Relationship between Occurrence and Progression of Lung Cancer and Nocturnal Intermittent Hypoxia, Apnea and Daytime Sleepiness

The possible relationship between lung cancer and nocturnal intermittent hypoxia,apnea and daytime sleepiness,especially the possible relationship between the occurrence and progression of lung cancer and obstructive sleep apnea syndrome (OSAS) was explored.Forty-five cases of primary lung cancer suitable for surgical resection at the Third Affiliated Hospital of Kunming Medical University between January 2017 and December 2017 were recruited (lung cancer group),and there were 45 patients in the control group who had no significant differences in age,sex and other general data from lung cancer group.The analyzed covariates included general situation,snore score,the Epworth Sleeping Scale (ESS),Pittsburgh Sleep Quality Index (PSQI),apnea and hypopneas index (AHI),oxygen desaturation index 4 (ODk),lowest arterial oxygen saturation [LSpCh (%)],oxygen below 90% of the time [T90%(min)],the percentage of the total recorded time spend below 90% oxygen saturation (TS90%),to explore the possible relationship between lung cancer and above indicators.The participants were followed up for one year.The results showed that:(1) There was significant difference in body mass index (BMI),ESS,AHI,T90%(min),TS90%,ODh,snore score and LSpCh (%) between lung cancer group and control group (P<0.05).There was no statistically significant difference in age,gender,PSQI score,incidence of concurrent hypertension,diabetes and coronary heart disease (CHD),and smoking history between the two groups (P>0.05);(2) Patients in the lung cancer group were divided into OSAS subgroup and non- OSAS subgroup according to the international standard for the diagnosis of OSAS.There was significant difference in BMI,age,staging,incidence of concurrent hypertension and concurrent CHD,snore score,ESS score,T90%(min),TS90%,ODh and LSpCh (%) between OSAS subgroup and non-OSAS subgroup (P<0.05).There was no statistically significant difference in gender,PSQI score,incidence of concurrent diabetes,smoking history and lung cancer type between the two groups (P>0.05);(3) AHI was strongly negatively correlated with the LSpCh (%) and positively with ESS,staging,snoring score,T90%(min),TS90%,ODh and BMI (P<0.05);(4) There were 3 deaths,5 cases of recurrence,and 4 cases of metastasis in OSAS subgroup;and there was 1 death,4 cases of recurrence and 2 cases of metastasis in non-OSAS subgroup during the follow-up period of one year,respectively.There was no significant difference in mortality,recurrence rate and metastasis rate between the two subgroups,and the total rate of deterioration in OSAS subgroup was significantly increased compared to the non-OSAS subgroup (P<0.05).It was concluded that the patients with lung cancer are prone to nocturnal hypoxemia,apnea,snoring and daytime sleepiness compared to control group.The incidence of OSAS in patients with lung cancer was higher,and the difference in the hypoxemia-related indicators was statistically significant.The mortality,recurrence rate,and metastasis rate increases in lung cancer patients with OSAS during the one-year follow-up period,suggesting that OSAS may be a contributing factor to the occurrence and progression of lung cancer.

Associations of Daytime Napping with Incident Cardiovascular Diseases and Hypertension in Chinese Adults:A Nationwide Cohort Study

Objective This study aimed to examine the associations of daytime napping with incident risks of cardiovascular diseases(CVDs)and hypertension(HTN).Methods Data for napping and CVD outcomes in 25 provinces were collected from baseline(2010)and three waves of follow-up(2012-2017)investigations of the China Family Panel Studies.Cox frailty models with random intercepts for the surveyed provinces were used to assess the longitudinal effects of daytime napping on CVD and HTN.Results Compared with non-nappers,30+min nappers had higher risks of CVD and HTN,while no significant associations were observed among<30 min nappers.Incident risks among 30-to<60-min nappers increased by 22%[hazard ratio(HR)1.22,95% confidence interval(CI)1.08-1.39]for CVD and 21%(1.21,1.04-1.41)for HTN,respectively,with corresponding HRs of CVD and HTN of 1.27(1.09-1.47)and 1.38(1.16-1.65)among≥60 min nappers.Nap-associated CVD risks varied by subgroups,with stronger associations in participants with lower body mass index(<24 kg/m^(2)),physically inactive persons,smokers,and participants with longer nighttime sleep(≥7 h/night).Significant effects of daytime napping were observed on rural and northern residents only,highlighting great regional variations in CVD risks associated with napping habits.Conclusions This cohort study revealed strong evidence that long daytime napping(≥30 min)is associated with an increased incidence of cardiovascular events.

Effects of primary glaucoma on sleep quality and daytime sleepiness of patients residing at an equatorial latitude

AIM:To investigate the impact of primary glaucoma on sleep quality and daytime sleepiness of patients.METHODS:Prospective cross-sectional study with consecutive sampling in South-East Asian population was performed.Validated questionnaires:the Pittsburg Sleep Quality Index(PSQI)and Epworth Sleepiness Scale(ESS)were administered prospectively.Subjects with nonglaucomatous optic neuropathy or concomitant retinal pathology were excluded.Glaucoma severity was based on HVF 24-2 perimetry.Binocular single vision was represented based on the better eye.Frequency of and predictive factors for poor sleep quality and excessive daytime sleepiness were compared.RESULTS:A total of 79 primary open angle glaucoma(POAG),27 primary angle-closure glaucoma(PACG)patients,and 89 controls were recruited.PACG patients had higher median PSQI scores(P=0.004)and poorer sleep quality(P<0.001).Compared to controls,PACG patients were 3.34 times more likely to have poor sleep quality(P=0.008),which remained significant after adjustment for demographics(P=0.016)and predictive variables(P=0.013).PACG patients have poorer sleep quality when visual acuity(VA)was 6/15 or worse(P=0.009).Univariate and multivariate analysis of predictive variables for poor sleep quality and daytime sleepiness did not find statistical significance.CONCLUSION:PACG patients have poorer sleep quality but not daytime sleepiness.This is important in South-East Asian population with heavy disease burden.Evaluations on sleep disturbances can be considered to provide more ho istic care.

Application and effect evaluation on Acknowledge-Introduce-Duration-Explanation-Thank you(AIDET)communication mode in cataract daytime operation nursing

Background:To explore the application effect of Acknowledge-Introduce-Duration-Explanation-Thank you(AIDET)communication mode in reducing anxiety and improving the care services satisfaction of the patients.Methods:The 100 cases undergoing cataract daytime operation from February to July 2019 were divided into test group and control group.The test group conducted health education and nursing care for patients during admission,pre-operation,post-operation,and discharge according to the AIDET communication mode.And the control group was given health education and nursing care to the patients according to the traditional way of communication.Results:The difference of the socioeconomic information between these two groups showed no statistical significance.The care services satisfaction score in the test group was statistically higher than that in the control group(P<0.05).The Self-Rating Anxiety Scale(SAS)score in the test group was significantly lower than that in the control group(P<0.01).This result indicated that the patients suffered less anxiety with the AIDET mode of communication.Conclusions:The application of AIDET communication mode to the nursing service of cataract daytime operation can reduce the tension and anxiety of the patients from the treatment and improve their satisfaction to care services.

DETECTION OF DAYTIME FOG IN SOUTH CHINA SEA USING MODIS DATA

Based on a current fog detection theory,a multiband threshold method for MODIS data was put forward to detect daytime fog in the South China Sea.It used Bands 1,2,18,20 and 31 of MODIS data to separate fog from the cloud and the sea surface.The digital detection indexes were as follows.If RB1<20%,RB2<20% and RB1>RB2,the pixel was identified to be the sea surface.If RB1>55%,RB2>55% and TB31<273 K,the pixel was identified to be a middle-and high-level cloud.If IFC>20,the pixel was classified to be sea fog.The method was verified with sea fog data observed from the coastal region of Guangdong during January-April 2011.Out of the 13 samples of satellite detection,nine were consistent with the surface observations,three were identified to be low-level the cloud according to the satellite detection but fog according to the surface observations,and only one sample was identified to be the ocean surface by the satellite detection but fog by the surface observations.Because the MODIS data cannot penetrate the cloud or fog,the model was designed for a single field of view which had only one layer of cloud or fog.It can accurately distinguish fog which is not covered by the cloud,but it identifies fog as cloud if the former is covered by a cloud.Generally speaking,the model is effective and feasible.

Efficient realization of daytime radiative cooling with hollow zigzag SiO_(2) metamaterials

A tunable selective emitter with hollow zigzag SiO_(2) metamaterials, which are deposited on Si_(3) N_(4) and Ag film, is proposed and numerically investigated for achieving excellent radiative cooling effects. The average emissivity reaches a high value of 98.7% in the atmospheric window and possesses a high reflectivity of 92.0% in the solar spectrum. To reveal the enhanced absorptivity, the confined electric field distribution is investigated, and it can be well explained by moth eye effects. Moreover, tunable emissivity can also be initiated with different incident angles and it stays above 83% when the incident angle is less than 80°, embodying the excellent cooling performance in the atmospheric transparency window.Its net cooling power achieves 100.6 W·m^(-2), with a temperature drop of 13°, and the cooling behavior can persist in the presence of non-radiative heat exchange conditions. Therefore, high and tunable selective emitters based on our designed structure could provide a new route to realizing high-performance radiative cooling. This work is also of great significance for saving energy and environmental protection.

Early Rehabilitation of Orthopedic Internal Fixation Removal in DaytimeWard

Children's fractures are very common,and many children's fractures need internal fixation.When the children are treated and recovered,it needs to be internally fixed and then taken out.With the development of internal fixation materials,the research of surgical methods and the improvement of surgical skills,postoperative removal of orthopedic surgery patients has gradually been included in daytime surgery.While ensuring the safety of children's surgery,it is necessary to shorten the postoperative limb and joint function recovery time,promote the recovery of limb and joint function,the healing of wounds and bones,and reduce the occurrence of these complications.In order to reduce the occurrence of these complications,carry out early rehabilitation education and development early rehabilitation training is very necessary.This paper puts forward the concept of early rehabilitation based on shared decision model,in which doctors,nurses,children and family members participate in the treatment of children before,during and after operation.The effect of early rehabilitation education in the daytime ward after removal of internal fixation was examined.Moreover,through the analysis of the control trial also confirmed that the clinical effect of early rehabilitation in improving and optimizing the rehabilitation of fracture in children is significant.

Relationship between Lifestyle, Quality of Sleep, and Daytime Drowsiness of Nursing Students of University A

The harmful effects of technological devices, including smart phones have been increasingly suspected among university students;bedtimes have become increasingly later at night, and leisure activities often extend through the night. Likewise, availability and need of increasing part-time job hours have been considered. The purpose of this research was to determine the relationship among lifestyles, quality of sleep, and daytime drowsiness of nursing students of University A. The research was conducted in June 2015, when student life rhythms were considered stable after two months of lectures. Responses with missing values or with inappropriate answers were excluded. Of the data collected from 96 respondents, only 71 were acceptable. The survey focused on lifestyle, daytime sleepiness (using ESS: Epworth Sleepiness Scale) and quality of subjective sleep (using the PSQI: Pittsburgh Sleep Quality Index). Approval was obtained from the Research Ethics Committee of Shikoku University. While in this study, more than half (63.4%) of the students had poor quality of sleep, however, there was no relationship between their quality of sleep and daytime drowsiness, or between their lifestyles and the quality of sleep. These findings suggest that while university students’ use of technological devices is suspected to influence on sleep deprivation and consequent daytime drowsiness, the findings did not provide the evidence.

Insomnia and Excessive Daytime Sleepiness in Parkinson’s Disease Patient—A Review Article

Sleep-wake disorders play an important role among non-motor symptoms in Parkinson’s Disease, being a constant subject of research in recent years. There are a multitude of sleep-wake disturbances that worsen the patient’s quality of life, insomnia and excessive daytime sleepiness being two of the most frequent complaints. The aim of this review is to highlight the most relevant clinical trials conducted during the last 5 years, focusing on the problematic of insomnia and daytime sleepiness correlated with Parkinson’s Disease and its treatment. Three electronic databases (Pubmed, Science Direct and Google Scholar) were searched during March and April 2020 for articles on this topic, finally selecting 21 most relevant articles that we have included in this review. Interesting aspects regarding correlation between sleep-wake disorders and Parkinson’s disease were found, showing that non-motor symptoms may be independent of the disease itself. We discussed the most recent advances in treatment opportunities and the adverse effects, with insomnia and daytime sleepiness among the most common complaints. Besides newly developed pharmacological therapy, consisting in mostly dopaminergic agonists or levodopa adjuvant drugs. Other possibly effective therapies on sleep-wake disorders such as deep brain stimulation, dietary changes, bright light therapy and alternative medicine protocols are also reviewed. Insomnia and excessive daytime sleepiness are common complaints in Parkinson’s disease patients, being either self-standing non-motor symptoms or adverse effects of the antiparkinsonian medication, diminishing patient’s quality of life. The effervescence of research on this topic shows promising results, with new clinical trials still to come in the near future.

Original Research: Pupillary Constriction Velocity and Latency to Predict Excessive Daytime Sleepiness

Background: Excessive daytime sleepiness (EDS) is common in adults. A need exists for an easier and faster objective clinical measures of EDS. The autonomic nervous system controls pupil size and prior pupillometry studies have demonstrated associations with sleepiness. We used a novel portable device to assess pupillometry and prospectively evaluated a sleep clinic cohort. Methods: Following IRB approval Pupillometry (The ForSiteTM, NeurOptics, Irvine, CA), was performed on 113 sleep clinic patients. Constriction and dilation velocity and latencies, minimum and maximum aperture were obtained along with Epworth Sleepiness Score (ESS), 10 point Visual Analog Scale (VAS), BMI, gender, age and AHI. Three sets of measures were obtained and analyzed with ANOVA, t-test, Linear Regression and Pearson correlation coefficients (SAS, Cary, NC). Results: Both constriction velocity and latency correlated with VAS (n = 88, r = 0.28, p = 0.007 and r = 0.31, p = 0.004). Only constriction velocity correlated with AHI (n = 78, r = -0.27, p = 0.016). Multivariate linear regression which includes VAS and age predicted constriction velocity (r = 0.36, p = 0.002) and latency (r = 0.38, p = 0.001). Using Pearson correlation, AHI and VAS combined were associated with constriction velocity (-0.273 (0.016), and 0.284 (0.007), respectively). Using a maximum constriction velocity threshold value (age adjusted) of 2.8, VAS ≥ 6 was predicted with a sensitivity of 83% and specificity of 84%. Conclusions: Pupillary constriction velocity and latency predict self-reported VAS state of sleepiness. While both are affected by age, only constriction velocity is affected by apnea severity. These data suggest that a portable pupillometer may provide a method to identify individuals with abnormal sleepiness.

Factors Associated with Excessive Daytime Sleepiness in Obstructive Sleep Apnea Syndrome under CPAP Treatment

The purpose of this study was to assess factors associated with subjective sleep evaluation, chiefly excessive daytime sleepiness (EDS) in obstructive sleep apnea syndrome (OSAS) adult outpatients under continuous positive airway pressure (CPAP) treatment. One thousand and forty-eight OSAS outpatients (mean age: 51.4% male: 90.5%) who were treated by CPAP were consecutively collected. Age, sex, CPAP compliance (CPAP usage as their device of nights with application-time of at least 4 hours per night objectively;%usage ≥ 4 h/d), and Japanese version of the Pittsburgh Sleep Quality Index (PSQI-J) of the patients showing EDS (Japanese version of the Epworth Sleepiness Scale;JESS ≥ 11) were compared cross-sectionally with those of the patients who did not show EDS (JESS < 11). Nineteen point two % of all patients showed EDS subjectively. Two hundred one patients were classified to an EDS(+) group and an 847 patients were classified to EDS(–) group. Age and global PSQI-J scores were significantly different between the two groups. Logistic regression showed that EDS was significantly associated with global PSQI-J scores, but not with age. Among PSQI-J components, overall sleep quality, duration of sleep, sleep disturbance, and day dysfunction due to sleepiness were significantly higher in the EDS(+) group. Especially, 19.4% of patient in the EDS(+) group reported actual sleep time during the past month to be less than 5 hours/day. Although functional relationship should be further evaluated, insufficient sleep is the main factor associated with EDS in the OSAS patients under CPAP treatment.

Application of a new daytime surgery and same-day discharge mode in cataract clinic

Background:This study aims to investigate the application and effect of a new daytime surgery and same-day discharge mode in cataract clinic.Methods:Two hundred patients with cataract intended to undertake daytime surgery from August 2019 to January 2020 in the Cataract department were enrolled for the study.Among them,100 patients from January 2020 with the new daytime surgery and same-day discharge were the experimental group.While the other 100 patients without the designated set-up from August 2019 worked as a control group.The length and cost of hospitalization,the length of waiting for the elevator,the patient satisfaction,and the awareness rate of health education were evaluated.Results:After application of the new daytime surgery and same-day discharge set-up,the patients’satisfaction rate increased from 91%to 95%,and the rate of awareness of health education increased from 87%to 90%,the difference was statistically significant(χ^(2)=0.61,P=0.04 andχ^(2)=0.22,P=0.01).The length of hospitalization,hospitalization costs and waiting time for elevators were much reduced than those without this set-up.Conclusions:The application of the cataract daytime surgery and same-day discharge set-up can effectively alleviate the overcrowding of the ward environment,reduce the workload of medical staff,and improve patient satisfaction.Therefore,the daytime surgery and same-day discharge set-up has wide clinical applications.

Boosting daytime radiative cooling performance with nanoporous polyethylene film

Radiative cooling without energy consumption and environmental pollution holds great promise as the next-generation cooling technology.To date,daytime radiative cooling performance is still slightly low,especially in humid areas.In this work,we demonstrated that nanoporous polyethylene(Nano PE)film can improve solar reflectivity from 96%to 99%,thus boosting radiative cooling performance.Moreover,the experimental results in humid areas indicate that Nano PE films can improve radiative cooling performance by∼76%in a clear day and 120%in a day with few clouds.Additionally,compared with ordinary PE films,thin Nano PE films have significantly higher weather fastness and mechanical strength.More importantly,nano PE films can scatter part of visible light,thus suppressing the generation of light pollution in practical applications.Lastly,the modeling results reveal that with Nano PE films,more than 95%of China’s areas can achieve daytime cooling performance.Our work can boost the development of radiative cooling technology with a very low cost.

Highly Porous Yet Transparent Mechanically Flexible Aerogels Realizing Solar-Thermal Regulatory Cooling

The demand for highly porous yet transparent aerogels with mechanical flexibility and solar-thermal dual-regulation for energy-saving windows is significant but challenging.Herein,a delaminated aerogel film(DAF)is fabricated through filtration-induced delaminated gelation and ambient drying.The delaminated gelation process involves the assembly of fluorinated cellulose nanofiber(FCNF)at the solid-liquid interface between the filter and the filtrate during filtration,resulting in the formation of lamellar FCNF hydrogels with strong intra-plane and weak interlayer hydrogen bonding.By exchanging the solvents from water to hexane,the hydrogen bonding in the FCNF hydrogel is further enhanced,enabling the formation of the DAF with intra-layer mesopores upon ambient drying.The resulting aerogel film is lightweight and ultra-flexible,which pos-sesses desirable properties of high visible-light transmittance(91.0%),low thermal conductivity(33 mW m^(-1) K^(-1)),and high atmospheric-window emissivity(90.1%).Furthermore,the DAF exhibits reduced surface energy and exceptional hydrophobicity due to the presence of fluorine-containing groups,enhancing its durability and UV resistance.Consequently,the DAF has demonstrated its potential as solar-thermal regulatory cooling window materials capable of simultaneously providing indoor lighting,thermal insulation,and daytime radiative cooling under direct sunlight.Significantly,the enclosed space protected by the DAF exhibits a temperature reduction of 2.6℃ compared to that shielded by conventional architectural glass.

Correlation of Epworth Sleepiness Scale with multiple sleep latency test and its diagnostic accuracy in assessing excessive daytime sleepiness in patients with obstructive sleep apnea hypopnea syndrome

Background Excessive daytime sleepiness （EDS） is often associated with obstructive sleep apnea hypopnea syndrome （OSAHS） and contributes to a number of comorbidities in these patients. Therefore, early detection of EDS is critical in disease management. We examined the association between Epworth Sleepiness Scale （ESS） and multiple sleep latency test （MSLT） and diagnostic accuracy of ESS in assessing EDS in OSAHS patients. Methods The ESS, MSLT and overnight polysomnography were administered to 107 Chinese patients to assess EDS and its correlations with polysomnographic parameters. The diagnostic accuracy of ESS in classifying EDS （mean sleep latency （MSL） 〈10 minutes） was evaluated by calculating the area under ROC curve. Results As the severity of OSAHS increased, MSL decreased with increase in ESS score. Conversely, patients with worsening EDS （shorter MSL） were characterized by advanced nocturnal hypoxaemia and sleep disruption compared to those with normal MSL, suggesting EDS is associated with more severe OSAHS. There was a negative correlation between ESS score and MSL and both moderately correlated with some polysomnographic nocturnal hypoxaemic parameters. The area under ROC curve of ESS for identifying EDS was 0.80 （95% CI： 0.71 to 0.88） and ESS score 〉12 provided the best predictive value with a sensitivity of 80% and specificity of 69%. Conclusion The ESS score moderately correlates with MSL and our ROC study supports ESS as a screening strategy for assessing EDS in OSAHS.

Excessive Daytime Sleepiness in Parkinson＇s Disease： Clinical Implications and Management

Objective：Excessive daytime sleepiness （EDS） is one of the most common sleep abnormalities in patients with Parkinson’s disease （PD）, yet its multifactorial etiology complicates its treatment. This review summarized recent studies on the epidemiology, etiology, clinical implications, associated features, and evaluation of EDS in PD. The efficacy of pharmacologic and non-pharmacologic treatments for EDS in PD was also reviewed.Data Sources：English language articles indexed in PubMed and Cochrane databases and Chinese-language papers indexed in Wanfang and National Knowledge Infrastructure databases that were published between January 1987 and November 2017 were located using the following search terms： ＂sleepiness＂ , ＂sleep and Parkinson’s disease＂ , and ＂Parkinson’s disease and treatment＂ .Study Selection：Original research articles and critical reviews related to EDS in PD were selected.Results：EDS is a major health hazard and is associated with many motor and nonmotor symptoms of PD. Its causes are multifactorial. There are few specific guidelines for the treatment of EDS in PD. It is first necessary to identify and treat any possible factors causing EDS. Recent studies showed that some nonpharmacologic （i.e., cognitive behavioral therapy, light therapy, and repetitive transcranial magnetic stimulation） and pharmacologic （i.e., modafinil, methylphenidate, caffeine, istradefylline, sodium oxybate, and atomoxetine） treatments may be effective in treating EDS in PD.Conclusions：EDS is common in the PD population and can have an immensely negative impact on quality of life. Its causes are multifactorial, which complicates its treatment. Further investigations are required to determine the safety and efficacy of potential therapies and to develop novel treatment approaches for EDS in PD.

Modeling the spatial distribution of urban population during the daytime and at night based on land use： A case study in Beijing, China

Urban population during the daytime and at night and their spatial distribution are important bases for planning urban infrastructure, public services and disaster relief. As current population statistics cannot distinguish urban population during the daytime from that at night, existed research in this field are quite limited. This paper tries to advance studies at this aspect by establishing a relationship model for the three components of ＇population, land use and time （daytime or night）＇ to explore the temporal and spatial characteristics of different types of population, which is aimed to estimate urban population during the daytime and at night and to analyze their spatial characteristics at grid scale. Furthermore, an empirical case study has been carried out at the Haidian District in Beijing, China to test the model. The results are as follows： （1） The spatial structure of urban population during the daytime is significantly different from that at night. The spatial distribution of urban population during the daytime is more extensive and more agglomerated that that at night. （2） Several types of spatial coupling relationship between population during the daytime and that at night have been identified, such as sandwich mode, symmetry mode, convergence mode and single mode, etc. （3） The spatial distribution of daytime and nighttime population also reflects certain factors during the development of China, such as the distribution of old residential areas, the construction of new industrial districts, and the differences between urban and rural areas, which can provide reference points for studies in this field and other regional research.

Progress of passive daytime radiative cooling technologies towards commercial applications

Global warming has become one of the major environmental problems facing mankind in the 21st century,The existing refrigeration technology of buildings,like air conditioning,consumes a lot of energy.Passive daytime radiative cooling technology works without consuming energy.nor emitting carbon dioxide and other greenhouse gases.This review summarizes the development of daytime passive radiative cooling technologyfrom the basic principles,structure and materials of radiative coolers;analyses and evaluates the various existing radiative coolers.The core of radiative cooling lies in the combination of multi-scale micro/nano structures.The cooler reflects sunlight thus preventing the building from being heated up;while allows the building toradiate its own heat out thus being cooled down;meanwhile maintains the temperature difference by the heat insulation effect ofthe porous structure in theflm.The common challenges and potential solutions for the commercialization of radiative cooling technologies are analyzed,which may promote the applications of the technology in the near future.

An Easy‑to‑Prepare Flexible Dual‑Mode Fiber Membrane for Daytime Outdoor Thermal Management

Excellent outdoor thermal management is vital for public health and safety.However,the ever-changing and uncontrol-lable outdoor environmental conditions,such as irrepressible sunlight and drastic temperature fluctuations,bring majestic challenges to outdoor thermal management.Here,we report a significant advancement toward designing and fabricating a novel fiber membrane with a dual-function of radiative cooling and solar heating for an efficient daytime outdoor thermal management.Unlike the reported dual-mode thermal management materials,which are usually fabricated by compounding organic polymers and metal/inorganic non-metal materials,our fiber-based membrane is composed of only two polymers,i.e.,poly(vinylidene fluoride-co-hexafluoropropene)(PVDF-HFP)and polypyrrole(PPy).The resulting membrane presents outstanding outdoor thermoregulation capacity,with a practically attainable sun-ambient cooling temperature of~4.5℃,super-ambient heating temperature of~35.8℃,in an outdoor environment,under solar intensity(Isolar)of~850 W m^(-2).Fabrication process is simple and cost-effective,which offers the possibility of preparing large-scale products.Owing to the scalable and simple fabrication process,and the exceptional outdoor thermoregulation ability,this dual-mode fiber membrane has great potential to maintain a comfortable outdoor environment for human activities and industrial operations.

Influence of excessive daytime sleepiness and sleep quality on anxiety and depression in patients with obstructive sleep apnea hypopnea syndrome.

Objective To explore the factors that contribute tothe anxiety and depression in obstructive sleep apnea hypopneasyndrome (OSAHS) patients in terms of excessivedaytime sleepiness (EDS) and sleep quality. MethodsA total of 196 OSAHS patients,including 103 severepatients and 93 mild-moderate patients,were enrolled.Polysomnography was carried on at the sleep center of theFirst Hospital of China Medical University between May2013 and November 2015. According to the Epworthsleepiness scale (ESS) and the subject daytime sleepinesssymptom,all patients were divided into EDS groupand non-EDS group. The patients' general informationand subjective symptoms were recorded. Emotional stateswere assessed with self-rating anxiety scale ( SAS) andself-rating depression scale ( SDS). Sleep quality wasevaluated with Pittsburgh sleep quality index ( PSQI).The anxiety and depression related factors were studiedby regression analysis.