population. These are also strong risk factors for the development of obstructive sleep apnea.

The prevalence of sleep-disordered breathing and associated risk factors in patients with decompensated congestive heart failure in Mozambique.

Study Objectives: Sleep-disordered breathing (SDB) is common in patients with congestive heart failure and has important implications regarding symptoms and prognosis. However, the burden of SDB on those with heart failure has not been well characterized in developing countries, including Mozambique in sub-Saharan Africa. Diagnosing SDB in individuals with congestive heart failure is important because treatment of SDB may improve outcomes.

The language of sleepiness in obstructive sleep apnea beyond the Epworth.

Purpose: Obstructive sleep apnea (OSA) is underdiagnosed, partially from variable clinical presentations. Emphasis is often placed on Epworth Sleepiness Scale (ESS), a subjective measure of sleepiness, but variable in OSA. We hypothesized that daytime complaints measured with Language of Sleepiness Questionnaire (LOS) in OSA are not being captured by ESS.

Isovolemic hemodilution in chronic mountain sickness acutely worsens nocturnal oxygenation and sleep apnea severity.

Study Objectives: Chronic mountain sickness (CMS) is commonly observed among Andean and other highland populations. Sleep-disordered breathing (SDB) is highly prevalent at high altitude, and SDB and nocturnal hypoxemia have been observed in CMS. Phlebotomy is commonly performed to treat CMS, but it is unknown whether reducing hematocrit improves SDB.

Compassion fatigue, compassion satisfaction, and burnout: A study of nurses in a large Texas health-care system.

Purpose: The purpose of this study is to examine compassion satisfaction, compassion fatigue, and burnout in nurses at a large nonprofit, Catholic-based health-care system in southern Texas.

Design And Methods: This is a cross-sectional, exploratory study using a self-report survey. The survey included a demographic questionnaire and the Professional Quality of Life Scale version 5 (ProQOL 5).

Point-of-care prediction model of loop gain in patients with obstructive sleep apnea: development and validation.

Background: High loop gain (unstable ventilatory control) is an important-but difficult to measure-contributor to obstructive sleep apnea (OSA) pathogenesis, predicting OSA sequelae and/or treatment response. Our objective was to develop and validate a clinical prediction tool of loop gain.

Methods: A retrospective cohort of consecutive adults with OSA (apnea-hypopnea index, AHI > 5/hour) based on in-laboratory polysomnography 01/2017-12/2018 was randomly split into a training and test-set (3:1-ratio).

Time of day, time of sleep, and time on task effects on sleepiness and cognitive performance of bus drivers.

Purpose: Optimal cognitive performance might prevent vehicle accidents. Identifying time-related circadian and homeostatic parameters having an impact on cognitive performance of drivers may be crucial to optimize drivers' performance.

Methods: In this prospective study conducted on bus drivers, two drivers alternated driving during a 24-h round trip and were accompanied by an interviewer.

Passive longitudinal weight and cardiopulmonary monitoring in the home bed.

Home health monitoring has the potential to improve outpatient management of chronic cardiopulmonary diseases such as heart failure. However, it is often limited by the need for adherence to self-measurement, charging and self-application of wearables, or usage of apps. Here, we describe a non-contact, adherence-independent sensor, that when placed beneath the legs of a patient's home bed, longitudinally monitors total body weight, detailed respiratory signals, and ballistocardiograms for months, without requiring any active patient participation.

Pathogenesis of obstructive sleep apnea in people living with HIV.

Obstructive sleep apnea (OSA) is highly prevalent in people living with human immunodeficiency virus (HIV) (PLWH), and it might contribute to frequently reported symptoms and comorbidities. Traditional risk factors for OSA are often absent in PLWH, suggesting that HIV or HIV medications might predispose to OSA. Therefore, we measured the anatomical and nonanatomical traits important for OSA pathogenesis in those with and without HIV.

A Pilot Randomized Controlled Trial of Effect of Genioglossus Muscle Strengthening on Obstructive Sleep Apnea Outcomes.

The genioglossus is a major upper airway dilator muscle. Our goal was to assess the efficacy of upper airway muscle training on Obstructive Sleep Apnea (OSA) as an adjunct treatment. Sixty-eight participants with OSA (AHI > 10/h) were recruited from our clinic.

Statistical uncertainty quantification to augment clinical decision support: a first implementation in sleep medicine.

Machine learning has the potential to change the practice of medicine, particularly in areas that require pattern recognition (e.g. radiology).

Improvements in sleep-disordered breathing during acclimatization to 3800 m and the impact on cognitive function.

Sojourners to high altitude often experience poor sleep quality due to sleep-disordered breathing. Additionally, multiple aspects of cognitive function are impaired at high altitude. However, the impact of acclimatization on sleep-disordered breathing and whether poor sleep is a major contributor to cognitive impairments at high altitude remains uncertain.

The Importance of Mask Selection on Continuous Positive Airway Pressure Outcomes for Obstructive Sleep Apnea. An Official American Thoracic Society Workshop Report.

Continuous positive airway pressure (CPAP) remains the major treatment option for obstructive sleep apnea (OSA). The American Thoracic Society organized a workshop to discuss the importance of mask selection for OSA treatment with CPAP. In this workshop report, we summarize available evidence about the breathing route during nasal and oronasal CPAP and the importance of nasal symptoms for CPAP outcomes.

Relationships Between Chemoreflex Responses, Sleep Quality, and Hematocrit in Andean Men and Women.

Andean highlanders are challenged by chronic hypoxia and many exhibit elevated hematocrit (Hct) and blunted ventilation compared to other high-altitude populations. While many Andeans develop Chronic Mountain Sickness (CMS) and excessive erythrocytosis, Hct varies markedly within Andean men and women and may be driven by individual differences in ventilatory control and/or sleep events which exacerbate hypoxemia. To test this hypothesis, we quantified relationships between resting ventilation and ventilatory chemoreflexes, sleep desaturation, breathing disturbance, and Hct in Andean men and women.