Defining Extreme Phenotypes of OSA Across International Sleep Centers.

BACKGROUND: Extreme phenotypes of OSA have not been systematically defined. RESEARCH QUESTION: This study developed objective definitions of extreme phenotypes of OSA by using a multivariate approach. The utility of these definitions for identifying characteristics that confer predisposition toward or protection against OSA is shown in a new prospective sample. STUDY DESIGN AND METHODS: In a large international sample, race-specific liability scores were calculated from a weighted logistic regression that included age, sex, and BMI. Extreme cases were defined as individuals with an apnea-hypopnea index (AHI) ≥ 30 events/hour but low likelihood of OSA based on age, sex, and BMI (liability scores > 90th percentile). Similarly, extreme controls were individuals with an AHI < 5 events/hour but high likelihood of OSA (liability scores < 10th percentile). Definitions were applied to a prospective sample from the Sleep Apnea Global Interdisciplinary Consortium, and differences in photography-based craniofacial and intraoral phenotypes were evaluated. RESULTS: This study included retrospective data from 81,338 individuals. A total of 4,168 extreme cases and 1,432 extreme controls were identified by using liability scores. Extreme cases were younger (43.1 ± 14.7 years), overweight (28.6 ± 6.8 kg/m2), and predominantly female (71.1%). Extreme controls were older (53.8 ± 14.1 years), obese (34.0 ± 8.1 kg/m2), and predominantly male (65.8%). These objective definitions identified 29 extreme cases and 87 extreme controls among 1,424 Sleep Apnea Global Interdisciplinary Consortium participants with photography-based phenotyping. Comparisons suggest that a greater cervicomental angle increases risk for OSA in the absence of clinical risk factors, and smaller facial widths are protective in the presence of clinical risk factors. INTERPRETATION: This objective definition can be applied in sleep centers throughout the world to consistently define OSA extreme phenotypes for future studies on genetic, anatomic, and physiologic pathways to OSA.

Molluscicidal activities of medicinal plants from eastern China against Oncomelania hupensis, the intermediate host of Schistosoma japonicum / Atividades moluscicida de plantas medicinais do leste da China contra Oncomelania hupensis, o hospedeiro intermediário da Schistosoma japonicum

In a search for natural products that could be used to control schistosomiasis, nineteen extracts of eleven medicinal plants from eastern China have been tested for molluscicidal activity against snail Oncomelania hupensis. The n-butanol fraction of the fresh leaf from Buddleja lindleyana Fortune, Buddlejaceae, showed significant activity against the snails. Statistical analysis revealed that the LC50 and LC90 values for the n-butanol fraction were 39.91 mg L-1 and 59.28 mg L-1 for 48 h, respectively. Otherwise, the LC50 values for the n-butanol fraction to zebrafish was 403.24 mg L-1 for 48 h. Therefore, the n-butanol fraction of the fresh leaf from B. lindleyana may be a potent and safe molluscicides.

Na busca por produtos naturais que podem ser utilizados para controle da esquistossomose, dezenove extratos de onze plantas medicinais do leste da China foram testados para atividade moluscicida contra o caramujo Oncomelania hupensis. A fração n-butanol das folhas frescas de Buddleja lindleyana Fortune, Buddlejaceae, mostrou atividade significativa contra os caracóis. A análise estatística revelou que os valores de CL50 e CL90 para a fração n-butanol foram 39,91 mg L-1 e 59,28 mg L-1 por 48 h, respectivamente. Por outro lado, a CL50 para a fração n-butanol para peixe-zebra foi 403,24 mg L-1 por 48 h. Portanto, a fração n-butanol das folhas frescas de B. lindleyana poderá vir a ser um moluscicidas potente e seguro.