A significant number of patients with obstructive sleep apnea neither tolerate positive airway pressure (PAP) therapy nor achieve successful outcomes from either upper airway surgeries or use of an ...oral appliance. The purpose of this paper, therefore, was to systematically evaluate available peer-reviewed data on the effectiveness of adjunctive medical therapies and summarize findings from these studies. A review from 1985 to 2005 of the English literature reveals several practical findings. Weight loss has additional health benefits and should be routinely recommended to most overweight patients. Presently, there are no widely effective pharmacotherapies for individuals with sleep apnea, with the important exceptions of individuals with hypothyroidism or with acromegaly. Treating the underlying medical condition can have pronounced effects on the apnea/hypopnea index. Stimulant therapy leads to a small but statistically significant improvement in objective sleepiness. Nonetheless, residual sleepiness remains a significant health concern. Supplemental oxygen and positional therapy may benefit subsets of patients, but whether these therapies reduce morbidities as PAP therapy does will require rigorous randomized trials. PAP therapy has set the bar high for successful treatment of sleep apnea and its associated morbidities. Nonetheless, we should strive towards the development of universally effective pharmacotherapies for sleep apnea. To accomplish this, we require a greater knowledge of the neurochemical mechanisms underlying sleep apnea, and we must use this infrastructure of knowledge to design well-controlled, adequately powered studies that examine, not only effects on the apnea/hypopnea index, but also the effects of pharmacotherapies on all health related outcomes shown beneficial with PAP therapy.
What is Next Fundis, Allison; Wagner, Daniel; Ballard, Robert D.
Oceanography (Washington, D.C.),
03/2023, Letnik:
36
Journal Article
Recenzirano
While E/V Nautilus expeditions in 2022 surveyed a wide range of habitats and geological features, vast areas across the US Pacific Island Region remain completely unexplored. Therefore, Nautilus ...expeditions in 2023 will return to many of these poorly surveyed regions to continue filling the large knowledge gaps that remain in US waters of the Central Pacific. This will include ROV and mapping explorations in Papahanaumokuakea Marine National Monument, as well as in the Johnston and Palmyra/Kingman Units of the Pacific Remote Islands Marine National Monument. Furthermore, in 2023 Nautilus will conduct dedicated seafloor mapping surveys in the US exclusive economic zone south of the Main Hawaiian Islands and also around Jarvis Island, where large seafloor areas remain unmapped.
A major goal of the Ocean Exploration Trust (OET) is to explore the ocean in order to provide the foundational knowledge needed to inform the sustainable stewardship of its resources and to share ...that information broadly. Given the magnitude and complexity of this task, partnerships are critical to OET's work. In 2022, OET continued to build on its long-standing collaborations in addition to our primary expedition partner NOAA Ocean Exploration and initiated new partnerships focused on meaningfully connecting OET's work to a wide array of ocean stakeholders, particularly those from geographies where E/V Nautilus operates.
WHAT’S NEXT Leonardi, Alan P.; Ballard, Robert D.; Soule, Adam
Oceanography (Washington, D.C.),
03/2021, Letnik:
34, Številka:
1
Journal Article
Recenzirano
The past year has been difficult. Many friends and loved ones were lost during the coronavirus pandemic. All of us had to adjust, adapt, and learn new ways to live and work together while keeping ...healthy and safe in a virtual workspace. During this time, the NOAA Office of Ocean Exploration and Research, the Ocean Exploration Trust, and the Schmidt Ocean Institute continued their unique partnership to map, explore, and characterize the ocean while supporting goals of the blue economy. The partners advanced this mission by using virtual tools such as telepresence and new technologies to explore the deep ocean remotely, and most importantly, by drawing on the resilience and creativity of their people. NOAA's Office of Ocean Exploration and Research suspended ship operations in 2020.
E/V Nautilus expedition NA135 conducted the first human exploration of an unnamed seamount chain ~240 km west of the Hawaiian island of Kauai in the Central Pacific. The chain is composed of seven ...seamounts that rise roughly 2,000 m from the abyssal seafloor to summit depths of 1,800 m to 1650 m. The seamounts are each 15-25 km in diameter and display typical structures, including elevated ridges or rift zones arrayed radially around the summit. The seamount chain sits between the Mid-Pacific Mountains to the southwest and the Hawaiian chain to the northeast and is bracketed in the northwest and southeast by Necker Ridge and the Molokai'i Fracture Zone, respectively.
Volcanoes in human history de Boer, Jelle Zeilinga; de Boer, Jelle Zeilinga; Sanders, Donald Theodore
2011., 20120102, 2012, 2001, 2002-01-01
eBook
When the volcano Tambora erupted in Indonesia in 1815, as many as 100,000 people perished as a result of the blast and an ensuing famine caused by the destruction of rice fields on Sumbawa and ...neighboring islands. Gases and dust particles ejected into the atmosphere changed weather patterns around the world, resulting in the infamous ''year without a summer'' in North America, food riots in Europe, and a widespread cholera epidemic. And the gloomy weather inspired Mary Shelley to write the gothic novel Frankenstein.
Ocean exploration remains a cornerstone research priority of the University of Rhode Island's Graduate School of Oceanography, the lead institution for the Ocean Exploration Cooperative Institute ...(OECI). Among significant changes in OECI leadership over this past year, Paula Bontempi was appointed as Dean of the Graduate School of Oceanography and assumed the role of OECI principal investigator. She came to URI from NASA where she served as Program Scientist for the Ocean Biology and Biogeochemistry program as well as Deputy Director for the Earth Science Division. Adam Soule joined the URI/GSO staff and assumed the role of OECI Executive Director as well as Director of the Center for Ocean Exploration. The Inner Space Center at URI/GSO continued to support OECI seagoing activities over the past year by providing telepresence support to E/V Nautilus. In addition, the ISC tested hardware and software and developed plans to support the next generation of telepresence to enable tele-engineering, tele-operations, and tele-science and to expand telepresence capabilities to a greater range of platforms.
Despite widespread agreement that continuous positive airway pressure is effective therapy for obstructive sleep apnea, it is estimated that 50% of patients recommended for therapy are noncompliant 1 ...year later. Interventions to improve compliance in such patients have not been studied. We evaluated a 2 phase intervention program to improve compliance in sleep apnea patients previously noncompliant with continuous positive airway pressure.
204 patients with previously diagnosed obstructive sleep apnea and noncompliant with continuous positive airway pressure were enrolled. Phase 1 evaluated standard interventions to improve therapy compliance, including mask optimization, heated humidification, topical nasal therapy, and sleep apnea education. Persistently noncompliant patients proceeded to phase 2, where compliance was compared in double-blind randomized fashion between standard continuous positive airway pressure and flexible bilevel positive airway pressure.
49 (24%) of 204 previously noncompliant patients became compliant (average nightly use > or =4 hours) after standard interventions. Then 104 of the 155 persistently noncompliant patients agreed to continue and were randomized to either CPAP or flexible bilevel positive airway pressure retitration and treatment for an additional ninety days. At follow-up 15 (28%) of the 53 randomized to CPAP and 25 (49%) of the 51 randomized to flexible bilevel positive airway pressure (p = 0.03) achieved compliance.
A two phase intervention program, first employing standard interventions, followed by a change to flexible bilevel airway pressure, can achieve improved compliance in patients previously noncompliant with continuous positive airway pressure.
Bottom trawl fishing presents a severe yet largely unquantified threat to shipwreck sites. Here we present a quantification of damage to sites from the Aegean and Black seas through high resolution ...imaging of 45 shipwrecks discovered by the E/V Nautilus expeditions, 2009–2012. These shipwrecks are part of a modern submarine landscape that is heavily damaged by trawls, which also remove sediment and smooth out natural features of the seabed. We quantify the severity of this threat to archaeological sites through repeat visits to one ancient shipwreck and quantify the change to the seabed over a period of eleven months. The results illustrate the benefits of enforced areas of restricted bottom trawling (Marine Protected Areas) to the in situ preservation of shipwreck sites and to natural seabed features and benthic habitats. Careful marine spatial planning and coordinated management of fishing activity can mitigate this destructive activity. In addition, we counter the claim made by some commercial salvors who use trawl damage as an excuse to salvage artifacts from wrecks, further destroying historically significant sites for profit.
•We document change to a shipwreck site by trawling over 11months.•49 shipwrecks in the Aegean and Black seas exhibit differing amounts of trawl damage.•Trawling destroys the historical, benthic ecological, and sedimental nature of wrecks.•Protecting shipwreck sites as artificial reefs can increase local fisheries.
In 2016, funding from NOAA OER supported systematic mapping of portions of Channel Islands National Marine Sanctuary (CINMS) by E/V Nautilus. One focus of that effort was to locate and explore ...submerged paleoshorelines formed over the last 22,000 years when sea level stopped rising for 2,000 to 3,000 years at a time. These lulls in sea level rise permitted pounding waves, typical of the high-energy coast of today’s Southern California shoreline,to excavate caves, as they continue to now. The goal of our 2017 expedition in the Channel Islands area of the Southern California Continental Borderland was to search for submerged sea caves. Areas initially selected for investigation were the islands of Santa Cruz, Catalina, and Santa Barbara, where numerous sea caves are known to exist above present sea level, as well as where divers have already located them at the base of rock scarps resting at the 8 m to 10 m and 33 m paleo-shorelines.
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