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<bold>Introduction:</bold> Hypoglossal nerve stimulation (HNS) is a novel treatment for patients with obstructive sleep apnoea (OSA). Despite its use in public healthcare there are limited published data from randomised controlled trials (RCT). <bold>Methods:</bold> We evaluated RCTs of HNS published up to 01/01/2024 related to HNS, and assessed the between-group difference in the apnoea-hypopnoea-index (AHI). Data are reported as treatment effect (delta) with the 95% confidence interval (CI). <bold>Results:</bold> There are five RCTs on HNS reporting the between group treatment effect (Table 1). The BLAST-OSA trial (Eastwood et al, <italic>Eur Resp J</italic> 2020), a single-arm trial that did not contain a control group, reported a treatment effect on the AHI of -10.8 (95% -14.6; -7.0) hour⁻¹. <table-wrap><object-id>erj;64/suppl_68/PA869/TB1</object-id><object-id>T1</object-id><object-id>TB1</object-id><table><colgroup><col></col><col></col></colgroup><tbody><tr><td><bold>RCT (author, publication)</bold></td><td><bold>Treatment Effect AHI (events x hour⁻¹)</bold></td></tr><tr><td>STAR trial (Strollo et al, <italic>NEJM</italic> 2014)^*</td><td>-17.3 (95%CI -20.7; -14.9)⁼</td></tr><tr><td>TESLA trial (Pengo et al, Thorax 2016)^{^}</td><td>-9.1 (95%CI -16.2; -2.0)⁺</td></tr><tr><td>Wu et al (Thorax, 2022)^{^}</td><td> -7.3 (95%CI -18.5; 3.9)⁺ -13.3 (95%CI -23.5; -3.1)^% </td></tr><tr><td>THN3 trial (Schwartz et al, JAMA Otolaryngol 2023)*</td><td> -14.4 (95%CI -18.0; -10.5)⁼ </td></tr><tr><td>TESLA home trial (Ratneswaran et al, <italic>eClinicalMedicine</italic> 2023)^{^}</td><td> -11.5 (95%CI -20.7; -2.3)⁺ unadjusted -7.0 (95%CI -15.7; 1.8)⁺ adjusted </td></tr></tbody></table></table-wrap> ^*unilateral invasive; ^{^}bilateral transcutaneous; ⁼triggered; ⁺continuous; ^%intermittent <bold>Conclusion:</bold> There are limited data from RCTs on HNS reporting the AHI treatment effect. Data suggest a greater reduction in the AHI using the invasive rather than the transcutaneous method. However, there is substantial overlap in the confidence intervals of the treatment effect, and different approaches in responder selection need to be considered.

<bold>Objectives:</bold> CAT was developed as a measure of COPD health status impairment for clinical practice and research. It was designed to have a total score from the sum of 8 items, but subsequently investigators have explored the use of individual items. This study analysed the factor structure of CAT and tested the potential to reduce items and create domains. <bold>Methods:</bold> Data are from the baseline of COMPASS (Liang, et al. <italic>ERJ Open Res</italic> 2021;7:00201). Exploratory factor analysis (EFA) was used to identify factors with Eigenvalues >1.0. <bold>Results:</bold> CAT data from 1696 COPD patients were available, 89.6% male, mean age 65.4 years, mean post-bronchodilator FEV₁ 66.6% predicted. Using all 8 CAT items, 3 Factors were identified: Activity (items 3, 4, 5, 6), Cough & Sputum (items 1, 2) and Sleep & Energy (items 7, 8); items 3 and 8 did not load strongly and were dropped. Item 7 was then dropped as a single item domain, as it correlated poorly with other measures (<bold>Table</bold>). The % of total variance in the model explained by the 8 items was 56.3%, 6 items 53.9%, and 5 items 61.3%. Correlations between different CAT items with SGRQ, mMRC and FEV₁ are tabulated (<bold>Table</bold>). Notably, CAT 5-item correlated as strongly with SGRQ total score as CAT 8-item. <bold>Conclusion:</bold> These findings suggest CAT may be reduced to 5 items with 2 domain scores (Cough & Sputum and Activity). These scores show convergent validity with scores captured by other patient-centred outcomes. <bold>Funding</bold> GSK (208630) <fig><object-id>erj;64/suppl_68/PA2162/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>

and Abnormal Cardiac Homeostasis in Adulthood 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) and similar environmental contaminants have previously been demonstrated to be potent cardiovascular teratogens in developing piscine and avian species. In the current study, we investigate the effects of TCDD on murine cardiovascular development. Pregnant mice were dosed with 1.5, 3, 6, 12, and 24 ug/kg TCDD on gestation day (GD) 14.5. No overt maternal or fetal toxicity was seen at this dose, and litter size and neonatal survival were normal in the offspring of TCDD-treated dams. At day GD17.5, fetal mice exhibited a dose-related decrease in heart-to-body weight ratio that was significantly reduced at a dose as low as 3 ug/kg TCDD. In addition, cardiac proliferation, as measured by both proliferating cell nuclear antigen (PCNA) and 5-bromo-2'deoxyuridine (BrdU) staining, was reduced in GD17.5 hearts treated with 6 ug/kg TCDD. To determine if this reduction in cardiac weight was transient, or continued after birth, mice treated with 6 ug/kg TCDD were allowed to come to term and remain with the original dam. While heart weights had normalized by post-natal day 7, TCDD-treated mice had increased heart-to-body weight ratios and increased expression of the cardiac hypertrophy markers 21 days after birth. At postnatal day 21, mice from TCDD-treated dams demonstrated a pronounced ST-segment depression in response to isoproterenol, suggesting cardiac ischemia. Furthermore, basal and isoproterenol-responsive heart rate was lower in TCDD-treated mice. These results demonstrate that TCDD reduces heart weight during cardiac development, and results in a compensative cardiac hypertrophy and altered cardiac functionality after birth.

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(1978). Roy Heath. The murderer. London: Allison and Busby, 1978. World Literature Written in English: Vol. 17, No. 2, pp. 656-658.

Journal Article A Comparison of Criteria of Susceptibility in the Response of Drosophila to Hydrocyanic Acid Gas: I. Stupefaction Time and Mortality Get access C. I. Bliss, C. I. Bliss London, England, Search for other works by this author on: Oxford Academic PubMed Google Scholar B. M. Broadben B. M. Broadben London, England, Search for other works by this author on: Oxford Academic PubMed Google Scholar Journal of Economic Entomology, Volume 28, Issue 6, 1 December 1935, Pages 989–1001, https://doi.org/10.1093/jee/28.6.989 Published: 01 December 1935