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Association of air pollution and body composition in obstructive sleep apnea

為了解決st2269s-2的問題，作者NGUYEN THANH TUNG 這樣論述：

A relationship between exposure to ambient air pollution and obstructive sleep apnea (OSA) severity was reported in epidemiological studies. Exposure to air pollution may result in increased oxidative stress, inflammation, epithelial barrier disruption, and permeability in the upper airway, which c

ould all predispose to OSA. However, there is paucity of data on the biological mechanism of this hyperpermeability. Furthermore, the overnight changes in body composition after exposure to air pollution and how they affected the severity of OSA is still unclear.To investigate the associations of bo

dy composition changes with OSA, pre- and post-sleep body composition of 1584 patients with OSA were collected. We observed that increases in limb fat deposition and visceral fat level were associated with increased OSA severity. Each increase in total fat deposition and segmental fat deposition was

associated with increased odds ratio of positional OSA. In patients with positional OSA, an increase in the fat distribution of the limbs was associated with increases in the total arousal index, especially in the non-rapid eye movement (NREM) stage.To examine the association of air pollutant expos

ure with nocturnal body composition changes and OSA, we measured pre- and post-sleep body composition of 197 subjects from a sleep center and their individual air pollution exposure (particulate matter (PM) less than 2.5 µm in aerodynamic diameter (PM2.5), ozone (O3), and nitric dioxide (NO2)). We o

bserved that exposure to air pollutants was associated with total muscle mass and leg fat percentage changes. We found an association between PM deposition in lung regions, especially in the alveolar region, and body fat accumulation in OSA. The leg fat deposition and total muscle mass changes was f

ound to be associated with the apnea-hypopnea index (AHI). These findings implied that air pollution was associated with increases in the leg fat percentage and total muscle mass changes, thus aggravating OSA severity.We then collected road dust PM2.5 from 20 cities in China and treated to human pha

ryngeal epithelial (FaDu) cells. We observed that road dust PM2.5 exposure led to declines in cell viability and increases in lactate dehydrogenase (LDH) and interleukin (IL)-6. PM2.5, especially the inorganic elemental components, led to decreases in E-cadherin and occludin and increases in EGFR an

d phosphorylated (p)-EGFR on FaDu cells, later confirmed by the knockdown of E-cadherin. The findings indicate that PM2.5 may induce the inflammation, disrupt the epithelial barrier integrity, and increase the permeability in human upper airway through the regulation of occludin, E-cadherin, EGFR, a

nd p-EGFR.Together, the air pollution-induced hyperpermeability could increase overnight fluid shift and body composition changes, thus aggravating OSA. Air pollution, particularly the PM2.5, had the potential to increase the severity of OSA through body composition changes and upper airway hyperper

meability. Our study shed light on the etiology of OSA and positional OSA. Decreasing the total fat mass and fat percentage may reduce OSA severity. Finally, measures to decrease air pollution in urban areas could be beneficial for OSA patients.

董事責任保險之研究

為了解決st2269s-2的問題，作者巫南課 這樣論述：

董事於公司治理負有受託義務，違反義務時，責任因而產生。面對與日俱增之決策錯誤風險及責任危機，董事為重大決策動輒得咎，而有責任風險分散之需求。在此情況下，要激發董事積極進取、勇於任事、洞燭機先、開創業務發展之新局，勢必需要一個更有推進動力之機制，董事責任保險是可能的解決方案。唯當董事責任風險移轉由保險人承擔後，所導致道德危險等弊端，需要一併解決。本文以董事責任保險相關制度發展及其重要問題為中心，探討董事責任保險制度之功能及其對於董事行為之影響，同時探討董事責任保險人扮演之角色與所得發揮之機能。本文認為董事責任保險制度雖難免有董事職務上行為發生道德危險之小瑕疵，整體而言，瑕不掩瑜。於經濟活動變動

頻繁，複雜性日增之時，興利之利大於除弊之弊，在此範圍，董事責任保險讓董事回歸到一個單純可以專心於其業務之執業環境。畢竟企業的決策者應該堅定地遵守道德原則，而不僅僅是遵守狹隘的規則。 董事責任保險應著眼於整體經濟活動發展需要之考量，讓董事回歸到一個單純可以專心於其業務之執業環境。本文因此認為若要提升董事責任保險之效益，幾個配套措施不可少。例如董事責任法制防弊設計、強化股東代表訴訟功能、引進董事責任保險人之監督功能等。結構方面，第一章為緒論，就研究動機、目的、方法、範圍為簡要之介紹；第二章董事責任保險概說，除介紹董事義務與責任，亦說明董事責任保險之法理基礎，闡明董事責任保險之作用、特性與功能

及其必要性；第三章說明董事責任保險之法律關係，就董事責任保險契約之效力、董事責任保險利益、保險事故、董事責任保險當事人與利害關係人等；第四章董事責任保險之保險內容，論及董事責任保險之保險標的論、保險範圍、保險事故並分析介紹董事責任保險費率之風險結構與風險定價方式；第五章董事責任保險之除外責任，說明董事責任保險逆選擇排除、道德危險排除相關之各種保險人不負保險責任之情形；第六章結論。關鍵字：董事、受託義務、公司治理、董事責任保險、道德危險、董事責任保險人、股東代表訴訟、逆選擇排除、董事責任保險利益