Optimized crystal orientation for enhanced reaction kinetics and reversibility of SnSe/NC hollow nanospheres towards high-rate and long-term lithium/sodium storage.

The development of anode materials with high theoretical capacity and cycling stability is very important for the electrochemical performance of lithium-ion batteries (LIBs) and sodium-ion batteries (SIBs). Herein, SnSe/NC hollow nanospheres with different crystal orientations were prepared by regulating the high-temperature selenization of the PDA@SnO2 precursor for lithium/sodium storage. In SnSe/NC hollow nanospheres, the physical buffering and chemical bonding of the nitrogen carbon matrix and SnSe nanoparticles could inhibit volume expansion and polyselenide loss, thus maintaining long-term structural stability. More importantly, electrochemical tests and DFT calculations show that the diffusion energy barrier of Li+/Na+ is significantly reduced at the SnSe (400) rather than the usual (111) facet, which is conducive to the uniformity of ion insertion into SnSe, thus effectively enhancing the reaction kinetics and reversibility of lithium/sodium storage. Therefore, SnSe/NC hollow nanospheres with rich SnSe (400) and good dispersion formed at 550 °C delivered the best reversible specific capacity and rate performance. After a long period of 900 cycles, the capacity retention of lithium/sodium ion batteries is close to 84.88% and 77.05%, respectively. Our findings provide valuable insights into the design of metal selenides for advanced LIBs/SIBs.

Comparative study of the SleepImage ring device and polysomnography for diagnosing obstructive sleep apnea.

Purpose We aim to evaluate the diagnostic performance of the SleepImage Ring device in identifying obstructive sleep apnea (OSA) across different severity in comparison to standard polysomnography (PSG). Methods Thirty-nine patients (mean age, 56.8 ± 15.0 years; 29 [74.3%] males) were measured with the SleepImage Ring and PSG study simultaneously in order to evaluate the diagnostic performance of the SleepImage device for diagnosing OSA. Variables such as sensitivity, specificity, positive and negative likelihood ratio, positive and negative predictive value, and accuracy were calculated with PSG-AHI thresholds of 5, 15, and 30 events/h. Receiver operating characteristic curves were also built according to the above PSG-AHI thresholds. In addition, we analyzed the correlation and agreement between the apnea-hypopnea index (AHI) obtained from the two measurement devices. Results There was a strong correlation (r = 0.89, P < 0.001 and high agreement in AHI between the SleepImage Ring and standard PSG. Also, the SleepImage Ring showed reliable diagnostic capability, with areas under the receiver operating characteristic curve of 1.00 (95% CI, 0.91, 1.00), 0.90 (95% CI, 0.77, 0.97), and 0.98 (95% CI, 0.88, 1.000) for corresponding PSG-AHI of 5, 15 and 30 events/h, respectively. Conclusion The SleepImage Ring could be a clinically reliable and cheaper alternative to the gold standard PSG when aiming to diagnose OSA in adults. Supplementary Information: The online version contains supplementary material available at 10.1007/s13534-023-00304-9.

[Cloning and functional verification of PhAEP gene, a key enzyme for biosynthesis of heterophyllin A in Pseudostellaria heterophylla].

This paper aimed to study the role of asparagine endopeptidase(AEP) gene in the biosynthesis mechanism of cyclic peptide compounds in Pseudostellaria heterophylla. The transcriptome database of P. heterophylla was systematically mined and screened, and an AEP gene, tentatively named PhAEP, was successfully cloned. The heterologous function verification by Nicotiana benthamiana showed that the expression of the gene played a role in the biosynthesis of heterophyllin A in P. heterophylla. Bioinformatics analysis showed that the cDNA of PhAEP was 1 488 bp in length, encoding 495 amino acids with a molecular weight of 54.72 kDa. The phylogenetic tree showed that the amino acid sequence encoded by PhAEP was highly similar to that of Butelase-1 in Clitoria ternatea, reaching 80%. The sequence homology and cyclase active site analysis revealed that the PhAEP enzyme may specifically hydrolyse the C-terminal Asn/Asp(Asx) site of the core peptide in the HA linear precursor peptide of P. heterophylla, thereby participating in the ring formation of the linear precursor peptide. The results of real-time quantitative polymerase chain reaction(RT-qPCR) showed that the expression level of PhAEP was the highest in fruits, followed by in roots, and the lowest in leaves. The heterophyllin A of P. heterophylla was detected in N. benthamiana that co-expressed PrePhHA and PhAEP genes instantaneously. In this study, the PhAEP gene, a key enzyme in the biosynthesis of heterophyllin A in P. heterophylla, has been successfully cloned, which lays a foundation for further analysis of the molecular mechanism of PhAEP enzyme in the biosynthesis of heterophyllin A in P. heterophylla and has important significance for the study of synthetic biology of cyclic peptide compounds in P. heterophylla.

Sodium Super Ionic Conductor-Type Hybrid Electrolytes for High Performance Lithium Metal Batteries.

Composite solid electrolytes (CSEs), composed of sodium superionic conductor (NASICON)-type Li1+xAlxTi2-x(PO4)3 (LATP), poly (vinylidene fluoride-hexafluoro propylene) (PVDF-HFP), and lithium bis (trifluoromethanesulfonyl)imide (LiTFSI) salt, are designed and fabricated for lithium-metal batteries. The effects of the key design parameters (i.e., LiTFSI/LATP ratio, CSE thickness, and carbon content) on the specific capacity, coulombic efficiency, and cyclic stability were systematically investigated. The optimal CSE configuration, superior specific capacity (~160 mAh g-1), low electrode polarization (~0.12 V), and remarkable cyclic stability (a capacity retention of 86.8%) were achieved during extended cycling (>200 cycles). In addition, with the optimal CSE structure, a high ionic conductivity (~2.83 × 10-4 S cm-1) was demonstrated at an ambient temperature. The CSE configuration demonstrated in this work can be employed for designing highly durable CSEs with enhanced ionic conductivity and significantly reduced interfacial electrolyte/electrode resistance.

Steric-hindrance effect and self-sacrificing template behavior induced PDA@SnO2-QDs/N-doped carbon hollow nanospheres: Enhanced structural stability and reaction kinetics for long-cyclic Li-ion half/full batteries.

Tin-based anode materials with high theoretical specific capacity are subject to huge volume expansion and poor reaction reversibility, leading to degradation of battery performance. Herein, the steric-hindrance effect and self-sacrificing template behavior of polydopamine were firstly developed to induce the formation of hollow nanospheres assembled by ultrafine SnO2 quantum dots (SnO2-QDs) and nitrogen-doped carbon (NC), containing residual polydopamine (PDA) cores. The PDA@SnO2-QDs/NC hollow nanospheres could effectively accommodate the volume expansion and maintain structural stability. More importantly, the PDA core could capture oxygen free radicals produced by the charge/discharge process and be involved in the evolution of the SEI layer, achieving enhanced electrochemical reaction kinetics. The optimized PDA@SnO2-QDs/NC anode shows a specific capacity of 898 mAh g-1 after 300 cycles at 0.3 A g-1, and scarcely capacity attenuation after 1500 cycles at 1 A g-1. The long-cyclic life is up to 3000 cycles at 3 A g-1. Even after 200 cycles, the anode in the PDA@SnO2-QDs/NC||LFP full battery gives a reversible capacity of 489 mAh g-1 at 0.3 A g-1, with a capacity retention of 77 %. This work casts new light on tin-based anode materials and interface optimization.

Differences in the prevalence of cardiovascular and metabolic diseases coinciding with clinical subtypes of obstructive sleep apnea.

BACKGROUND: It is unclear about the cardiovascular and metabolic diseases (CMD) among Chinese patients with different clinical subtypes of obstructive sleep apnea (OSA). HYPOTHESIS: The prevalence of CMD varies among OSA patients of different clinical subtypes. METHODS: A total of 1483 Chinese patients with OSA were assessed to evaluate the existence of clinical subtypes of OSA using latent class analysis. We compared the differences in demographic characteristics and prevalence of CMD using ANOVA and χ2 tests. Associations between clinical subtypes and disease prevalence were assessed using adjusted logistic regression. RESULTS: We identified prevalent CMD in Chinese patients with the four subtypes of OSA: excessively sleepy (ES), moderately sleepy with disturbed sleep (ModSwDS), moderately sleepy (ModS), and minimally symptomatic (MinS). The ES subtype had a higher body mass index, average Epworth Sleepiness Scale score, Apnea-hypopnea index, and oxyhemoglobin saturation below 90% compared with the other subtypes (p < .05). The MinS subtype had the lowest mean ESS score (p < .05). We found a significant difference in the prevalence of CMD among the four subtypes, with the highest proportion of cases of CMD in the ES subtype. In adjusted models, significant associations with CMD were also found. ES, ModSwDS, ModS, and MinS subtypes are very high-risk, high-risk, medium-risk, and low-risk in prevalent CMD. CONCLUSIONS: This study identified four clinical subtypes of OSA in Chinese patients. Each clinical subtype corresponds with a different level of prevalence of CMD; this finding is helpful for the more precise treatment of patients with different clinical manifestations.

Daytime sleepiness is associated with increased coronary plaque burden among patients with obstructive sleep apnea.

PURPOSE: To investigate the cross-sectional associations of daytime sleepiness with coronary plaque volume and composition in patients with obstructive sleep apnea (OSA), and whether or not these associations are modified by age, gender, and obesity. METHODS: Patients who were confirmed with OSA through respiratory polygraphy and also underwent coronary CTA at a tertiary hospital were consecutively enrolled. The interval between the sleep monitoring and coronary CTA scan was < 3 months. Every patient completed the Epworth sleepiness scale (ESS) to assess daytime sleepiness, and an ESS score of ≥ 11 was recognized as excessive daytime sleepiness (EDS). Coronary plaque volume and composition were measured using semi-automatic software. RESULTS: Of the 394 patients with OSA (median [IQR] age, 56.0 [49.0-64.0] years; median [IQR] body mass index, 27.9 [25.5-30.2] kg/m2; median [IQR] apnea-hypopnea index, 21.3 [11.7, 36.3] events/h), a total of 200 patients had EDS. In the overall participants, a significant dose-response relationship between ESS scores and low-attenuation plaque volume was found in the fully adjusted model (P = 0.019). Further analysis demonstrated that there was a significant interactive effect of ESS levels and obesity on coronary plaque volume (all P values for interaction analysis < 0.05). Specifically, ESS levels were associated with total plaque volume, volumes of noncalcified, low-attenuation, and calcified plaque (P = 0.008, 0.006, 0.005, and 0.043 respectively) in obese patients with OSA. CONCLUSION: Daytime sleepiness is significantly correlated with increased coronary plaque burden among patients with OSA. Thus, clinicians should recognize that patients with OSA reporting high ESS scores, especially those with obesity, are more prone to experience adverse coronary events.

Cardiopulmonary Coupling.

Cardiopulmonary coupling (CPC) is a technique that generates sleep spectrogram by calculating the cross-spectral power and coherence of heart rate variability and respiratory tidal volume fluctuations. There are several forms of CPC in the sleep spectrogram, which may provide information about normal sleep physiology and pathological sleep states. Since CPC can be calculated from any signal recording containing heart rate and respiration information, such as photoplethysmography (PPG) or blood pressure, it can be widely used in various applications, including wearables and non-contact devices. When derived from PPG, an automatic apnea-hypopnea index can be calculated from CPC-oximetry as PPG can be obtained from oximetry alone. CPC-based sleep profiling reveals the effects of stable and unstable sleep on sleep apnea, insomnia, cardiovascular regulation, and metabolic disorders. Here, we introduce, with examples, the current knowledge and understanding of the CPC technique, especially the physiological basis, analytical methods, and its clinical applications.

Association between Arousals during Sleep and Subclinical Coronary Atherosclerosis in Patients with Obstructive Sleep Apnea.

(1) Aim: We aim to evaluate the association between arousals during sleep and subclinical coronary atherosclerosis detected by coronary computed tomography angiography (CTA) in patients with obstructive sleep apnea (OSA). (2) Methods: This was a cross-sectional study. Consecutive newly diagnosed OSA patients, who underwent coronary CTA examinations within 3 months of the sleep study, were eligible. We used the arousal index (ArI) derived from polysomnography to assess arousals during sleep and a semi-automated plaque quantification software to characterize and quantify the subclinical coronary atherosclerosis. Multiple regression models were used to evaluate the associations of the ArI with the coronary atherosclerotic plaque presence, volume, and composition. (3) Results: A total of 99 patients with OSA were included in the study. In the multivariable models, patients with a high ArI (ArI > 32.2 events/h) were more likely to have coronary plaques compared to those with a low ArI (ArI ≤ 32.2 events/h) (OR: 3.29 [95% CI: 1.284 to 8.427], p = 0.013). Furthermore, the ArI exhibited significant associations with total (ß = 0.015), noncalcified (ß = 0.015), and low-attenuation (ß = 0.012) coronary plaque volume after accounting for established risk factors (p = 0.008, 0.004, and 0.002, respectively). However, no association between the ArI and calcified plaque volume was found. (4) Conclusion: Repetitive arousals during sleep are associated with an increased coronary plaque burden in patients with OSA, which remained robust after adjusting for multiple established cardiovascular risk factors.

Surface chemical heterogeneous distribution in over-lithiated Li1+xCoO2 electrodes.

In commercial Li-ion batteries, the internal short circuits or over-lithiation often cause structural transformation in electrodes and may lead to safety risks. Herein, we investigate the over-discharged mechanism of LiCoO2/graphite pouch cells, especially spatially resolving the morphological, surface phase, and local electronic structure of LiCoO2 electrode. With synchrotron-based X-ray techniques and Raman mapping, together with spectroscopy simulations, we demonstrate that over-lithiation reaction is a surface effect, accompanied by Co reduction and surface structure transformation to Li2CoO2/Co3O4/CoO/Li2O-like phases. This surface chemical distribution variation is relevant to the depth and exposed crystalline planes of LiCoO2 particles, and the distribution of binder/conductive additives. Theoretical calculations confirm that Li2CoO2-phase has lower electronic/ionic conductivity than LiCoO2-phase, further revealing the critical effect of distribution of conductive additives on the surface chemical heterogeneity evolution. Our findings on such surface phenomena are non-trivial and highlight the capability of synchrotron-based X-ray techniques for studying the spatial chemical phase heterogeneity.

Copper Substitution in P2-Type Sodium Layered Oxide To Mitigate Phase Transition and Enhance Cyclability of Sodium-Ion Batteries.

Development of high-performance cathode materials is one of the key challenges in the practical application of sodium-ion batteries. Among all the cathode materials, layered sodium transition-metal oxides are particularly attractive. However, undesired phase transitions are often reported and have detrimental effects on the structure stability and electrochemical performance. Cu substitution of zinc in the P2-type Na0.6Mn0.7Ni0.15Zn0.15-xCuxO2 (x = 0, 0.075, and 0.15) composites was investigated in this study for mitigating the biphase transition and enhancing the electrochemical performance of sodium-ion batteries. The coupling effect of Zn and Cu enables an excellent capacity retention of 96.4% of the initial discharge capacity after 150 cycles at 0.1 C in the Na/Na0.6Mn0.7Ni0.15Zn0.075Cu0.075O2 cell. The biphase transition that occurred in the high voltage range has been significantly suppressed after the incorporation of Cu in Na0.6Mn0.7Ni0.15Zn0.15O2, which was confirmed by in situ X-ray diffraction studies. Moreover, the substitution of the inert element Zn with electrochemically active Cu leads to the suppression of anionic redox and the occurrence of Cu2+/3+ redox reaction, and the electrolyte decomposition is impeded after the introduction of electrochemically active Cu in the Na0.6Mn0.7Ni0.15Zn0.15-xCuxO2 composite cathode. The enhanced electrochemical performance in the Na0.6Mn0.7Ni0.15Zn0.075Cu0.075O2 electrode can be ascribed to the coexistence of Zn and Cu and alleviated volumetric change as well as suppressed electrode/electrolyte side reaction after Cu substitution.

Presence of Mobile Tigecycline Resistance Gene tet(X4) in Clinical Klebsiella pneumoniae.

The recently emerged plasmid-mediated tigecycline resistance gene tet(X4) has mainly been detected in Escherichia coli but never in Klebsiella pneumoniae. Herein, we identified a clinical K. pneumoniae isolate that harbored the tet(X4) gene located on a non-self-transferable IncFII-type plasmid, which could be cotransferred with a conjugative plasmid to E. coli C600. The extending of bacterial species carrying tet(X4) suggested the increasing risk of spreading mobile tigecycline resistance genes among important pathogens in clinical settings. IMPORTANCE Tigecycline, the first member of glycylcycline class antibiotic, is often considered one of the effective antibiotics against multidrug-resistant (MDR) infections. However, the emergence and wide distribution of two novel plasmid-mediated tigecycline resistance genes, tet(X3) and tet(X4), pose a great threat to the clinical use of tigecycline. The newly tet(X) variants have been identified from multiple different bacterial species, but the tet(X) variant in the Klebsiella pneumoniae strain has been reported only once before. In this study, we identified a clinical K. pneumoniae isolate that harbored a non-self-transferable tet(X4)-carrying plasmid. This plasmid has never been found in other tet(X4)-harboring strains and could be cotransferred with a conjugative plasmid to the recipient strain. Our findings indicate that the tet(X4) gene breaks through its original bacterial species and spreads to some important nosocomial pathogens, which posed a serious threat to public health.

Responses of JNK signaling pathway to the toxic dinoflagellate Prorocentrum lima in the mussel Perna viridis.

Diarrheic shellfish poisoning (DSP) toxins are widely distributed over the world, causing diarrhea, vomiting, and even tumor in human. However, bivalves, the main carrier of the DSP toxins, have some tolerant mechanisms to DSP toxins, though it remains unclear. In this study, we scrutinized the role of Jun N-terminal kinases (JNK) in tolerance of DSP toxins and the relationship between JNK, apoptosis and nuclear factor E2-related factor/antioxidant response element (Nrf2/ARE) pathways. We found that the phosphorylated level of JNK protein was significantly increased both in hemocytes (6 h) and gills (3 h) of the mussel Perna viridis after short-term exposure to DSP toxins-producing dinoflagellate Prorocentrum lima. Exposure of P. lima induced oxidative stress in mussels. Hemocytes and gills displayed different sensitivities to the cytotoxicity of DSP toxins. Exposure of P. lima activated caspase-3 and induced apoptosis in gills but did not induce caspase-3 and apoptosis in hemocytes. The short-term exposure of P. lima could activate Nrf2/ARE signaling pathway in hemocytes (6 h), while longer-term exposure could induce glutathione reductase (GR) expression in hemocytes (96 h) and glutathione-S-transferases (GST) in gills (96 h). Based on the phylogenetic tree of Nrf2, Nrf2 in P. viridis was closely related to that in other mussels, especially Mytilus coruscus, but far from that in Mus musculus. The most likely phosphorylated site of Nrf2 in the mussels P. viridis is threonine 504 for JNK, which is different from that in M. musculus. Taken all together, the tolerant mechanism of P. viridis to DSP toxins might be involved in JNK and Nrf2/ARE signaling pathways, and JNK play a key role in the mechanism. Our findings provide a new clue to further understand tolerant mechanisms of bivalves to DSP toxins.

Obstructive sleep apnea increases the risk of cardiovascular damage: a systematic review and meta-analysis of imaging studies.

BACKGROUND: We aimed to perform a systematic review and meta-analysis of the association between obstructive sleep apnea (OSA) and cardiac as well as coronary impairment evaluated using imaging modalities. Finding of this study will provide more robust evidence regarding OSA-induced cardiovascular damage. METHODS: We systematically searched through PubMed, EMBASE, and Cochrane library databases for relevant literatures on the association between OSA and cardiovascular damage evaluated using imaging modalities, and manually searched the references of selected articles for additional relevant articles. For each clinical parameter relevant to the meta-analysis, we first evaluated the methodological heterogeneity of the relevant studies and thereafter pooled the data together using fixed effect or random effect model. The difference in the relevant indices of cardiovascular damage between OSA patients and controls was evaluated using the standardized mean difference. RESULTS: Of the 82 articles included in the final systematic analysis, 20 studies explored the association between OSA and coronary atherosclerosis. OSA patients had higher rate of coronary atherosclerosis assessed by coronary artery calcification score and plaque volume. Moreover, the severity of OSA and coronary atherosclerosis displayed a positive correlation. The rest of the studies (n = 62) evaluated cardiac alterations in OSA patients. According to the inclusion and exclusion criteria, 46 studies yielding 3082 OSA patients and 1774 controls were pooled for the meta-analysis. For left cardiac structure and function, OSA patients exhibited significantly wider left atrial diameter; higher left atrium volume index; wider left ventricular end-systolic diameter, left ventricular end-diastolic diameter, and left ventricular mass; higher left ventricular mass index; wider interventricular septum diameter and posterior wall diameter; and higher left ventricular myocardial performance index (all p < 0.05). In addition, compared with controls, left ventricular ejection fraction was significantly decreased in OSA patients (p = 0.001). For right cardiac structure and function, OSA patients displayed a significant increase in right ventricular diameter and right ventricular myocardial performance index (both p < 0.001). Finally, compared with controls, OSA patients displayed significant decrease in tricuspid annular plane systolic excursion and RV fractional area change (p = 0.001). CONCLUSION: Overall, this systematic review and meta-analysis provides imaging evidence in support that OSA patients are at a higher risk of developing coronary atherosclerosis and display cardiac remodeling and dysfunction.

Association Between OSA and Quantitative Atherosclerotic Plaque Burden: A Coronary CT Angiography Study.

BACKGROUND: Limited evidence is available regarding the association between OSA and coronary plaque assessed by using quantitative coronary CT angiography. RESEARCH QUESTION: Are there any associations between OSA severity-related indexes and the presence and burden of coronary plaque? STUDY DESIGN AND METHODS: Cross-sectional data from 692 patients who underwent sleep monitoring and coronary CT angiography were used for this study. Of these patients, 120 (17.3%) underwent polysomnography, and 572 (82.7%) underwent respiratory polygraphy. Multivariable logistic and linear regression analyses were used to investigate the associations of OSA severity-related indexes with the presence, volume, and composition of plaque. RESULTS: In multivariable analyses, patients with moderate to severe OSA were more likely to have coronary plaques (P = .037), and plaques were more likely to contain a noncalcified plaque (NCP) component (P = .032) and a low-density NCP (LD NCP) component (P = .030). Furthermore, the apnea-hypopnea index and oxygen desaturation index as continuous variables were both associated with the presence of plaque, NCP, and LD NCP (all, P < .05). Multivariable linear regression models showed that moderate to severe OSA was associated with NCP volume (ß = 50.328; P = .042) and LD NCP volume (ß = 15.707; P = .011). Moreover, the apnea-hypopnea index (P = .015), oxygen desaturation index (P = .005), and percentage of nighttime with oxygen saturation < 90% (P = .017) were all significant predictors of LD NCP volume. Compared with those with no or mild OSA, patients with severe OSA had a significantly higher total plaque volume (P = .036), NCP volume (P = .036), and LD NCP volume (P = .013). INTERPRETATION: OSA was independently associated with the presence and burden of coronary plaque, which suggests an increased risk of coronary events. CLINICAL TRIAL REGISTRATION: Chinese Clinical Trial Registry; No. ChiCTR-ROC-17011027; http://chictr.org.cn.

A nanosensor for precise discrimination of nephrotoxic drug mechanisms via dynamic fluorescence fingerprint strategy.

Drug-induced kidney injury causes structural or functional abnormalities of kidney, seriously affecting clinical practice and drug discovery. However, rapid and effective identification of nephrotoxic drug mechanisms is yet a challenging task arising from the complexity and diversity of various nephrotoxic mechanisms. Herein, we have constructed a polydopamine-polyethyleneimine/quantum dots sensor to instantaneously read out the nephrotoxic drugs mechanisms based on the disparate cell surface phenotypes. Cell surface components induced by multiple nephrotoxic drugs can change the fluorescence emission of multicolor quantum dots, generating their corresponding fluorescent fingerprints. The fluorescence response signatures induced by different nephrotoxic agents are gained with 84% accuracy via linear discriminant analysis. Furthermore, taking the time-toxicity relationship into consideration, dynamic fluorescent fingerprint is obtained through continuous monitoring the progress of renal cell damage, achieving 100% precise classification for nephrotoxic mechanisms of four types of antibiotics. Notably, the fluorescent fingerprint-based high-throughput sensor has been demonstrated by successfully distinguishing nephrotoxic drugs in seconds, employing a promising protocol to discriminate the specific mechanism of nephrotoxic drugs, as well as drug safety evaluation.

Obstructive sleep apnoea, intermittent hypoxia and heart failure with a preserved ejection fraction.

Obstructive sleep apnoea (OSA) is recognised to be a potent risk factor for hypertension, coronary heart disease, strokes and heart failure with a reduced ejection fraction. However, the association between OSA and heart failure with a preserved ejection fraction (HFpEF) is less well recognised. Both conditions are very common globally.It appears that there are many similarities between the pathological effects of OSA and other known aetiologies of HFpEF and its postulated pathophysiology. Intermittent hypoxia induced by OSA leads to widespread stimulation of the sympathetic nervous system, renin-angiotensin-aldosterone system and more importantly a systemic inflammatory state associated with oxidative stress. This is similar to the consequences of hypertension, diabetes, obesity and ageing that are the common precursors to HFpEF. The final common pathway is probably via the development of myocardial fibrosis and structural changes in collagen and myocardial titin that cause myocardial stiffening. Thus, considering the pathophysiology of OSA and HFpEF, OSA is likely to be a significant risk factor for HFpEF and further trials of preventive treatment should be considered.

A NaNi0.5Mn0.5SnxO2 cathode with anti-structural deformation enhancing long lifespan and super power for a sodium ion battery.

The enlarged interlayer spacing in NaNi0.5Mn0.5O by doping with Sn4+ prevents TMO2 slips and eliminates irreversible multiphase transitions during cycling, achieving a high capacity of 191 mA h g-1 at 0.1C for half cells, as well as 1000 long cycles at 1C and high power ability at 50C for the full cell.