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

Search for the chiral magnetic effect in collisions between two isobars with nuclear structures

Isobar collisions which were thought with a same background and different magnetic fields provide an opportunity to verify the chiral magnetic effect (CME) in relativistic heavy-ion collisions. However, the first result from the RHIC-STAR isobar experiment did not observed the CME signal, but discovered that the backgrounds are different between $_{44}^{96}\textrm{Ru}+_{44}^{96}\textrm{Ru}$ and $_{40}^{96}\textrm{Zr}+_{40}^{96}\textrm{Zr}$ collisions. We test eighteen cases of Woods-Saxon parameter settings resulted from different nuclear deformation or nuclear structure effects using a mutiphase transport model. We find out that seven cases can reasonably reproduce three reference ratios measured by the STAR experiment. With considering both the halo-type neutron skin structure and CME-like charge separation, we demonstrate that it is difficult for the CME observables ($\Delta\delta$, $\Delta\delta$ ratio, $\Delta\gamma$ and $\Delta\gamma/v_{2}$ ratio) to distinguish the presence or absence of the CME, if the CME strength is weak in isobar collisions. It is because the final state interactions significantly weaken the initial CME signal, resulting in non-linear sensitivities of the CME observables to the CME strength. Therefore, more sensitive observables are required to search for the possible small CME signal in isobar collisions.Comment: 10 pages, 6 figure

Understanding Users’ Recommendation Intention of Taxi-hailing Apps: An Internal Perception Perspective

Users’ recommendation intention has drawn greater intention by both scholars and managers under the context of electronic commerce. Based on TAM (Technology Acceptance Model), this study aims to examine factors affecting users’ recommendation intention of Taxi-hailing apps in Chinese context. Structural equation model is used in this study. Data collected from 261 Taxi-hailing apps users. The results show the following key interesting findings: (1) both perceived usefulness and perceived ease of use have positive effect on users’ perceived benefits; (2) perceived benefits has positive effect on users’ trust, while perceived privacy risk has negative effect on users’ trust; (3) users’ trust has positive effect on users’ recommendation intention; (4) perceived benefits acts as a partial mediator between perceived usefulness/users’ trust and perceived ease of use/users’ trust, and users’ trust acts as a partial mediator between perceived benefits and users’ recommendation intention. Implications for researchers and practice are discussed

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

Adiponectin improves coronary no-reflow injury by protecting the endothelium in rats with type 2 diabetes mellitus.

To determine the effect of adiponectin (APN) on the coronary no-reflow (NR) injury in rats with Type 2 diabetes mellitus (T2DM), 80 male Sprague-Dawley rats were fed with a high-sugar-high-fat diet to build a T2DM model. Rats received vehicle or APN in the last week and then were subjected to myocardial ischemia reperfusion (MI/R) injury. Endothelium-dependent vasorelaxation of the thoracic aorta was significantly decreased and serum levels of endothelin-1 (ET-1), intercellular cell adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) were noticably increased in T2DM rats compared with rats without T2DM. Serum APN was positively correlated with the endothelium-dependent vasorelaxation, but negatively correlated with the serum level of ET-1. Treatment with APN improved T2DM-induced endothelium-dependent vasorelaxation, recovered cardiac function, and decreased both NR size and the levels of ET-1, ICAM-1 and VCAM-1. Hypoadiponectinemia was associated with the aggravation of coronary NR in T2DM rats. APN could alleviate coronary NR injury in T2DM rats by protecting the endothelium and improving microcirculation

Co-Loan Network of Chinese Banking System Based on Listed Companies’ Loan Data

Based on the loan data of Chinese listed companies from 2008 to 2016, this paper constructs a co-loan network of the Chinese banking system and analyzes the topological structures and corresponding evolvement characteristics from the perspective of complex network. Through the empirical studies, we find that the co-loan network always displays a core-periphery structure; for example, ten banks including four state banks and six large commercial banks are always in the core region of the Chinese banking system for nine consecutive years. Furthermore, the co-loan network is a small-world network lasting for nine years