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Daytime sleepiness is a cardinal symptom of obstructive sleep apnoea (OSA) and a well-recognised side effect of beta-blockers, therefore patients with OSA under this treatment may have worse sleepiness. However, the interaction between daytime sleepiness and beta-blockers use has not been thoroughly investigated in patients with OSA before. We analysed the data of 2183 individuals (1852 patients with OSA and 331 snorer controls) from 3 countries (Greece, Hungary and Moldova). Medical history, including medication usage and the Epworth Sleepiness Scale (ESS) were recorded. Patients and controls were divided into somnolent (ESS ≥ 11) and non-somnolent (ESS p = 0.24) or control (p = 0.64) groups. These results were similar in sensitivity analyses (all p > 0.05). ESS was related to BMI (ρ = 0.25), total sleep time (ρ = 0.07), AHI (ρ = 0.32), oxygen desaturation index (ρ = 0.33) and minimum oxygen saturation (ρ = – 0.32, all p p

L’articolo propone una riflessione metodologica sull’educazione alle STEM che pone l’attenzione su alcuni elementi che possano rappresentare un’innovazione del modo in cui si concepisce l’apprendimento in questo ambito. Lo fa attraverso l’analisi di Future Inventors, un progetto del Museo Nazionale della Scienza e della Tecnologia Leonardo da Vinci, che aspira a creare un nuovo approccio all’educazione alle STEM trasferibile nella pratica scolastica. La riflessione pone attenzione particolare sull’esperienza estetica – qui intesa come una chiave di lettura del mondo che considera come inseparabili l’esperienza cognitiva e quella affettiva; integra la costruzione del sapere con l’apprezzamento della bellezza e della forza delle idee; e attiva un processo trasformativo attraverso cui comprendiamo meglio le cose e noi stessi – in un tentativo di riposizionarla al suo posto primario nel processo di un apprendimento nelle STEM più interdisciplinare ed ecologico.

INTRODUCTION Accumulating evidence suggests that cardiovascular disease (CVD) is highly prevalent among patients with concurrent obstructive sleep apnoea syndrome (OSAS) and chronic obstructive pulmonary disease, otherwise known as overlap syndrome (OS). OBJECTIVES The aim of this study was to investigate the 10-year risk for CVD in OS patients compared with OSAS patients and controls. METHODS Consecutive patients, referred for symptoms suggestive of OSAS, were evaluated with polysomnography and pulmonary function testing. Cardiovascular risk was assessed using the Framingham risk score (FRS) and systematic coronary risk evaluation (SCORE). RESULTS Overall, 244 participants (184 males) without CVD and diabetes were divided into 3 groups: controls (n = 63), OSAS (n = 139) and OS (n = 42). Both FRS and SCORE were found to be elevated in the OS group compared with the OSAS and control groups (P

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as a major threat to global public health. The virus causes the clinical syndrome known as coronavirus disease 2019 (COVID-19), in which multiple organs can get affected. Apart from manifestations of the respiratory system, which predominate, its clinical presentation is frequently accompanied by symptoms of the gastro-intestinal (GI) tract and liver abnormalities. The correlation of symptoms and abnormalities with disease severity is discussed, leading to ambiguous results from international literature. Moreover, the disease infects patients with co-existing liver and GI disorders affecting both their health status and the availability of healthcare services provided to them. The risk of transmission of the disease during aerosol-generating procedures has changed the diagnostic approach and follow-up algorithms for liver and GI diseases. For the safety of both doctors and patients, telemedicine and distant evaluation have become everyday practice, whereas several routines and emergency visits at outpatient and emergency departments have been postponed or delayed. Vaccination against SARS-CoV-2 is underway, providing hope to humanity and the expectation that the post-COVID-19 era is near. This review aims to update knowledge about the manifestations of COVID-19 related to liver and GI diseases and the effect of the pandemic on the diagnostic and therapeutic procedures for these diseases with a special focus on how current practices have changed and what changes will possibly remain in the future.

Background: Evidence suggests that metabolic syndrome (MetS) is highly prevalent in patients with obstructive sleep apnea syndrome (OSAS) and chronic obstructive pulmonary disease (COPD). However, ...

Numerous studies have indicated that obstructive sleep apnea syndrome (OSAS), may contribute to the development of metabolic syndrome (MetS) and diabetes. Moreover, OSAS has been associated with lowered vitamin D (Vit D) levels, but reports are inconclusive. Aim of the study was to compare Vit D levels according to the presence of MetS and its components in OSAS patients.The presence of MetS was evaluated and serum 25-hydroxy vitamin D [25(OH)D] levels were measured in consecutive newly diagnosed, by polysomnography, subjects with OSAS.A total of 107 subjects (88 men) with OSAS were included in the study. Patients were divided into group A (OSAS with MetS group: 55 subjects) and group B (OSAS without MetS: 52 subjects). There were no differences between the two groups in terms of age, body mass index, and sleep parameters. Patients in group A exhibited higher levels of daytime sleepiness, as expressed by Epworth Sleepiness Scale score (12 ± 5.5 vs. 9.3 ± 4.8 for groups A vs. B, p = 0.008). Serum 25(OH)D levels were significantly decreased in group A, as compared with group B (18 ± 8.6 ng/mL vs. 23.9 ± 14.1 ng/mL, respectively, p = 0.012). Group A was then subdivided in two smaller groups, according to patients' metabolic index: OSAS patients with metabolic score = 3 and OSAS patients with metabolic score3. Serum 25(OH)D levels were higher in OSAS patients with metabolic score = 3 compared with OSAS patients with metabolic score3 (19.8 ± 8.9 ng/mL vs. 15.1 ± 7.3 ng/mL respectively, p = 0.038).OSAS patients with concurrent MetS exhibit lower serum Vit D levels, as compared with those without MetS.

Objectives. Obstructive sleep apnea syndrome (OSAS) is associated with increased cardiovascular morbidity and mortality. The aim of this study was to assess whether the 10-year risk for cardiovascular disease in newly diagnosed patients with OSAS is increased. Materials and Methods. Recently diagnosed, with polysomnography, consecutive OSAS patients were included. The Systematic Coronary Risk Evaluation (SCORE) and the Framingham Risk Score (FRS) were used to estimate the 10-year risk for cardiovascular disease. Results. Totally, 393 individuals (73.3% males), scheduled to undergo a polysomnographic study with symptoms indicative of OSAS, were enrolled. According to apnea-hypopnea index (AHI), subjects were divided in four groups: mild OSAS (AHI 5–14.9/h) was diagnosed in 91 patients (23.2%), moderate OSAS (AHI 15–29.9/h) in 58 patients (14.8%), severe OSAS (AHI > 30/h) in 167 patients (42.5%), while 77 individuals (19.6%) had an AHI p<0.001 and FRS values p<0.001. More specifically, a significant correlation was observed both between AHI and SCORE r=0.251, p<0.001 and AHI and FRS values r=0.291, p<0.001. Furthermore, a negative correlation was observed between FRS values and sleep efficiency r=−0.224, p=0.006. Conclusions. The 10-year risk for cardiovascular morbidity and mortality seems to increase with severity of OSAS. Physicians should bear this finding in mind, in order to seek for and consecutively eliminate risk factors for cardiovascular disease and to prevent future cardiovascular events in OSAS patients.

Background: Obstructive sleep apnoea syndrome (OSAS) has been linked with abnormal glucose metabolism, insulin resistance (IR) and development of diabetes mellitus. Methods: Non-diabetic patients (n=69) with OSAS, diagnosed by polysomnography, were prospectively recruited. To evaluate IR among OSAS patients, the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and Insulin sensitivity by Quantitative Insulin sensitivity Check Index (QUICKI) were used. Results: HOMA-IR was positively associated with body-mass index (BMI) (ρ=0.364, p=0.002), time with oxyhaemoglobin saturation Conclusions: An independent association between OSAS and IR in patients without pre-existing diabetes mellitus was observed. Recurrent hypoxia and sleep fragmentation in OSAS are associated with IR in these patients.

Background: Idiopathic pulmonary fibrosis (IPF) is associated with a prothrombotic state. Aim: To study mean platelet volume (MPV) and Platelet Distribution Width (PDW) as markers of platelet activation and their potential association with lung function in patients with recently diagnosed IPF. Materials and Methods: This study included 56 patients with IPF (age 64.9±7.4 years) and 79 controls (age 64.2 ± 5.9 years). Results: An inverse relation was demonstrated between platelet count and MPV in the control group but not among patients with IPF. Platelet count was significantly lower in patients with IPF compared with controls (230 ± 60 vs 256 ± 75 × 103/μL, P = .038). Conversely, MPV was higher in patients versus controls (10.3 ± 1.2 vs 9.8 ± 1.2 fl, P = .024), while there was no difference between the groups in PDW. Respiratory function was, as expected, significantly impaired in patients with IPF versus controls in terms of forced expiratory volume in first second (FEV1; 67.2 ± 23.1 vs 102.6 ± 15.9% of predicted value, P < .001), forced vital capacity (FVC; 65.3 ± 21 vs 95.2 ± 16.1% of predicted value, P < .001), FEV1/FVC (83.1 ± 15 vs 87.5 ± 6.4%, P = .041) and partial pressure of oxygen in arterial blood (PaO2; 67.1 ± 10.3 vs 81.5 ± 15.2 mm Hg, P < .001). No significant correlation was seen between MPV and FVC ( r = −.1497, P = .275), MPV and lung diffusion capacity for carbon monoxide ( r = .035, P = .798) and total lung capacity ( r = .032, P = .820). Conclusions: Patients with IPF exhibit higher MPV values and lower platelet count. Further studies are needed to assess the clinical implications of these findings.

Background and Aim:Hypoxia, a major feature of obstructive sleep apnea (OSA), modifies Vascular Endothelial Growth Factor (VEGF) and Insulin-like Growth Factor Binding Protein-3 (IGFBP-3) levels, which contribute to atherogenesis and occurrence of cardiovascular (CV) events. We assessed and compared serum levels of VEGF and IGFBP-3 in newly diagnosed OSA patients and controls, to explore associations with anthropometric and sleep parameters and to study the effect of continuous positive airway pressure (CPAP) treatment on these levels.Materials and Methods:Serum levels of VEGF and IGFBP-3 were measured in 65 OSA patients and 31 age- and body mass index- matched controls. In OSA patients, measurements were repeated after 6 months of CPAP therapy. All participants were non-smokers, without any comorbidities or systemic medication use.Results:At baseline, serum VEGF levels in OSA patients were higher compared with controls (pConclusion:In newly diagnosed OSA patients, serum levels of VEGF are elevated, while IGFBP-3 levels are low. After 6 months of CPAP treatment these levels change. These results may reflect an increased CV risk in untreated OSA patients, which is ameliorated after CPAP therapy.

Obstructive sleep apnea syndrome (OSAS) has been recently proposed as an independent risk factor for chronic kidney disease. Cystatin C (Cyst C) and neutrophil gelatinase-associated lipocalin (NGAL) are novel biomarkers for the earlier detection of latent kidney disease. The aim of the study was to assess serum Cyst C and NGAL levels in otherwise healthy OSAS patients and to explore possible associations with sleep parameters. Consecutive subjects (n = 96, 79.2% males), without known comorbidities, with symptoms suggestive of OSAS were included. All of them underwent polysomnography (PSG) and blood examination for the measurement of serum Cyst C and NGAL levels. Based on apnea-hypopnea index (AHI), subjects were classified into two groups: 32 controls and 64 OSAS patients, with no significant differences in terms of age (50.1 ± 11.7 vs 51 ± 12.2 years, p = 0.747) and BMI (33.9 ± 8.8 vs 35.9 ± 13.1 kg/m2, p = 0.449). Serum Cyst C and NGAL mean levels were higher in OSAS patients compared to those in controls (1155.2 ± 319.3 vs 966.8 ± 173 ng/ml, p = 0.001, and 43.7 ± 23.2 vs 35.6 ± 13.8 ng/ml, p = 0.035, respectively). After adjustment for age and BMI in OSAS patients, serum NGAL levels were associated with AHI (β = 0.341, p = 0.015) and minimum oxyhemoglobin saturation during sleep (β = − 0.275, p = 0.032), while serum Cyst C levels were associated with percentage of time with oxyhemoglobin saturation

BACKGROUND Vitamin D (Vit D) insufficiency has been implicated in the pathophysiology of numerous diseases. Obstructive sleep apnoea syndrome (OSAS), a disorder associated with increased cardiovascular and cerebrovascular morbidity, has been associated with decreased Vit D levels, but reports are inconclusive. AIM To evaluate the association between serum 25-hydroxyvitamin D [25(OH)D], a marker of Vit D status, with anthropometric and sleep characteristics of OSAS patients and to compare those levels between OSAS patients and non-apnoeic controls. METHOD Consecutive subjects who had undergone polysomnography and pulmonary function testing were divided into controls (apnoea-hypopnea index, AHI

Aim of the study was to evaluate anthropometric, clinical and sleep characteristics of Obesity Hypoventilation Syndrome (OHS) patients, in comparison to obese eucapnic Obstructive Sleep Apnea Syndrome (OSAS) patients and controls. Methods Included were 942 consecutive subjects with BMI≥30kg/m 2 (69.9% males, age 54.9±11.9 years), examined with polysomnography (PSG), due to suspected OSAS. All had undergone pulmonary function testing and ABGs examination and had completed the Epworth Sleepiness Scale (ESS) and Athens Insomnia Scale (AIS) for sleepiness and insomnia assessment, respectively. They were categorized as follows: OHS patients (n=177), obese, eucapnic OSAS patients (AHI≥5/h, n=615), and obese controls with AHI Results OHS patients had the highest BMI (p 1, SpO 2 , PaO 2 , PaCO 2 and HCO 3 values in awake (p 2 and averSpO 2 during sleep were more impaired in OHS patients (p Conclusions OHS patients were more obese, differed significantly in several sleep characteristics and reported insomnia and daytime sleepiness more frequently, compared with obese OSAS patients and controls.

The last 5 years have been a turning point when speaking about education and learning. User-generated knowledge and connectivity seem to be at the basis of ever more personalized learning experiences, while the debate on the 21st century competences is gaining ground. What does all this mean for the field and profession of learning experts and facilitators in museums? What change in skills and competences, training, programme development, and face-to-face interaction with visitors is taking place? How are learning experts expected to contribute to the consequent evolution of the museum’s mission, policy, and practice? This chapter reflects on the above questions by (a) analysing the current trends and their implications for museums and learning experts; and (b) focusing on the specific case of the National Museum of Science and Technology Leonardo da Vinci. It will attempt to answer the above questions by putting together theoretical and methodological principles with inputs from practice aiming to emphasise the great potential that museum learning experts have for individuals’ learning, experience and social engagement as they appear to be evolving today.

Reviewed by Maria XanthoudakiNational Museum of Science and Technology, Milan, ItalyThis book could have been written by a museum educator, but it is not. This is not a bad thing—on the contrary, i...

We evaluated early atherosclerotic lesions in 20 non-smokers with newly diagnosed Obstructive Sleep Apnoea (OSA) and without known comorbidities by measuring common carotid artery intima media thickness (CCA-IMT), transcranial Doppler ultrasound (TCD), and ankle brachial index (ABI). These were compared with 20 healthy age- and BMI-matched controls. In OSA patients, CCA-IMT was not significantly higher vs. controls (0.74±0.17 vs. 0.66±0.12 mm, p=0.201) and it was positively correlated with neck circumference (r=0.466, p=0.039), arousal index (r=0.663, p=0.001), gamma-glutamyl transpeptidase activity (r=0.474, p=0.035) while it was negatively correlated with Forced Expiratory Volume in 1 sec (r=-0.055, p=0.012). No difference was noted between patients and controls in terms of vascular stenosis on TCD examination, while asymptomatic peripheral artery disease was found in one patient with OSA. In conclusion, OSA patients without known comorbidities exhibit a non-significant increase in CCA-IMT without further evidence of vascular disease, but additional experience in a larger patient series is needed.

Frontline museum floor staff people are critical agents in the field's efforts to catalyze greater community engagement and participation at the intersections of science, art, history, and society....

Introduction: Idiopathic Pulmonary Fibrosis (IPF) is a progressive disease of unknown pathogenesis, associated among others, with sleep disturbances. Aim: of the study was to explore the association between sleep quality and indices of health-related quality of life (QoL), physical activity, anxiety or depression, as well as PFTs. Methods: Newly-diagnosed consecutive IPF patients (n=36) underwent PFTs and completed the following questionnaires: Pittsburgh Sleep Quality Index (PSQI), Saint George Respiratory Questionnaire (SGRQ), International Physical Activity Questionnaire (IPAQ), Zung Self-Rating Anxiety Scale (SAS), Zung Self-Rating Depression Scale (SDS) and Epworth Sleepiness Scale (ESS). Results: Mean age of IPF patients was 69. 6±6.2 years, the majority (n=33, 91.6%) were males. Their mean BMI was 28.2±3 Kg/m 2 while the total SGRQ score was 41±22.1 (symptoms and activity score were 41.4±21.7 and 62.6±29.6 respectively). Eleven patients (30.6%) had a PSQI≥5, indicative of poor sleep quality. Compared with those with good sleep quality (PSQI 2 , p=0.613 respectively). No difference was found in scores of SGRQ (47.06±19.95 vs. 48.16±22.92, p=0.886), IPAQ (404.25±711.63 vs. 497.84±624.19, p=0.691), SDS (43.57±5.4 vs. 41.78±8.82, p=0.485) and ESS (5.36±3.73 vs. 6±5.42, p=0.705). Likewise, PFTs revealed no difference. A significant difference was observed only in SAS score for anxiety (34.79±4.87 vs. 40.16±7.81, p=0.021). Conclusions: IPF patients often report poor sleep quality that cannot be predicted by lung function or overall health-related QoL and must be detected by specific questionnaires.

> Drawing on observations of classroom art practice and visits to one museum and two galleries and on interviews with teachers and museum and gallery educators, this article examines the interactive relationship between school art education and museum and gallery visits. It studies: the ways primary teachers use such visits for art teaching purposes; and the reasons for the existing limitations in incorporating museum or gallery visits into school art education despite the wide acknowledgement of their educational value. The findings suggest the presence of two models of educational programmes which appear to influence differently the ‘three‐part unit’ of preliminary work, visit to the institution and follow‐up activities in the classroom.

The article draws on the case study of the European In-service training course ‘School and Science Museum: Cooperation for Improving Teaching, Learning and Discovering’ aiming to offer insights into the training of educators in museums. It discusses training and contributes suggestions in the context of the contemporary museum context as well as approaches to visitors' learning.

The chapter analyses the contribution of museums and galleries to art education in primary schools. In particular, it focuses on the ways teachers use stimuli and ideas offered during a museum visit into their classroom art practice. The evidence is drawn from comparative research in two museums, three galleries and sixteen primary schools in England and Greece. The research revealed two basic methodological ‘models’ of educational programmes in terms of their contribution to art education: 1) ‘the gallery as a classroom resource’ and 2) ‘the gallery as teacher about its own collection’, models which differ in terms of teaching and learning approaches, flexibility of educational tasks and relation to classroom teaching. The models are discussed in the context of the existing curricula and school practice in the two countries, and also of educational provision in the museums and galleries. The comparative approach aims to draw attention to more ‘universal’ realities rather than institutional, classroom or country characteristics, and develop suggestions for the improvement of the relationship between museum educational services and art practice in schools.

This short comment presents a few suggestions for the enrichment of JCOM seen from the perspective of an informal learning expert.

This paper addresses the role of museums in education in science and technology through the discussion of a specific project entitled EST “Educate in Science and Technology”. The Project puts together methodologies and activities through which museums can be used as resources for long-term project work. In-service training for teachers, work in class with learning kits or with materials brought in by a Science Van, and visits to the museum are planned and developed jointly by museum experts and teachers. The Project proposes a teaching and learning model which sees the museum experience as central and integral part of a teaching and learning process with more effective outcomes. The analysis of the Project activities and methodologies is based on the work carried out at the National Museum of Science and Technology Leonardo da Vinci, which perceives the learner (the visitor) at the heart of its educational methodologies and provision.