Differences in gas exchange, chlorophyll fluorescence, and modulated reflection of light at 820 nm between two rhododendron cultivars under aluminum stress conditions.

Aluminum (Al) toxicity is an important factor restricting the normal growth of plants in acidic soil. Rhododendron (Ericaceae) can grow relatively well in acidic soil. To uncover the adaptive mechanisms of photosynthesis under Al stress, the influence of Al stress on the photosynthetic activities of Al-sensitive (Baijinpao) and Al-resistant (Kangnaixin) rhododendron cultivars was examined by measuring gas exchange, chlorophyll fluorescence, and the modulated reflection of light at 820 nm. Under Al stress conditions, the net photosynthetic rate and stomatal conductance of the rhododendron leaves decreased, whereas the intercellular CO2 concentration increased. The Al stress treatment damaged the oxygen-evolving complex of the rhododendron seedlings, while also inhibiting electron transport on the photosystem II (PSII) donor side. In addition, the exposure to Al stress restricted the oxidation of plastocyanin (PC) and the photosystem I (PSI) reaction center (P700) and led to the re-reduction of PC+ and P700+. The comparison with Kangnaixin revealed an increase in the PSII connectivity in Baijinpao. Additionally, the donor-side electron transport efficiency was more inhibited and the overall activity of PSII, PSI, and the intersystem electron transport chain decreased more extensively in Baijinpao than in Kangnaixin. On the basis of the study findings, we concluded that Al stress adversely affects photosynthesis in rhododendron seedlings by significantly decreasing the activity of PSII and PSI. Under Al stress, Kangnaixin showed stronger tolerance compared with Baijinpao.

[The relationship between birth weight and obstructive sleep apnea in children].

Objective:To study the relationship between children's birth weight and obstructive sleep apnea（OSA）. Methods:The sleep data and birth information of children who underwent polysomnography in the Department of Otorhinolaryngology-Head and Neck Surgery of Henan Children's Hospital from October 2020 to July 2022 were retrospectively analyzed. The data of OSA detection rate, OSA severity, sleep structure and respiratory parameters in different birth weight groups were analyzed. Results:A total of 2 778 children met the inclusion criteria, including 1 833 males and 945 females. According to birth weight, the selected children were divided into three groups: 122 small for gestational age（SGA） group, 2 313 appropriate for gestational age（AGA）, and 343 large for gestational age（LGA） group. There was no significant difference in age between different groups（P=0.061）. In each group, boys are significantly more numerous than girls（P=0.001）. The difference in current body mass index（BMI） between groups was statistically significant: the current BMI was higher in the LGA group（17.51±4.01, P<0.001）. The severity of OSA was different in different birth weight groups（P=0.037）. There was a strong positive correlation between the severity of OSA and birth weight（r=0.992）. Children in the SGA group had shorter rapid eye movement（REM） sleep period（19.00[15.18, 23.33], P=0.012）, higher obstructive apnea-hypopnea index（OAHI） values（1.75[0.60, 5.13], P=0.019）, and had lower central apnea hypopnea index（CAHI） values（0.10[0.00, 0.50], P=0.020）. There were no significant differences in sleep structure and respiratory parameters between the LGA group and the AGA group. Multiple regression analysis of the factors affecting the OAHI index showed that the OAHI index of boys was higher than that of girls（95%CI 1.311-2.096, P<0.001）, and age was negatively correlated with the OAHI index（r=-0.105, 95%CI 0.856-0.946, P<0.001）, current BMI and OAHI index were positively correlated（r=0.037, 95%CI 1.010-1.065, P=0.007）. LGA was positively correlated with OAHI index（r=0.346, 95%CI 1.039-1.921, P=0.027）, and the correlation between LGA and OAHI（r=0.346） was higher than that between SGA and OAHI（r=0.340）. Conclusion:There was no significant difference in the incidence of OSA in children with different birth weight groups, but the OSA severity of LGA group was higher. Gender, age, BMI index and large for gestational age were the influencing factors for the occurrence of OSA in children, which should be paid more attention to in clinical practice.

Unveiling the Properties of Sulfhydryl Groups in a Single-Molecule Junction.

The metal-thiol interface is ubiquitous in nanotechnology and surface chemistry. It is not only used to construct nanocomposites but also plays a decisive role in the properties of these materials. When organothiol molecules bind to the gold surface, there is still controversy over whether sulfhydryl groups can form disulfide bonds and whether these disulfide bonds can remain stable on the gold surface. Here, we investigate the intrinsic properties of sulfhydryl groups on the gold surface at the single-molecule level using a scanning tunneling microscope break junction technique. Our findings indicate that sulfhydryl groups can react with each other to form disulfide bonds on the gold surface, and the electric field can promote the sulfhydryl coupling reaction. In addition to these findings, ultraviolet irradiation is used to effectively regulate the coupling between sulfhydryl groups, leading to the formation and cleavage of disulfide bonds. These results unveil the intrinsic properties of sulfhydryl groups on the gold surface, therefore facilitating the accurate construction of broad nanocomposites with the desired functionalities.

Transcriptome and photosynthetic analyses provide new insight into the molecular mechanisms underlying heat stress tolerance in Rhododendron × pulchrum Sweet.

Rhododendron species provide excellent ornamental use worldwide, yet heat stress (HS) is one of the major threats to their cultivation. However, the intricate mechanisms underlying the photochemical and transcriptional regulations associated with the heat stress response in Rhododendron remain relatively unexplored. In this study, the analyses of morphological characteristics and chlorophyll fluorescence (ChlF) kinetics showed that HS (40 °C/35 °C) had a notable impact on both the donor's and acceptor's sides of photosystem II (PSII), resulting in reduced PSII activity and electron transfer capacity. The gradual recovery of plants observed following a 5-day period of culture under normal conditions indicates the reversible nature of the HS impact on Rhododendron × pulchrum. Analysis of transcriptome data unveiled noteworthy trends: four genes associated with photosynthesis-antenna protein synthesis (LHCb1, LHCb2 and LHCb3) and the antioxidant system (glutamate-cysteine ligase) experienced significant down-regulation in the leaves of R. × pulchrum during HS. Conversely, aseorbate peroxidase and glutathione S-transferase TAU 8 demonstrated an up-regulated pattern. Furthermore, six down-regulated genes (phos-phoenolpyruvate carboxylase 4, sedoheptulose-bisphosphatase, ribose-5-phosphate isomerase 2, high cyclic electron flow 1, beta glucosidase 32 and starch synthase 2) and two up-regulated genes (beta glucosidase 2 and UDP-glucose pyrophosphorylase 2) implicated in photosynthetic carbon fixation and starch/sucrose metabolism were identified during the recovery process. To augment these insights, a weighted gene co-expression network analysis yielded a co-expression network, pinpointing the hub genes correlated with ChlF dynamics' variation trends. The cumulative results showed that HS inhibited the synthesis of photosynthesis-antenna proteins in R. × pulchrum leaves. This disruption subsequently led to diminished photochemical activities in both PSII and PSI, albeit with PSI exhibiting heightened thermostability. Depending on the regulation of the reactive oxygen species scavenging system and heat dissipation, photoprotection sustained the recoverability of R. × pulchrum to HS.

The Exploration of Flowering Mechanisms in Cherry Plants.

Flowering cherry (Cerasus sp.) are significant spring-blooming trees. However, the short blooming period and the rarity of early and late-flowering varieties limit their use in gardens in northern China. The experiment incorporated annually early-flowering species such as Cerasus discoidea, Cerasus pseudocerasus 'Introtsa', Cerasus dielsiana, Cerasus campanulata 'Youkou', Cerasus yedoensis 'Somei-Yoshino', and Cerasus spachiana f. ascendens, as well as twice-a-year flowering species like Cerasus subhirtella 'Autumnalis' and Cerasus subhirtella 'Accolade'. We observed the timing of natural events and growth measurements for specific plants over a span of two years. This research involved a thorough examination of their ability to withstand cold temperatures, considering their physiological aspects. We examined the levels of nutrients and hormones in the flower buds at various stages of development in plants that bloom yearly and every two years. The findings indicated that C. subhirtella 'Autumnalis' is adaptable, offering the lengthiest autumn blooming phase lasting 54 days. The hierarchy of cold tolerance was as follows: C. pseudocerasus 'Introtsa' > C. discoidea > Cerasus × subhirtella 'Autumnalis' > C. dielsiana > C. 'Youkou'. Furthermore, the soluble protein content in leaves increased before autumn flower buds' sprout of twice-a-year flowering varieties but declined in C. yedoensis 'Somei-Yoshino' within the same time. We determined that changes in nutrient content significantly contribute to the autumn opening of C. subhirtella 'Autumnalis' robust short branch flower buds. During the final phase of flower bud development, the rise in trans-Zeatin-riboside (ZR) and indolacetic acid (IAA) promotes the initiation of the first flowering period in C. subhirtella 'Autumnalis' prior to its mandatory hibernation. The occurrence of secondary flowering involves a multifaceted regulatory process. These findings serve as valuable references for delving deeper into the mechanisms governing cherry blossom formation and secondary flowering.

Effects of plant density on alfalfa (Medicago sativa L.) seed yield in western Heilongjiang areas.

Alfalfa (Medicago sativa L.) is known as the "king of forages". The aim of the current study is to determine the optimum planting density as the key cultivation technique for high yield of alfalfa seed. Alfalfa variety (Longmu 801) was planted in experimental fields from 2014 to 2017. In the planting density test, the row spacing was 65, 80, and 95 cm, and the plant spacing was 30, 45, 60, 75, and 90 cm. The seed yield and yield components in the row spacing and plant spacing tests were measured. On the basis of 3 years average of the experimental data, the highest seed yield of 225.49 kg ha-1 was obtained with row spacing vs plant spacing of 65 and 60 cm, respectively. Correlation analysis showed a significant positive correlation between the racemes per stem, pods per raceme, pods per stem, seeds per pod, and the seed yield. These results suggested that Longmu 801 should be cultivated with 65 cm row spacing and 60 cm plant spacing to maximize seed yields in western Heilongjiang areas.

A Genome-Wide Analysis and Expression Profile of Heat Shock Transcription Factor (Hsf) Gene Family in Rhododendron simsii.

Heat shock transcription factors are key players in a number of transcriptional regulatory pathways that function during plant growth and development. However, their mode of action in Rhododendron simsii is still unclear. In this study, 22 RsHsf genes were identified from genomic data of R. simsii. The 22 genes were randomly distributed on 12 chromosomes, and were divided into three major groups according to their phylogenetic relationships. The structures and conserved motifs were predicted for the 22 genes. Analysis of cis-acting elements revealed stress-responsive and phytohormone-responsive elements in the gene promoter regions, but the types and number varied among the different groups of genes. Transcriptional profile analyses revealed that RsHsfs were expressed in a tissue-specific manner, with particularly high transcript levels in the roots. The transcriptional profiles under abiotic stress were detected by qRT-PCR, and the results further validated the critical function of RsHsfs. This study provides basic information about RsHsf family in R. simsii, and paves the way for further research to clarify their precise roles and to breed new stress-tolerant varieties.

Screening practices for obstructive sleep apnea in healthy community people: a Chinese community-based study.

Background: Owing to the lack of clear guidelines, the significance of obstructive sleep apnea (OSA) screening in healthy community people is unclear. This study aimed to screen for OSA in a healthy community population and provide a basis for its screening. Methods: Permanent residents from five communities in the coastal and mountainous areas of south China were selected. The screening process included demographic and sleep questionnaire surveys, and an OSA screening. To compare the prevalence and risk factors of OSA in different areas, a type IV wearable intelligent sleep monitor (WISM) was used for screening. Results: A total of 3,650 participants completed all studies, with a mean age of 53.81±12.71 years. In addition, 4,318 participants completed the OSA screening within 30 days, and the objective screening speed was 200 people per day. The recovery rate of the screening equipment was 99.37% (4,291/4,318), the screening success rate was 89.63% (3,846/4,291), and the rejection rate was 2.7% (120/4,438). The prevalence of high-risk OSA screened using the Stop-Bang questionnaire was 42.8% (1,563/3,650) and that screened using the device was 30.7% (1,119/3,650). The prevalence of OSA screened using the Stop-Bang questionnaire was higher than that screened using the device (P<0.01). Further analysis of sleep quality and daytime sleepiness showed that 47.6% (1,736/3,650) of the community population had good sleep quality and 6.6% (240/3,650) had daytime sleepiness. Age, sex, body mass index (BMI), neck circumference, and hypertension were risk factors for OSA in the community population. Conclusions: The use of objective type IV sleep detection equipment to screen a large sample population in the community in a short time is feasible. The prevalence of high-risk OSA screened using the Stop-Bang questionnaire was higher than that screened using the objective screening device.

Identification of pivotal genes with prognostic evaluation value in lung adenocarcinoma by bioinformatics analysis.

Lung cancer remains the leading cause of cancer morbidity and mortality worldwide, and over-diagnosis causes various unnecessary losses in patients' lives and health. How to more effectively screen lung cancer patients and their potential prognostic risk become the focus of our current study. By analyzing the LUAD expression profile in The Cancer Genome Atlas (TCGA), we constructed a weighted gene co-expression network using differentially expressed genes (DEGs) to find the key modules and pivotal genes. A COX proportional risk regression model based on the least absolute shrinkage and selection operator (LASSO) was used to assess the predictive value of the model for the prognosis of LUAD patients. A total of 4107 up-regulated DEGs and 2022 down-regulated DEGs were identified in this study, and enrichment analysis showed that these analyzes were associated with the extracellular matrix of cells and adhesion. Ten gene markers consisting of LDHA, TOP2A, UBE2C, TYMS, TRIP13, EXO1, TTK, TPX2, ZWINT, and UHRF1 were established by extracting the central genes in the key modules, and the upregulation of these genes was accompanied by an increased prognostic risk of patients. Among them, high expression of LDHA, TRIP13, and TTK in LUAD was associated with shorter overall survival and could be used as independent prognostic factors to participate in metabolic processes such as tumor NAD. The present study provides a powerful molecular target for the study of LUAD prognosis and provides a theoretical basis for the diagnosis and treatment of LUAD and the development of targeted inhibitors.

Pulse rate variability predicted cardiovascular disease in sleep disordered breathing: The Guangdong sleep health study.

OBJECTIVES: Pulse rate variability (PRV) predicts stroke in patients with sleep disordered breathing (SDB). However, the relationship between PRV and cardiovascular disease (CVD) was unknown in SDB. METHODS: This was a cross-sectional study. Community residents in Guangdong were investigated. Sleep study were conducted with a type Ⅳ sleep monitoring. PRV parameters was assessed from the pulse waveforms derived from the sleep monitoring. RESULTS: 3747 participants were enrolled. The mean age was 53.9 ± 12.7 years. 1149 (30.7%) were diagnosed as SDB. PRV parameters, except for the averages of pulse-to-pulse intervals (ANN), were higher in participants with SDB than those without. After adjusting for traditional CVD risk factors, deceleration capacity of rate (DC), ANN, and the percentage of pulse-to-pulse interval differences that were more than 50 ms (PNN50) were correlated with CVD risk in participants with SDB (OR were 0.826, 1.002, and 1.285; P were 0.003, 0.009, and 0.010), but not in participants without SDB. There was no interaction effect between DC, ANN, PNN50 and oxygen desaturation index. In hierarchical analysis, DC and ANN were predictors for CVD in SDB patients with age <60 years, male, overweight, diabetes, and normal lipid metabolism. PNN50 was predictor for CVD in the elderly SDB patients without overweight, diabetes or dyslipidemia. CONCLUSIONS: PRV parameters may be specific predictors for CVD in SDB. PNN50 was a potent biomarker for CVD risk in the elderly with SDB, event without traditional CVD risk factors.

Alternative Splicing for Leucanthemella linearis NST1 Contributes to Variable Abiotic Stress Resistance in Transgenic Tobacco.

Leucanthemella linearis is a marsh plant in the family Compositae. It has good water and moisture resistance and ornamental properties, which makes it one of the important materials for chrysanthemum breeding and genetic improvement. The NST1 (NAC secondary wall enhancement factor 1) gene is associated with the thickening of the secondary walls of fiber cells in the plant ducts and the secondary xylem and plays an important role in plant stress resistance. In this study, two variable spliceosomes of the NST1 gene were identified from a chrysanthemum plant by using bioinformatics, qRT-PCR, transgene, and paraffin section methods to explore the molecular mechanism of the variable splicing of NST1 under abiotic stress. The results show that only three amino acids were found to be different between the two LlNST1 variants. After being treated with salt, drought, and low temperatures, analysis of the expression levels of the LlNST1 and LlNST1.1 genes in Ll showed that LlNST1.1 could respond to low temperatures and salt stress and had a weak response to drought stress. However, the expression level of LlNST1 under the three treatments was lower than that of LlNST1.1. LlNST1 transgenic tobacco showed increased saline-alkali resistance and low-temperature resistance at the seedling stage. LlNST1.1 transgenic tobacco also showed enhanced saline-alkali resistance and drought resistance at the seedling stage. In conclusion, the functions of the two variable spliceosomes of the NST1 gene are very different under abiotic stress. Therefore, this study verified the function of the variable spliceosome of NST1 and improved the stress resistance of the chrysanthemum plant under examination by regulating the expression of the NST protein, which lays a material foundation for the improvement of plant stress resistance materials and has important significance for the study of the resistance of chrysanthemum plants to abiotic stress.

APAP Treatment Acceptance Rate and Cost-Effectiveness of Telemedicine in Patients with Obstructive Sleep Apnea: A Randomized Controlled Trial.

Purpose: This study evaluated the treatment acceptance rate and cost-effectiveness of the telemedicine model in clinical practice for adult patients with obstructive sleep apnea (OSA). Patients and Methods: Patients admitted to the sleep center for snoring were randomly divided into telemedicine and control groups. Patients diagnosed with moderate-to-severe OSA using the Home Sleep Apnea Test (HSAT) were voluntarily treated with auto-adjusted positive airway pressure (APAP) therapy. The acceptance rate of the APAP treatment, cost of patient visits, time cost, and labor cost of doctors in the two groups were observed. Results: A total of 57 subjects were included, with an average age of 40.12±11.73 years, including 47 males (82.5%); 26 patients were in the telemedicine group, and 31 were in the control group. Follow-up results showed that the acceptance rate of APAP treatment was 57.7% and 54.8% in the telemedicine and control groups, respectively, with no significant difference between the two groups (p=0.829). The cost-benefit analysis showed that the telemedicine group reduced the cost of patients' medical treatment [-457.84(-551.19,1466.87)] but increased the extra intervention frequency and time outside the doctor's office. Further analysis showed that male subjects of older age, higher education level, distant residence, no fatty liver, poor sleep quality, severe insomnia, and higher OSA severity were more likely to receive telemedicine diagnosis and treatment. Conclusion: The APAP treatment acceptance rate and compliance of OSA patients in the telemedicine group were similar to those in the control group, and the cost of patients' medical treatment was reduced. However, telemedicine increases the frequency and duration of additional out-of-hospital interventions.

Caveolin-1 Promotes the Imbalance of Th17/Treg in Chronic Obstructive Pulmonary Disease by Regulating Hsp70 Expression.

Objective: To investigate whether the expression of Hsp70 is associated with Cav-1 in promoting the imbalance of Th17/Treg cells in COPD. Methods: The plasma Cav-1, Hsp70 expression were quantified by enzyme-linked immunosorbent assay (ELISA). The frequencies of circulating Th17, Treg cells and Th17/Treg ratio were determined by flow cytometry. Peripheral blood mononuclear cells (PBMCs) from subjects were transfected with Cav-1 or control plasmids and Hsp70 plasmid. Results: We found that Cav-1 expression was lower but the levels of Hsp70 and Th17 cells were higher in COPD than in healthy control (HC). Hsp70 expressions were positively correlated with Cav-1 levels, Th17 cells, and Th17/Treg ratio in COPD but not in HC. Cav-1 over-expression resulted in an increase in Hsp70 and Th17 levels. Suppressing Hsp70 expressing by small interfering RNA (siRNA), the decline of Th17 frequency was observed in Cav-1-overexpressed PBMCs. Conclusion: Collectively, our results illuminate that Cav-1 contributes to the imbalance of Th17/Treg through potentially regulating Hsp70 expression.

The study of the characteristics of the secondary flowering of Cerasus subhirtella 'Autumnalis'.

The short flowering period of ornamental cherry trees is the main factor limiting their use in gardens. Determining the secondary flowering characteristics of ornamental cherry trees is required to prolong their flowering period. In this experiment, Cerasus subhirtella 'Autumnalis' was used as the experimental material. The phenological differences in their annual growth cycle were observed using the BBCH coding system. The cooling requirements of the flower buds were evaluated by the chilling hours model (temperature between 0 and 7.2 °C) and the Utah model. The expression of the core gene involved in bud dormancy regulation DAM (dormancy-associated MADS-box) from the completion of flower bud differentiation in one year until the following year was measured by performing real-time fluorescence-based quantitative PCR. The results showed that the flowering duration of C. subhirtella 'Autumnalis' from November to December was longer than that of C. yedoensis 'Somei Yoshino', which was from March to April. The progress from seed bud-break to flower bud opening took about 10 days for C. subhirtella 'Autumnalis', while the same stage for C. yedoensis 'Somei Yoshino' took around 20 days. Additionally, the flower buds of C. subhirtella 'Autumnalis' needed only the chilling temperature unit of 54.08 to satisfy the chilling requirement, while C. yedoensis 'Somei Yoshino' required a chilling temperature unit of 596.75. After the completion of flower bud differentiation, during low-temperature storage, the expression of DAM4 and DAM5 genes first increased and then decreased, whereas, the expression of the DAM6 gene continued to decrease, and the expression of DAM4, DAM5, and DAM6 in C. yedoensis 'Somei Yoshino' increased rapidly and was maintained at a high level. This showed that the upregulation of the expression of the DAM4, DAM5, and DAM6 genes can inhibit the flower bud germination of Cherry Blossom. The relative expression of the DAM gene of C. subhirtella 'Autumnalis' was significantly lower than that of the DAM gene of C. yedoensis 'Somei Yoshino' from the end of October to the beginning of December, leading to its secondary flowering in autumn. These results might elucidate why the flower buds of C. subhirtella 'Autumnalis' can break their internal dormancy and bloom in the autumn and then again in the following year. Our findings might provide a reference for conducting further studies on the mechanisms of secondary flowering and bud dormancy in cherries.

Classification of Ultrafine Particles Using a Novel 3D-Printed Hydrocyclone with an Arc Inlet: Experiment and CFD Modeling.

Ultrafine particle classification can be realized using hydrocyclones with novel structures to overcome the limitations of conventional hydrocyclones with tangential inlets or cone structures. Herein, the hydrocyclones with different inlet structures and cone angles were investigated for classifying ultrafine particles. Computational fluid dynamics (CFD) simulations were performed using the Eulerian-Eulerian method, and ultrafine MnO2 powder was used as a case study. The simulation results show a fine particle (≤5 µm) removal efficiency of 0.89 and coarse particle (>5 µm) recovery efficiency of 0.99 for a hydrocyclone design combining an arc inlet and a 30° cone angle under a solid concentration of 2.5 wt %. Dynamic analysis indicated that the novel arc inlet provided a preclassification effect to reduce the misplacement of fine/coarse particles, which cannot be provided by conventional tangential or involute inlets. Furthermore, the proposed design afforded comprehensive improvement in the flow field by regulating the residence time and radial acceleration. Subsequently, a novel hydrocyclone with an arc inlet and 30° cone angle was manufactured using the three-dimensional (3D) printing technology. Experiments were conducted for classifying ultrafine MnO2 particles using the novel 3D-printed hydrocyclone and conventional hydrocyclone. The results demonstrate that the classification performance of the 3D-printed hydrocyclone was superior to that of the conventional one, in particular, the removal efficiency of fine particles from 0.719 to 0.930 using a 10 wt % feed slurry.

The changes of AHI after long-term CPAP in patients with comorbid OSA and cardiovascular disease.

PURPOSE: To evaluate the effect of long-term continuous positive airway pressure (CPAP) treatment on disease severity of obstructive sleep apnea (OSA). METHODS: We analyzed results from the Sleep Apnea and Cardiovascular Events (SAVE) study involving participants recruited at the Guangdong Provincial People's Hospital, China. Participants were aged 45-75 years with a history of cardiac or cerebrovascular disease. OSA was confirmed by home sleep apnea testing (HSAT). Participants were randomized to receive CPAP plus standard cardiovascular care (CPAP group) or standard care alone (UC group) and followed for several years. At the study conclusion, surviving participants were invited to repeat HSAT. Changes in OSA indicators were compared by independent samples t-tests and subgroup analysis was implied among groups stratified by OSA severity. RESULTS: One hundred two adults were recruited (51 per group) and followed for 48.0 ± 14.5 months. Daily CPAP usage in the CPAP group was 4.1 ± 1.9 h. AHI decreased from baseline to end-of-study in both CPAP and UC groups (- 5.0 (- 12.5,2.0), P = 0.000; - 4.0 (- 12.5,1.5), P = 0.007, respectively), with no between-group difference (P = 0.453). An improvement in nadir SpO2 showed from baseline to end-of-study in the CPAP but not UC group (2.3% ± 6.1%, P = 0.011 and - 0.7% ± 7.6%, P = 0.511, respectively; between-group difference P = 0.032). Subgroup analysis shows that CPAP could improve AHI in patients with moderate OSA (- 8.0 (- 11.8, - 2.8) in CPAP group, - 2.0 (- 0.8,6.0) in UC group, P = 0.022) and improve nadir SpO2 in patients with severe OSA (5.0 (- 0.8, - 0.8,7.0) in CPAP group, 0.0 (- 8.5,2.5) in UC group, P = 0.032). CONCLUSION: Long-term CPAP use did not result in clinically significant changes in AHI or ODI overall but showed variable effects stratified by OSA severity. CLINICAL TRIAL REGISTRATION: Registry: Clinical Trials.gov, title: Continuous Positive Airway Pressure Treatment of Obstructive Sleep Apnea to Prevent Cardiovascular Disease (SAVE), URL: www. CLINICALTRIALS: gov , identifier: NCT00738179.

Comparative study of a wearable intelligent sleep monitor and polysomnography monitor for the diagnosis of obstructive sleep apnea.

PURPOSE: Due to the lack of an objective population-based screening tool for obstructive sleep apnea (OSA), a large number of patients with potential OSA have not been identified in the general population. Our study compared an objective wearable sleep monitoring device with polysomnography (PSG) to provide a reference for OSA screening in a large population. METHODS: Using a self-control method, patients admitted to our sleep center from July 2020 to March 2021 were selected for overnight PSG and wearable intelligent sleep monitor (WISM) at the same time. The sensitivity and specificity of the device for the diagnosis of OSA were evaluated. RESULTS: A total of 196 participants (mean age: 45.1 ± 12.3 years [18-80 years]; 168 men [86%]) completed both PSG and WISM monitoring. Using an apnea-hypopnea index (AHI) ≥ 5 events/h as the diagnostic criterion, the sensitivity, specificity, kappa value, and area under the receiver operating characteristic curve of the WISM for OSA diagnosis were 93%, 77%, 0.6, and 0.95, respectively. Using an AHI ≥ 15 events/h as the diagnostic criterion for moderate-to-severe OSA, these values were 92%, 89%, 0.8, and 0.95, respectively. The mean difference in the AHI between PSG and the artificial intelligence oxygen desaturation index from the WISM was 6.8 events/h (95% confidence interval: - 13.1 to 26.7). CONCLUSION: Compared with the PSG, WISM exhibits good sensitivity and specificity for the diagnosis of OSA. This small, simple, and easy-to-use device is more suitable for OSA screening in a large population because of its single-step application procedure.

Screening for obstructive sleep apnea before coronary angiography.

INTRODUCTION: The prevalence of obstructive sleep apnea (OSA) in patients with suspected coronary heart disease (CHD) is yet to be clarified. This study aimed to investigate the prevalence of OSA before coronary angiography (CAG). METHODS: We retrospectively evaluated patients with suspected CHD admitted to the Department of Geriatric Cardiology of our hospital between July 2019 and July 2021. OSA was screened using the level III home sleep apnea test before CAG. The prevalence of OSA was then compared between the CHD and non-CHD groups. CHD severity was determined using the Gensini score of CAG results, and OSA severity was graded using the apnea-hypopnea index (AHI). RESULTS: Among the 327 patients, 211 had CHD. In total, 264 patients were diagnosed with OSA (80.7%) (184 patients, CHD group [87.2%]; 80 patients, non-CHD group [69.0%]). The CHD group had a significantly higher prevalence of OSA (P < 0.01) and higher AHI (CHD group 18.76 ± 14.94, non-CHD group 11.56 ± 10.67, P < 0.01). The Gensini score was positively correlated with OSA severity in patients with CHD, and AHI ≥ 20 was a risk factor for CHD (odds ratio: 1.961, 95% confidence interval: 1.065-3.608, P < 0.05). CONCLUSION: OSA screening before CAG revealed a higher prevalence in CHD patients than in non-CHD patients. The degree of coronary artery obstruction is positively correlated with AHI, and AHI ≥ 20 is a risk factor for CHD. Therefore, attention should be paid to OSA screening and management before CAG in patients with suspected CHD.

Distinct phenotypic clusters of sleep-disordered breathing and their association with medical care-seeking behaviour and sleep habits: the Guangdong Sleep Health Study.

Sleep-disordered breathing (SDB) is highly prevalent, but its rates of diagnosis and treatment are low. As a heterogeneous condition, it is associated with delayed diagnosis and/or suboptimal treatment. We aimed to determine distinct SDB clusters and examine their association with medical care-seeking behaviour and sleep habits in a community-dwelling population in South China. Participants were enrolled in the 'Guangdong Sleep Health Study'. Five distinct community sites were investigated. Participant information was collected, and overnight sleep monitoring was performed. Latent class analysis was performed to classify patients with SDB based on patterns of SDB-related symptoms and signs. Overall, 1,524 patients with SDB were evaluated. Four distinct clusters were identified: 'minimally symptomatic' (Cluster 2), which was the most dominant subtype (41.6%), followed by 'pure insomnia/fewer daytime symptoms' (Cluster 4; 24.7%), 'insomnia/multiple daytime symptoms' (Cluster 3; 17.8%), and 'upper airway symptoms with sleepiness' (Cluster 1; 15.9%). The overall medical care-seeking rate attributable to sleep and breathing disorders was only 3.3%: 10.3% in Cluster 3, 2.5% in Cluster 1, 2.1% in Cluster 4, and 1.3% in Cluster 2, in which Cluster 3 was the highest and Cluster 2 was the lowest (adjusted p < 0.05). Regarding the sleep habit of going to bed and waking up at a consistent time, Cluster 3 exhibited the worst performance and Cluster 2 the best. In conclusion, distinct phenotypic subtypes were identified in community-dwelling patients with SDB. Tailored strategies to encourage medical care-seeking, early identification, and optimisation of treatment are necessary considering the different subtypes.

Land use differentially affects fungal communities and network complexity in northeast China.

Background: The soil fungal community is one of the most important drivers of the soil nutrient cycling that sustains plant growth. However, little research has been done on the effects of different land uses on soil fungal communities in northeast China. Methods: In this study, we conducted a field experiment to investigate the effects of continuous cropping of grass, maize, and alfalfa on their respective fungal communities and co-occurrence networks. Results: We showed that the physicochemical properties of the soil, such as nitrate (NO 3 - N), available phosphorus, and soil pH, were the most important driving factors affecting the structure of the soil fungal community in different cropping systems. In addition, compared to the cultivation of grass and maize, the continuous cropping of alfalfa increased the abundance of several beneficial as well as pathogenic species, such as Mortierella and Gaiellales. In addition, the networks differed among plant species and according to the number of years of continuous cultivation. Conclusion: This suggests that the continuous cropping of alfalfa results in greater cooperation among fungi, which may be beneficial to the soil as well as to the development of the alfalfa.