A proof of concept study describing extraoesophageal reflux in patients with obstructive sleep apnoea and asthma and the effects of continuous positive airway pressure
Bibliographic record
Abstract
Introduction: Literature suggests that Asthma and Obstructive Sleep Apnoea (OSA) could worsen potential extraoesophageal (EER) reflux and microaspiration (MAS). There is little data on the potential effects of continuous positive airway pressure (CPAP) therapy. Aims: To examine EER and the impact of CPAP therapy in Asthma and OSA patients. Methodology: Patients were recruited at Newcastle upon Tyne hospitals, UK. The study included four groups; G1: Patients with OSA + asthma (n=10), G2: asthma alone (n=10), G3: OSA alone (n=10) and G4: healthy volunteers (n=12). All subjects at recruitment-completed questionnaires about symptoms of EER; Reflux Symptoms Index (RSI). Salivary pepsin samples were also obtained from all subjects (Peptest). All tests were repeated after 1-month CPAP treatment. Results: The RSI score discriminated reflux symptoms among groups at baseline (P=0.00). Salivary pepsin result showed no differences between groups at baseline. After 1-month CPAP, patient reported salivary pepsin concentration and RSI significantly reduced in OSA patients (P= 0.05), (P= 0.04) respectively (Fig. A & B) and in asthma + OSA patients (P=0.00), (P= 0.00) respectively (Fig. C & D). All OSA patients who were taking PPIs (n=10) discontinued these medications after 1-month CPAP, associated with the symptomatic resolution of their reflux (p=0.00). Conclusion: CPAP may modulate reflux and MAS in patients with Asthma and OSA. If confirmed, by formal powered studies, these novel proof of concept findings could be of translational significance in these patient populations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".