No abstract

Background and objective: We evaluated inattention and behavioural outcomes following surgery versus watchful waiting (WW) in school-aged children with mild obstructive sleep apnoea (OSA). Methods: A prospective randomized controlled study was performed in pre-pubertal children aged 6-11 years with polysomnography (PSG)-confirmed mild OSA. They were assigned randomly to early surgical intervention (ES) or WW. The surgical intervention consisting of tonsillectomy with or without adenoidectomy and turbinate reduction was carried out within 4-6 weeks after randomization. Both groups underwent PSG, attention and behavioural assessment and review by an otorhinolaryngologist at baseline and 9-month follow-up. The primary outcome was omission T score from Conners' continuous performance test (CPT). Secondary outcomes were parentreported behaviours, quality of life, symptoms and PSG parameters. Results: A total of 114 participants were randomized. Data of 35 subjects from the ES and 36 from the WW group were available for final analysis. No significant treatment effect could be found in all CPT parameters and behavioural outcomes. Nevertheless, significantly greater reductions were seen in PSG parameters (obstructive apnoeahypopnoea index [−1.4 AE 2.0 cf. +0.3 AE 4.1/h, p = 0.038] and arousal index [−1.3 AE 4.4 cf. +1.4 AE 4.5/h, p = 0.013]) and OSA-18 total symptom score (−17.3 AE 19.7 cf. −3.6 AE 14.1, p = 0.001) in the ES group. Subjects who underwent surgery also had significantly greater weight gain (+3.3 AE 2.1 cf. +2.2 AE 1.5 kg, p = 0.014) and increase in systolic blood pressure (+5.1 AE 12.4 cf. −1.2 AE 8.7 mm Hg, p = 0.016). Conclusion: Despite improvements in PSG parameters and parent-reported symptoms, surgical treatment did not lead to parallel improvements in objective attention measures in school-aged children with mild OSA.

We conclude that the Hong Kong flap procedure is simple and desirable for mastoid reconstruction to achieve a safe and dry cavity with few complications.

The development of the bench model of a hybrid (rigid-flexible) morphing leading edge is presented in this paper. The distinctive feature of this design centers on compounding a fully rigid nose with a flexible structure to create a seamless morphing leading edge. The rigid nose guarantees a precise shape control in the aerodynamically critical region of the wing whereas the flexible structure allows for an increase in both chord length and its camber. These improvements offer potential solutions to many of the challenges reported in the literature about the existing morphing wing designs. In order to evaluate the feasibility of the hybrid (rigid-flexible) concept and to demonstrate the aforementioned improvements, a bench model is developed and tested in-house. This paper focuses on the analysis performed to develop this model, including (1) aerodynamic shape optimization to devise the desired drooped shape; (2) geometry optimization to specify the dimensions of the rigid nose; (3) finite element analysis to characterize the skin component of the flexible structure; and (4) finite element analysis to estimate the actuation authority. Overall, the numerical and experimental results reveal the inherent advantage of the hybrid (rigid-flexible) concept from the smart structure standpoint; however, significant considerations are required to advance the technical readiness level of this design to a commercially viable solution for aircraft manufacturers.