Clinical Phenotypes and Comorbidity in European Sleep Apnoea Patients

Background Clinical presentation phenotypes of obstructive sleep apnoea (OSA) and their association with comorbidity as well as impact on adherence to continuous positive airway pressure (CPAP) treatment have not been established. Methods A prospective follow-up cohort of adult patients with OSA (apnoea-hypopnoea index (AHI) of 655/h) from 17 European countries and Israel (n = 6,555) was divided into four clinical presentation phenotypes based on daytime symptoms labelled as excessive daytime sleepiness ("EDS") and nocturnal sleep problems other than OSA (labelled as "insomnia"): 1) EDS (daytime+/nighttime-), 2) EDS/insomnia (daytime+/nighttime+), 3) non-EDS/noninsomnia (daytime-/nighttime-), 4) and insomnia (daytime-/nighttime+) phenotype. Results The EDS phenotype comprised 20.7%, the non-EDS/non-insomnia type 25.8%, the EDS/ insomnia type 23.7%, and the insomnia phenotype 29.8% of the entire cohort. Thus, clinical presentation phenotypes with insomnia symptoms were dominant with 53.5%, but only 5.6% had physician diagnosed insomnia. Cardiovascular comorbidity was less prevalent in the EDS and most common in the insomnia phenotype (48.9% vs. 56.8%, p<0.001) despite more severe OSA in the EDS group (AHI 35.0\ub125.5/h vs. 27.9\ub122.5/h, p<0.001, respectively). Psychiatric comorbidity was associated with insomnia like OSA phenotypes independent of age, gender and body mass index (HR 1.5 (1.188-1.905), p<0.001). The EDS phenotype tended to associate with higher CPAP usage (22.7 min/d, p = 0.069) when controlled for age, gender, BMI and sleep apnoea severity. Conclusions Phenotypes with insomnia symptoms comprised more than half of OSA patients and were more frequently linked with comorbidity than those with EDS, despite less severe OSA. CPAP usage was slightly higher in phenotypes with EDS

Multinational data show that conspiracy beliefs are associated with the perception (and reality) of poor national economic performance

While a great deal is known about the individual difference factors associated with conspiracy beliefs, much less is known about the country-level factors that shape people's willingness to believe conspiracy theories. In the current article we discuss the possibility that willingness to believe conspiracy theories might be shaped by the perception (and reality) of poor economic performance at the national level. To test this notion, we surveyed 6723 participants from 36 countries. In line with predictions, propensity to believe conspiracy theories was negatively associated with perceptions of current and future national economic vitality. Furthermore, countries with higher GDP per capita tended to have lower belief in conspiracy theories. The data suggest that conspiracy beliefs are not just caused by intrapsychic factors but are also shaped by difficult economic circumstances for which distrust might have a rational basis

Evaluation of the elastic properties of bulk metallic glasses

The development of bulk metallic glasses as a prominent class of functional and structural materials has attracted considerable interest in the last years. One of the fundamental physical quantities necessary to describe the mechanical properties of the materials is the bulk modulus. In the present article, a simple method to estimate the bulk modulus and its pressure derivative is proposed. It is shown that these quantities can be estimated from the values of the constituent elements and their compositions. Comparison with measured data shows good agreement. The physical background of the method is discussed based on the jellium model of metals