Alignment Patterns Research Articles

Land surveying in early medieval Norway: a St. Olav pilgrimage path as a means of creating an integrated Christian society in a Viking landscape?

The pilgrimage routes to St. Olav’s crypt offered new cultural landscape experiences. Primary attention to Christian dogma and art as discursive text leaves a ritual transformation from a Viking landscape unexplored. Pilgrim mental maps and belief may have been structured by land surveyed patterns of churches on the route. This article will map points of one route, Østerdalsleden. Among the six churches on today’s recreational route, four are replaced with the earliest in the community. A complex pattern of alignments integrating all six church locations are compared to patterns created by substituting random points within community test areas. The existing pattern does not randomly reproduce in 10 000 sets of eleven total route points, leaving the high probability that these churches were organised as a cultural concept of pilgrimage landscape.

Positional MR imaging of normal and injured knees.

This study uses a practical positional MRI protocol to evaluate tibiofemoral translation and rotation in normal and injured knees. Following ethics approval, positional knee MRI of both knees was performed at 35° flexion, extension, and hyperextension in 34 normal subjects (mean age 31.1 ± 10 years) and 51 knee injury patients (mean age 36.4 ± 11.5 years, ACL tear n = 23, non-ACL injury n = 28). At each position, tibiofemoral translation and rotation were measured. Normal knees showed 8.1 ± 3.3° external tibial rotation (i.e., compatible with physiological screw home mechanism) in hyperextension. The unaffected knee of ACL tear patients showed increased tibial anterior translation laterally (p = 0.005) and decreased external rotation (p = 0.002) in hyperextension compared to normal knees. ACL-tear knees had increased tibial anterior translation laterally (p < 0.001) and decreased external rotation (p < 0.001) compared to normal knees. Applying normal thresholds, fifteen (65%) of 23 ACL knees had excessive tibial anterior translation laterally while 17 (74%) had limited external rotation. None (0%) of 28 non-ACL-injured knees had excessive tibial anterior translation laterally while 13 (46%) had limited external rotation. Multidirectional malalignment was much more common in ACL-tear knees. Positional MRI shows (a) physiological tibiofemoral movement in normal knees, (b) aberrant tibiofemoral alignment in the unaffected knee of ACL tear patients, and (c) a high frequency of abnormal tibiofemoral malalignment in injured knees which was more frequent, more pronounced, more multidirectional, and of a different pattern in ACL-tear knees than non-ACL-injured knees. • Positional MRI shows physiological tibiofemoral translation and rotation in normal knees. • Positional MRI shows a different pattern of tibiofemoral alignment in the unaffected knee of ACL tear patients compared to normal control knees. • Positional MRI shows a high prevalence of abnormal tibiofemoral alignment in injured knees, which is more frequent and pronounced in ACL-tear knees than in ACL-intact injured knees.

Figure-Ground Alignment Patterns in Indonesian

This paper investigates the syntax and semantics of two verbal suffixes in Indonesian. The two verbal suffixes are the suffix –kan and -i. Many linguists have studied the verbal suffix -kan, whereas the verbal suffix –i got less attention. This paper discusses the suffix –kan in conjunction with the suffix –i. The suffix –kan marks a causative verb, and the suffix –i a locative verb. A causative verb has A FIGURE object, whereas a locative verb has a GROUND object. The proposed analysis employing causative and locative alignment patterns showed a more revealing result of the main functions of the suffix –kan and –i.

Stress anisotropy in confined populations of growing rods.

A central feature of living matter is its ability to grow and multiply. The mechanical activity associated with growth produces both macroscopic flows shaped by confinement, and striking self-organization phenomena, such as orientational order and alignment, which are particularly prominent in populations of rod-shaped bacteria due to their nematic properties. However, how active stresses, passive mechanical interactions and flow-induced effects interact to give rise to the observed global alignment patterns remains elusive. Here, we study in silico colonies of growing rod-shaped particles of different aspect ratios confined in channel-like geometries. A spatially resolved analysis of the stress tensor reveals a strong relationship between near-perfect alignment and an inversion of stress anisotropy for particles with large length-to-width ratios. We show that, in quantitative agreement with an asymptotic theory, strong alignment can lead to a decoupling of active and passive stresses parallel and perpendicular to the direction of growth, respectively. We demonstrate the robustness of these effects in a geometry that provides less restrictive confinement and introduces natural perturbations in alignment. Our results illustrate the complexity arising from the inherent coupling between nematic order and active stresses in growing active matter, which is modulated by geometric and configurational constraints due to confinement.

Focusing Curriculum Alignment to Enhance Student Learning Outcomes: Implications for English Language Teachers at Secondary Level

This study was aimed to know the perception of secondary school English language teachers regarding curriculum alignment pattern between three components; written SLOs documented in the National Curriculum 2006, teaching practices, and assessment techniques. A qualitative research design was used and 20 English language teachers from the Federal Directorate of Education, Islamabad were selected. Due to the saturation point only 12 participants (M=7, F=5) were interviewed. The interviews were transcribed, categorized and then thematically analyzed. Three main themes and eight sub-themes emerged. The main themes stressed the need to Understand curriculum alignment in terms of the English language, focus curriculum alignment at the instructional level, and align assessment with given student learning outcomes. It was found that teachers are not trained in using written curriculum document. Additionally, it was reported that equal representation was not given to four areas of language i.e., writing, speaking, listening and reading. It was, therefore, recommended that teacher training programs may be initiated to train teacher on the use of written curriculum documents and help them understand the importance of written curriculum with classroom teaching and assessments. Moreover, it is suggested to provide adequate resources to the teachers for effective implementation of written curriculum and enhancement of students learning outcomes.

Lower limb alignment in patients with primary valgus ankle arthritis: A comparative analysis with patients with varus ankle arthritis and healthy controls

BackgroundWhile it is commonly acknowledged that the combined effect of lower limb orientation and ankle and hindfoot alignment play a fundamental role in ankle arthritis, supramalleolar/lower limb alignment has received less attention in valgus ankle arthritis. The purpose of this study was to analyze the lower limb alignment of patients with valgus ankle arthritis with primary origin, compared to that of varus ankle arthritis and normal controls. We hypothesized that patients with valgus ankle arthritis would have the opposite pattern of lower limb alignment as those with varus ankle arthritis. MethodsA retrospective radiographic analysis was performed on 61 patients (62 ankles, mean age, 59.3 ± 12 years) with primary valgus ankle arthritis. On preoperative radiographs, seven parameters, including talar tilt angle, medial distal tibial angle (MDTA), talar center migration, anterior distal tibial angle, talo-first metatarsal (Meary's) angle, hindfoot moment arm (HMA), and mechanical axis deviation (MAD), were measured and compared to those of primary varus ankle arthritis (n = 55; mean age, 59.7 ± 8.1 years) and control patients (n = 59; mean age, 29.3 ± 7.3 years). ResultsThe valgus group had a significantly lower mean MDTA than the control group (p < 0.0001), indicating a varus distal tibial plafond in comparison to the control group. Meary's angle and HMA were significantly lower in the valgus group compared to the varus group (p < 0.05 and p < 0.0001, respectively), indicating a lower medial longitudinal arch and valgus hindfoot alignment. On whole limb radiographs, the valgus group showed a greater MAD than the control group, indicating varus lower limb alignment (p < 0.05). However, the MAD did not differ significantly between the valgus and varus groups (p = 0.7031). ConclusionOur findings indicate that a significant proportion of ankles with primary valgus arthritis have a varus tibial plafond and a varus lower limb mechanical axis. This study contributes to our understanding of primary valgus ankle arthritis and suggests that lower limb alignment should be analyzed and considered throughout valgus ankle arthritis realignment procedures.

Can Binocular Alignment Distinguish Hypertropia in Sagging Eye Syndrome From Superior Oblique Palsy?

PurposeAlthough the three-step test (3ST) is typically used to diagnose superior oblique palsy (SOP), sagging eye syndrome (SES) has clinical similarities. We sought to determine if alignment measurements can distinguish unilateral SOP from hypertropia in SES.MethodsWe studied hypertropic subjects who underwent surface-coil magnetic resonance imaging (MRI) demonstrating either SO cross-section reduction indicative of congenital or acquired palsy (SOP group) or lateral rectus muscle sag (SES group). Alignment was measured by Hess screen and prism-cover testing. Multiple supervised machine learning methods were employed to evaluate diagnostic accuracy. Rectus pulley coordinates were determined in SES cases fulfilling the 3ST.ResultsTwenty-three subjects had unilateral SOP manifested by SO atrophy. Eighteen others had normal SO size but MRI findings of SES. Maximum cross-section of the palsied SO was much smaller than contralaterally and in SES (P < 2 × 10−5). Inferior oblique cross-sections were similar in SOP and SES. In both SOP and SES, hypertropia increased in contralateral and decreased in ipsilateral gaze and was greater in ipsilateral than contralateral head tilt. In SES, nine subjects (50%) fulfilled the 3ST and had greater infraplacement of the lateral than medial rectus pulleys in the hypotropic orbit. Supervised machine learning of alignment data distinguished the diagnoses with areas under the receiver operating curves up to 0.93, representing excellent yet imperfect differential diagnosis.ConclusionsBecause the 3ST is often positive in SES, clinical alignment patterns may confound SES with unilateral SOP, particularly acquired SOP. Machine learning substantially but imperfectly improves classification accuracy.

A pilot trial of movement-based pelvic floor physical therapy to address pelvic floor myofascial pain and lower urinary tract symptoms.

Pelvic floor myofascial pain (PFMP) is associated with lower urinary tract symptoms (LUTS). The objective of this study was to test movement-based pelvic floor physical therapy (PT) for patients with PFMP and LUTS. We hypothesized that movement-based PT designed to target PFMP would result in significant improvement in both PFMP and concomitant LUTS. This pilot trial enrolled patients with moderate-to-severe PFMP on palpation who were referred to movement-based PT to diagnose and treat pelvic floor dysfunction in the context of body alignment and movement patterns. The primary outcome was change in Urogenital Distress Inventory (UDI) scores after PT. Factors associated with PT attendance were also measured. We aimed to enroll 55 participants to achieve 80% power to detect a difference in 11 points on the UDI scores with an alpha-level of 0.05, accounting for a 10% loss to follow-up. The sample size was increased to 65 owing to a higher-than-expected loss-to-follow-up rate. Sixty-five patients were enrolled and 62 analyzed. Thirty-eight (61.3%) attended PT, and 30 (48.4%) completed a follow-up PT Attendance (PTA) survey. Overall, UDI score and irritative, obstructive, and stress subscales (p<0.0001) improved in participants who attended PT as well as mean myofascial examination scores at each site. Participants who attended movement-based PT demonstrated an improvement in LUTS. Future studies should extend our findings by: first, confirming whether the myofascial pain-directed elements of PT improved LUTS; second, investigating whether movement-based PT improves prolapse symptoms; and third, including a non-PT control arm to rule out the possible influence of a placebo effect and behavioral modifications on LUTS and PFMP.

Sagittal alignment in patients with flexion contracture of the hip before and after total hip arthroplasty.

In hip osteoarthritis, hip flexion contracture can severely alter the patient's alignment, and, therefore, affect the patient's quality of life (QOL). Hip contracture is not well-studied, partly because of the difficulties of its diagnosis. The aim of this study was to propose a quantitative definition of hip flexion contracture, and to analyse sagittal alignment in these patients compared to non-contracture ones, before and 12months after total hip arthroplasty (THA). Consecutive patients with hip arthrosis and an indication for THA were included (N = 123). Sagittal full-body radiographs were acquired in free standing position and in extension. QOL questionnaires were administered before and after surgery. Spinopelvic parameters were measured, including the pelvic-femur angle (PFA). Patients with low pelvic incidence (< 45°) were included in the hip contracture group if PFA > 5°, or PFA > -5° when pelvic incidence ≥ 45°. 29% of patients were in the hip flexion contracture group, and they showed lower pelvic tilt than the no-contracture group (p < 0.001), larger lumbar lordosis (LL) and smaller PI-LL (p < 0.001), as well as a forward position of the head. 16% of patients still had hip contracture 12-months postop. Contracture patients showed higher QOL scores after surgery. The proposed method to diagnose hip contracture group allowed to define a group of patients who showed a specific pattern of sagittal spinopelvic alignment. These patients improved their alignment and quality of life postoperatively, but their hip mobility was not always restored. Diagnosing these patients is a first step toward the development of more specific surgical approaches, aiming to improve their surgical outcome.

Multilayer Electrospun-Aligned Fibroin/Gelatin Implant for Annulus Fibrosus Repair: An In Vitro and In Vivo Evaluation.

Annulus fibrosus (AF) damage is proven to prompt intervertebral disc (IVD) degeneration, and unrepaired AF lesions after surgical discectomy may boost herniation of the nucleus pulposus (NP) which may lead to further compression of neural structures. Moreover, vascular and neural ingrowth may occur within the defect which is known as a possible reason for discogenic pain. Due to a limited healing capacity, an effective strategy to repair and close the AF defect is necessary. In this study, using electrospinning technology, two nature polymers, silk fibroin and gelatin, were linked to imitate the unique lamellae structure of native AF. Our findings revealed that a multilayer electrospun-aligned fibroin/gelatin scaffold with mechanical and morphological properties mimicking those of native AF lamellae have been developed. The average diameter of the nanofiber is 162.9 ± 38.8 nm. The young’s modulus is around 6.70 MPa with an ultimate tensile strength of around 1.81 MP along preferred orientation. The in vitro test confirmed its biocompatibility and ability to maintain cell viability and colonization. Using a porcine model, we demonstrated that the multilayer-aligned scaffold offered a crucial microenvironment to induce collagen fibrous tissue production within native AF defect. In the implant-repaired AF, H&E staining showed homogeneous fibroblast-like cell infiltration at the repaired defect with very little vascular ingrowth, which was confirmed by magnetic resonance imaging findings. Picrosirius red staining and immunohistochemical staining against type I collagen revealed positively stained fibrous tissue in an aligned pattern within the implant-integrated site. Relative to the intact control group, the disc height index of the serial X-ray decreased significantly in both the injury control and implant group at 4 weeks and 8 weeks (p < 0.05) which indicated this scaffold may not reverse the degenerative process. However, the results of the discography showed that the effectiveness of annulus repair of the implant group is much superior to that of the untreated group. The scaffold, composed with nature fibroin/gelatin polymers, could potentially enhance AF healing that could prevent IVD recurrent herniation, as well as neural and neovascular ingrowth after discectomy surgeries.

First-Principles Study of Cu-Based Inorganic Hole Transport Materials for Solar Cell Applications.

Perovskite solar cells (PSCs) and dye-sensitized solar cells (DSCs) both represent promising strategies for the sustainable conversion of sunlight into electricity and fuels. However, a few flaws of current devices hinder the large-scale establishment of such technologies. On one hand, PSCs suffer from instabilities and undesired phenomena mostly linked to the perovskite/hole transport layer (HTL) interface. Most of the currently employed organic HTL (e.g., Spiro-OMeTAD) are supposed to contribute to the perovskite decomposition and to be responsible for charge recombination processes and polarization barriers. On the other hand, power conversion efficiencies (PCEs) of DSCs are still too low to compete with other conversion technologies. Tandem cells are built by assembling p-type and n-type DSCs in a cascade architecture and, since each dye absorbs on a different portion of the solar spectrum, the harvesting window is increased and the theoretical efficiency limit for a single chromophore (i.e., the Shockley–Queisser limit) is overcome. However, such a strategy is hindered by the lack of a p-type semiconductor with optimal photocathode features. Nickel oxide has been, by far, the first-choice inorganic p-type semiconductor for both PV technologies, but its toxicity and non-optimal features (e.g., too low open circuit voltage and the presence of trap states) call for alternatives. Herein, we study of three p-type semiconductors as possible alternative to NiO, namely CuI, CuSCN and Cu2O. To this aim, we compare the structural and electronic features of the three materials by means of a unified theoretical approach based on the state-of-the art density functional theory (DFT). We focus on the calculation of their valence band edge energies and compare such values with those of two widely employed photo-absorbers, i.e., methylammonium lead iodide (MAPI) and the triple cation MAFACsPbBrI in PSCs and P1 and Y123 dyes in DSCs, given that the band alignment and the energy offset are crucial for the charge transport at the interfaces and have direct implications on the final efficiency. We dissect the effect a copper vacancy (i.e., intrinsic p-type doping) on the alignment pattern and rationalize it from both a structural and an electronic perspective. Our data show how defects can represent a crucial degree of freedom to control the driving force for hole injection in these devices.

ITO:n-ZnO:p-NiO and ITO:n-ZnO:p-NZO thin films: Study of crystalline structures, surface statistical metrics, and optical properties.

The article presents results on fabrication and characterization of transparent, oxide-based junction diodes on quartz substrates. The devices are made by radio frequency magnetron sputtering in the form of sandwich structures: ITO:n-ZnO:p-NiO (homojunction) and ITO:n-ZnO:p-NZO (heterojunction). The microstructure, crystalline structure, and micromorphology features of deposited samples are studied by means of X-ray diffraction, Atomic Force Microscopy, and Scanning Electron Microscopy. Obtained results are used to derive statistical, fractal and functional surface characteristics that exhibited secondary alignment patterns. Apart from that, optical and electrical measurements are carried out as well. Optical transmittance peaked at 80% in visible range, but substantially increased after annealing. Due to structural differences, heterojunction was found to follow linear current-voltage dependence specific of ohmic contacts, whereas homojunction was found to follow non-linear characteristics as in junction diode.

Selective biofunctionalization of 3D cell-imprinted PDMS with collagen immobilization for targeted cell attachment

Cell-imprinted polydimethylsiloxane substrates, in terms of their ability to mimic the physiological niche, low microfabrication cost, and excellent biocompatibility were widely used in tissue engineering. Cells inside the mature cells' cell-imprinted PDMS pattern have been shown in previous research to be capable of being differentiated into a specific mature cell line. On the other hand, the hydrophobicity of PDMS substrate leads to weak cell adhesion. Moreover, there was no guarantee that the cells would be exactly located in the cavities of the cells' pattern. In many studies, PDMS surface was modified by plasma treatment, chemical modification, and ECM coating. Hence, to increase the efficiency of cell-imprinting method, the concavity region created by the cell-imprinted pattern is conjugated with collagen. A simple and economical method of epoxy silane resin was applied for the selective protein immobilization on the desired regions of the PDMS substrate. This method could be paved to enhance the cell trapping into the cell-imprinted pattern, and it could be helpful for stem cell differentiation studies. The applied method for selective protein attachment, and as a consequence, selective cell integration was assessed on the aligned cell-imprinted PDMS. A microfluidic chip created the aligned cell pattern. After Ar+ plasma and APTES treatment of the PDMS substrate, collagen immobilization was performed. The immobilized collagen was removed by epoxy silane resin stamp from the ridge area where the substrate lacked cell pattern and leaving the collagen only within the patterned areas. Coomassie brilliant blue staining was evaluated for selective collagen immobilization, and the collagen-binding stability was assessed by BCA analysis. MTT assay for the evaluation of cell viability on the modified surface was further analyzed. Subsequently, the crystal violet staining has confirmed the selective cell integration to the collagen-immobilized site on the PDMS substrate. The results proved the successfully selective collagen immobilization on the cell-imprinted PDMS and showed that this method increased the affinity of cells to attach inside the cell pattern cavity.

Comparing machine learning and deep learning regression frameworks for accurate prediction of dielectrophoretic force

An intelligent sensing framework using Machine Learning (ML) and Deep Learning (DL) architectures to precisely quantify dielectrophoretic force invoked on microparticles in a textile electrode-based DEP sensing device is reported. The prediction accuracy and generalization ability of the framework was validated using experimental results. Images of pearl chain alignment at varying input voltages were used to build deep regression models using modified ML and CNN architectures that can correlate pearl chain alignment patterns of Saccharomyces cerevisiae(yeast) cells and polystyrene microbeads to DEP force. Various ML models such as K-Nearest Neighbor, Support Vector Machine, Random Forest, Neural Networks, and Linear Regression along with DL models such as Convolutional Neural Network (CNN) architectures of AlexNet, ResNet-50, MobileNetV2, and GoogLeNet have been analyzed in order to build an effective regression framework to estimate the force induced on yeast cells and microbeads. The efficiencies of the models were evaluated using Mean Absolute Error, Mean Absolute Relative, Mean Squared Error, R-squared, and Root Mean Square Error (RMSE) as evaluation metrics. ResNet-50 with RMSPROP gave the best performance, with a validation RMSE of 0.0918 on yeast cells while AlexNet with ADAM optimizer gave the best performance, with a validation RMSE of 0.1745 on microbeads. This provides a baseline for further studies in the application of deep learning in DEP aided Lab-on-Chip devices.

The crux of astronomical alignment in Neolithic Malta: Using 3D simulation to produce new data

Like many prehistoric monuments, the Neolithic Temples of Malta have been the subject of astronomical studies, aimed at identifying possible alignments with cosmological events. The orientations of several sites have been suggested as evidence of an interest in the movement of the sun, moon, and stars, and of the importance of certain days such as the equinoxes and solstices. However, while individual sites may seem to align to specific events, a wider study into patterns of orientation is needed to determine whether these are the result of human action or random chance. In this paper, alignments at extant sites are investigated through 3D simulation, providing new data and statistical evidence for (and against) previously identified alignments. The methodology proposed uses Raycasting in Unity3D to identify the accuracy of orientations throughout the Maltese Neolithic (3700-2400 BC) at 23 temples sites. The orientation is analysed in relation to plausible astronomical events, as suggested by material evidence. The data produced shows possible patterns of alignment, rejecting commonly accepted targets such as the sun, in favour of a cautious acceptance of an alignment with the constellation of Crux. This shift in focus alters heliocentric interpretations of Maltese temple culture, while also supporting a wider landscape cosmology. This study demonstrates the use of 3D simulations as a tool for investigation of archaeological queries. The research not only provides a new methodology for the automatic calculation of alignment patterns, but also establishes how 3D simulation can create new data which can impact current archaeological theories.

Role Conception of the Asia-Pacific Middle Powers: Comparative Analysis of Indonesia, South Korea, Australia and Vietnam

This article examines the variety of roles enacted by Asia-Pacific middle powers in response to the rise of China. This article identifies two factors determining such variety, especially in the security realm: alignment pattern and geopolitical constraints. We argue that the differences in level of alignment with the United States and the risk of geopolitical tension with China affect the role conception taken by the middle powers. We assert that the combination of a high-level of alignment and high geopolitical risk tends to cause them to take a bridging role, a low-level of alignment and low geopolitical risk drive them to take the role of regional leader, a high-level of alignment and low geopolitical risk allow them to become faithful allies, and a low-level of alignment and high geopolitical risk enable them to take an active independent role. We illustrate this framework through the comparative analysis of Indonesia, South Korea, Australia and Vietnam.

Computational Models of Linguistic Alignment for Clustering Group Participants and Predicting Task Outcomes

This work examines the relationships between several measures of linguistic alignment in task-based group conversation, and assesses how useful these measures are for predicting task performance and participant affect. The study is carried out using human-human conversational data, with potential implications for human-AI conversations where an artificial agent can decide if and how to align itself linguistically with human subjects. We implement several alignment measures including long-term measures that assess the level of convergence over the course of the conversation, as well as short-term coordination measures that have been related in previous research to power dynamics. The study uses two publicly available English-language survival task datasets. After analyzing correlations between the various linguistic alignment measures, we perform clustering in order to unveil the main types of alignment patterns that are prevalent in the data. Finally, we use the alignment measures as machine learning features to predict participant task performance and participant affect.

0766 Group Trajectories Demonstrate Robust Effects of Targeted Hypoglossal Nerve Stimulation in the THN3 Randomized, Controlled Trial

Abstract Introduction THN3 was the first reported parallel-arm, randomized controlled trial (RCT) of hypoglossal nerve stimulation (HGNS), wherein targeted HGNS (THN) was shown to be safe and efficacious at ameliorating sleep disordered breathing in patients with moderate to severe OSA and BMI≤35kg/m2 without screening with drug-induced sleep endoscopy. Unique among reported HGNS trials, separate cohorts of patients receiving early and late THN were followed longitudinally. Methods Measurements of apnea-hypopnea index (AHI) were available Pre-enrollment, Baseline (2 nights), Month 4 and Month 12/15. Except for Pre-enrollment, AHI values were calculated by an independent core laboratory from polysomnographic recordings. All subjects with complete data were included for analysis. AHI trajectories were constructed for early and late THN activation (Treatment[T], N=83, Month 1 and Control[C], N=45, Month 4, respectively) by computing median values. Confidence intervals were calculated by bootstrapping each median (N=30,000). Patient-reported outcome measures (PROMs) were treated similarly. Results AHI (Median (95% CI)) trajectories demonstrated a consistent pattern of pre-implant alignment (Pre-enrollment T:39.1 (36.0-45.0), C:38.0 (32.0-41.0); Baseline 1 T:36.1 (33.0-39.9), C:31.3 (27.2-38.6); Baseline 2 T:37.0 (34.3-41.0), C:35.2 (32.3-38.2)), divergence at the conclusion of the randomization period (Month 4 T:15.6 (11.9-25.3), C:30.6 (23.7-38.6)) and reconvergence following 11 months of treatment (Month 12/15 T:20.7 (16.0-26.4), C:18.1 (16.3-23.3)). Non-standardized Pre-enrollment AHI was slightly higher than Baseline values. Trajectories were similar for oxygen desaturation index (Baseline 1 T:35.3 (31.9-38.0),C:34.3 (27.5-40.3); Baseline 2 T:37.1 (33.4-39.3),C:36.8 (33.9-38.3); Month 4 T:19.5 (16.2-28.5), C:33.8 (25.4-41.1); Month 12/15 T:19.5 (16.0-25.6), C:19.7 (16.3-26.0)), the Epworth Sleepiness Scale (Baseline T:11.0 (10.0-13.0),C:11.5 (8.5-14.0); Month 4 T:6.0 (5.0-7.0), C:11.5 (8.0-12.5); Month 12/15 T:6.0 (4.0-7.0), C:5.5 (4.5-6.0)), the Functional Outcomes of Sleep Questionnaire (Baseline T:15.3 (14.0-16.5),C:14.7 (13.3-16.6); Month 4 T:18.3 (17.7-18.8), C:16.7 (14.9-17.7); Month 12/15 T:18.8 (18.3-19.3), C:18.5 (17.5-19.5)) and the Snore Outcomes Survey (Baseline T:26.6 (21.9-31.3),C:21.9 (18.8-31.3); Month 4 T:60.9 (56.3-67.9), C:29.7 (23.4-42.9); Month 12/15 T:62.5 (59.4-68.8), C:68.8 (62.5-71.9)). Conclusion Group trajectories of sleep-disordered breathing and PROMs further demonstrate the robust effects of THN in patients with moderate to severe OSA and the value of parallel-arm RCTs. Similar results may be expected in the ongoing OSPREY confirmatory trial of THN. Support (If Any) LivaNova

0350 At-home Sample Collection for Measurement of Diurnal Rhythms of Urinary Cortisol and Melatonin

Abstract Introduction Sleep- and stress-related hormones (e.g., melatonin, cortisol) can be measured from dried urine samples collected at-home and sent for laboratory testing. These measures may be used to identify patterns of circadian alignment, peak nocturnal melatonin levels as well as a cortisol awakening response. The purpose of this analysis was to describe diurnal patterns and reference ranges from a 4-timepoint serial assessment of urinary cortisol and melatonin in a large cohort of at-home self collected samples. Methods This retrospective analysis evaluated data from 3,966 individuals who used an at-home Sleep and Stress Test (Everlywell, Inc.) between September 28, 2017 and July 14, 2021. Individuals provided four urine samples according to habitual sleep patterns: upon waking (T1), two hours after waking (T2), prior to the evening meal (T3), and at bedtime (T4). Melatonin and cortisol distributions were normalized to creatinine and log transformed to approximate normal distributions to define respective reference ranges (two standard deviations above and below the log transformed mean) and reverted to original units for reporting. Results 71% (n=2,832) of users were female and mean age was 42.8 (sd=12.0) years. Mean (sd) urinary values were as follows: Cortisol: T1, 29.3 (37.9) ug/g Cr; T2, 47.2 (49.8); T3, 14.9 (36.3); T4. 8.38 (26.9). Melatonin: T1, 745 (3208) ug/g Cr; T2, 169 (1189); T3, 45 (620); T4, 155 (1701). For cortisol, only 4-5% of samples fell outside the defined reference ranges across time points. Melatonin was more variable with 23% and 15% falling outside the reference range at time points T3 and T4, respectively. A majority of individuals’ peak cortisol occurred at T2 (67.4%), and melatonin at T1 (85.2%). Conclusion This analysis demonstrates measurable physiological diurnal patterns for cortisol and melatonin using at-home self-collection for dried urine tests. This provides evidence that at-home sample collection kits using dried urine spots are a viable tool for assessing diurnal patterns of sleep and stress. Future controlled studies are needed to evaluate the utility in identifying abnormal patterns associated with shift-work or sleep disorders. Support (If Any)

Echoes of Past Contact: Venetian Influence on Cretan Greek Intonation.

Prosodic aspects of cross-linguistic contact are under-researched, especially past contact that has subsequently ceased. In this paper, we investigate declarative and polar question tunes of contemporary Cretan Greek, a regional variety of Greek whose speakers were in contact with Venetian speakers during the four and half centuries of Venetian rule on the island, from 1204 to 1669. The F0 contours of the Cretan tunes and alignment of peaks and troughs of interest with the nuclear vowel are compared to the corresponding tunes in Venetian dialect and Venetian Italian and to those in Athenian (Standard) Greek, which are used as control. The data (1610 declarative utterances and 698 polar questions) were drawn from natural speech corpora based on pragmatic criteria: broad focus for declaratives, broad focus, and information-seeking interpretation for polar questions. The pitch contour shapes of the tunes are modeled using polynomial basis functions, and the F0 alignment points are determined analytically. The results show the robustness of contact effects almost three and a half centuries after regular contact ceased and indicate that the shapes of the F0 contours of Cretan and Venetian declarative and polar question tunes are similar. In addition, Cretan alignment patterns are similar to Venetian and significantly different from Athenian. Insights are gained from research into how long prosodic characteristics may persist in a recipient language-decades or even centuries after the cessation of contact.