Preoperative sleep apnea screening protocol reduces medical emergency team activation in patients with atrial fibrillation.

Study Objectives: The association of in-hospital medical emergency team activation (META) among patients with atrial fibrillation (AF) at risk for obstructive sleep apnea (OSA) is unclear. This study evaluates the performance of the DOISNORE50 sleep questionnaire as an OSA screener for patients with AF and determines the prevalence of META among perioperative patients with underlying AF who have a diagnosis or are at risk for OSA.

Methods: A prospective perioperative cohort of 2,926 patients with the diagnosis of AF was assessed for DOISNORE50 questionnaire screening.

Reduction in medical emergency team activation among postoperative surgical patients at risk for undiagnosed obstructive sleep apnea.

Study Objectives: Obstructive sleep apnea (OSA) is an under-recognized condition that results in morbidity and mortality. Postoperative complications, including medical emergency team activation (META), are disproportionally increased among surgical patients at risk for OSA. A systematic approach is needed to improve provider recognition and treatment, but protocols that demonstrate improvement in META are lacking.

DOISNORE50: a perioperative sleep questionnaire predictive of obstructive sleep apnea and postoperative medical emergency team activation. A learning health system approach to sleep questionnaire development and screening.

Study Objectives: Patients with obstructive sleep apnea (OSA) have a disproportionate increase in postoperative complications and medical emergency team activation (META). We previously introduced DOISNORE50 (iseases, bserved apnea, nsomnia, noring, eck circumference > 18 inches, besity with BMI > 32, = are you male, xcessive daytime sleepiness, = age ≥ 50) from sleep questionnaire ISNORED using features associated with increased odds of META in perioperative patients. Performance of DOISNORE50 (DOISNORE) had yet to be tested.

Hypokalemic Periodic Paralysis Masquerading as a Compressive Neuraxial Lesion Following Lumbar Epidural Placement in a Parturient: A Case Report.

We report the management of a parturient with undiagnosed hypokalemic periodic paralysis (HOKPP) who underwent epidural analgesia for labor, complicated by an unintentional dural puncture, and the eventual use of epidural anesthesia for cesarean delivery. Following discharge, she represented with lower extremity paresis. After being evaluated for a compressive neuraxial lesion, she made a full recovery following potassium repletion.

Food-dependent set-up of the DiDGI® dynamic in vitro system: Correlation with the porcine model for protein digestion of soya-based food.

The present study compared in vivo protein digestion in a miniature pig model with the dynamic in vitro system DiDGI®, using three digestive compartments (stomach, duodenum, and jejunum + ileum). Two soya-based meals-commercial soya milk and tofu-were studied, each with the same macronutrient content but different macrostructures. Our aim was to first deduce from the in vivo experiments in pigs key digestive parameters such as gastric pH, stomach emptying kinetics, and intestinal transit time, in order to design a relevant set-up for the dynamic in vitro system.

Progress in the measurement and reduction of thermal noise in optical coatings for gravitational-wave detectors.

Coating thermal noise is a fundamental limit for precision experiments based on optical and quantum transducers. In this review, after a brief overview of the techniques for coating thermal noise measurements, we present the latest worldwide research activity on low-noise coatings, with a focus on the results obtained at the Laboratoire des Matériaux Avancés. We report new updated values for the , -, and coatings of the Advanced LIGO, Advanced Virgo, and KAGRA detectors, and new results from sputtered , -, -, , , and silicon nitride coatings.

Large and extremely low loss: the unique challenges of gravitational wave mirrors.

This paper describes the making of large mirrors for laser interferometer gravitational wave detectors. These optics, working in the near infrared, are among the best optics ever created and played a crucial role in the first direct detection of gravitational waves from black holes or neutron star fusions.

Preoperative Sleep Questionnaires Identify Medical Emergency Team Activation in Older Adults.

Unlabelled: Patients with obstructive sleep apnea (OSA) have increased postoperative complications that are important for patient safety and healthcare utilization. Questionnaires help identify patients at risk for OSA; however, among older adults who preoperatively self-administered OSA questionnaires, the frequency of postoperative Medical Emergency Team Activation (META), rapid response, code blue, code stroke, is unknown.

Objectives: Identify whether having OSA questionnaires completed by patients is feasible in the preoperative clinic.

Preoperative Laboratory Testing.

Obtaining routine preoperative laboratory tests increases health care costs and has been listed, by the Choosing Wisely Campaign, as one of the top 5 practices anesthesiologists should avoid. Routine testing without clinical indication is not cost-effective and could cause harm and unnecessary delays. Abnormal findings are more likely to be false positive and costly to pursue, introduce new risks, and increase anxiety for the patient.

Optical performance of large-area crystalline coatings.

Given their excellent optical and mechanical properties, substrate-transferred crystalline coatings are an exciting alternative to amorphous multilayers for applications in precision interferometry. The high mechanical quality factor of these single-crystal interference coatings reduces the limiting thermal noise in precision optical instruments such as reference cavities for narrow-linewidth laser systems and interferometric gravitational wave detectors. In this manuscript, we explore the optical performance of GaAs/AlGaAs crystalline coatings transferred to 50.

A Prospective Comparison of Intraluminal and Extraluminal Placement of the 9-French Arndt Bronchial Blocker in Adult Thoracic Surgery Patients.

Objective: To compare the standard intraluminal approach with the placement of the 9-French Arndt endobronchial blocker with an extraluminal approach by measuring the time to positioning and other relevant intraoperative and postoperative parameters.

Design: A prospective, randomized, controlled trial.

Setting: University hospital.

Residual Enoxaparin Activity, Anti-Xa Levels, and Concerns About the American Society of Regional Anesthesia and Pain Medicine Anticoagulation Guidelines.

Currently, the American Society of Regional Anesthesia and Pain Medicine (ASRA) anticoagulation guidelines recommend that before the performance of a neuraxial procedure a minimum of 24 hours should elapse following a treatment dose of enoxaparin (1 mg/kg twice daily or 1.5 mg/kg once daily). The guidelines have since their inception also consistently recommended against the routine use of anti-Xa level monitoring for patients receiving enoxaparin.

Physicians Report Sleep Apnea Infrequently in Older and Older Vulnerable Adults.

Objectives: To determine how often outpatient physician visits detect sleep apnea (SA) in older persons in the United States.

Design: Retrospective Analysis.

Setting: US non hospital and hospital based clinics.

Mirrors used in the LIGO interferometers for first detection of gravitational waves.

For the first time, direct detection of gravitational waves occurred in the Laser Interferometer Gravitational-wave Observatory (LIGO) interferometers. These advanced detectors require large fused silica mirrors with optical and mechanical properties and have never been reached until now. This paper details the main achievements of these ion beam sputtering coatings.

Breakdown pathways during oral processing of different breads: impact of crumb and crust structures.

Oral processing during bread consumption is a key process related to the dynamics of texture perceptions, sensory stimuli release and starch digestion. The aim of this study was to determine the respective contribution of bread properties (composition and structure of crumb and crust) and of the oral physiology of subjects to the breakdown pathways in the mouth. The properties of the in vivo bread bolus obtained from eight healthy subjects were studied at three key points in time during their oral processing.

Cellular models and therapies for age-related macular degeneration.

Age-related macular degeneration (AMD) is a complex neurodegenerative visual disorder that causes profound physical and psychosocial effects. Visual impairment in AMD is caused by the loss of retinal pigmented epithelium (RPE) cells and the light-sensitive photoreceptor cells that they support. There is currently no effective treatment for the most common form of this disease (dry AMD).

New compstatin peptides containing N-terminal extensions and non-natural amino acids exhibit potent complement inhibition and improved solubility characteristics.

Compstatin peptides are complement inhibitors that bind and inhibit cleavage of complement C3. Peptide binding is enhanced by hydrophobic interactions; however, poor solubility promotes aggregation in aqueous environments. We have designed new compstatin peptides derived from the W4A9 sequence (Ac-ICVWQDWGAHRCT-NH2, cyclized between C2 and C12), based on structural, computational, and experimental studies.

Novel compstatin family peptides inhibit complement activation by drusen-like deposits in human retinal pigmented epithelial cell cultures.

We have used a novel human retinal pigmented epithelial (RPE) cell-based model that mimics drusen biogenesis and the pathobiology of age-related macular degeneration to evaluate the efficacy of newly designed peptide inhibitors of the complement system. The peptides belong to the compstatin family and, compared to existing compstatin analogs, have been optimized to promote binding to their target, complement protein C3, and to enhance solubility by improving their polarity/hydrophobicity ratios. Based on analysis of molecular dynamics simulation data of peptide-C3 complexes, novel binding features were designed by introducing intermolecular salt bridge-forming arginines at the N-terminus and at position -1 of N-terminal dipeptide extensions.

Bulk optical absorption of high resistivity silicon at 1550 nm.

We report on the measurement of the optical absorption of bulk crystalline silicon at 1550 nm. Using the photodeflection technique, absorption as low as 5 ppm/cm has been measured on a sample with a resistivity of 10 kΩ·cm. The absorption as a function of the resistivity has been derived for n-type silicon.

Cell culture model that mimics drusen formation and triggers complement activation associated with age-related macular degeneration.

We introduce a human retinal pigmented epithelial (RPE) cell-culture model that mimics several key aspects of early stage age-related macular degeneration (AMD). These include accumulation of sub-RPE deposits that contain molecular constituents of human drusen, and activation of complement leading to formation of deposit-associated terminal complement complexes. Abundant sub-RPE deposits that are rich in apolipoprotein E (APOE), a prominent drusen constituent, are formed by RPE cells grown on porous supports.

Twin mirrors for laser interferometric gravitational-wave detectors.

Gravitational-wave detectors such as Virgo and the laser interferometric gravitational-wave observatory (LIGO) use a long-baseline Michelson interferometer with Fabry-Perot cavities in the arms to search for gravitational waves. The symmetry between the two Fabry-Perot cavities is crucial to reduce the interferometer's sensitivity to the laser amplitude and frequency noise. To this purpose, the transmittance of the mirrors in both cavities should be as close as possible.