Type of Mask May Impact on Continuous Positive Airway Pressure Adherence in Apneic Patients.

Type of mask may impact on continuous positive airway pressure adherence in apneic patients.

PLoS One. 2013; 8(5): e64382
Borel JC, Tamisier R, Dias-Domingos S, Sapene M, Martin F, Stach B, Grillet Y, Muir JF, Levy P, Series F, Pepin JL,

In obstructive sleep apnea patients (OSA), continuous positive airway pressure (CPAP) adherence is crucial to improve symptoms and cardiometabolic outcomes. The choice of mask may influence CPAP adherence but this issue has never been addressed properly.To evaluate the impact of nasal pillows, nasal and oronasal masks on CPAP adherence in a cohort of OSA.Newly CPAP treated OSA participating in “Observatoire Sommeil de la Fédération de Pneumologie”, a French national prospective cohort, were included between March 2009 and December 2011. Anthropometric data, medical history, OSA severity, sleepiness, depressive status, treatment modalities (auto-CPAP versus fixed pressure, pressure level, interface type, use of humidifiers) and CPAP-related side effects were included in multivariate analysis to determine independent variables associated with CPAP adherence.2311 OSA (age?=?57(12) years, apnea+hypopnea index?=?41(21)/h, 29% female) were included. Nasal masks, oronasal masks and nasal pillows were used by 62.4, 26.2 and 11.4% of the patients, respectively. In univariate analysis, oronasal masks and nasal pillows were associated with higher risk of CPAP non-adherence. CPAP non-adherence was also associated with younger age, female gender, mild OSA, gastroesophageal reflux, depression status, low effective pressure and CPAP-related side effects. In multivariate analysis, CPAP non-adherence was associated with the use of oronasal masks (OR?=?2.0; 95%CI?=?1.6; 2.5), depression, low effective pressure, and side effects.As oronasal masks negatively impact on CPAP adherence, a nasal mask should be preferred as the first option. Patients on oronasal masks should be carefully followed. HubMed – depression


Context and time in causal learning: contingency and mood dependent effects.

PLoS One. 2013; 8(5): e64063
Msetfi RM, Wade C, Murphy RA

Defining cues for instrumental causality are the temporal, spatial and contingency relationships between actions and their effects. In this study, we carried out a series of causal learning experiments that systematically manipulated time and context in positive and negative contingency conditions. In addition, we tested participants categorized as non-dysphoric and mildly dysphoric because depressed mood has been shown to affect the processing of all these causal cues. Findings showed that causal judgements made by non-dysphoric participants were contextualized at baseline and were affected by the temporal spacing of actions and effects only with generative, but not preventative, contingency relationships. Participants categorized as dysphoric made less contextualized causal ratings at baseline but were more sensitive than others to temporal manipulations across the contingencies. These effects were consistent with depression affecting causal learning through the effects of slowed time experience on accrued exposure to the context in which causal events took place. Taken together, these findings are consistent with associative approaches to causal judgement. HubMed – depression


Three-Dimensional, High-Resolution Skeletal Kinematics of the Avian Wing and Shoulder during Ascending Flapping Flight and Uphill Flap-Running.

PLoS One. 2013; 8(5): e63982
Baier DB, Gatesy SM, Dial KP

Past studies have shown that birds use their wings not only for flight, but also when ascending steep inclines. Uphill flap-running or wing-assisted incline running (WAIR) is used by both flight-incapable fledglings and flight-capable adults to retreat to an elevated refuge. Despite the broadly varying direction of travel during WAIR, level, and descending flight, recent studies have found that the basic wing path remains relatively invariant with reference to gravity. If so, joints undergo disparate motions to maintain a consistent wing path during those specific flapping modes. The underlying skeletal motions, however, are masked by feathers and skin. To improve our understanding of the form-functional relationship of the skeletal apparatus and joint morphology with a corresponding locomotor behavior, we used XROMM (X-ray Reconstruction of Moving Morphology) to quantify 3-D skeletal kinematics in chukars (Alectoris chukar) during WAIR (ascending with legs and wings) and ascending flight (AF, ascending with wings only) along comparable trajectories. Evidence here from the wing joints demonstrates that the glenohumeral joint controls the vast majority of wing movements. More distal joints are primarily involved in modifying wing shape. All bones are in relatively similar orientations at the top of upstroke during both behaviors, but then diverge through downstroke. Total excursion of the wing is much smaller during WAIR and the tip of the manus follows a more vertical path. The WAIR stroke appears “truncated” relative to ascending flight, primarily stemming from ca. 50% reduction in humeral depression. Additionally, the elbow and wrist exhibit reduced ranges of angular excursions during WAIR. The glenohumeral joint moves in a pattern congruent with being constrained by the acrocoracohumeral ligament. Finally, we found pronounced lateral bending of the furcula during the wingbeat cycle during ascending flight only, though the phasic pattern in chukars is opposite of that observed in starlings (Sturnus vulgaris). HubMed – depression


Yohimbine Promotes Cardiac NE Release and Prevents LPS-Induced Cardiac Dysfunction via Blockade of Presynaptic ?2A-Adrenergic Receptor.

PLoS One. 2013; 8(5): e63622
Wang Y, Yu X, Wang F, Wang Y, Wang Y, Li H, Lv X, Lu D, Wang H

Myocardial depression is an important contributor to mortality in sepsis. We have recently demonstrated that ?2-adrenoceptor (AR) antagonist, yohimbine (YHB), attenuates lipopolysaccharide (LPS)-induced myocardial depression. However, the mechanisms for this action of YHB are unclear. Here, we demonstrated that YHB decreased nitric oxide (NO) and tumor necrosis factor-alpha (TNF-?) levels in the myocardium and plasma, attenuated cardiac and hepatic dysfunction, but not kidney and lung injuries in endotoxemic mice. Immunohistochemical analysis revealed that cardiac ?2A-AR was mostly located in sympathetic nerve presynaptic membrane; YHB decreased cardiac ?2A-AR level and promoted cardiac norepinephrine (NE) release in endotoxemic mice. Reserpine that exhausted cardiac NE without markedly decreasing plasma NE level abrogated the inhibitory effects of YHB on cardiac TNF-? and iNOS expression as well as cardiac dysfunction, but not the suppressive effects of YHB on plasma TNF-? and NO elevation in LPS-challenged mice. Furthermore, both reserpine and YHB significantly inhibited LPS-induced myocardial apoptosis. ?1-AR, ?2-AR, but not ?1-AR antagonists reversed the inhibitory effect of YHB on LPS-stimulated myocardial apoptosis. However, ?1-AR antagonist attenuated LPS-caused cardiomyocyte apoptosis, partly abolished the protective effect of YHB on the left ventricular ejection fraction in endotoxemic mice. Altogether, these findings indicate that YHB attenuates LPS-induced cardiac dysfunction, at least in part, through blocking presynaptic ?2A-AR and thus increasing cardiac NE release. YHB-elevated cardiac NE improves cardiac function via suppressing cardiac iNOS and TNF-? expression, activating ?1-AR and inhibiting cardiomyocyte apoptosis through ?1- and ?2-AR in endotoxemic mice. However, cardiac ?1-AR activation promotes LPS-induced cardiomyocyte apoptosis. HubMed – depression