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Objective: To compare the cardio- and cerebrovascular outcomes and survival rates of surgical and nonsurgical interventions for patients with obstructive sleep apnea (OSA) based on a national population-based database. Study Design: Retrospective cohort study. Setting: Taiwan National Health Insurance Research Database. Methods: We analyzed all cases of OSA among adults (age >20 years and confirmed with ICD-9-CM) from January 2001 to December 2013. We compared the patients with OSA who received upper airway surgery with age-, sex-, and comorbidity index–matched controls with continuous positive airway pressure (CPAP) treatment. The risk of myocardial infarction (MI) or stroke after treatment of OSA-related surgery versus CPAP was investigated. Results: During follow-up, 112 and 92 incident cases of MI occurred in the OSA surgery and CPAP treatment groups, respectively (rates of 327 and 298 per 100,000 person-years). Furthermore, 50 and 39 cases were newly diagnosed with stroke in the OSA surgery and CPAP treatment groups (rates of 144 and 125 per 100,000 person-years). Cox proportional hazard regressions showed that the OSA treatment groups (OSA surgery vs CPAP) were not significantly related to MI (hazard ratio, 1.03 [95% CI, 0.781-1.359]; P =.833) and stroke (hazard ratio, 1.12 [95% CI, 0.736-1.706]; P =.596) at follow-up, after adjustment for sex, age at index date, days from diagnosis to treatment, and comorbidities. Conclusion: Our study demonstrated that there was no difference of cardio- and cerebrovascular results between CPAP and surgery for patients with OSA in a 13-year follow-up. Level of Evidence: 3. [ABSTRACT FROM AUTHOR]

A knot is a worldwide used complication and one of the most ancient technologies in human history. A knot can be found in a wide range of applications such as providing practical structural robustness and mechanical connections between objectives. Here, we report a responsive knot that can self-adjust its geometry upon external stimuli. The knot is tightened in a thread made of a liquid crystal gel, the diameter and internal friction of which vary upon thermal/chemical stimulus. An overhand knot and a reef knot are demonstrated to exhibit auto-untie action responsive to external stimuli. A self-dropping device is shown to sense its surrounding temperature and chemical change in the environment, providing the proof-of-concept for sensing application. The results offer new alternatives for soft micro-robots and automation control for non-electric devices. [ABSTRACT FROM AUTHOR]

Ferulic acid (FA) exhibits antioxidant and anti-inflammatory properties, making it valuable for numerous industrial applications. Traditionally, FA is produced by the alkaline hydrolysis of γ -oryzanol, which is typically associated with wastewater generation. Recently, an increasing demand of natural FA necessitates its green production via enzymatic hydrolysis of γ -oryzanol, a mixture comprising triterpene alcohol ferulates and phytosteryl ferulates. Thus far, γ -oryzanol can be hydrolyzed by only four commercial cholesterol esterases with low yields. Herein, we report a recombinant cholesterol esterase from Mustela putorius furo (MPFCE) for the enzymatic hydrolysis of γ -oryzanol. The enzyme yielded 25.5% FA, which is the highest reported through enzymatic means thus far. The hydrolysis profile revealed that the enhanced yield primarily resulted from the near-complete hydrolysis of phytosteryl ferulates, together with slight hydrolysis of triterpene alcohol ferulates. MPFCE serves as a potential candidate for the enzymatic production of FA through targeted hydrolysis of γ -oryzanol.