Clinical significance of obstructive sleep apnea in patients with acute coronary syndrome in relation to diabetes status.

Objective: The prognostic significance of obstructive sleep apnea (OSA) in patients with acute coronary syndrome (ACS) according to diabetes mellitus (DM) status remains unclear. We aimed to elucidate the association of OSA with subsequent cardiovascular events in patients with ACS with or without DM. Research design and methods: In this prospective cohort study, consecutive eligible patients with ACS underwent cardiorespiratory polygraphy between June 2015 and May 2017. OSA was defined as an Apnea Hypopnea Index ≥15 events/hour. The primary end point was major adverse cardiovascular and cerebrovascular events (MACCEs), including cardiovascular death, myocardial infarction, stroke, ischemia-driven revascularization, or hospitalization for unstable angina or heart failure. Results: Among 804 patients, 248 (30.8%) had DM and 403 (50.1%) had OSA. OSA was associated with 2.5 times the risk of 1 year MACCE in patients with DM (22.3% vs 7.1% in the non-OSA group; adjusted HR (HR)=2.49, 95% CI 1.16 to 5.35, p=0.019), but not in patients without DM (8.5% vs 7.7% in the non-OSA group, adjusted HR=0.94, 95% CI 0.51 to 1.75, p=0.85). Patients with DM without OSA had a similar 1 year MACCE rate as patients without DM. The increased risk of events was predominately isolated to patients with OSA with baseline glucose or hemoglobin A1c levels above the median. Combined OSA and longer hypoxia duration (time with arterial oxygen saturation22 min) further increased the MACCE rate to 31.0% in patients with DM. Conclusions: OSA was associated with increased risk of 1 year MACCE following ACS in patients with DM, but not in non-DM patients. Further trials exploring the efficacy of OSA treatment in high-risk patients with ACS and DM are warranted

Association of Obstructive Sleep Apnea With Cardiovascular Outcomes in Patients With Acute Coronary Syndrome.

Background The prognostic significance of obstructive sleep apnea ( OSA ) in patients with acute coronary syndrome ( ACS ) in the contemporary era is unclear. We performed a large, prospective cohort study and did a landmark analysis to delineate the association of OSA with subsequent cardiovascular events after ACS onset. Methods and Results Between June 2015 and May 2017, consecutive eligible patients admitted for ACS underwent cardiorespiratory polygraphy during hospitalization. OSA was defined as an apnea-hypopnea index ≥15 events·h-1. The primary end point was major adverse cardiovascular and cerebrovascular event ( MACCE ), including cardiovascular death, myocardial infarction, stroke, ischemia-driven revascularization, or hospitalization for unstable angina or heart failure. OSA was present in 403 of 804 (50.1%) patients. During median follow-up of 1 year, cumulative incidence of MACCE was significantly higher in the OSA group than in the non- OSA group (log-rank, P=0.041). Multivariate analysis showed that OSA was nominally associated with incidence of MACCE (adjusted hazard ratio, 1.55; 95% CI, 0.94-2.57; P=0.085). In the landmark analysis, patients with OSA had 3.9 times the risk of incurring a MACCE after 1 year (adjusted hazard ratio, 3.87; 95% CI, 1.20-12.46; P=0.023), but no increased risk was found within 1-year follow-up (adjusted hazard ratio, 1.18; 95% CI, 0.67-2.09; P=0.575). No significant differences were found in the incidence of cardiovascular death, myocardial infarction, and ischemia-driven revascularization, except for a higher rate of hospitalization for unstable angina in the OSA group than in the non- OSA group (adjusted hazard ratio, 2.10; 95% CI, 1.09-4.05; P=0.027). Conclusions There was no independent correlation between OSA and 1-year MACCE after ACS . The increased risk associated with OSA was only observed after 1-year follow-up. Efficacy of OSA treatment as secondary prevention after ACS requires further investigation

Structural characterization of an α-1, 6-linked galactomannan from natural Cordyceps 2 sinensis

An α-1, 6-linked galactomannan was isolated and purified from natural Cordyceps sinensis. The fine structure analysis of this polysaccharide was elucidated based on partial acid hydrolysis, monosaccharide composition, methylation and 1D/2D nuclear magnetic resonance (NMR) spectroscopy. Monosaccharide composition analysis revealed that this polysaccharide was mainly composed of galactose (68.65%), glucose (6.65%) and mannose (24.02%). However, after partial acid hydrolysis the percentages of galactose, glucose and mannose were changed to 3.96%, 13.82% and 82.22%, respectively. The molecular weight of this polysaccharide was 7207. Methylation and NMR analysis revealed that this galactomannan had a highly branched structure, mainly consisted of a mannan skeleton and galactofuranosyl chains. The structure of galactofuranosyl part was formed by alternating (1 → 5)-lined β-Galf and (1 → 6)-liked β-Galf or a single (1 → 6)-liked β-Galf, attaching to the O-2 and O-4 of the mannose chain, and terminated at β-T-Galf. The mannan core was revealed by analyzing the partial acid hydrolysate of the galactomannan and the structure was composed of (1 → 6)-linked α-Manp backbone, with substituted at C-2 by short chains of 2-substituted Manp or Galf branches

Anomalous optical and electronic properties of dense sodium

Based on ab initio density-functional-theory using generalized gradient approximation, we systematically study the optical and electronic properties of the insulating dense sodium phase (Na-hp4) reported recently [Ma \textit{et al.}, Nature \textbf{458}, 182 (2009)]. The structure is found optically anisotropic and transparent to visible light, which can be well interpreted using its electronic band structure and angular moment decomposed density of states. Through the bader analysis of Na-hp4 at different pressures, we conclude that ionicity exists in the structure and becomes stronger with increasing pressure. In addition, the absorption spectra in the energy range from 1.4 to 2.4 eV are compared with recent experimental results and found good agreement. It is found that the deep-lying valence electrons participate in the interband transition.Comment: 7 pages, 7 figure

Generic functional modelling of multi-pulse auto-transformer rectifier units for more-electric aircraft applications

The Auto-Transformer Rectifier Unit (ATRU) is one preferred solution for high-power AC/DC power conversion in aircraft. This is mainly due to its simple structure, high reliability and reduced kVA ratings. Indeed, the ATRU has become a preferred AC/DC solution to supply power to the electric environment control system on-board future aircraft. In this paper, a general modelling method for ATRUs is introduced. The developed model is based on the fact that the DC voltage and current are strongly related to the voltage and current vectors at the AC terminals of ATRUs. In this paper, we carry on our research in modelling symmetric 18-pulse ATRUs and develop a generic modelling technique. The developed generic model can study not only symmetric but also asymmetric ATRUs. An 18-pulse asymmetric ATRU is used to demonstrate the accuracy and efficiency of the developed model by comparing with corresponding detailed switching SABER models provided by our industrial partner. The functional models also allow accelerated and accurate simulations and thus enable whole-scale more-electric aircraft electrical power system studies in the future

Knockdown of Sucla2 decreases the viability of mouse spermatocytes by inducing apoptosis through injury of the mitochondrial function of cells

Introduction. Sucla2, a β subunit of succinyl coenzyme A synthase, is located in the mitochondrial matrix. Sucla2 catalyzes the reversible synthesis of succinate and adenosine triphosphate (ATP) in the tricarboxylic acid cycle. Sucla2 expression was found to be correlated with the capacitation of boar spermatozoa. We have previously reported that Sucla2 was decreased in the testes of rats with spermatogenesis failure after exposure to endocrine disruptor BDE47. Yet, the expression model of Sucla2 in spermatogenesis and the function of Sucla2 in spermatogenic cells are still unclear. Our objective was to explore the localization of Sucla2 during mouse spermatogenesis and its function in the mouse spermatocyte line (GC2). Material and methods. The localization of Sucla2 in the mouse testis was explored through immunohistochemistry (IHC). Sucla2 was knocked down in GC2 cells and its expression was detected by Western blot (WB) to verify the efficiency of the siRNA transfection. Mitochondrial membrane potential (MMP), apoptosis and ROS of GC2 were detected by flow cytometry. ATP production was measured by the luminometric method and the presence of Bcl2 of GC2 was detected by WB. Results. Sucla2 is highly expressed in all germ cells but not in interstitial cells. Coarse Sucla2 signals are found in spermatocytes in stages VII–XII of mouse spermatogenesis. In GC2 cells, knockdown of Sucla2 decreased cell viability and MMP, induced apoptosis of GC2 cells, decreased ATP production, and Bcl2 expression, and increased ROS levels. Conclusions. Sucla2 is related to the developmental stages of mouse spermatogenesis. Knockdown of Sucla2 decreases the viability of mouse spermatocytes by inducing apoptosis via decreased mitochondrial function of the cells

Concomitant Retrograde Coronary Venous Infusion of Basic Fibroblast Growth Factor Enhances Engraftment and Differentiation of Bone Marrow Mesenchymal Stem Cells for Cardiac Repair after Myocardial Infarction.

AIM: Basic fibroblast growth factor (bFGF) increases the migration and viability of bone marrow mesenchymal stem cells (MSCs) in vitro. Retrograde coronary venous infusion can provide both increased regional bFGF concentrations and homogeneous cell dissemination. We determined whether retrograde delivery of bFGF enhances the potency of transplanted MSCs for cardiac repair in a canine infarct model. METHODS AND RESULTS: Under hypoxic conditions, cellular migration was significantly increased in MSCs co-cultured with bFGF compared to vascular endothelial growth factor or insulin-like growth factor, and bFGF promoted MSCs differentiation into a cardiomyocyte phenotype. A canine infarct model was employed by coronary ligation. One week later, animals were subjected to retrograde infusion of combination bFGF (200ng/mL) and MSCs (1×10(8) cells) (n=5), MSCs (1×10(8) cells, n=5), bFGF (200ng/mL, n=5), or placebo (phosphate-buffered saline, n=3). Four weeks after infusion, only the bFGF+MSCs therapy exhibited significantly increased left ventricular ejection fraction (LVEF) by echocardiography (p CONCLUSIONS: Retrograde coronary venous bFGF infusion augments engraftment and differentiation capacity of transplanted MSCs, recovering cardiac function and preventing adverse remodeling. This novel combined treatment and delivery method is a promising strategy for cardiac repair after ischemic injury