Observational study on efficacy of negative expiratory pressure test proposed as screening for obstructive sleep apnea syndrome among commercial interstate bus drivers - protocol study

Background: Obstructive sleep apnea (OSA) is a respiratory disease characterized by the collapse of the extrathoracic airway and has important social implications related to accidents and cardiovascular risk. The main objective of the present study was to investigate whether the drop in expiratory flow and the volume expired in 0.2 s during the application of negative expiratory pressure (NEP) are associated with the presence and severity of OSA in a population of professional interstate bus drivers who travel medium and long distances.Methods/Design: An observational, analytic study will be carried out involving adult male subjects of an interstate bus company. Those who agree to participate will undergo a detailed patient history, physical examination involving determination of blood pressure, anthropometric data, circumference measurements (hips, waist and neck), tonsils and Mallampati index. Moreover, specific questionnaires addressing sleep apnea and excessive daytime sleepiness will be administered. Data acquisition will be completely anonymous. Following the medical examination, the participants will perform a spirometry, NEP test and standard overnight polysomnography. The NEP test is performed through the administration of negative pressure at the mouth during expiration. This is a practical test performed while awake and requires little cooperation from the subject. In the absence of expiratory flow limitation, the increase in the pressure gradient between the alveoli and open upper airway caused by NEP results in an increase in expiratory flow.Discussion: Despite the abundance of scientific evidence, OSA is still underdiagnosed in the general population. In addition, diagnostic procedures are expensive, and predictive criteria are still unsatisfactory. Because increased upper airway collapsibility is one of the main determinants of OSA, the response to the application of NEP could be a predictor of this disorder. With the enrollment of this study protocol, the expectation is to encounter predictive NEP values for different degrees of OSA in order to contribute toward an early diagnosis of this condition and reduce its impact and complications among commercial interstate bus drivers.

Sleep apnea and automobile accidents: Review of regulation for drivers

Several studies show a crescent association between sleep-disordered breathing, excessive sleepiness and automobile accidents. Many countries already discussed about specific regulations for drivers with these conditions, including questionnaire and/or investigation by a qualified specialist. In Brazil, these discussions have barely begun. In view of that, we suggest some items to be included in our traffic law.

Local and regional ecological drivers of fish assemblages in Brazilian estuaries

Spatial patterns in assemblage structures are generated by ecological processes that occur on multiple scales. Identifying these processes is important for the prediction of impact, for restoration and for conservation of biodiversity. This study used a hierarchical sampling design to quantify variations in assemblage structures of Brazilian estuarine fish across 2 spatial scales and to reveal the ecological processes underlying the patterns observed. Eight areas separated by 0.7 to 25 km (local scale) were sampled in 5 estuaries separated by 970 to 6000 km (regional scale) along the coast, encompassing both tropical and subtropical regions. The assemblage structure varied significantly in terms of relative biomass and presence/absence of species on both scales, but the regional variation was greater than the local variation for either dataset. However, the 5 estuaries sampled segregated into 2 major groups largely congruent with the Brazilian and Argentinian biogeographic provinces. Three environmental variables (mean temperature of the coldest month, mangrove area and mean annual precipitation) and distance between estuaries explained 44.8 and 16.3%, respectively, of the regional-scale variability in the species relative biomass. At the local scale, the importance of environmental predictors for the spatial structure of the assemblages differed between estuarine systems. Overall, these results support the idea that on a regional scale, the composition of fish assemblages is simultaneously determined by environmental filters and species dispersal capacity, while on a local scale, the effect of environmental factors should vary depending on estuary-specific physical and hydrological characteristics © 2013 Inter-Research.

Do Circadian Preferences Influence the Sleep Patterns of Night Shift Drivers?

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Recurrent genomic alterations in sequential progressive leukoplakia and oral cancer: drivers of oral tumorigenesis?

A significant proportion (up to 62) of oral squamous cell carcinomas (OSCCs) may arise from oral potential malignant lesions (OPMLs), such as leukoplakia. Patient outcomes may thus be improved through detection of lesions at a risk for malignant transformation, by identifying and categorizing genetic changes in sequential, progressive OPMLs. We conducted array comparative genomic hybridization analysis of 25 sequential, progressive OPMLs and same-site OSCCs from five patients. Recurrent DNA copy number gains were identified on 1p in 20/25 cases (80) with minimal, high-level amplification regions on 1p35 and 1p36. Other regions of gains were frequently observed: 11q13.4 (68), 9q34.13 (64), 21q22.3 (60), 6p21 and 6q25 (56) and 10q24, 19q13.2, 22q12, 5q31.2, 7p13, 10q24 and 14q22 (48). DNA losses were observed in 20 of samples and mainly detected on 5q31.2 (35), 16p13.2 (30), 9q33.1 and 9q33.29 (25) and 17q11.2, 3p26.2, 18q21.1, 4q34.1 and 8p23.2 (20). Such copy number alterations (CNAs) were mapped in all grades of dysplasia that progressed, and their corresponding OSCCs, in 70 of patients, indicating that these CNAs may be associated with disease progression. Amplified genes mapping within recurrent CNAs (KHDRBS1, PARP1, RAB1A, HBEGF, PAIP2, BTBD7) were selected for validation, by quantitative real-time PCR, in an independent set of 32 progressive leukoplakia, 32 OSSCs and 21 non-progressive leukoplakia samples. Amplification of BTBD7, KHDRBS1, PARP1 and RAB1A was exclusively detected in progressive leukoplakia and corresponding OSCC. BTBD7, KHDRBS1, PARP1 and RAB1A may be associated with OSCC progression. Proteinprotein interaction networks were created to identify possible pathways associated with OSCC progression.

Drivers of clutch-size in Fork-tailed Flycatchers (Tyrannus savana) at temperate and tropical latitudes in South America

Many species of birds exhibit a latitudinal gradient in annual reproductive investment, laying more eggs and producing more nestlings at higher latitudes. However, few studies have evaluated the mechanisms that underlie such patterns and such differences in grassland birds specifically. We monitored nests of Fork-tailed Flycatchers (Tyrannus savana) over two breeding seasons at a tropical site in Bolivia (in 2010-11 and 2011-12) and three breeding seasons at a southern temperate site in Argentina (2010-11, 2011-12 and 2012-13), testing two hypotheses explaining variation in clutch-size among populations: the food-limitation hypothesis and the nest-predation hypothesis. Mean clutch-size and mean brood-size were significantly larger at the temperate study site than at the tropical site. Availability of arthropod food per individual bird was significantly higher at the temperate site. There was no relationship, positive or negative, between rates of nest predation and either clutch- or brood-size, and thus no support for the nest-predation hypothesis. We conclude that food availability explains much of the latitudinal variation in clutch-size in this species. We discuss avenues for future research on the mechanisms underlying geographical variation in the life histories of Neotropical birds.

Diastolic blood pressure associated with accumulated work time among drivers and collectors

The relationship between diastolic blood pressure and the variables total cumulative working time and age was examined by regression analysis. The study was carried out among 839 bus drivers and conductors, users of an occupational health center in Campinas, S. Paulo State, Brazil. The main results were a positive association between diastolic blood pressure and cumulative working time, as well as an interaction between this variable and the bus worker's age.

Drivers of change in animal protein production systems: changes from 'traditional' to 'modern' beef cattle production systems in Brazil

Until 1990, beef cattle production in Brazil was recognized as an enterprise of low investment, low cost of production, as well as an extensive production system that used large land areas to be economically feasible. The situation changed for the Brazilian beef market when the economy stabilized in 1994 and all sectors involved in the beef supply chain were able to predict their associated costs and profits. During the same period, purchasing power of the Brazilian population grew, and as a consequence, consumers began to demand higher quality beef products. This new scenario in the late 1990s and early 2000s has led to more intensive beef production systems in Brazil as well as the need for a greater understanding of how technologies might be applied. As consequence of this evolution, in the last five years, a necessity to increase beef production has occurred. The quality of Brazilian beef has improved compared with beef produced 15 years ago, but continued improvements are needed to achieve excellence in terms of large-scale production of high quality beef, be sustainable over a long period of time, and increase our contribution to global food security.