Phase Of Movement Research Articles

Reliability of motion phase identification for long-track speed skating using inertial measurement units.

Precise identification of motion phases in long-track speed skating is critical to characterize and optimize performance. This study aimed to estimate the intra- and inter-rater reliability of movement phase identification using inertial measurement units (IMUs) in long-track speed skating. We analyzed 15 skaters using IMUs attached to specific body locations during a 500m skate, focusing on the stance phase, and identifying three movement events: Onset, Edge-flip, and Push-off. Reliability was assessed using intraclass correlation coefficients (ICC) and Bland-Altman analysis. Results showed high intra- and inter-rater reliability (ICC [1,1]: 0.86 to 0.99; ICC [2,1]: 0.81 to 0.99) across all events. Absolute error ranged from 0.56 to 6.15 ms and from 0.92 to 26.29 ms for intra- and inter-rater reliability, respectively. Minimally detectable change (MDC) ranged from 17.56 to 62.22 ms and from 33.23 to 131.25 ms for intra- and inter-rater reliability, respectively. Despite some additive and proportional errors, the overall error range was within acceptable limits, indicating negligible systematic errors. The measurement error range was small, demonstrating the accuracy of IMUs. IMUs demonstrate high reliability in movement phase identification during speed skating, endorsing their application in sports science for enhanced kinematic studies and training.

The age-related effects on orthodontic tooth movement and the surrounding periodontal environment.

Orthodontic treatment in adults is often related to longer treatment time as well as higher periodontal risks compared to adolescents. The aim of this review is to explore the influence of age-related chages on orthodontic tooth movement (OTM) from macro and micro perspectives. Adults tend to show slower tooth movement speed compared to adolescence, especially during the early phase. Under orthodontic forces, the biological responses of the periodontal ligament (PDL) and alveolar bone is different between adult and adolescents. The adult PDL shows extended disorganization time, increased cell senescence, less cell signaling and a more inflammatory microenvironment than the adolescent PDL. In addition, the blood vessel surface area is reduced during the late movement phase, and fiber elasticity decreases. At the same time, adult alveolar bone shows a higher density, as well as a reduced osteoblast and osteoclast activation, under orthodontic forces. The local cytokine expression also differs between adults and adolescents. Side-effects, such as excessive root resorption, greater orthodontic pain, and reduced pulpal blood flow, also occur more frequently in adults than in adolescents.

An investigation on the application of exercise biomechanics in competitive wushu routine training

Abstract Combining the athletes’ wushu jumping action data from the perspective of sports biomechanics, forming a finite element model based on finite element analysis of the landing speed of wushu jumping action on the landing stability correction finite element model, solving the different heights, can not be difficult to land the PvGRF of the wushu action, the use of kinematics sensitive indexes to diagnose the difficulty of competitive wushu sets of action. Measure the movement data of wushu athletes’ spinning foot 720° catching horse stance movement, and analyze the swing changes and rotational angular velocities of various body segments in the assisted jumping phase and the aerial movement phase. A core stability training method was proposed and tested during a 12-week training period, and an index test of balance was conducted. The results of the balance index test of the wushu athletes showed that after the core stability training, the static right foot standing index was 179.55±196.35, which formed a significant difference with the pre-training period, P<0.05. The combination of core stability and sports biomechanics can improve the completion of difficult movements in the movement training of competitive wushu athletes.

Estimation of Vessel Rotational Motion From Satellite SAR Using Target Motion Phase Refocusing

Estimation of Vessel Rotational Motion From Satellite SAR Using Target Motion Phase Refocusing

Temporal development of the displacement field of the Ponzano landslide in February 2017

The conducted research determined the temporal evolution of the displacement field for the Ponzano landslide case study. The offset-tracking method, so far used mainly for the relatively rapid but uniform displacement of glaciers, was tested for the 2017 study of the Ponzano landslide in Italy. The suitability of the method for high-resolution TerraSAR-X and medium-resolution Sentinel-1 imagery was investigated. The results proved the applicability of the OT method for studying processes with high and variable displacement dynamics. However, for such purposes, high-resolution radar data are crucial. With an uncertainty in the determination of residual displacements of about ±1 m, it was shown that the values of residual displacements occurring up to several days after the main phase of landslide movements are within the range of uncertainty but are determinable. The research conducted in the paper filled a gap in the analysis of the phenomenon just after the main movement phase. It allowed determination of the time and speed of extinction of landslide movements.

Social Media's Impact on Kashmir's Liberation Movement

The youth-driven liberation struggle in Indian Held Kashmir (IHK) goes beyond the armed insurrection. The non-violent technique uses social media to expose and denounce Indian armed forces brutality and human rights violations, including systematic torture, rape, extrajudicial killings, and prisoner mistreatment. The victims' stories have been widely shared on social media. The next phase of the liberation movement began in 2016 after the Indian military forces killed Burhan Muzaffar Wani. Wani, a young leader and freedom fighter, used social media to mobilize the youth of Kashmir for the cause. Modern communication platforms like social media ensure the Kashmiri people's story about their struggle for liberation from Indian occupation and worldwide persecution is spread. The IHK liberation movement is examined using social movement framing analysis in this research. It seeks to understand how activists reinvent the movement through international protests. The activists are reiterating the global relevance of modern human rights mobilizations.

Linear hydrodynamic model of rotating lift-based wave energy converters

A linear potential flow model of a rotating lift-based wave energy converter is developed by assuming that the lift is generated by a pair of equal and opposite circulations and that the amplitude of motion is small. The linearisation of the hydrodynamics means that the forces can decomposed and expressions for the wave excitation force and radiation damping force are derived independently and shown to be related to each other through the Haskind Relations. The expressions for the forces are used to show that there is an optimum phase and product of circulation and radius of rotation to maximise the wave power extracted, which is equivalent to the optimum phase and amplitude of motion from ‘conventional’ wave energy converter theory. It is also shown that at this optimum condition 100% of the incident wave energy can be extracted. It is shown that the forces are directly proportional to the velocities due to the motion of the vortices, the water particle velocities due to the incident wave, and the water particle velocities induced by the vortices. The effect of the vortex-induced water particle velocities is considered and the importance of including these velocities on the passive generation of circulation, e.g. by hydrofoils, is highlighted. The impact of a sub-optimum product of circulation and radius of rotation is also investigated and shown that the power capture is not highly sensitive to the optimal conditions in the same way as ‘conventional’ wave energy converters

Effects of object working memory load on visual search in basketball players: an eye movement study

BackgroundWorking memory may affect the athletes’ visual search ability. Objective: This study aimed to examine the differences in the performance of visual search tasks among basketball players of varying sport levels, considering the influence of different object working memory loads. Method: This study recruited forty-two participants who were divided into three groups based on the classification of elite athletes: competitive elite, semi-elite, and novice. Results: Objective working memory load significantly impacts the accuracy of visual search, reaction time, and gaze fixation in basketball players. In the visual search task of the basketball sports scene, the inclusion of object working memory load led to a significant decrease in the accuracy of visual search, a significant increase in reaction time, a significant increase in the number of fixation points, and a more complex gaze trajectory. In a visual search task with object working memory load, the difference in reaction time between basketball players of different sport levels was observed during the search initiation time and scanning time, with higher sport levels associated with shorter reaction times. The effect of object working memory load on the eye movement phase of visual search varied among basketball players of different sport levels. For the novice group, the effect was on the reaction time during the verification phase, while for the semi-elite and competitive elite groups, the effect was on the reaction time during the scanning phase. Conclusion: The effect of object working memory load on visual search varied among basketball players of different sport levels.

Hydrothermal fluid alteration of the Ordovician epigenetic karstification reservoir in the Tahe Oilfield, Tarim Basin, NW China

In recent years, the Ordovician carbonate reservoirs in the Tarim Basin have received attention due to continuous advancements in of deep strata exploration for oil and gas. The Ordovician carbonates in the Tahe Oilfield have experienced multiple phases of tectonic movement and ancient karst action to form reservoirs consisting of multi-scale spaces such as large caves, fractures, and dissolution pores. This study identifies indicators of atmospheric freshwater karst and hydrothermal karst in the Ordovician carbonate rocks of the Tahe Oilfield by comparing and analyzing lithological observation, geochemical data, fluid inclusions, logging interpretation, and seismic data. The spatial and temporal distribution of karst reservoirs are summarized, and the results show that the stage of tectonic movement and pulsating uplift of strata occurred in the early Caledonian and Hercynian orogenies, and the carbonate rocks were uplifted to the surface and large-scale atmospheric freshwater karstification.In the deeper strata, the thermal convection of fluids caused by volcanic activity accelerated the thermochemical sulfate reduction (TSR), and the generated H2S gas accompanied the upward transport of hydrothermal fluids, which further dissolved and modified the original karst system, increasing the storage space. However, away from the heat source, calcite (positive Eu anomaly, higher 87Sr/86Sr ratio, lower δ18O value,) reprecipitated due to the temperature reduction, so the role of hydrothermal activity in reservoir reconstruction is limited. The two karst action patterns indicated that epigenetic karstification is an important process for forming carbonate reservoirs in the Tahe Oilfield and the basis of hydrothermal karst reservoir formation. This study demonstrates the research and exploration value of karstification for the geo-energy field, which could benefit sustainable development in the Tarim Basin.

Human arm endpoint-impedance in rhythmic human-robot interaction exhibits cyclic variations

Estimating the human endpoint-impedance interacting with a physical environment provides insights into goal-directed human movements during physical interactions. This work examined the endpoint-impedance of the upper limb during a hybrid ball-bouncing task with simulated haptic feedback while participants manipulated an admittance-controlled robot. Two experiments implemented a force-perturbation method to estimate the endpoint parameters of 31 participants. Experimental conditions of the ball-bouncing task were simulated in a digital environment. One experiment studied the influence of the target height, while the other explored the impedance at three cyclic phases of the rhythmic movement induced by the task. The participants’ performances were analyzed and clustered to establish a potential influence of endpoint impedance on performance in the ball-bouncing task. Results showed that endpoint-impedance parameters ranged from 45 to 445 N/m, 2.2 to 17.5 Ns/m, and 227 to 893 g for the stiffness, damping, and mass, respectively. Results did not support such a critical role of endpoint impedance in performance. Nevertheless, the three endpoint-impedance parameters described significant variations throughout the arm cycle. The stiffness is linked to a quasi-linear increase, with a maximum value reached before the ball impacts. The observed damping and mass cyclic variations seemed to be caused by geometric and kinematic variations. Although this study reveals rapid and within-cycles variations of endpoint-impedance parameters, no direct relationship between endpoint-impedance values and performance levels in ball-bouncing could be found.

A new method for finding the proper initial conditions in passive locomotion of bipedal robotic systems

In this paper, the walking motion of a biped robot consisting of upper and lower body members (arms, legs, upper trunk and neck) on an inclined surface is analyzed kinematically and dynamically. Some of the challenges faced by this research include the dual-phase dynamics that govern the periodic gait of this robotic system and the consideration of all the body parts that are involved in the walking motion; which make it extremely difficult to derive the kinetic equations of such robotic systems. To deal with these challenges, the Gibbs-Appell formulation and the Newton's impact laws are employed to derive the most general form of the system's dynamic equations in the swing and transient phases of motion. Subsequently, by using the obtained motion equations and implementing a systematic procedure, we achieve an eigenvalue problem. By solving this problem, the suitable initial conditions that are necessary for the passive gait of this biped robot on a sloping surface are determined. By considering the obtained initial conditions as well as the dynamic response of the system to the Earth's gravity, we describe a general method for designing a biped robot's walking trajectory on an inclined surface. The most important feature of the designed trajectory is its close agreement with the trajectory followed by a biped robot walking passively down a sloping ramp. This close match between the said trajectories enables us to guide the robot in tracking a desired path by applying very small control torques to the robot joints at the start of each step. This claim is corroborated by the simulations carried out for a biped walking robot composed of 6 rigid links, in which the control torques that are applied to the actuated robot joints are obtained by employing a feedback linearization method and via a designed LQR controller.

A data-driven simulation and Gaussian process regression model for hydraulic press condition diagnosis

Improving overall performance and increasing operational reliability are currently among the leading research topics in the field of hydraulic systems. In recent years, the use of artificial intelligence-based modeling and design techniques has developed rapidly to account for the nonlinear properties of Gaussian systems and to predict fault reasoning in hydraulic systems. In this study, feature acquisition and selection are proposed to prepare input data for a simulation-based learning approach. In addition, a cause-and-effect analysis is performed by considering various what-if scenarios as external disturbances that affect the response of the hydraulic press. While the objective of the sheet metal bending cycle and a pulley system is to initiate a load on the hydraulic press, an intelligent sensing system is used to observe the behavior of the hydraulic press during the phases of sheet metal bending cycle, i.e., the forming, leveling, and movement. In addition, the Gaussian process regression method is used to build data-driven prediction models with different predictors that contribute significantly to improving predictive accuracy. The condition diagnosis indicates the accurate performance of predictive models observing the coefficient of determination R2 at 0.998 for the bending phase, 0.962 for the leveling phase, and 0.999 for the movement phase. Although the approximation of the simulation model is efficient, it is found that certain features are reasonably well approximated with regard to the forming phases.

The dahliagram: An interdisciplinary tool for investigation, visualization, and communication of past human-environmental interaction.

Investigation into the nexus of human-environmental behavior has seen increasing collaboration of archaeologists, historians, and paleo-scientists. However, many studies still lack interdisciplinarity and overlook incompatibilities in spatiotemporal scaling of environmental and societal data and their uncertainties. Here, we argue for a strengthened commitment to collaborative work and introduce the "dahliagram" as a tool to analyze and visualize quantitative and qualitative knowledge from diverse disciplinary sources and epistemological backgrounds. On the basis of regional cases of past human mobility in eastern Africa, Inner Eurasia, and the North Atlantic, we develop three dahliagrams that illustrate pull and push factors underlying key phases of population movement across different geographical scales and over contrasting periods of time since the end of the last Ice Age. Agnostic to analytical units, dahliagrams offer an effective tool for interdisciplinary investigation, visualization, and communication of complex human-environmental interactions at a diversity of spatiotemporal scales.

Characteristics and control factors of tectonic fractures of ultra-deep tight sandstone: Case study of the Lower Cretaceous reservoir in Bozi-Dabei area, Kuqa Depression, Tarim Basin, China

The Bozi-Dabei area in the Kuqa Depression host high-quality reservoirs in the Bashijiqike Formation and Baxigai Formation sandstones of the Lower Cretaceous, in which reservoirs yield significant industrial gas flow despite being situated at a considerable burial depth of 8200 m. The geological history of the target formation involves multiple phases of tectonic movements, resulting in the development of multi-genetic fractures that enhance the reservoir's storage and seepage capacity. Based on the results of the drilling core, field profile survey, imaging logging, and experimental analysis, this study presents an analysis of fractures in the Lower Cretaceous dense sandstone reservoir of the Bozi-Dabei area, andclarifies the characteristics and controlling factors of the multi-genesis and multi-period fractures. Additionally, it proposes an effective fracture development model that accounts for geo-stress control. In the Bozi-Dabei area, the prevailing high extrusion stress environment has led to the development of predominantly regional tectonic fractures and fault-related fractures, with relatively gentle deformation-related fractures. The results of a combination of multi-attribute data determination techniques, including fracture filling, inter-cutting relationship, fracture filling isotope, inclusions, and cathode luminescence tests, this study reveals that the reservoir fractures have experienced three major periods of tectonic movement. The regional tectonic fracture development is mainly controlled by stratigraphic lithology and thickness, while the proximity influences fault co-derived fractures to the fault and the relative positions of the upper and lower plates of the fault. The shift in the direction of the late horizontal maximum principal stress leads to the opening or closing of early fractures under different conditions in the Bozi-Dabei area, consequently affecting the degree of fracture opening and effectiveness. Notably, when the horizontal maximum principal stress is deflected to intersect with early fractures at a smaller angle or even superimpose, the fracture effectiveness of the related group system in the deflection direction improves, resulting in an overall coordination. The distribution characteristics of the fracture system in this highly productive reservoir are the result of dominant configurations from multi-phases of geological activities.

Assistance control strategy for upper-limb rehabilitation robot based on motion trend

Abstract. Robot-assisted rehabilitation has proven to improve a subject's upper-extremity motor function. However, it is still challenging to control the robot to provide minimal assistance based on the subject's performance. This paper proposes a motion-trend-based assistance control strategy to solve this problem. The control strategy provides the corresponding normal and tangential forces by constructing an adaptive virtual assistance force field around a predetermined training trajectory. In the normal direction, a performance function based on the position-tracking error and normal motion trend is established to adjust the normal assistance force field strength in real time; in the tangential direction, a performance function based on the tangential interaction force and tangential motion trend is established to adjust the tangential assistance force field strength in real time. Additionally, good motion trends can quickly reduce the assistance force field. The normal motion trend represents the state of the subject moving toward the target trajectory, and the tangential motion trend represents the state of increasing tangential interaction force. Finally, the performance of this control strategy was evaluated by training experiments with eight healthy subjects. Preliminary experiments showed that the normal assist force in the active movement phase was 92.48 % smaller than that in the poor phase, and the tangential assist force was 90.73 % smaller than that in the slack phase. And the normal assist force and tangential assist force will become zero within 0.2 s when the subject has a good tendency to move. This shows that the control strategy proposed in this paper can quickly adjust the assistance according to the subject's motor performance. In addition, the assistance can be quickly reduced when the subject has a good movement trend. Future work will incorporate OpenSim (muscle and bone simulation software) to develop a pathway suitable for the subject's arm rehabilitation.

The impact of platform motion phase differences on the power and load performance of tandem floating offshore wind turbines

The interactions between tandem floating offshore wind turbines remain an essential research topic with a view to optimizing future large-scale offshore wind farms. The focus of past floating offshore wind turbine aerodynamic research was centred on platform motion impact on rotor aerodynamics for standalone or in-phase tandem turbines. The question of how the differences in the surge motion phase of tandem turbines influence the performance of the downstream turbine remains open. Recent investigations reveal that these motions might not invariably be in-phase. This study seeks to determine the repercussions of platform motion phase differences on power, thrust, and wake recovery. Notably, it postulates that phase differences could detrimentally affect fatigue. Using a validated Navier–Stokes actuator line model rooted in the OpenFOAM® toolbox, the study aims to address this hypothesis. It was found that the out-of-plane root bending moment amplitude increase by 100% when the rotors are out of phase. A 72% increase in amplitude was also observed for CT. Both of these observations have also been linked to an increase in angle of attack amplitude over the blade span. This work stimulates future research in floating offshore turbine control strategies and provides guidance to minimize turbine failures and downtime.

A Single-Chip Single-Antenna Radar for Remote Vital Sign Monitoring

This article proposes an effective way to use self-injection locking (SIL) in a radar system to detect human chest cavity movement for vital signs monitoring with minimal hardware. The proposed approach expands the idea of using a phase-locked loop (PLL) system as a demodulator and a single antenna, making the system more compact. The system includes on-chip dc offset cancellation for system initialization. This work investigates and compares an <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$LC$</tex-math> </inline-formula> -based voltage-controlled oscillator (LCVCO) and a ring voltage-controlled oscillator (RVCO) in terms of primary sensitivity for motion detection and phase noise. A study of injection-locking of both the LCVCO and RVCO is also established. The study shows that the RVCO is superior to the LCVCO in terms of sensitivity while the phase noise does not differ significantly as the frequencies of interest are very small, i.e., heart rate and respiration are bandwidth-limited to a few hertz. To verify the proposed idea, a design of both systems, an LCVCO-based PLL and an RVCO-based PLL, was implemented in 65 nm CMOS technology at 1.5 GHz. The simulation and measurement results confirm the idea proposed: the RVCO shows better performance across all metrics, e.g., higher sensitivity by 4 dB, lower power consumption by 30%, and reduced area (almost half) compared to the LCVCO.

Algorithm for the classification of phases and stages of sleep in patients with chronic disorders of consciousness based on logical artificial intelligence

BACKGROUND: The analysis of sleep patterns in patients with chronic disorders of consciousness is attracting increasing attention in terms of diagnosis, prognosis, and treatment of severe brain damage. The study describes a software package based on an artificial intelligence (AI) expert system designed to classify the phases and stages of sleep, taking into account the characteristics of impaired cortical rhythm in such patients.&#x0D; AIM: To develop a specialized AI-based software package focused on patients with chronic impairment of consciousness for automatic classification of sleep phases and stages, with an emphasis on identifying sleep spindles and non-rapid eye movement (REM) and REM sleep phases.&#x0D; MATERIALS AND METHODS: To ensure the correct operation of the software package, receiver operating characteristic (ROC) curves were analyzed considering the binary classification of slow sleep, REM sleep, and wakefulness.&#x0D; RESULTS: The average sensitivity and specificity of the algorithm were 87.9 and 70.1, respectively. The average area under the ROC curve was 0.790. The algorithm for determining the REM phase demonstrates low specificity with high sensitivity, and its graph was similar to that of wakefulness, as well as the irregularity of the presence of REMs in the REM sleep phase in patients with CNS and the frequent presence of nystagmus in the waking state. Information about the presence of nystagmus, entered at the start of the program, allowed us to slightly increase the efficiency of the algorithm; however, this aspect probably needs further improvement.&#x0D; CONCLUSION: A software package that takes into account the features of electroencephalography of patients with chronic disorders of consciousness and analyzes sleep and wakefulness automatically is not only useful as a diagnostic tool for neurologists and somnologists but also contributes to a wider dissemination of this technique in clinical practice.

Network analyses reveal the interaction between physical features, fear of movement and neck pain and disability in people with acute and chronic whiplash-associated disorders.

A network analysis can be used to quantitatively assess and graphically describe multiple interactions. This study applied network analyses to determine the interaction between physical and pain-related factors and fear of movement in people with whiplash-associated disorders (WAD) during periods of acute and chronic pain. Physical measurements, including pressure pain-thresholds (PPT) over neural structures, cervical range of motion, neck flexor and extensor endurance and the cranio-cervical flexion test (CCFT), in addition to subjective reports including the Tampa Scale of Kinesiophobia (TSK-11), Neck Disability Index (NDI) and neck pain and headache intensity, were assessed at baseline in 47 participants with acute WAD. TSK-11, NDI and pain intensity were assessed for the same participants 6 months later (n = 45). Two network analyses were conducted to estimate the associations between features at baseline and at 6 months and their centrality indices. Both network analyses revealed that the greatest weight indices were found for NDI and CCFT at baseline and for neck pain and headache intensity and NDI and TSK-11 at both time points. Associations were also found betweeen cervical muscle endurance and neck pain intensity in the acute phase. Cervical muscle endurance assesssed during the acute phase was also associated with NDI after 6 months - whereas PPT measured at baseline was associsated with headache intensity after 6 months. The strongest associations were found for headache and neck pain intensity and neck disability and fear of movement, both during acute pain and when mesured 6 months later. The extent of neck endurance and measures of PPT at baseline may be associated with neck disability and headache, respectively, 6 months after a whiplash injury. Through two network analyses, we evaluated the interaction between pain-related factors, fear of movement, neck disability and physical factors in people who had experienced a whiplash injury. We demonstrated that physical factors may be involved in the maintenance and development of chronic pain after a whiplash injury. Nevertheless, the strongest associations were found for headache and neck pain intensity and neck disability and fear of movement, both during acute and chronic phases.

REM-OSA as a Tool to Understand Both the Architecture of Sleep and Pathogenesis of Sleep Apnea-Literature Review.

Sleep is a complex physiological state, which can be divided into the non-rapid eye movement (NREM) phase and the REM phase. Both have some unique features and functions. This difference is best visible in electroencephalography recordings, respiratory system activity, arousals, autonomic nervous system activity, or metabolism. Obstructive sleep apnea (OSA) is a common condition characterized by recurrent episodes of pauses in breathing during sleep caused by blockage of the upper airways. This common condition has multifactorial ethiopathogenesis (e.g., anatomical predisposition, sex, obesity, and age). Within this heterogenous syndrome, some distinctive phenotypes sharing similar clinical features can be recognized, one of them being REM sleep predominant OSA (REM-OSA). The aim of this review was to describe the pathomechanism of REM-OSA phenotype, its specific clinical presentation, and its consequences. Available data suggest that in this group of patients, the severity of specific cardiovascular and metabolic complications is increased. Due to the impact of apneas and hypopneas predominance during REM sleep, patients are more prone to develop hypertension or glucose metabolism impairment. Additionally, due to the specific function of REM sleep, which is predominantly fragmented in the REM-OSA, this group presents with decreased neurocognitive performance, reflected in memory deterioration, and mood changes including depression. REM-OSA clinical diagnosis and treatment can alleviate these outcomes, surpassing the traditional treatment and focusing on a more personalized approach, such as using longer therapy of continuous positive airway pressure or oral appliance use.