Association of subjective and objective sleep disturbance with the spectrum of gastroesophageal reflux disease.

STUDY OBJECTIVES: The relationship between obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD) is complex. We aim to determine the association of subjective and objective sleep parameters with diverse manifestations of the GERD spectrum. METHODS: We prospectively recruited 561 subjects who underwent an electrocardiogram-based cardiopulmonary coupling (CPC) for OSA screening during a health check-up. All subjects received the Reflux Disease Questionnaire (RDQ) and an upper endoscopy to determine the presence of troublesome reflux symptoms and erosive esophagitis (EE). Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI) and sleep dysfunction was defined as a PSQI > 5. OSA was defined as a CPC-derived apnea/hypopnea index exceeding 15 events per hour. Comparisons were made between subjects on the GERD spectrum with respect to their various subjective and objective sleep parameters. RESULTS: Among the 277 subjects with GERD (49.4%), 198 (35.3%) had EE. Subjects with GERD had higher scores of PSQI (6.99 ± 3.97 vs. 6.07 ± 3.73, P = 0.005) and a higher prevalence of sleep dysfunction (60.6% vs. 49.6%, P = 0.009). Subjects with EE had a higher prevalence of OSA (42.9% vs. 33.9%, P = 0.034). Along the GERD spectrum, symptomatic EE subjects had the highest PSQI scores and prevalence of sleep dysfunction (70.7%), while asymptomatic EE subjects had the highest prevalence of OSA (44%). CONCLUSIONS: Our findings indicate a high prevalence of sleep dysfunction among individuals with GERD. Furthermore, patients on the GERD spectrum are prone to experiencing a range of subjective and objective sleep disturbances.

Adaptive filtering and smoothing algorithm based on variable structure interactive multiple model.

For maneuvering target tracking, a novel adaptive variable structure interactive multiple model filtering and smoothing (AVSIMMFS) algorithm is proposed in this paper. Firstly, an accurate model of the variable structure interactive multiple model algorithm is established. Secondly, by constructing a new model subset based on the original model subsets, the matching accuracy between the model subset and the actual maneuvering mode of the target is improved. Then, the AVSIMMFS algorithm is obtained by smoothing the filtered data of the new model subset. Because of the combination of forward filtering and backward smoothing, the target tracking accuracy is further improved. Finally, in order to verify the effectiveness of the algorithm, the simulation is carried out on two cases. The simulation results show that the tracking performance of AVSIMMFS algorithm is better than other methods and has lower calculation cost.

The Phosphorylation Status of Hsp82 Regulates Mitochondrial Homeostasis During Glucose Sensing in Saccharomyces cerevisiae.

Sensing extracellular glucose, budding yeast switches from aerobic glycolysis to oxidative phosphorylation to adapt to environmental changes. During the conversion of metabolic mode, mitochondrial function and morphology change significantly. Mitochondria are the main supply factories of energy for various life activities in cells. However, the research on the signal pathways from glucose sensing to changes in mitochondrial function and morphology is still scarce and worthy of further exploration. In this study, we found that in addition to the known involvement of molecular chaperone Hsp82 in stress response during the conversion of metabolic mode, the phosphorylation status of Hsp82 at S485 residue regulates mitochondrial function and morphology to maintain mitochondrial homeostasis. The Hsp82S485A mutant that mimics dephosphorylation at S485 residue showed abnormal growth phenotypes related to mitochondrial defects, such as the petite phenotype, slow growth rates, and inability to use non-fermentable carbon sources. Further exploring the causes of growth defects, we found that the Hsp82S485A mutant caused mitochondrial dysfunction, including a decrease in cellular oxygen consumption rate, defects in mitochondrial electron transport chain, decreased mitochondrial membrane potential and complete loss of mtDNA. Furthermore, the Hsp82S485A mutant displayed fragmented or globular mitochondria, which may be responsible for its mitochondrial dysfunction. Our findings suggested that the phosphorylation status of Hsp82 at S485 residue might regulate mitochondrial function and morphology by affecting the stability of mitochondrial fission and fusion-related proteins. Thus, Hsp82 might be a key molecule in the signal pathway from glucose sensing to changes in mitochondrial function and morphology.

Compound weighted fusion evaluation and optimization of intelligent tracking algorithm in radar seeker.

This paper designs a hierarchical weighted fusion evaluation/optimization scheme for the radar seeker neural network (NN) tracking algorithm. The first weighted fusion of closed-loop performance index is carried out to exclude the hardware influence on algorithm evaluation. Then, according to different tracking scenarios, the tracking index is divided into different periods; a single period score is given by a linear-nonlinear hybrid scoring mechanism. Furthermore, in a single index, the internal scores of different time periods are weighted and fused for the second time to obtain the index overall score. Finally, the third weighted fusion of the multi-index scores obtains the comprehensive score of the algorithm. We design the parameter evaluation case sets and repeat the aforementioned compound weighting; hence the case with the highest comprehensive score is obtained. Finally, the algorithm is optimized by the highest-score case. The experiment using fuzzy NN radar seeker verifies the effectiveness of the method.

Bionic adaptive fault-tolerant control of non-Gaussian stochastic attitude hypersonic vehicle.

This study investigates an adaptive fault-tolerant control (FTC) for hypersonic flight vehicles (HFVs) with incipient faults and non-Gaussian stochastic output attitudes. In the nonlinear HFV dynamics, a hybrid fuzzy approximation method achieves the linearization, then the stochastic outputs are transformed into probability density functions (PDFs) via rational square root B-spline. The disturbance and faults are estimated simultaneously by an adaptive augmented observer. Then actuator faults are compensated by an bionic adaptive fault-tolerant controller to ensure that the output PDFs accurately track the expected PDFs, thereby matching actual attitude angles with the desired ones, the bionic prey adaptive law can make FTC accurately repair the incipient fault deviations. Lyapunov theory proves the robust stability of the scheme, and simulation illustrates the effectiveness.

Adaptive Sliding Mode Fault Compensation for Sensor Faults of Variable Structure Hypersonic Vehicle.

This paper investigates the sensor fault detection and fault-tolerant control (FTC) technology of a variable-structure hypersonic flight vehicle (HFV). First, an HFV nonlinear system considering sensor compound faults, disturbance, and the variable structure parameter is established, which is divided into the attitude angle outer and angular rate inner loops. Then a nonlinear fault integrated detector is proposed to detect the moment of fault occurrence and provide the residual to design the sliding mode equations. Furthermore, the sliding mode method combined with the virtual adaptive controller constitutes the outer loop FTC scheme, and the adaptive dynamic surface combined with the disturbance estimation constitutes the inner loop robust controller; these controllers finally realize the direct compensation of the compound sensor faults under the disturbance condition. This scheme does not require fault isolation and diagnosis observer loops; it only uses a variable structure FTC with a direct estimation algorithm and integrated residual to complete the self-repairing stable flight of variable-structure HFV, which exhibits a high reliability and quick response. Lyapunov theory proved the stability of the system, and numerical simulation proved the effectiveness of the FTC scheme.

Fuzzy adaptive fault diagnosis and compensation for variable structure hypersonic vehicle with multiple faults.

Based on the type-II fuzzy logic, this paper proposes a robust adaptive fault diagnosis and fault-tolerant control (FTC) scheme for multisensor faults in the variable structure hypersonic vehicles with parameter uncertainties. Type-II fuzzy method approximates the original models while eliminating the parameter uncertainties. Hence the sensor faults are detected and isolated by the multiple output residuals and thresholds considering nonlinear approximation errors and disturbance. Based on the fuzzy adaptive augmented observer, the faults and disturbance are all estimated accurately by an improved proportional-differential part. Then a variable structure FTC scheme repairs the faults by the estimation, the fast-varying disturbance is considered in FTC scheme and is compensated by the control parameters designed based on its derivative function, thereby enhancing the output robust tracking accuracy of the variable structure hypersonic vehicles. The Lyapunov theory proves the system robust stability, semi-physical simulation verifies the validity of the proposed method and the superiority compared with the traditional method.

Clinical features and prognosis of acute myocardial infarction caused by non-tumor origin coronary artery embolism.

BACKGROUND: Several studies have indicated that acute myocardial infarction (AMI) secondary to coronary artery embolism (CE) has a poor prognosis. However, in the latter studies, CE of tumor origin accounts for a considerable proportion of cases and the clinical features and contribution to overall prognosis of non-tumor CE are unknown and therefore the subject of this study. METHODS: We retrospectively studied 2006 consecutive patients with AMI at our medical center from January 2014 to October 2018. Non-tumor CE was diagnosed based on angiographic, biochemical, and imaging criteria. Patients were divided into two groups: patients without CE (control) and patients with non-tumor CE. RESULTS: Atrial fibrillation was the most frequent etiology (n = 32, 69.6%) in the non-tumor CE group (n = 46). Compared with the control group, the non-tumor CE group had (all p < 0.05): higher incidence of atrial fibrillation; larger left atrial diameter, left ventricular end-diastolic diameter and left ventricular end-systolic diameter; lower left ventricular ejection fraction, ST-segment-elevation myocardial infarction incidence and low density lipoprotein cholesterol level; lower incidence of multivessel coronary stenosis, level of culprit lesion stenosis and proportion of angioplasty; higher ratio of manual thrombectomy and antithrombotic drugs alone therapy; lower thrombolysis in myocardial infarction (TIMI) grade and higher corrected TIMI frame counts (CTFC) after reperfusion; and statistically similar overall survival at median 864 (interquartile range, 413-1272) days. CONCLUSIONS: The overall incidence of non-tumor CE was 2.3%, with atrial fibrillation as its most common etiology. Midterm overall survival was similar between AMI patients secondary to non-tumor CE and those without CE.