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There were no differences in the number of EEG arousals associated with sleep-disordered breathing events. These differences also corresponded with quality of life outcomes between the two groups. An ArI with a duration of 5 s or greater had the best combination of sensitivity (70.0%) and specificity (66.7%) compared with the usual 3 s duration (sensitivity and specificity of 70.0% and 53.3%, respectively). Conclusion A re-examination of the EEG arousal scoring rules, and their duration, may help with allocation of health resources to OSA patients most in need.Purpose Increased neck circumference is a major risk factor for obstructive sleep apnea (OSA). New data suggest that increased adipose tissue in the neck may be a contributory cause of OSA. The aim of this study was to investigate safety and efficacy of a recently developed injectable ice slurry in selective reduction of neck adipose tissue in a mouse model. Methods We used the New Zealand obese mice that have increased volume of anterior neck fat, and are commonly used in OSA studies. MRI imaging was used to measure changes in fat tissue volume. Results Thirty animals were used in this study. Volumetric measurements in MRI images showed thatchanges in anterior neck adipose tissue volume from baseline in treated mice was significantly different in comparison with the control group (-1.09/kg ± 0.33/kg vs 0.68/kg ± 0.37/kg; p less then 0.01 by two-tailed Student's t test). Histological analysis of samples from the treated area of the neck did not show scarring or damage to the surrounding tissues. Conclusions Injection of ice slurry safely, effectively, and selectively reduces upper airway fat in New Zealand obese mice without scarring or damage to surrounding tissue. Our results suggest that slurry injection may be a novel and minimally invasive method of removing neck adipose tissue. This intervention should be further investigated to determine its suitability for treatment of OSA.Exploring the different mechanisms involved in the application of actinide is necessary to obtain a more comprehensive understanding of actinide science. In this study, the mechanisms of gas-phase Np and Pu atoms dissociating NH3 molecules forming Neptunimine and Plutonimine complexes were systematically investigated using different approaches of density functional theory. A new dehydrogenation channel was discovered. The results reveal that the intermediates HAn-NH2 are the lowest energy in the overall reaction, and the direct planar evolution dehydrogenations are the lowest energy reaction path. Besides, the mechanism of the initial complexation process is discussed on the electron localization function, atoms-in-molecules, atomic dipole moment corrected Hirshfeld atomic charges, and electron density difference analysis. The results indicate that An-N in complex I exhibits a very weak covalent interaction, and it comes down to pulling the original dipole moment of the NH3 molecule and stretched between An atom and three H atoms. Graphical abstract.Abiotrophia defectiva is a rare pathogen of infective endocarditis (IE) but is frequently involved in embolic complication and valvular dysfunction. IE caused by A. defectiva in children is poorly studied. This study reports four cases of A. defectiva IE in children and reviews previously reported five pediatric cases of A. defectiva IE. Most of the patients presented with a subacute course, with prolonged fever or atypical symptoms. Eight patients had embolic complications at presentation. All nine children were treated with combination antimicrobial therapy and six of them received surgical intervention. All patients recovered well without relapse. A. defectiva should be considered in children with infective endocarditis, especially in those with atypical presentations. As complications are frequent and more than half of the patients need surgical treatment, prompt diagnosis along with appropriate treatment is necessary.We report a case of sudden death due to systemic sarcoidosis in a fifty-four year old male who was reportedly healthy. A computerized tomography (CT) scan was performed before the autopsy. It showed cardiomegaly with hilar and abdominal lymphadenopathy. The autopsy showed pale yellow plaque deposition on the heart surface which was infiltrating the myocardium. Histological examination of the heart, lungs, liver, and spleen showed extensive sarcoid granulomata which helped in establishing the cause of death.Background and objectives The vaccine adjuvant, AS04, present in bivalent human papilloma virus (bHPV) vaccines, induces greater local immune responses than the aluminum adjuvant in quadrivalent HPV (qHPV) vaccines. see more These distinctions might also result in disparities in immunogenicity and responsiveness, possibly contributing to differences in adverse events (AEs) between these vaccines. Here we comparatively analyzed AEs between qHPV and bHPV vaccines based on 10-year real-world AE data. Methods We evaluated the Korea Adverse Events Reporting System (KAERS), a nationwide drug database including vaccines from January 2007 to December 2016, analyzing AEs reported for qHPV and bHPV vaccines. Vaccine-AE pairs were generated, and the characteristics of all reported AEs were analyzed. Signals were derived using the disproportionality method of signal detection algorithms (reporting odds ratios and information component). Results Of the total 2566 HPV vaccine-associated AE reports, 2686 and 1994 were vaccine-AE pairs for qHPV and bHPV, respectively. Application site disorders were the most frequent AEs for both vaccines but were more frequently reported with the bHPV vaccine. The characteristics of non-application site AEs between the two vaccines were generally similar, but systemic AEs such as fever and fatigue were more common with the bHPV vaccine. Tremor, rash, eye pain, myopathy and circulatory failure were identified as signals in both qHPV and bHPV vaccines. Conclusions Both application site disorders and systemic AEs were somewhat more frequent with the bHPV vaccine than with the qHPV vaccine. This might be caused by an immune response induced by adjuvants contained within the vaccines.
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