Assessment of Nocturnal Autonomic Cardiac Imbalance in Positional Obstructive Sleep Apnea. A Multiscale Nonlinear Approach

Comparison of Two Different Alfaxalone Concentrations Combined with Midazolam to Anesthetize Cynomolgus Macaques (Macaca fascicularis) for Plethysmography

Plethysmography is employed in nonhuman primates (NHPs) to calculate respiratory minute volume and determine the exposure time required to deliver an aerosol at the target dose. Anesthetic drugs can impact breathing parameters like steady-state minute volume (SSMV) central to aerosol dosing. Alfaxalone-midazolam mixtures (AM) provide superior parameters for plethysmography in cynomolgus macaques. An obstacle to the use of AM is the volume required to anesthetize via intramuscular injection. A more concentrated formulation of alfaxalone will reduce injection volumes and refine AM protocols. The purpose of this study was to compare AM using the Indexed 10-mg/mL (AM10) formulation compared with an investigational 40-mg/mL (AM40) formulation for IM administration in cynomolgus macaques undergoing plethysmography. We hypothesized that AM10 and AM40 would show no difference in quality of anesthesia (QA), duration of anesthesia, SSMV, accumulated minute volume (AMV), and side effects. We also hypothesized that female macaques would have a longer duration of anesthesia compared with males using both formulations. The study used 15 cynomolgus macaques comprised of 8 females and 7 males. NHPs were compared between 2 separate and randomized anesthetic events no less than one week apart. Each animal served as its own control and animals were randomized by random number generation. Anesthetized NHPs were placed in a sealed plethysmography chamber, and minute volume measurements were calculated every 10 s to determine SSMV. Once SSMV was achieved for 20 min, the trial ended. There were no statistically significant differences between AM10 and AM40 for duration of anesthesia, SSMV, AMV, side effects, or QA. AM40 had a significantly smaller injection volume. Females did not show a significantly longer median duration of anesthesia using either of the alfaxalone formulations. Overall, AM40 offers a more humane anesthetic than AM10 for plethysmography in cynomolgus macaques.

Exploring the Impact of Positional Sleep Apnea in a Turkish Population: Unveiling the Untold Story

BACKGROUND The present study aimed to investigate the risk factors associated with demographical, clinical and polysomnographic features of positional sleep apnea through different criterion of positional sleep apnea (POSA vs e-POSA) in a large patient cohort from a tertiary referral center MATERIAL AND METHODS A total of 782 OSA patients who were further diagnosed with POSA (total: n=470, e-POSA: n=204) or non-POSA (n=312) based on apnea-hypopnea index (AHI) events by overnight polysomnography were included. Demographical, clinical, and polysomnographic characteristics were recorded, while independent predictors of POSA and e-POSA were determined via linear regression analysis. RESULTS Severe OSA (AHI ≥30/h) was less common in the POSA (33.4% vs 71.5%, P<0.001) and e-POSA (9.8% vs 62.3%, P<0.001) groups than in the non-POSA and non-e-POSA groups, respectively. For POSA and e-POSA, male sex (OR 2.195, P<0.001 and OR 2.021, P=0.004, respectively), low body mass index (BMI; OR 0.932, P<0.001 and OR 0.948, P=0.006), low AHI (OR 0.954 and OR 0.902, P<0.001 for each), and less desaturation (T90%, OR 0.972 and OR 0.968, P<0.001 for each) were the common statistically significant predictors. Younger age was an independent predictor of POSA (OR 0.97, P=0.003). POSA (median 20.4 s) and e-POSA (20.5 s) groups demonstrated similar apnea-hypopnea durations (min) as the non-POSA (median 21.1 s) group. CONCLUSIONS Our findings revealed that male sex and lower values of BMI, AHI, and desaturation were common determinants of POSA and e-POSA, while younger age independently predicted POSA. POSA and e-POSA had similar clinical and polysomnographic characteristics and shared the unvaried hypoxic burden.

Entropy analysis and grey cluster analysis of multiple indexes of 5 kinds of genuine medicinal materials

5 kinds of genuine medicinal materials, including Diding (Latin name: Corydalis bungeana Turcz), Purslane (Latin name: Portulaca oleracea L.), straw sandal board (Latin name: Hoya carnosa (L.f.) R. Br), June snow (Latin name: Serissa japonica (Thunb.) Thunb.), pine vine rattan (Latin name: Lycopodiastrum casuarinoides (Spring) Holub. [Lycopodium casuarinoides Spring]), were selected as the research objects. The combustion heat, thermo gravimetric parameters, and fat content, calcium content, trace element content, ash content of 5 kinds of genuine medicinal materials were measured. The combustion heat, differential thermal gravimetric analysis, fat content, calcium content, trace elements content, and ash content of 5 kinds of genuine medicinal materials were used to build a systematic multi-index evaluation system by gray pattern recognition and grey correlation coefficient cluster analysis, which can make up for the gaps in this area and provide scientific basis and research significance for the study of genuine medicinal materials quality. The results showed that the order of combustion heat of 5 kinds of genuine medicinal materials, including Diding, Purslane, straw sandal board, June snow, pine vine rattan, was Diding > June snow > straw sandal board > Purslane > pine vine rattan, the order of fat content (%) of 5 kinds of genuine medicinal materials was straw sandal board > Diding > pine vine rattan > June snow > Purslane, the order of calcium content (%) was pine vine rattan > June snow > Purslane > straw sandal board > Diding, the order of ash content was June snow > Purslane > straw sandal board > pine vine rattan > Diding. From the analysis of thermogravimetric analysis results and thermogravimetric combustion stability, the order of combustion stability of 5 kinds of genuine medicinal materials was June snow > pine Vine rattan > straw sandal board > Diding > Portulaca oleracea. The order of the content of 12 trace elements in 5 kinds of genuine medicinal materials, in terms of trace element content, June snow contains the highest trace elements in all samples. According to combustion heat, combustibility (combustion stability of genuine medicinal materials), fat, calcium, ash, trace element content, the comprehensive evaluation results of multi-index analysis constructed by gray correlation degree, gray correlation coefficient factor analysis, and gray hierarchical cluster analysis showed that the comprehensive evaluation multi-index order of 5 genuine medicinal materials, including Diding, Purslane, straw sandal board, June snow and pine vine rattan, was June snow > straw sandal board > Diding > Purslane > pine vine rattan. Therefore, the comprehensive evaluation results of the quality of genuine medicinal materials selected in this study were June snow the best, followed by straw sandal board. This research has important theoretical and practical significance for the multi-index measurement and comprehensive evaluation of genuine medicinal materials, and can provide scientific basis and research significance for the research of multi-index quality control of genuine medicinal material.

Preliminary study on clinical characteristics of Chinese patients with positional obstructive sleep apnea

PURPOSE

The objective of this study was to evaluate the prevalence, the clinical characteristics, and the possible predictors of Chinese patients with positional obstructive sleep apnea (POSA) according to the Amsterdam Positional Obstructive Sleep Apnea Classification (APOC).

METHODS

A retrospective study in the sleep unit of Peking Union Medical College Hospital was conducted to analyze the clinical and polysomnography data of Chinese patients with obstructive sleep apnea (OSA).

RESULTS

Of 372 patients with OSA, 54% met the APOC criteria for POSA. The prevalence of POSA was significantly higher in women with OSA than in men. Chinese patients with POSA had a lower apnea-hypopnea index, oxygen desaturation index, and the percentage of time spent at oxygen saturation below 90% in total sleep time; and a higher mean oxygen saturation (SaO₂) and minimum SaO₂ during sleep, which were remarkable in the APOC I group. By multivariate logistic regression analyses, the higher mean SaO₂ (≥95%) during sleep and mild and moderate OSA were positive predictors of POSA. Mild and moderate OSA was the independent predictor of POSA in women. Higher mean SaO₂ (≥95%) during sleep was the independent predictor of POSA in men.

CONCLUSION

According to the APOC, the prevalence of POSA is high in Chinese patients with OSA, especially in women. Chinese patients with POSA had less severe OSA and a lower degree of nocturnal hypoxia, which was remarkable in the APOC I group.