Oropharyngeal Muscle Exercise Therapy Improves Signs and Symptoms of Post-stroke Moderate Obstructive Sleep Apnea Syndrome

The primary aim of the current study was to assess the effects of oropharingeal muscle exercises in obstruction severity on stroke patients with OSAS. The secondary aims were to evaluate the effects of the exercises on rehabilitation of neurological function, sleeping, and morphology change of upper airway. An open-label, single-blind, parallel-group, randomized, controlled trial was designed. Fifty post-stroke patients with moderate OSAS were randomly assigned into 2 groups (25 in each group). For the therapy group, oropharyngeal muscle exercise was performed during the daytime for 20 min, twice a day, for 6 weeks. The control group was subjected to sham therapy of deep breathing. Primary outcomes were the obstruction severity by polysomnography. Secondary outcomes included recovery of motor and neurocognitive function, personal activities of daily living assessment (ADL), sleep quality and sleepiness scale. It also included upper airway magnetic resonance imaging (MRI) measurements. Assessments were made at baseline and after 6-week exercise. Finally, 49 patients completed the study. The apnea–hypopnea index, snore index, arousal index, and minimum oxygen saturation improved after exercise (P < 0.05). Oropharyngeal muscle exercises improved subjective measurements of sleep quality (P = 0.017), daily sleepiness (P = 0.005), and performance (both P < 0.05) except for neurocognition (P = 0.741). The changes in obstruction improvement, sleep characteristics and performance scale were also associated with training time, as detected by Pearson's correlation analysis. The anatomic structural remodeling of the pharyngeal airway was measured using MRI, including the lager retropalatal distance (P = 0.018) and shorter length of soft palate (P = 0.044) compared with the baseline. Hence, oropharyngeal muscle exercise is a promising alternative treatment strategy for stroke patients with moderate OSAS.Clinical Trial Registration:http://www.chictr.org.cn. Unique identifier: ChiCTR-IPR-1600997

Integrated Optical Vortex Microcomb

The explorations of physical degrees of freedom with infinite dimensionalities, such as orbital angular momentum and frequency of light, have profoundly reshaped the landscape of modern optics with representative photonic functional devices including optical vortex emitters and frequency combs. In nanophotonics, whispering gallery mode microresonators naturally support orbital angular momentum of light and have been demonstrated as on-chip emitters of monochromatic optical vortices. On the other hand, whispering gallery mode microresonators serve as a highly efficient nonlinear optical platform for producing light at different frequencies - i.e., microcombs. Here, we interlace the optical vortices and microcombs by demonstrating an optical vortex comb on an III-V integrated nonlinear microresonator. The angular-grating-dressed nonlinear microring simultaneously emits spatiotemporal light springs consisting of 50 orbital angular momentum modes that are each spectrally addressed to the frequency components (longitudinal whispering gallery modes) of the generated microcomb. We further experimentally generate optical pulses with time-varying orbital angular momenta by carefully introducing a specific intermodal phase relation to spatiotemporal light springs. This work may immediately boost the development of integrated nonlinear/quantum photonics for exploring fundamental optical physics and advancing photonic quantum technology.Comment: To appear in Nature Photonic

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

<b>Theoretical study on electronic structures and spectroscopy of triarylborane substituted by thiophene</b>

The electronic structures of a series of triarylborane derivatives were studied using the AM1 method and density function theory (DFT) at B3LYP/6-31G(d) level. Based on the B3LYP/6-31G(d) optimized geometries, the electronic spectra, IR and 13C NMR spectra of these compounds were calculated with the INDO/CIS, AM1 and B3LYP/6-31G(d) methods, respectively. The presence of electron-donating alkyl groups and the increase in the number of thiophene rings in the derivatives lead to the decrease in LUMO-HOMO energy gaps. At the same time, the first absorptions in the electronic spectra and the stretching vibrations of the C-C as well as C-H bonds in the IR spectra of these compounds compared with those of the parent compound are red-shifted. Also, the 13C chemical shifts of the carbon atoms on the phenyl rings in these compounds are upfield relative to those of the same carbon atoms in the parent compound

miR-203a-3p inhibits proliferation of human hepatocellular carcinoma cell lines

Objective To explore the molecular mechanism of regulation on the proliferation and apoptosis in hepatocellular carcinoma(HCC) cells by miR-203a-3p. Methods RT-qPCR was used to detect the expression of miR-203 a-3p in the sample of liver cancer tissues and liver cancer cell lines. The HepG2 cell model expressing miR-203a-3p was established. Cell proliferation was observed by MTT method and the apoptosis of cells was detected by flow cytometry. Plate colony formation assay was used to detect clone formation and cell scratch assay was used to detect cell migration. Expression profile chip was applied in the detection of mRNA and ELISA was used to detect the secretion of transforming growth factor-β1 (TGF-β1). TGF-β1 protein expression was examined by Western blod technology. Results miR-203a-3p was weekly expressed in HCC tissues (PPPPPPPPPPPConclusions miR-203a-3p inhibits proliferation of human hepatocellular carcinoma cell lines, promotes apoptosis and inhibits the expression of TGF-β1 protein

A Dynamic Model of Electric Vehicle Adoption: The Role of Social Commerce in New Transportation

This research explores the adoption of electric vehicles (EVs) as a substitute for internal combustion engine vehicles (ICVs) and examines its emergence as a mobile intelligent terminal of social commerce. We present a system dynamics (SD) model incorporating fuzzy logic to simulate the adoption process. The results suggest that consumers’ vague perceptions and the dispersion of pilot EV projects have caused EV adoption to be delayed; nevertheless, the introduction of social commerce to EVs can help relieve this problem and promote EV adoption. However, the timing of introducing social commerce is critical for enhancing its positive effect on EV adoption

Modified Modulation Strategy of 1: 1: 2 Asymmetric Nine-Level Inverter and Its Power Balance Method

The three unit nine-level inverter can output more voltage levels with fewer h-bridge units, while having better output waveform quality. However, in the conventional hybrid frequency modulation strategy, only one low-voltage unit adopts pulse width modulation (PWM), which causes the problem of switching loss and uneven heat distribution between the two low-voltage units. At the same time, the output power of the conventional modulation strategy is unbalanced. Aiming to resolve the above problems, a modified hybrid modulation strategy and a power balance control method under the strategy is proposed in this paper. The modulation strategy achieves output power balance between the three units and an even distribution of switching losses between the two low voltage units while maintaining the same output power quality. Simulation and experimental results verify the feasibility of the modulation strategy

Multiband SHEPWM Control Technology Based on Walsh Functions

The drawback of modulation ratio limitation in selective harmonic elimination pulse width modulation (SHEPWM) technology based on Walsh function transformation. In order to solve this problem, a multiband SHEPWM control technology method for a multilevel inverter based on Walsh functions is proposed. By analyzing multiband SHEPWM for multilevel inverter voltage waveforms under a Fourier series transform, the unified nonlinear multiband SHEPWM equations for a multilevel inverter with a modulation index varying from 0 to 1 can be generalized. The equations can be solved by Walsh function transform. In this way, the difficulties faced in expanding the modulation index, online calculation, and real-time control are resolved simultaneously. A seven-level inverter is taken as the example, for which the piecewise linear equations of Walsh functions under different bands and the trajectories of switching angles are given. Meanwhile, the conditions for multiple sets of solutions at such a point where the modulation index is switched over are also taken into account. The feasibility of the proposed method is verified by simulation based on MATLAB and SIMULINK. Finally, the feasibility of the practical application is proved by the experiment based on Digital Signal Processor (DSP)

Spatial distribution characteristics and analysis of influencing factors on different manufacturing types in Shandong Province.

Investigating the spatial distribution characteristics and influencing factors of various industry types is critical for promoting the high-quality transformation and development of China's industry. This study combined the Getis-Ord Gi* statistic method, the random forest-based importance assessment method, and the geographically weighted regression method to determine the spatial distribution characteristics of four industry types and their influencing factors. The results revealed that the raw material industry was primarily concentrated in the surrounding districts and counties of Linyi and Qingdao. The food and light textile industry was mainly concentrated in the surrounding districts and counties of Qingdao, and a few were concentrated in some counties of Linyi. The processing and manufacturing industry was also concentrated in the surrounding districts and counties of Qingdao, and a few were concentrated in the belt regions connecting Jinan, Zibo, and Weifang. The high-tech industry was mainly concentrated in the surrounding districts and counties of Jinan and Qingdao. The key spatial influencing factors of the four industry types were different. The number of employees in the secondary industry and road density were most important in determining the spatial distribution of the raw material industry. The financial environment and number of research institutions were most important to the spatial distribution of the food and light textile industry. The gross domestic product and number of medical facilities were most important to the spatial distribution of the processing and manufacturing industry. Urbanization rate, number of research institutions, and gross domestic product were most important to the spatial distribution of the high-tech industry. Geographically weighted regression analysis revealed that the impact intensity of these key factors on the industry exhibits significant spatial heterogeneity. Taken together, these results are useful for formulating the development strategy for each industrial type in different regions