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Adherence is a critical issue in the treatment of obstructive sleep apnea with continuous positive airway pressure (CPAP). Approximately 40% of patients treated with CPAP are at risk of discontinuation or insufficient use (< 4 h/night). Assuming that the first few days on CPAP are critical for continued treatment, we tested the predictive value at day 14 (D14) of the Philips Adherence Profiler™ (AP) algorithm for adherence at 3 months (D90). The AP™ algorithm uses CPAP machine data hosted in the database of EncoreAnywhere™. This retrospective study involved 457 patients (66% men, 60.0 ± 11.9 years; BMI = 31.2 ± 5.9 kg/m2; AHI = 37.8 ± 19.2; Epworth score = 10.0 ± 4.8) from the Pays de la Loire Sleep Cohort. At D90, 88% of the patients were adherent as defined by a mean daily CPAP use of ≥ 4 h. In a univariate analysis, the factors significantly associated with CPAP adherence at D90 were older age, lower BMI, CPAP adherence (≥ 4 h/night) at D14, and AP™ prediction at D14. In a multivariate analysis, only older age (OR 2.10 [1.29–3.41], p = 0.003) and the AP™ prediction at D14 (OR 16.99 [7.26–39.75], p < 0.0001) were significant predictors. CPAP adherence at D90 was not associated with device-derived residual events, nor with the levels of pressure or leakage except in the case of very significant leakage when it persisted for 90 days. Automatic telemonitoring algorithms are relevant tools for early prediction of CPAP therapy adherence and may make it possible to focus therapeutic follow-up efforts on patients who are at risk of non-adherence.

STUDY OBJECTIVES: Thermistors, nasal cannulas, and respiratory inductance plethysmography (RIP) are the recommended reference sensors of the American Academy of Sleep Medicine (AASM) for the detection and characterization of apneas and hypopneas; however, these sensors are not well tolerated by patients and have poor scorability. We evaluated the performance of an alternative method using a combination of tracheal sounds (TSs) and RIP signals. METHODS: Consecutive recordings of 70 adult patients from the Pays de la Loire Sleep Cohort were manually scored in random order using the AASM standard signals and the combination TS and RIP signals, without respiratory sensors placed on the patient’s face. The TS-RIP scoring used the TS and RIP-flow signals for detection of apneas and hypopneas, respectively, and the suprasternal pressure and RIP belt signals for the characterization of apneas. RESULTS: Sensitivity and specificity of the TS-RIP combination were 96.21% and 91.34% for apnea detection and 89.94% and 93.25% for detecting hypopneas, respectively, with a kappa coefficient of 0.87. For the characterization of apneas, sensitivity and specificity were 98.67% and 96.17% for obstructive apneas, 92.66% and 99.36% for mixed apneas, and 96.14% and 98.89% for central apneas, respectively, with a kappa coefficient of 0.94. The TS-RIP scoring revealed a high agreement for classifying obstructive sleep apnea into severity classes (none, mild, moderate, and severe obstructive sleep apnea) with a Cohen’s kappa coefficient of 0.96. CONCLUSIONS: Compared with the AASM reference sensors, the TS-RIP combination allows reliable noninvasive detection and characterization of respiratory events with a high degree of sensitivity and specificity. TS-RIP combination could be used for diagnosis of obstructive sleep apnea in adults, either as an alternative to the AASM sensors or in combination with the recommended AASM sensors. CITATION: Sabil AK, Marien C, LeVaillant M, Baffet G, Meslier N, Gagnadpix F. Diagnosis of sleep apnea without sensors on the patient’s face. J Clin Sleep Med. 2020;16(7):1161–1169.

In Morocco, Leishmania infantum species is the main causative agents of visceral leishmaniasis (VL). However, cutaneous leishmaniasis (CL) due to L. infantum has been reported sporadically. Moreover, the recent geographical expansion of L. infantum in the Mediterranean subregion leads us to suggest whether the nonsporadic cases of CL due to this species are present. In this context, this review is written to establish a retrospective study of cutaneous and visceral leishmaniasis in northern Morocco between 1997 and 2018 and also to conduct a molecular study to identify the circulating species responsible for the recent cases of leishmaniases in this region. Data concerning leishmaniases cases were collected from the Epidemiology and Disease Control Directorate from 1997 to 2018. Human samples obtained from peripheral laboratories were examined using PCR-ITS1 method. The ITS1 products were subjected to digestion with the restriction endonuclease Mn1-I. Between 1997 and 2018, a total of 1,255 cases of cutaneous and visceral leishmaniasis were recorded in Tangier-Tetouan-Al Hoceima Region, i.e., 1.56% of the reported cases in Morocco (1,255/80,299). Concerning the geographical study covering the period 2007-2018, 79.5% (105/132) of the sectors were affected by leishmaniases. The molecular results showed that Humans were found to be infected with the L. infantum species with a high infection rate compared to L. tropica infection. Moreover, molecular characterization using ITS1 PCR-RFLP showed that the density of L. infantum was significantly higher (n = 68/81; 84%) than that of L. tropica (n = 13/81; 16%) (P-value 9.894e-10). While regarding visceral leishmaniasis, L. infantum was the only species responsible of this form. These findings of this study showed the emergence of L. infantum in Morocco and suggest that this species might be more prevalent than previously thought. Furthermore, the molecular determination of L. infantum will be helpful for control strategies by taking into consideration the reservoir of this species.

To determine if recording of suprasternal pressure (SSP) can classify apneas and hypopneas as reliably as respiratory inductance plethysmography (RIP) belts and to compare the two methods to classification with esophageal pressure (Pes), the reference method for assessing respiratory effort. In addition to polysomnographic recordings that included Pes, SSP was recorded. Recordings from 32 patients (25 males, mean age 66.7 ± 15.3 years, and mean BMI 30.1 ± 4.5 kg/m2) were used to compare the classification of detected apneas and hypopneas by three methods of respiratory effort evaluation (Pes, RIP belts, and SSP). Signals were analyzed randomly and independently from each other. All recordings were analyzed according to AASM guidelines. Using Pes as a reference for apnea characterization, the Cohen kappa (κ) was 0.93 for SSP and 0.87 for the RIP. The sensitivity/specificity of SSP was 97.0%/96.9% for obstructive, 93.9%/98.3% for central, and 94.9%/97.9% for mixed apneas. The sensitivity/specificity of the RIP was 97.4%/91.9% for obstructive, 87.5%/97.9% for central, and 85.6%/96.6% for mixed apneas. For hypopnea characterization using the Pes as a reference, κ was 0.92 for SSP and 0.86 for the RIP. The sensitivity/specificity of SSP was 99.7%/97.6% for obstructive and 97.6%/99.7% for central. The sensitivity/specificity of the RIP was 99.8%/81.1% for obstructive and 81.1%/99.8% for central. These results confirm the excellent agreement in the detection of respiratory effort between SSP, RIP belts, and Pes signals. Thus, we conclude that apnea and hypopnea characterization in adults with SSP is a reliable method.

International audience; Manuscript word count: 1,374 "take home" message: Indices of sleep apnoea-related hypoxic burden and heart rate variability derived from full-night polysomnography might be useful for identifying sleep apnoea patients at risk for stroke.

STUDY OBJECTIVES: To assess, in a large cohort of patients with obstructive sleep apnea, the factors that are independently associated with positional obstructive sleep apnea (POSA) and exclusive POSA (e-POSA) and determine their prevalence. The secondary objective was to evaluate the outcome of positive airway pressure (PAP) therapy for patients with POSA and e-POSA. METHODS: This retrospective study included 6,437 patients with typical mild‐to‐severe OSA from the Pays de la Loire sleep cohort. Patients with POSA and e-POSA were compared to those with non-POSA for clinical and polysomnographic characteristics. In a subgroup of patients (n = 3,000) included in a PAP follow-up analysis, we determined whether POSA and e-POSA phenotypes were associated with treatment outcomes at 6 months. RESULTS: POSA and e-POSA had a prevalence of 53.5% and 20.1%, respectively, and were independently associated with time in supine position, male sex, younger age, lower apnea-hypopnea index and lower body mass index. After adjustment for confounding factors, patients with POSA and e-POSA had a significantly lower likelihood of treatment adherence (PAP daily use ≥ 4 h) at 6 months and were at higher risk of PAP treatment withdrawal compared to those with non-POSA. CONCLUSIONS: The prevalence and independent predictors of POSA and e-POSA were determined in this large clinical population. Patients with POSA and e-POSA have lower PAP therapy adherence, and this choice of treatment may not be optimal. Thus, there is a need to offer these patients an alternative therapy. CITATION: Sabil A, Blanchard M, Trzepizur W, et al. Positional obstructive sleep apnea within a large multicenter French cohort: prevalence, characteristics, and treatment outcomes. J Clin Sleep Med. 2020;16(12):2037–2046.

© 2020 by the authors., Mediterranean plants, such as fig and olive leaves, are well-known to exert beneficial effects in humans because of the presence of a wide range of bioactive compounds. However, scarce information regarding the impact of extraction methods, such as ultrasound and types of solvents, on their profile of antioxidant and anti-inflammatory compounds is provided. In addition, no information is available on the effects of extraction methods and solvents on the inhibition of pathogenic bacteria or promoting probiotic growth. In this scenario, this study was aimed to study the effects of ultrasound-assisted extraction (UAE) and solvent on the phenolic profile (Triple TOF-LC-MS/MS), antioxidant and anti-inflammatory compounds of olive and fig leaves. Results showed that UAE extracted more carotenoids compared to conventional extraction, while the conventional extraction impacted on higher flavonoids (olive leaves) and total phenolics (fig leaves). The antioxidant capacity of aqueous extract of fig leaves was three times higher than the extract obtained with ethanol for conventional extraction and four times higher for UAE. In general terms, hydroethanolic extracts presented the highest bacterial growth inhibition, and showed the highest anti-inflammatory activity. In conclusion, these side streams can be used as sources of bioactive compounds for further development of high-added-value products., J.V.G.-P. acknowledges the financial support from the Spanish National Research Agency through the MEFPROC project (PCI2018-093161, Era-NET SUSFOOD2). F.J.B. and A.R.J. would like to thank Croatian Science Foundation for project: “High voltage discharges for green solvent extraction of bioactive compounds from Mediterranean herbs (IP-2016-06-1913)”.

STUDY OBJECTIVES: Oronasal thermistor and nasal cannula are recommended for the scoring of respiratory events (RE) but these sensors are poorly tolerated in children. The aim of the study was to evaluate tracheal sounds (TS) and suprasternal pressure (SSP) for the scoring of RE during sleep in children. METHODS: We compared the detection and characterization of RE by AASM-recommended sensors (“AASM” scoring), with the detection and characterization of RE by the combination of TS and SSP with respiratory inductance plethysmography-sum (TS-RIP scoring), and TS and SSP only (TS scoring). RESULTS: The recordings of 17 patients were analyzed. The TS, SSP, and RIP flow signals were present during 95%, 95%, and 99% of the validated recording time, respectively, as compared to 79% and 86% for nasal cannula and oronasal thermistor. A total of 1,456 RE were scored with the “AASM” scoring, 1,335 with the TS-RIP scoring, and 1,311 with the TS scoring. Sensitivity for apnea and hypopnea detection was 88% and 84% for the TS-RIP scoring, and 86% and 77% for the TS scoring. For apnea characterization, the TS-RIP scoring sensitivities and specificities were 97% and 100%, 76% and 98%, and 95% and 97%, for obstructive, mixed, and central apnea, respectively. For the TS scoring, they were 95% and 100%, 95% and 97%, and 91% and 97%, respectively. CONCLUSIONS: TS and SSP + RIP-sum has a good sensitivity and specificity for the detection and characterization of apnea and hypopnea in children. TS and SSP alone have good sensitivity and specificity for apnea detection and characterization but lower sensitivity for hypopnea detection. CITATION: Amaddeo A, Sabil A, Arroyo JO et al. Tracheal sounds for the scoring of sleep respiratory events in children. J Clin Sleep Med. 2020;16(3):361–369.

Resume L’analyse des sons tracheaux fournit des informations precieuses en relation avec l’apnee obstructive du sommeil. Cet article fait le point sur les travaux originaux et les recherches en cours sur l’analyse des sons tracheaux en rapport avec l’obstruction des voies aeriennes superieures pendant le sommeil. L’analyse des sons tracheaux est une methode simple, peu couteuse et non invasive pour etudier la pathologie des voies aeriennes superieures. Le developpement des techniques de traitement du signal et l’amelioration de la qualite des sons tracheaux au cours de la derniere decennie ont permis d’ameliorer la precision et la pertinence clinique du diagnostic grâce a cette technologie. Les recherches passees et actuelles suggerent que les sons tracheaux peuvent jouer un role important dans le diagnostic du syndrome d’apnees du sommeil.

Summary Introduction Retention during both the active and passive phases of treatment has given rise to numerous publications concerning its efficacy, the range of systems available and its variability over time. There are currently many different retention protocols regularly used by orthodontists; however, their efficacy and duration are still subject to debate. There is as yet no consensus as to which retention protocol is the most effective or for how long the retention device needs to be worn. The aim of this research was to perform a systematic review of the scientific literature in order to evaluate the efficacy of the different retention systems and clinical protocols among those most widely used, so as to make recommendations beneficial to both patient and practitioner. Materials and methods A search of the literature was performed in the following databases: PubMed (MEDLINE), ScienceDirect and Cochrane Library. The search was limited to publications in English and French during the period 2006–2016. Results Out of 1952 references initially identified, 17 articles corresponded to our inclusion criteria. The results show that: fixed retention is more effective than removable retainers for the maintenance of incisor alignment during the first six months of retention; there is no significant difference in efficacy between the different fixed retention systems; there is no significant difference in efficacy between the vacuum-formed systems and the Hawley retainer; part-time use of removable retainers (between 8–10 h/day) is sufficient; the most widely used retention protocol combines a vacuum-formed splint or Hawley retainer in the upper arch with mandibular fixed retention. Conclusion Despite the large number of studies devoted to orthodontic retention only a few articles corresponded to the methodological criteria of bio statistical analysis. Also, on account of the variations in experimental protocols, the levels of proof relating to the efficacy of different systems are very weak. Research into this topic should first seek to normalize methods of analysis and then perform randomized controlled long-term trials to shed light on this problem.

Resume Introduction La mixite de la contention entre phase active et phase passive du traitement a genere de nombreuses publications a la recherche de son efficacite, de la multiplicite des dispositifs et de la variabilite dans la duree. En effet Il y’a actuellement differents protocoles de contentions communement adoptes par les orthodontistes mais dont l’efficacite et la duree de port font toujours l’objet d’un debat. En effet, il n’y a pas encore de consensus sur quel protocole de contention est le plus efficace et pour combien de temps l’appareil de contention devra etre porte. L’objectif de notre recherche est d’effectuer une revue systematique de la litterature scientifique afin d’evaluer l’efficacite des differents appareillages de contention et des protocoles cliniques les plus utilises, en vue de degager des recommandations benefiques pour le patient et pour le praticien. Materiels et methode Une recherche de la litterature a ete faite sur les bases de donnees suivantes : PubMed (MEDLINE), ScienceDirect et Cochrane library. La recherche a ete limitee aux publications en anglais et en francais durant la periode entre 2006 et 2016. Resultats De 1952 citations initialement identifiees, 17 articles correspondaient a nos criteres d’inclusion. Les resultats ont montre que : les contentions fixes etaient plus efficaces que les contentions amovibles dans le maintien de l’alignement incisif mandibulaire durant les six premiers mois de contention ; il n’y avait pas de difference significative en terme d’efficacite entre les differents types de contentions fixes ; il n’y avait pas de difference significative en termes d’efficacite entre les gouttieres thermoformees et la plaque de Hawley ; le port a temps partiel (entre 8 et 10 heures) des contentions amovibles est suffisant ; le protocole de contention le plus utilise etait une gouttiere thermoformee ou une plaque de Hawley au maxillaire et une contention fixe a la mandibule. Conclusion En depit du nombre important d’etudes sur les contentions orthodontiques, seuls quelques articles repondent aux criteres de la methodologie biostatistique. De plus, la variation des protocoles experimentaux a engendre un faible niveau de preuve sur l’efficacite des differents appareillages. La recherche sur le sujet devrait d’abord obeir a la normalisation des methodes d’analyse et ensuite realiser des essais controles et randomises a long terme qui pourront nous eclairer sur cette problematique.

Tracheal sounds have been the subject of many research studies. In this review, we describe the state of the art, original work relevant to upper airways obstruction during sleep, and ongoing research concerning the methods used when analysing tracheal sounds. Tracheal sound sensors are a simple and noninvasive means of measurement and are more reliable than other breathing sensors. Developments in acoustic processing techniques and enhancements in tracheal sound signals over the past decade have led to improvements in the accuracy and clinical relevance of diagnoses based on this technology. Past and current research suggests that they may have a significant role in the diagnosis of obstructive sleep apnoea. Key points Tracheal sounds are currently a topic of significant interest but are not yet used in most routine sleep study systems. Measured at the suprasternal notch, tracheal sounds can provide reliable information on breathing sounds, snoring sounds and respiratory efforts. Tracheal sounds may be used as a noninvasive method of studying abnormalities of the upper airways during wakefulness. Educational aims To understand the principles of tracheal sound measurement and analysis. To highlight the importance of tracheal sounds for the diagnosis of sleep apnoea–hypopnoea syndrome. To present the most relevant clinical studies that have validated the use of tracheal sound sensors and to make future clinical validation studies possible., Tracheal sounds analysis may have a significant role in the diagnosis of obstructive sleep apnoea http://ow.ly/f7ax30cAcnP

Introduction: The AASM recommends the use of oronasal thermistor and nasal cannulas to detect respiratory events and respiratory inductance plethysmography (RIP) to characterise apnoeas. However nasal cannulas have a poor scorability. The aim of the study was to evaluate the use of tracheal sounds (TS) and suprasternal pressure (SSP) as an alternative of oronasal thermistor and nasal cannulas for the diagnosis of sleep apnoea in children. Materials and methods: Polysomnographic recordings of 17 children were used. We compared the detection and characterisation of apnoeas by 3 methods: AASM using standard signals (AASM scoring), combination of TS and SSP with RIPflow and pulse oximetry (SpO2) without nasal cannulas (scoring 2) and TS and SSP combined with SpO2 (scoring 3). Results: AASM scoring identified 1149 apnoeas, scoring 2 and 3 identified 1054 and 1049 apnoeas respectively. Sensitivity for apnoeas detection was 92% (scoring 2) and 91% (scoring 3). For apnoea characterisation, scoring 2 sensitivity and specificity were 97% and 100%, 77% and 99% and 98% and 98% for obstructive, mixed and central apnoeas respectively. For scoring 3, they were 96% and 100%, 90% and 96% and 88% and 98% for obstructive, mixed and central apnoeas respectively. Conclusions: The combination of TS and SSP with RIP flow and SpO2 without oronasal thermistor and nasal cannulas can be used for the detection and characterisation of apnoeas in children, and may be used as an alternative when these signals are not available.

Objectives To evaluate changes in cerebral oxygenation by means of near-infrared spectroscopy during respiratory events in children with sleep-disordered breathing (SDB) and associated disorders. Study design Sixty-five children suspected of having SDB underwent a respiratory polygraphy with simultaneous recording of cerebral oxygenation indices. Respiratory events were analyzed by type of event, duration, variations of pulse oximetry (oxygen saturation [SpO2]), cerebral tissue oxygenation index (TOI), and heart rate. Data were categorized according to the severity of SDB and age. Results There were 540 obstructive and mixed apneas, 172 central apneas, and 393 obstructive hypopneas analyzed. The mean decreases in SpO2 and TOI were 4.1 ± 3.1% and 3.4 ± 2.8%, respectively. The mean TOI decrease was significantly smaller for obstructive hypopnea compared with apneas. The TOI decrease was significantly less in children with mild SDB as compared with those with moderate-to-severe SDB and in children >7 years as compared with those Conclusions In children with SDB and associated disorders, cerebral oxygenation variations depend on the type of respiratory event, severity of SDB, and age.

Polysomnography (PSG) is necessary for the accurate estimation of total sleep time (TST) and the calculation of the apnea-hypopnea index (AHI). In type III home sleep apnea testing (HSAT), TST is overestimated because of the lack of electrophysiological sleep recordings. The aim of this study was to evaluate the accuracy and reliability of a novel automated sleep/wake scoring algorithm combining a single electroencephalogram (EEG) channel with actimetry and HSAT signals. The study included 160 patients investigated by PSG for suspected obstructive sleep apnea (OSA). Each PSG was recorded and scored manually using American Academy of Sleep Medicine (AASM) rules. The automatic sleep/wake-scoring algorithm was based on a single-channel EEG (FP2-A1) and the variability analysis of HSAT signals (airflow, snoring, actimetry, light and respiratory inductive plethysmography). Optimal detection thresholds were derived for each signal using a training set. Automatic and manual scorings were then compared epoch by epoch considering two states (sleep and wake). Cohen's kappa coefficient between the manual scoring and the proposed automatic algorithm was substantial, 0.74 ± 0.18, in separating wakefulness and sleep. The sensitivity, specificity and the positive and negative predictive values for the detection of wakefulness were 76.51% ± 21.67%, 95.48% ± 5.27%, 81.84% ± 15.42% and 93.85% ± 6.23% respectively. Compared with HSAT signals alone, AHI increased by 22.12% and 27 patients changed categories of OSA severity with the automatic sleep/wake-scoring algorithm. Automatic sleep/wake detection using a single-channel EEG combined with HSAT signals was a reliable method for TST estimation and improved AHI calculation compared with HSAT.

Physicochemical parameters (pH, colour and texture), proximate composition (moisture, protein, lipid and ash content), amino acid content, and taste profile of beef patties elaborated with soy (control), pulses (pea, lentil and bean) and microalgal (Chlorella and Spirulina) proteins were assessed. The pH, colour, ash content, total, essential and non-essential amino acids and amino acid content were significantly different among the beef patties studied. In this regard, beef patties prepared with pea protein presented the highest values for pH; whereas beef patties manufactured with pea also showed the highest values for lightness and patties elaborated with bean the highest values for redness. Similar textural parameters were observed among the six batches of beef patties manufactured. Regarding ash content, a significant higher content was observed in the beef patties prepared with soy compared to the other ones. On the other hand, the beef patties elaborated with bean and seaweeds showed the highest values for the total amino acids content. The inclusion of bean and seaweed proteins increased the concentrations of all amino acids in beef patties, being glutamic acids, lysine and aspartic acid the predominant amino acids. Regarding the taste analysis, a similar profile was found among the six batches of beef patties studied. Considering all studied parameters, beef patties elaborated with bean protein could be used as an alternative protein source respect to soy protein because of it showed a similar nutritional content and taste profile and higher amino acid content.

In this paper, the behavior of Coplanar Waveguide (CPW) fed SIERPINSKI curve fractal antenna is studied. The results show that there is a relationship between the iteration number and the resonance frequencies. With increase in the number of iteration the resonance frequency decreases with a constant ratio. The use of fractal structures to design antennas makes them more miniaturized. The simulated results obtained from CADFEKO a Method of Moments (MoM) model based Solver and measurement using Vector Network Analyzer Anritsu MS2026C are in good agreement.

Objectif Le codage de l’eveil et du sommeil necessite au moins trois EEG, deux EOG et un EMG et il est couteux et chronophage. Dans une polygraphie ventilatoire (PV), le temps total d’enregistrement plutot que le temps total de sommeil (TTS) est utilise pour calculer l’indice d’apnees et d’hypopnees (IAH). Ainsi, l’IAH est generalement sous-estime. L’objectif de cette etude etait d’evaluer la performance d’un algorithme de detection automatique de l’eveil et du sommeil, base sur une seule voie EEG, par rapport a la lecture manuelle de polysomnographie (PSG). Methodes Une cohorte de 162 patients avec un IAH entre 0 et 50/h repartis dans des groupes de developpement et de test a ete utilisee. Aucun patient n’etait sous traitement medicamenteux pouvant alterer l’EEG au moment de l’enregistrement. Chaque PSG a ete codee selon les recommandations AASM. L’algorithme de detection eveil/sommeil utilise la derivation FP2-A1 associee a la variabilite de certains signaux de la PV. Les detections automatique et manuelle de l’eveil et du sommeil ont ete comparees epoque par epoque. Resultats Le coefficient Kappa etait de 0,73, et le pourcentage d’accord de 91 %. La sensibilite, la specificite et la valeur predictive positive de la detection de l’eveil etaient respectivement de 79 %, 94 % et 79 %. Conclusion La detection automatique de l’eveil et du sommeil basee sur une seule voie EEG ajoutee a une PV de routine pourrait etre utilisee comme methode efficace et rentable pour l’estimation de TTS et l’amelioration du calcul de l’IAH.

Advances in technology have made it possible to reliably and not invasively record physiological parameters to diagnose sleep disorders. The most common sleep-related breathing disorder is sleep apnea. Complete cessation of airflow, apneas, or reduction of airflow, hypopneas occurs during sleep [1]. Based on the underlying pathophysiology, these respiratory events are classified as obstructive or central, with or without respiratory efforts. Accurate and reliable detection and classification of apneas and hypopneas are critical for the diagnosis and quantifying of the disease severity, morbidity, or mortality, as well as for appropriate therapy selection.

This study deals with the phytochemical analyses, antioxidant and antimicrobial activities screening of Erodium glaucophyllum root bark. Organic extracts (Chloroformic Acid and Ethyl acetate) were screened for their biochemical composition as well as antioxidant and antibacterial activities. Phytochemical screening of Erodium glaucophyllum root bark showed the presence of flavonoids, coumarins, saponins, tannins, antracenosides, phenolics compounds and mucilage. Biochemical screening of the two organic extracts show a highest total polyphenolic content of the two solvent (78.022 ± 0.28 mg GAE/g DM in Chloroform extract and 95.468 ± 0.078 mg GAE/g methyl acetate extract). These values were recorded in the proportion of 70% MeOH. The antioxidant activity was evaluated using DPPH tests, chelation, and the total antioxidant capacity. The antibacterial activity was evaluated by the diffusion test agar vis-a-vis of six bacterial strains. The results show that the levels of polyphenolic content influenced these activities.

In obstructive sleep apnea (OSA) esophageal pressure (Pes) is the gold standard for measurement of respiratory effort, and respiratory inductance plethysmography (RIP) is considered an accepted measurement technique. However, the use of RIP could lead to limited accuracy in certain cases and therefore suprasternal pressure (SSP) monitoring might improve the reliability of OSA diagnosis. We aimed to use SSP for the visual characterization of respiratory events in adults and compared results to those obtained by RIP from polysomnography (PSG).In patients with OSA, a 1-night SSP recording using the PneaVoX sensor (Cidelec, Sainte-Gemmes-sur-Loire, France) was done. In parallel, PSG was performed according to American Academy of Sleep Medicine criteria. A subgroup of patients agreed to have Pes measurement in addition. Characterizations of apneas as obstructive, central, and mixed as well as hypopneas as central and obstructive were done by visual evaluation of SSP, RIP, and Pes in random order by two independent scores (S1 and S2). The sensitivity and specificity of characterization by SSP compared to RIP and to Pes were calculated.Synchronous recordings of SSP and PSG were analyzed from n = 34 patients with OSA (AHI 34.1 ± 24.2 events/h); 9 of them had synchronized Pes monitoring as well. Interscorer agreement for apnea characterization as obstructive, central, and mixed based on SSP, RIP, and Pes were found, with RThis study demonstrated a good agreement in the detection of respiratory effort with the SSP signal using the PneaVoX sensor compared to the RIP belts signals as well as to the Pes signal. These findings were consistently found by two independent scorers. In summary, results suggest that SSP is a reliable signal for the classification of respiratory events and could be used as an additional tool for OSA characterization in clinical practice.

Nowadays, communications systems have become more mobile and personal, that means materials used must be as smaller as possible. Low weight reduced volume and low cost are some of the characteristics that must be accomplished in modern telecommunication equipment. It is well known that the antenna is one of the most important devices in the radiofrequency (RF) section. This element needs to perform effectively according to the necessities. To achieve low weight, small volume and low cost, the size needs to be reduced, but keeping the main characteristics. The size reduction of antennas can be made by several techniques according to the type of the element. In this study we will present the fundamental limitations of small antennas as a major constraint of antenna miniaturization, then we will discuss major techniques that have been reported in literature to reduce the size of an antenna. Feasibility, features, effects on the miniaturisation of antennas of each technique will be presented and discussed. At the end of this study we will give some examples of real systems that used antennas miniaturization techniques.

Objectif Evaluer l’apport des sons tracheaux (ST) et de la pression susternale (Pss) pour optimiser l’analyse respiratoire de la PSG ambulatoire dans le diagnostic du SAOS pediatrique. Les criteres d’evaluation etaient : la qualite de signal (pourcentage du temps passe en l’absence d’artefact pour chaque signal) et la qualite globale de l’enregistrement sans, puis avec l’apport de ST et Pss (temps de sommeil avec une qualite satisfaisante observee simultanement sur tous les signaux). Methodes Cent dix-neuf enfants sans comorbidite associee âges de 2 a 18 ans, adresses a l’unite de somnologie pour ronflement et/ou suspicion de SAOS. Une PSG ambulatoire utilisant le capteur PneaVox (CIDELEC, France) a ete mise en place. La qualite des signaux respiratoires, ST, Pss, pression nasale (Pnas), bandes thoraciques et abdominales (RIP) et capteur d’oxymetrie, a ete evaluee. Resultats Cent treize enregistrements ont ete analyses. Le temps d’enregistrement moyen etait de 556 minutes Sur la base des signaux sans l’apport du PneaVox (ST et Pss), 62,8 % des enregistrements ont ete consideres comme etant d’« excellente qualite », et 74,3 % de « tres bonne qualite ». En rajoutant la Pss, 77 % des enregistrements etaient d’« excellente » qualite et 77,9 % de « tres bonne qualite ». Enfin, en rajoutant les ST, 95,6 % des enregistrements etaient d’« excellente » qualite, et 95,6 % de « tres bonne qualite ». Conclusion L’association des signaux ST au signal de Pnas et Pss au RIP permet d’ameliorer significativement la qualite de l’analyse du debit et de l’effort respiratoire.

A highly specific and sensitive competitive enzyme-linked immunosorbent assay for detection of specific antibody to Babesia equi in serum from equids was validated for use in Morocco. The assay is based on the specific inhibition of binding of a monoclonal antibody to a conserved epitope within a recombinant parasite peptide by serum from infected animals. The assay was compared to an established indirect immunofluorescence assay, with a concordance of 91%. The assay was used to determine seroprevalence for B. equi infections in donkeys and horses throughout Morocco. A total of 578 sera (163 horses and 415 donkeys) from 6 locations representing different bioclimatic regions were assayed. An analysis of variance, indicated no significant effect of location; however, donkeys were significantly more likely than horses to be seropositive. Management conditions contribute to greater tick infestations and thus Babesia exposure in donkeys than in horses.

International audience; Abstract - Canine leishmaniasis (canL) is widespread in the north of Morocco and the Leishmania infantum local strains are highly virulent. An epidemiological survey was carried out in 1993-1995 in the Khemisset province. In this region, the severity of the disease was assessed during regular visits to the identified foci by clinical examination of 323 dogs. Clinical signs were protean and occurred in various combinations. Biopsies were made on available sick dogs; the main histological changes were severe infiltration of the spleen, lymph nodes and bone marrow by mononuclear cells and hyperplasia of macrophage cells with amastigotes in their cytoplasm. The seroprevalence among 323 dog sera tested by ELISA showed a rate of 16.71% . The highest prevalence of the disease was 23.6% in the Sid El Ghandour hamlet. A comparison of the results of this study with those from the year following the first examination on the same site (Sid El Ghandour) of 67 dogs showed that the disease prevalence had not increased significantly (23.6% to 25.33% ).; La leishmaniose canine : étude sérologique, clinique et histopathologique dans la province de Khemisset, Maroc. La leishmaniose canine (L.can) est largement répandue dans la partie Nord du Maroc et les souches de Leishmania infantum sont très virulentes. Dans la présente étude, nous rapportons les résultats d'une enquête sur la leishmaniose canine au Maroc dans la province de Khemisset de 1993 à 1995. La gravité de la maladie a été évaluée par l'examen clinique minutieux de 323 chiens lors de visites régulières dans les foyers identifiés. Les signes cliniques ont révélé un caractère protéiforme et un manque de constance des symptômes. Les biopsies des ganglions, rate et moelle osseuse ont montré une infiltration massive par les cellules mononucléaires et une hyperplasie de macrophages avec des amastigotes dans leur cytoplasme. La recherche des anticorps anti-Leishmania effectuée par la technique ELISA a révélé une séro-prévalence moyenne de 16,71 % avec 23,63 % dans la localité de Sid El Ghandour seule. La comparaison des résultats de cette étude avec ceux d'une année après la première visite dans cette dernière localité sur 67 chiens a montré que la prévalence n'a pas augmenté significativement (23,6 % à 25,33 % ).

The development of Muellerius capillaris in the lung of goats was associated with marked tissue damage and pronounced a cellular reaction. Using broncho-alveolar lavage, the time course of the cellular responses was studied following primary and secondary infection. During the primary infection, there was a biphasic increase in total broncho-alveolar leucocytes (an average of 294.0 +/- 137.0 cells microl[-1]) and in the absolute number of macrophages (182.0 +/- 82.0 cells ul[-1]), lymphocytes (68.5 +/- 35.0 cells microl[-1]), eosinophils (35.3 +/- 16.4 cells microl[-1]) and neutrophils (10.9 +/- 8.7 cell microl[-1]). The lung tissue reaction against worms consisted of a mild infiltration of inflammatory cells. The secondary infection resulted in significant changes in the pulmonary tissue characterised by severe inflammation, leading to widespread granulomatous formation throughout the parenchyma, hyperplasia of cells Type II and a leucocytosis in the broncho-alveolar fluids, with an anamnestic-like response by all cell types. The overall average of the total leucocytes, macrophages, lymphocytes, eosinophils and neutrophils was 529.3 +/- 347.4; 265.4 +/- 148.1; 127.3 +/- 100; 125.4 +/- 100.1 and 14.0 +/- 8.7 cells microl(-1), respectively. Secondary infection also resulted in 56% reduction of worms established in the lungs and 72.3% of L1 larval production. These data suggest that the broncho-alveolar leucocyte response to infection has an immunological basis and that the alveolar macrophages, neutrophils, eosinophils, and lymphocytes may play a significant role in lung resistance against protostrongylid nematodes.

Monoclonal antibodies (mAbs) were obtained against the surface antigens of the Eimeria falciformis sporozoite by immunizing mice with whole homogenized sporozoite. The hybridomas were selected by their reactivities against oocyst extracts, then against glutaraldehyde-treated sporozoites. Three mAbs recognized both the surface of E. falciformis, E. tenella, and E. acervulina and their refractile bodies, whereas a fourth mAb recognized only one epitope on the refractile bodies. All mAbs bound to the same immunoaffinity-purified antigens in Western-blot analysis (P27 for E. falciformis and P25 for E. tenella and E. acervulina). Thus, the mAbs define at least two shared epitopes between sporozoite antigens from different eimerian species. Two of these mAbs are involved in the in vitro phagocytosis of E. falciformis sporozoites by macrophages and also in their lysis by neutrophils. Altogether, these properties showed that the four mAbs came from different activated B-cells. The P27 antigen recognized by our mAbs represents a major target of the in vitro destructive immune response.