Effect of Continuous Positive Airway Pressure on Incident Frailty in Elderly Patients with Obstructive Sleep Apnea: A Study Based on Propensity Score Matching.

Background: The concomitant rise in the prevalence of obstructive sleep apnea (OSA) and frailty among the elderly population has been linked to an increase in mortality rates. Despite continuous positive airway pressure (CPAP) being the gold standard treatment for OSA, its impact on incident frailty remains inadequately explored. Methods: In this cohort study, we analyzed data from 1290 patients diagnosed with OSA, aged 60 years and older. A subset of 71 patients who demonstrated high adherence to CPAP therapy were categorized as the CPAP group. Propensity score matching (PSM) was employed at a 1:4 ratio, matching for variables such as age, gender, body mass index (BMI), and sleep apnea-hypopnea index (AHI), to establish a non-CPAP group for comparison. The FRAIL scale was utilized to evaluate the frailty status of participants. Logistic regression analysis examined the relationship between CPAP therapy and incident frailty, as well as its individual components, in elderly patients with OSA. Results: During a median follow-up period of 52 months, incident frailty was observed in 70 patients (19.7%). Patients with OSA receiving CPAP therapy exhibited a lower incidence of frailty compared to those not receiving CPAP (11.26% vs 21.83%, P=0.045). In the multivariate model, CPAP therapy was significantly correlated with a reduced risk of incident frailty (OR = 0.36, 95% CI, 0.15-0.88; P = 0.025). Subcomponent analyses revealed that CPAP was associated with a lower risk of fatigue (OR=0.35, 95% CI, 0.19-0.63; P < 0.001), resistance (OR = 0.32, 95% CI, 0.14-0.74; P=0.008), and weight loss (OR = 0.38, 95% CI, 0.19-0.75; P = 0.007). Conclusion: CPAP therapy was associated with a reduced risk of incident frailty among elderly patients with OSA.

Association of Depression with Long-Term Cardiovascular Risks in Older Patients with Obstructive Sleep Apnea.

Introduction: Obstructive sleep apnea (OSA) is associated with an increased risk of cardiovascular disease (CVD). Depression is a crucial factor among the various factors that are associated with OSA and CVD. Purpose: This study was conducted with an aim to assess the prognostic significance of depression on the MACE in older patients with OSA. Patients and Methods: 1106 older patients with OSA, without myocardial infarction (MI), history of hospitalization for unstable angina, or heart failure at baseline were enrolled and followed up prospectively. Incidence rates were expressed as cumulative incidence. Cox proportional hazards analysis was used to estimate the risk of all events. The primary outcomes were major adverse cardiovascular events (MACE). Each patient underwent polysomnography (PSG) and GDS-12 scale assessment. Those with an apnea-hypopnea index (AHI) greater than 5 were diagnosed with OSA, while those with a scale score greater than 3 were diagnosed with depression. Results: Among the 1106 older patients with OSA, depression was found in 133(12.0%) patients, 96(8.7%) patients experienced MACE during the follow-up. Depression was associated with a higher cumulative incidence of MACE in older patients with OSA. Multivariate analysis revealed that depression independently increased the risk of MACE (adjusted hazard ratio [aHR] = 2.29; 95% confidence interval [CI]: 1.34-3.90; P = 0.002). Subgroup analyses showed that male patients (aHR = 2.96; 95% CI: 1.52-5.77; P = 0.001), overweight-obese individuals (aHR = 2.98; 95% CI: 1.49-6.00; P = 0.002), and those with moderate-severe OSA (aHR = 2.82; 95% CI: 1.55-5.14; P = 0.001) and concurrent depression were at a higher risk for MACE. Conclusion: Depression is common in older patients with OSA in the absence of MI, hospitalization for unstable angina, or heart failure, and confers an independent, increased risk of MACE.

Distinct morphology-dependent behaviors for Au/γ-Al2O3 catalysts: enhanced thermal stabilization in CO oxidation reaction.

The durability of supported metal catalysts usually suffers from sintering, the metal nanoparticles aggregating into larger sizes and subsequent loss of reactive surface, resulting in catalysts deactivation when heated at elevated temperatures. Herein, we investigate the evolution of Au species on different morphologies of γ-Al2O3 and surprisingly found vastly different behavior for the dispersion of surface Au nanoparticles. A nanorod-shaped γ-Al2O3 is prepared by the hydrothermal method resulting in an extraordinary catalyst support that can stabilize Au nanoparticles at annealing temperatures up to 700 °C. In contrast, the Au-supported catalyst prepared using commercial γ-Al2O3 shows a greater degree of inactivation under the same conditions. Remarkably, the unique morphology of such nanorod-shaped γ-Al2O3 is beneficial in preventing Au nanoparticles from sintering. The γ-Al2O3 nanorods are more effective than the commercial γ-Al2O3 at anchoring the Au nanoparticles. The results of X-ray photoelectron spectroscopy (XPS), in situ diffuse reflectance infrared Fourier transform spectroscopy (DRIFTS) and H2-TPR, reveal the interfacial interactions between Au nanoparticles and γ-Al2O3 nanorods, yielding a sinter-stability of the obtained Au/γ-Al2O3 nanorods catalyst. This synthetic strategy is simple and amenable to the large-scale manufacture of thermally stable γ-Al2O3 for industrial applications. Here, we investigate the morphology-dependent behavior of Au nanoparticles dispersed on different morphologies of γ-Al2O3. The result of X-ray photoelectron spectroscopy (XPS), in situ diffuse reflectance infrared Fourier transform spectroscopy (DRIFTS) and H2-TPR, reveal the interfacial interactions between Au nanoparticles and gamma alumina nanorods. Au nanoparticles on γ-Al2O3 nanorods exhibit higher sinter-resistant performance than those on commercial γ-Al2O3.

An efficient hydrogenation catalyst in sulfuric acid for the conversion of nitrobenzene to p-aminophenol: N-doped carbon with encapsulated molybdenum carbide.

The transfer of catalytic function from molybdenum carbide to N-doped carbon has been tested by encapsulating molybdenum carbide with N-doped carbon using a one-pot preparation process. The outer layer of N-doped carbon, inert itself, exhibits high activity and excellent selectivity with molybdenum carbide as the catalyst for the hydrogenation of nitrobenzene to p-aminophenol in sulfuric acid.