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  1. SLEEP-GOAL: A multicenter success criteria outcome study on 302 obstructive sleep apnoea (OSA) patients
    Pang KP, Baptista PM, Olszewska E, Braverman I, Carrasco-Llatas M, Kishore S, et al.
    Med J Malaysia, 2020 03;75(2):117-123.
    PMID: 32281591
    OBJECTIVE: To demonstrate SLEEP-GOAL as a more holistic and comprehensive success criterion for Obstructive Sleep Apnoea (OSA) treatment.

    METHODS: A prospective 7-country clinical trial of 302 OSA patients, who met the selection criteria, and underwent nose, palate and/or tongue surgery. Pre- and post-operative data were recorded and analysed based on both the Sher criteria (apnoea hypopnea index, AHI reduction 50% and <20) and the SLEEP-GOAL.

    RESULTS: There were 229 males and 73 females, mean age of 42.4±17.3 years, mean BMI 27.9±4.2. The mean VAS score improved from 7.7±1.4 to 2.5±1.7 (p<0.05), mean Epworth score (ESS) improved from 12.2±4.6 to 4.9±2.8 (p<0.05), mean body mass index (BMI) decreased from 27.9±4.2 to 26.1±3.7 (p>0.05), gross weight decreased from 81.9±14.3kg to 76.6±13.3kg. The mean AHI decreased 33.4±18.9 to 14.6±11.0 (p<0.05), mean lowest oxygen saturation (LSAT) improved 79.4±9.2% to 86.9±5.9% (p<0.05), and mean duration of oxygen <90% decreased from 32.6±8.9 minutes to 7.3±2.1 minutes (p<0.05). The overall success rate (302 patients) based on the Sher criteria was 66.2%. Crosstabulation of respective major/minor criteria fulfilment, based on fulfilment of two major and two minor or better, the success rate (based on SLEEP-GOAL) was 69.8%. Based solely on the Sher criteria, 63 patients who had significant blood pressure reduction, 29 patients who had BMI reduction and 66 patients who had clinically significant decrease in duration of oxygen <90% would have been misclassified as "failures".

    CONCLUSION: AHI as a single parameter is unreliable. Assessing true success outcomes of OSA treatment, requires comprehensive and holistic parameters, reflecting true end-organ injury/function; the SLEEP-GOAL meets these requirements.

  2. Fulltext Pest categorisation of coconut cadang-cadang viroid
    EFSA Panel on Plant Health (PLH), Bragard C, Baptista P, Chatzivassiliou E, Gonthier P, Miret JAJ, et al.
    EFSA J, 2023 May;21(5):e08021.
    PMID: 37234272 DOI: 10.2903/j.efsa.2023.8021
    The EFSA Panel on Plant Health updated its 2017 pest categorisation of coconut cadang cadang viroid (CCCVd) for the EU territory due to new data on its host range. The identity of CCCVd, a member of the genus Cocadviroid (family Pospiviroidae), is established and detection and identification methods are available. It is included as a quarantine pest for the EU in the Commission Implementing Regulation (EU) 2019/2072. CCCVd has been reported from the Philippines and Malaysia. It is not known to be present in the EU. The host range of CCCVd is restricted to Arecaceae species (palms), in particular, coconut palm (Cocos nucifera) to which it causes a lethal disease. Oil palm (Elaeis guineensis) and buri palm (Corypha utan) are other natural hosts of CCCVd. Palm species of several genera, including Phoenix spp. and other species grown and/or cultivated in the EU, have been identified as potential hosts. The viroid is naturally transmitted at low rate by seeds and pollen and possibly by additional not yet identified natural transmission means. It can be transmitted through vegetative propagation applied to some palm species. Plants for planting including seeds of its hosts have been identified as the main entry pathway of CCCVd. Potential hosts of CCCVd are present in the EU, therefore establishment is possible. Should the pest establish in the EU, an impact is expected, with uncertainty on its magnitude. The Panel identified the susceptibility of palm species grown in the EU as a key uncertainty potentially affecting the conclusion of this pest categorisation. Nevertheless, the pest satisfies the criteria that are within the remit of EFSA to assess for this viroid to be regarded as potential Union quarantine pest.
  3. Pest categorisation of Lepidosaphes pineti, L. pini and L. piniphila
    EFSA Panel on Plant Health (PLH), Bragard C, Baptista P, Chatzivassiliou E, Di Serio F, Gonthier P, et al.
    EFSA J, 2023 Nov;21(11):e08408.
    PMID: 38035140 DOI: 10.2903/j.efsa.2023.8408
    The EFSA Panel on Plant Health performed a pest categorisation of Lepidosaphes pineti Borchsenius the pine oyster scale, Lepidosaphes pini (Maskell) the Oriental pine scale and Lepidosaphes piniphila Borchsenius (Hemiptera: Diaspididae) for the EU, following a commodity risk assessment of dwarfed Pinus parviflora grafted onto P. thunbergii from China in which the three Lepidosaphes species were identified as pests of possible concern to the EU. All three species are native to Asia. L. pineti is only known from China; L. piniphila occurs in China, Japan and Malaysia; and L. pini is present in China, Japan, South Korea, Taiwan, and has been introduced to the USA. All three species feed primarily on Pinus spp., including several important forestry and ornamental trees, and L. pineti and L. pini have adapted to feed on North American species of pine. L. pineti also feeds on Torreya grandis; L. pini on Abies sp., Cunninghamia lanceolata, Cycas spp., Podocarpus spp., Taxus sp. and Torreya sp.; and L. piniphila on Podocarpus spp. and T. grandis. All developmental stages occur on the foliage. Host plants for planting and cut branches with foliage could provide pathways into the EU. However, prohibitions on the import of Pinus close the main pathway. Certain dwarfed Pinus spp. from Japan are provided with a derogation for entry into the EU. The main hosts (Pinus spp.) occur throughout the EU in climate zones that match those where the three Lepidosaphes species occur in Asia. If any of the three Lepidosaphes species were to enter the EU, conditions in most of the EU are conducive to establishment. Following establishment, impacts on pines by L. pineti and L. pini would be expected. There are no published reports of L. piniphila causing damage to pine. L. pineti and L. pini satisfy the criteria that are within the remit of EFSA to assess for them to be regarded as potential Union quarantine pests. L. piniphila does not satisfy the criteria, as there is no evidence that it is harmful; however, there is a key uncertainty regarding whether it is synonymous with a closely related species, L. pitysophila, which is recorded as a pest of pine in China.
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