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Obstructive sleep apnea (OSA) is a high prevalent chronic disease that may lead to many complications, and cause great potential harm to health. Epidemiological studies have showed that OSA is closely related to the development of various cardiovascular diseases. There are about 66 million patients with moderate to severe OSA in China, but 80% of potential OSA patients have not been diagnosed and treated in time. OSA is mainly diagnosed and treated in a hospital-based sleep center currently, as the process is time-consuming and laborious, which may be lead to a delay in diagnosis and treatment of many patients. Supported by the development of Internet of Things, Internet technologies and other emerging technologies, remote medicine has been increasingly used in the diagnosis and management of chronic diseases owing to its advantages of easy access, interactivity, high efficiency, resource sharing, service continuity and without space-time constraints. Our center has initially built a management system for remote diagnosis and treatment of OSA, but its clinical efficacy and economic value need to be further verified. We designed a randomized controlled trial protocol to assess whether the clinical benefits of the low-cost remote healthcare model are similar to those of the traditional healthcare model by comparing them in terms of clinical efficacy and health economic benefits, hoping to provide a reference for the efficient use of medical resources and further promotion of remote diagnosis and treatment of chronic diseases.

Background The treatment adherence is closely related to the effect of continuous positive airway pressure (CPAP) therapy in patients with obstructive sleep apnea (OSA) , which is also strongly influenced by patients' psychosocial characteristics. However, the influence of depression symptoms on the adherence to CPAP needs to be further explored. Objective To evaluate the relationship of depression symptoms with adherence to CPAP, and the pathwaybetween the associated factors in OSA patients. Methods A total of 177 patients who were diagnosed with OSA and treated with CPAP in the Respiratory and Sleep Medicine Center, Peking University People's Hospital from May 2019 to July 2021 were selected. The general information, disease severity and adherence to CPAP were evaluated. The prevalence of depression symptoms was measured by the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) . The severity of insomnia was assessed by the Insomnia Severity Index (ISI) . The influence of daytime sleepiness on activities of daily living was measured by the 10-item Functional Outcomes of Sleep Questionnaire (FOSQ-10) . The 12-item Short Form Health Survey (SF-12) was used to evaluate the quality of life. The relationships among variables were determined by path analysis. Results The prevalence of depressive symptoms in OSA patients was relatively high (19.7%, 35/177) in our study. Depression symptoms were associated with increased insomnia prevalence (r=0.65, P0.05) , but could increase the adherence to CPAP by decreasing the activities of daily living (β=0.078, P

Aimed at the buckling problem of deep implantation of flexible neural probe, a grooved cross-section silicon needle is designed as an auxiliary implant tool to provide temporary stiffness for probe implantation. In order to quantitatively evaluate the comprehensive performance of auxiliary tools, combining critical buckling force and cross-section area, and considering mechanical and biological properties, the performance evaluation index of auxiliary tools is proposed. Based on this evaluation index, the optimal groove depth ratio and groove width ratio of the grooved cross-section silicon needle are studied. The best groove depth ratio is the maximum value within the process requirements while the best groove width ratio increases with the thickness of the silicon needle. Moreover, the performance evaluation index is used to quantitatively prove that the grooved cross-section silicon needle has obvious performance advantages over the traditional circular and rectangular cross-section silicon needles. The simulation design of the grooved cross-section silicon needle is conducive to screening the best parameter combination of the cross-section, reducing the number of processing and the cost of experiments.

The advancement of acoustic metamaterials enables the highly efficient absorption of low-frequency noise with a subwavelength structure thickness, but the complexity of these structures often hinders their large-scale practical applications. Here, we propose a straightforward and compact acoustic metamaterial structure composed of Helmholtz resonators with side slits (HRSS) for low-frequency noise absorption. The introduction of side slits not only simplifies the overall structure but also allows for easy adjustment of acoustic characteristics. By adjusting the depth of the resonator within the slit across 25 distinct units, an absorption coefficient above 0.8 is realized from 470 to 930 Hz. This work demonstrates the extensive low-frequency sound absorption capability of HRSS, providing valuable insights into the design of future practical acoustic materials. [ABSTRACT FROM AUTHOR]

Although mandibular advancement device (MAD) treatment of adults with obstructive sleep apnea (OSA) is generally less efficacious than positive airway pressure (PAP), the two treatments are associated, with similar clinical outcomes. As a sub‐analysis of a randomized trial comparing the effect of MAD versus PAP on blood pressure, this study compared objectively measured adherence to MAD versus PAP treatment in adults with OSA. Adults with OSA (age 54.1 ± 11.2 [standard deviation] years, 71.1% male, apnea–hypopnea index 31.6 ± 22.7 events/h) were randomized to MAD (n = 89) or PAP (n = 91) treatment for 3–6 months. Objective adherence was assessed with a thermal sensor embedded in the MAD and a pressure sensor in the PAP unit. In a per protocol analysis, no difference was observed in average daily hours of use over all days in participants on MAD (n = 35, 4.4 ± 2.9 h) versus PAP (n = 51, 4.7 ± 1.6 h, p =.597) treatment when days with missing adherence data were included as no use. MAD was used on a lower percentage of days (62.5 ± 36.4% versus 79.9 ± 19.8%, p =.047), but with greater average daily hours of use on days used (6.4 ± 1.9 h versus 5.7 ± 1.2 h, p =.013). Average daily hours of use in the first week were associated with long‐term adherence to MAD (p <.0001) and PAP (p =.0009) treatment. Similar results were obtained when excluding days with missing adherence data. In conclusion, no significant difference was observed in objectively measured average daily hours of MAD and PAP adherence in adults with OSA, despite differences in the patterns of use. MAD adherence in the first week predicted long‐term use. [ABSTRACT FROM AUTHOR]

Study Objectives: This study assessed the current state of sleep medicine accreditation and training in Asia by conducting a comprehensive survey across 29 Asian countries and regions facilitated by the Asian Society of Sleep Medicine (ASSM) to identify existing gaps and provide recommendations for future enhancements., Methods: The ASSM Education Task Force Committee designed a survey to gather data on accreditation, education, and training standards in sleep medicine, including information on challenges in enhancing education in the field., Results: With an 86% (25 countries/regions) response rate, the survey showed that sleep medicine is recognized as an independent specialty in just nine countries/regions (36% of the countries/regions surveyed). Ten countries/regions have established sleep medicine training programs, with Japan and Saudi Arabia offering it as a distinct specialty. Significant disparities in training and accreditation standards were identified, with many countries/regions lacking formalized training and practice guidelines. The survey also revealed that most local sleep societies across Asia support the development of an Asian Sleep Medicine Training Curriculum led by the ASSM. However, several barriers significantly impede the establishment and development of sleep medicine training programs, including the scarcity of trained specialists and technologists and the absence of national accreditation for sleep medicine., Conclusions: The survey highlights the need for standardized sleep medicine training and accreditation across Asia. Developing an Asian Sleep Medicine Training Curriculum and promoting ASSM accreditation guidelines are key recommendations. Implementing these strategies is essential for advancing sleep medicine as a widely recognized discipline throughout Asia., (© 2024 American Academy of Sleep Medicine.)