Effects of continuous positive airway pressure treatment on coronary vasoreactivity measured by (82)Rb cardiac PET/CT in obstructive sleep apnea patients.

PURPOSE: Obstructive sleep apnea syndrome (OSA) increases the risk of cardiovascular disease. We aimed at evaluating the effect of continuous positive airway pressure (CPAP) treatment on coronary endothelium-dependent vasoreactivity in OSA patients by quantifying myocardial blood flow (MBF) response to cold pressure testing (CPT). METHODS: In the morning after polysomnography (PSG), all participants underwent a dynamic (82)Rb cardiac positron emitting tomography/computed tomography (PET/CT) scan at rest, during CPT and adenosine stress. PSG and PET/CT were repeated at least 6 weeks after initiating CPAP treatment. OSA patients were compared to controls and according to response to CPAP. Patients' characteristics and PSG parameters were used to determine predictors of CPT-MBF. RESULTS: Thirty-two untreated OSA patients (age 58 ± 13 years, 27 men) and 9 controls (age 62 ± 5 years, 4 men) were enrolled. At baseline, compared to controls (apnea-hypopnea index (AHI) = 5.3 ± 2.6/h), untreated OSA patients (AHI = 48.6 ± 19.7/h) tend to have a lower CPT-MBF (1.1 ± 0.2 mL/min/g vs. 1.3 ± 0.4 mL/min/g, p = 0.09). After initiating CPAP, CPT-MBF was not different between well-treated patients (AHI <10/h) and controls (1.3 ± 0.3 mL/min/g vs. 1.3 ± 0.4 mL/min/g, p = 0.83), but it was lower for insufficiently treated patients (AHI ≥10/h) (0.9 ± 0.2 mL/min/g vs. 1.3 ± 0.4 mL/min/g, p = 0.0045). CPT-MBF was also higher in well-treated than in insufficiently treated patients (1.3 ± 0.3 mL/min/g vs. 0.9 ± 0.2 mL/min/g, p = 0.001). Mean nocturnal oxygen saturation (β = -0.55, p = 0.02) and BMI (β = -0.58, p = 0.02) were independent predictors of CPT-MBF in OSA patients. CONCLUSIONS: Coronary endothelial vasoreactivity is impaired in insufficiently treated OSA patients compared to well-treated patients and controls, confirming the need for CPAP optimization.

Ydinreaktorin painesäiliön ulkoisen jäähdytyksen lämmönsiirtokokeita

The purpose of this work was to design and carry out thermal-hydraulic experiments dealing with overcooling transients of a VVER-440-type nuclear reactor pressure vessel. Sudden overcooling accident could have negative effect on the mechanical strength of the pressure vessel. If part of the pressure vessel is compromised, the intense pressure inside a pressurized water reactor could cause the wall to fracture. Information on the heat transfer along the outside of the pressure vessel wall is necessary for stress analysis. Basic knowledge of the overcooling accident and heat transfer types on the outside of the pressure vessel is presented as background information. Test facility was designed and built based to study and measure heat transfer during specific overcooling scenarios. Two test series were conducted with the first one concentrating on the very beginning of the transient and the second one concentrating on steady state heat transfer. Heat transfer coefficients are calculated from the test data using an inverse method, which yields better results in fast transients than direct calculation from the measurement results. The results show that heat transfer rate varies considerably during the transient, being very high in the beginning and dropping to steady state in a few minutes. The test results show that appropriate correlations can be used in future analysis.

La Enseñanza de los sistemas externos de representación matemáticos y lingüísticos en la educación infantil

El objetivo de este estudio es identificar factores que contribuyen a mantener un enfoque básicamente instrumental para enseñar los sistemas externos de representación matemáticos y lingüísticos en las primeras edades de escolarización. En el estudio han participado 123 maestros de Educación Infantil de diversos centros escolares públicos de Andalucía, Asturias, Cataluña y Navarra que han asistido a cursos de formación permanente del profesorado. El análisis cualitativo realizado se basa en grupos de discusión a partir de tópicos. Los resultados evidencian la influencia de diversos factores: el currículo de Educación Infantil; las concepciones del profesorado; las presiones entre etapas educativas; y, finalmente, la presión social. La identificación de los factores asociados a una enseñanza instrumental de los sistemas externos de representación puede entenderse como un tipo de información relevante acerca de las condiciones de la enseñanza de estos sistemas que, además, pueden servir de base para reconstruir las prácticas educativas