Knowledge and Attitudes of Obstructive Sleep Apnea among Jordanian Otolaryngologists: A Cross-Sectional Study.

Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder that affects almost one billion individuals worldwide. An estimated 16.8% of adults in Jordan have been diagnosed with OSA. Given the importance of management of OSA by otolaryngologists, we assessed the knowledge and attitudes of Jordanian otolaryngologists in managing OSA in adult and pediatric patients. A survey, conducted anonymously online, was sent present otolaryngology residents and specialist in Jordan, in the English language. The participants were given the OSA Knowledge and Attitude questionnaire (OSAKA, OSAKA-KIDS), which have been previously validated. Data were obtained and then analyzed via SPSS software. A total of 140 residents and specialist of otolaryngology were selected. A significant difference in OSAKA scores were found between otolaryngologists under 30 years of age and those above, with higher scores for the older age group. The proportion of specialists who 'agreed' or 'strongly agreed' they are confident in their ability to manage patients with OSA was significantly higher that junior residents (73.8% vs 33.3%; p = 0.008). More than 10 years at practice was associated with statistically significant higher levels of knowledge towards OSAKA scale (AOR = 0.09; p = 0.044). Additionally, being a senior resident was significantly associated with more knowledge towards OSAKA-KIDS scale (AOR = 0.19; p = 0.03). Otolaryngology residents and specialists' knowledge of OSA was very good. Further improving in the level of the knowledge toward OSA among the otolaryngology resident doctors should be implemented as possible by following the updated guidelines for the diagnosis and management OSA. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-04180-8.

A Hydrogen-Bonded Organic Framework Equipped with a Molecular Nanovalve.

The concept of a molecular nanovalve is applied to a synthesized biocompatible hydrogen-bonded organic framework (HOF), termed RSS-140, to load, trap, and subsequently release an antioxidant on command. Specifically, we exploit the pore windows of RSS-140 (i.e., ß-CD cavities) to first load and trap the antioxidant, Trolox, within the internal pores of the HOF (Trolox⊂RSS-140) and, to prevent it from leaching, utilize supramolecular chemistry to complex azobenzene (Azo) with ß-CD (Trolox⊂Azo@RSS-140). The molecular nanovalve is fully realized upon exposing Trolox⊂Azo@RSS-140 to UV light with a specific wavelength, which induces Azo isomerization, Azo decomplexation from ß-CD, and subsequent release of Trolox from the pores of RSS-140. The biocompatibility and nontoxicity of Trolox⊂Azo@RSS-140, together with the absolute control over the nanovalve opening, were established to yield a system that safely and slowly releases Trolox for longer-lasting antioxidant efficacy. As the field of supramolecular chemistry is rich with similar systems and many such systems can be used as building blocks to construct HOFs or other extended framework materials, we envision the molecular nanovalve concept to be applied widely for controllably delivering molecular cargo for diverse applications.

Spontaneous Vertebral Artery Dissection Is an Under-Recognized Cause of Stroke in Young Patients: Two Case Reports and Review.

Cervicocerebral artery dissection (CAD) is an important and under-recognized cause of strokes in young and middle-aged patients. Spontaneous vertebral artery dissection (VAD) is a rare condition that can potentially cause a stroke without any preceding trauma or other causes of dissection. VAD rarely simulates classical headache syndromes. In this report, we discuss two young patients who were initially misdiagnosed as cases of headache until they presented with ischemic events, and were eventually diagnosed with spontaneous VAD. Case 1 involves a 41-year-old male patient who presented with severe headache radiating to left posterior neck pain and dizziness. He was initially misdiagnosed as a case of cervicogenic headache. He was subsequently diagnosed with extracranial VAD complicated by a delayed embolic ischemic stroke. However, he made full recovery within the next few days. Case 2 pertains to a 33-year-old female patient who presented with right-sided headache mimicking migraine; later on, new neurological signs prompted a diagnosis of acute ischemic infarction as a complication of intracranial VAD. In conclusion, VAD should be seriously considered when dealing with patients complaining of the first attack of headache that mimics migraine or those with cervicogenic headaches, which fail to respond to the usual treatment. Moreover, posterior circulation stroke among young patients or stroke with pain in the head and neck should be investigated carefully with extensive neuroimaging. Finally, prompt and accurate diagnosis of VAD followed by proper treatment is crucial for good outcomes and will prevent disability or even fatal complications in patients.