Abstract: Emerging-market equity exchanges require regime forecasting systems that are continuous in time, robust to heavy-tailed distributions, and optimised against false alarms. No existing method addresses all three simultaneously, and no prior study has reported a crisis false alarm rate on JSE equities. We propose S-NODE-ANF-RRC: a Stochastic Neural ODE embedded within an Adaptive Neuro-Fuzzy Risk-Regime Clustering architecture, motivated by the Heston stochastic volatility framework and integrated by a Milstein scheme with Lyapunov-regularised dual-loss training. The system is evaluated as a one-step-ahead probabilistic forecaster (h = 1 trading day) on 2696 daily observations across 17 JSE securities (March 2015–March 2026). Gaussian mixture clustering on raw features (kurtosis 54.8) inflates ARI by 1.3×; log-transformation corrects this systematic artefact. Two operational profiles emerge after correction: the N-ODE-ANF-RRC achieves the lowest cost (10,350 bp, 65.1% below GMM), longest lead time (0.71 days), and best MCC (0.596); the S-NODE-ANF-RRC achieves the lowest false alarm rate among probabilistic architectures (FAR = 0.051, log-loss = 1.07), with a 42.0% cost reduction versus GMM (bootstrap 95% CI [5, 250, 19, 600] bp; McNemar p = 0.027). Ablation confirms drift, diffusion, and dual-loss as the minimum viable daily-frequency configuration. The interdisciplinary fusion of physics-informed SDE dynamics, time series forecasting, and fuzzy interpretability yields two complementary JSE risk tools: an early-warning forecaster (N-ODE) and a low-false-alarm crisis classifier (S-NODE). Code and data: https://doi.org/10.5281/zenodo.19787658.

Abstract: In tropical island cities, the combined pressures of rapid high-density urbanization and year-round hot-humid climates make the pedestrian-level wind environment a critical determinant of outdoor thermal comfort and cooling performance. Focusing on Haikou, a tropical island city, this study optimizes building layouts on commercial plots under constant development intensity. A Pedestrian-level Cooling Performance Index (PLCPI) was constructed, prioritizing summer cooling and winter wind control through an AHP-EWM combined weighting method. The index integrates maximum pedestrian-level wind speeds and amplification factors to evaluate 65 layout configurations, including detached, row, perimeter, and courtyard types. The results reveal a nonlinear relationship between building count and cooling performance. Single-building layouts achieve the highest mean PLCPI (2.367), three-building layouts the lowest (1.825), prone to ventilation stagnation, and four-building layouts show a performance rebound (2.271) with stable efficiency. Crucially, spatial enclosure form is the decisive determinant under a constant building count: the optimal two-building layout B-8 (PLCPI=2.456) surpasses the best single-building layout A-2 (2.419), demonstrating that well-designed dispersed layouts can outperform centralized ones. This study proposes a dual-season adaptive evaluation framework for tropical commercial plots and reveals the nonlinear mechanism between building quantity and cooling performance, providing a scientific basis for fine-grained urban design in tropical island climates.

Abstract:

We establish new Lyapunov stability theory for ψ-Caputo fractional-order systems by strengthening Lyapunov functions under reasonable guiding wings of Class-K_∞ functions and their fractional derivative inequalities. The new generalized ψ-Gronwall inequalities and conceptual definitions of stability that are linked with the ψ-Mittag-Leffler function were introduced. Our main results are Lyapunov stability theorems whenever one finds a potential Lyapunov function that has upper and lower bounds and obeys typical Lyapunov fractional differential inequalities along imagined real trajectories of such systems. This theory works with some typical worked-out dynamic models, in which the stability dynamics are discussed.

Abstract: Pollen constitutes the primary source of proteins, amino acids, lipids, sterols, vitamins, and minerals for honey bees. However, not all pollen types provide the same resources or have the same biological value. Its chemical composition changes according to botanical origin, geographic location, and environmental conditions. This variability can influence metabolism, the immune system, oxidative balance, and the ability to resist or tolerate infections. This article examines the available evidence on the relationship between pollen chemical quality and the dynamics of Deformed Wing Virus (DWV) infection in Apis mellifera. The analysis is approached from molecular, physiological, ecological, and seasonal perspectives. Current findings suggest that more diverse and higher-quality pollen diets are generally associated with greater colony survival and improved health status, although their effects on viral load are more heterogeneous and context-dependent. In some studies, pollen intake is linked to a reduction in DWV, while in others the viral load remains stable, but bees survive longer or show better health indicators. These differences suggest that pollen may act not only by enhancing resistance to the virus but also by increasing tolerance to infection-associated damage. The potential role of pollen bioactive compounds, particularly flavonoids and phenolic acids, is also discussed. Nevertheless, evidence of direct antiviral action of these compounds in bees remains limited, as many proposed mechanisms derive from other organisms. This synthesis provides an integrative perspective on pollen nutrition and its relevance for colony resilience against viral infections.

Abstract: Transferosomes have emerged as one of the most extensively investigated ultradeformable vesicular systems for drug delivery, particularly for non-invasive administration across biological barriers. Their distinctive architecture, typically composed of phospholipids and edge activators, confers enhanced membrane flexibility compared with conventional liposomes, enabling improved adaptation to restrictive biological environments. Despite the growing body of literature, the field remains characterized by inconsistent terminology, heterogeneity in formulation strategies, and significant variability in characterization methods, which hinder meaningful comparison across studies and limit translational progress. This review provides a critical and integrated analysis of transferosomes, focusing on the relationship between formulation design, vesicle properties, deformability, and biological performance. The structural basis of transferosomes is examined with emphasis on the role of phospholipids, edge activators, and auxiliary components in modulating membrane organization, encapsulation behavior, colloidal stability, and drug release. Key quality attributes, including vesicle size, size distribution, surface charge, morphology, encapsulation efficiency, and physical stability, are discussed together with the main analytical approaches used for their evaluation. Deformability is addressed as the central functional feature of transferosomes, highlighting current experimental methods, sources of variability, and limitations affecting reproducibility and inter-study comparability. The interaction of transferosomes with biological barriers is critically examined, including the ongoing debate regarding intact vesicle penetration versus drug release prior to permeation. Major therapeutic applications are summarized, and transferosomes are positioned in comparison with conventional liposomes, ethosomes, and transethosomes within a context-dependent framework. Finally, key translational challenges are analyzed, including limited standardization, scalability constraints, storage instability, and regulatory uncertainty. In this context, this review establishes a structured framework linking formulation design, deformability, and biological performance, and identifies the critical parameters that must be controlled to enable reproducible, scalable, and clinically relevant transferosome-based drug delivery systems.

Abstract: The major challenge limiting the application of terahertz(THz) technology lies in the significant attenuation of THz waves loss of THz waves during free-space transmission arising from water vapor absorption and gas molecule scattering. Compared with free space propagation, low-loss and stable transmission of THz wave can be achieved through the waveguide. Waveguide transmission at low THz frequencies has attracted considerable attention, particularly at around 300 GHz (0.3 THz). Among the various types of THz waveguides, hollow waveguides offer a simple structure, ease of fabrication, low cost, and excellent transmission performance in the THz regime. Here, we design and fabricate a low-loss THz metal dielectric hollow waveguide based on polypropylene (PP) tubing, where an external silver film coated on the PP tube forms a leaky-type hollow waveguide structure. The linear transmission loss is measured to be 1.35 dB/m at 300 GHz. By optimizing this low-loss THz hollow waveguide, we achieve a far-field THz digital holographic (TDH) imaging recording configuration for the first time. To evaluate the imaging performance, different types of samples are measured. Experimental results for a plastic plate with aluminum strips validate a lateral resolution of ∼2.5 mm. The proposed method holds potential as a powerful tool for investigating spontaneous phenomena in the THz band.

Abstract: Bergamot-derived products have gained increasing interest as dietary supplements in small animal nutrition, due to their potential to improve meat quality, and provide functional bioactive compounds. This paper investigated the effects of feeding dried bergamot pulp on performance and meat quality in Japanese quails. 140 quails aging 15 days were divided into two groups of 70 quail each (7 replicates of 10 quails for group) and fed, for three weeks, a basal diet (control group) or the basal diet in which part of the maize was replaced with 10% of dried bergamot pulp (BP10 group). The integration of dried bergamot pulp (BP) reduced dry matter i ntake, a verage d aily g ain, a nd consequently final body weight compared to control treatment. Quails from BP10 group showed the highest feed conversion ratio. The BP10 treatment tended to increase eicosapentaenoic acid and ω-3 PUFA. The inclusion of bergamot pulp in quail diet did not alter the TBARS value in meat. Color analysis showed that the integration of bergamot into the quail diet led to higher lightness (L*) and yellow index (b*) values compared to the control group. This study demonstrates that dietary supplementation with 10% of BP to quails led to a reduction in dry matter i ntake ( DMI) a nd consequently in average daily gain (ADG) in quails. However, a positive trend toward an increase in ω-3 fatty acids has been observed.

Abstract: Background/Objectives: Probiotic interventions are widely used to improve intestinal health; however, comparative evidence on multi-strain formulations with different po-tencies, particularly when combined with plant-based complexes, remains limited. eval-uated the effects of two probiotic blends containing phytonutrients (PBP1 and PBP2) on bowel function, microbial metabolites, and gut barrier-related markers. Methods: In this randomized, double-blind, placebo-controlled trial, participants received PBP1, PBP2, or placebo for 8 weeks. Stool patterns (7-day Bristol Stool Form Scale (BSFS) diary), fecal short-chain fatty acids (SCFAs), tryptophan metabolites, zonulin, and gut microbiota were assessed at baseline and Week 8. Efficacy was evaluated by comparing each inter-vention group with the placebo group. Results: Both PBP1 and PBP2 significantly in-creased the proportion of normal stool types (BSFS types 3–5) compared with placebo (p < 0.05). Fecal SCFA levels, including acetate, propionate, and butyrate, were significantly increased in both intervention groups. Notably, butyrate levels were significantly ele-vated compared with placebo. Fecal tryptophan levels decreased, while indole metabo-lites showed increasing trends, with an inverse correlation observed between tryptophan and indole, particularly in the PBP2 group. Fecal zonulin showed a decreasing trend, with significant reductions in participants with 25.0≤BMI<30.0 kg/m². Microbiome analysis revealed preserved alpha diversity with selective compositional shifts, including en-richment of Lactobacillus-related taxa. Conclusions: Supplementation with PBP1 and PBP2 improved bowel function and was associated with changes in microbiome-derived metabolites, including SCFAs and tryptophan–indole metabolism, with BMI-dependent changes in barrier markers. These findings suggest a potential role of microbi-ome-mediated metabolic modulation in intestinal health.

Abstract: Human fertility has declined sharply since 1950, and a growing body of evidence suggests that conventional socioeconomic explanations do not fully account for the timing and breadth of this trend. This review examines the Circadian-Light Hygiene hypothesis, which proposes that daily light exposure is a fundamental regulator of reproductive health. We synthesize findings from photobiology, endocrinology, reproductive medicine, and epidemiology to evaluate how artificial light at night, insufficient daytime light, and irregular light-dark patterns may disrupt the hormonal timing systems that support reproduction. The available evidence indicates that such disruption can alter melatonin signaling, circadian gene regulation, and neuroendocrine rhythms, with downstream effects on ovulation, sperm quality, endometriosis, polycystic ovary syndrome, pregnancy outcomes, and developmental programming. Urbanization, screen use, and shift work appear to amplify these effects, while genetic variation may modify individual susceptibility. Although direct causal evidence in humans remains limited for several endpoints, the convergence of observational, experimental, and translational data supports circadian light misalignment as a plausible and potentially modifiable contributor to fertility decline. Optimizing daily light exposure may therefore represent a low-cost and scalable strategy for improving reproductive health.

Abstract: Construction companies, petrochemical companies, and airports are classified as large-scale organizational and technical systems. In organizational and technical system is implemented using hierarchical distributed control systems. To achieve goals, numerous parallel technological operations and business processes are executed, requiring synchronization and consuming significant energy resources. To optimize energy resources at all hierarchical levels, an up-to-date picture of the system state is necessary. This paper proposes constructing a snapshot of the system's state, which allows for an assessment of system performance within selected criteria and the selection of appropriate solutions within the entire control system. Procedures for constructing a snapshot are discussed. An example of optimizing the energy consumption of a control system based on snapshot analysis is provided.

Abstract: This study aims to evaluate multiple feature sets composed of sensor-based biomarkers acquired during walking for the automated estimation of post-stroke motor impairment levels using Fugl-Meyer Lower Extremity Assessment (FMA-LE) derived classes. Sensor-based walking data from the open-source ARRA dataset were combined with data collected at the Hospital of Braga. Data from 32 post-stroke individuals (FMA-LE:24±3) were included. A decision tree classifier was evaluated using stratified 6-fold cross-validation across different feature configurations, including: correlated versus full feature sets; spatiotemporal versus electromyographic (EMG) features; inclusion of demographic variables; and the use of data augmentation. The best performance was achieved using correlated EMG features combined with age, paretic side, and body mass, along with noise-based data augmentation, yielding a validation MCC of 0.85±0.16 and a test MCC of 0.70. EMG features provided improved classification performance compared to spatiotemporal features, and comparable results were obtained using a reduced subset of muscles. These results demonstrate the feasibility of using EMG-based features acquired during walking to classify post-stroke motor impairment levels. Feature reduction and inclusion of demographic variables may support efficient model design, while data augmentation may enhance generalization. Further validation in larger and more diverse datasets is required to assess robustness and clinical applicability.

Abstract: Background/Objectives: African Swine Fever (ASF) represents one of the most serious threats to animal health and global food security. The causative agent of ASF is the African swine fever virus (ASFV), a DNA virus belonging to the Asfarviridae family. Here, we describe ex vivo results for an original anti-ASFV vaccine approach based on the cellular immune response induced by extracellular vesicles (EVs) engineered to express four ASFV antigens. EV engineering was achieved by expressing a DNA vector encoding a biologically inactive HIV-1 Nef protein (Nef^mut), which exhibits unusually high efficiency of incorporation into EVs, even when fused to foreign proteins. Previous studies have demonstrated that intramuscular injection of Nef^mut-based vectors leads to the engineering of EVs spontaneously released by muscle cells and induction of antigen-specific CD8⁺ T cell immunity. Methods: We designed DNA vectors expressing the fusion products between Nef^mut and each of the four ASFV structural proteins p³⁰, p⁵⁴, pp⁶², and p⁷². Engineered EVs were molecularly characterized by western blot and nanotrack analysis, and their potential immunogenicity was assessed by priming and cross-presentation assays. Results: We assessed that the four antigens were successfully expressed in transfected mammalian cells, with the release of valuable amounts of engineered EVs. When immature swine dendritic cells were challenged with the engineered EVs and then co-cultivated with autologous peripheral blood lymphocytes in priming assays, lymphocyte subpopulations specifically reacting against each ASFV antigen were elicited, as detected by an IFN-γ ELISpot assay. In addition, we provide evidence that the Nef^mut-based fusion products incorporated into the engineered EVs can be cross-presented by professional antigen-presenting cells, leading to cross-priming of autologous lymphocytes. Conclusions: These results represent the best premise to go forward with experiments of immunogenicity and antiviral efficiency in pigs.

Abstract: Robo-advisors have expanded access to automated investment services, but many platforms continue to rely on relatively static onboarding procedures and limited forms of user interaction. This study examines how participants with investment experience respond to two next-generation robo-advisory design features: financial digital twins, understood as dynamic investor profiles that integrate goals, risk tolerance, cash-flow patterns, and anticipated life events, and conversational artificial intelligence (AI), understood as an interactive interface for explaining recommendations. Using a scenario-based randomized 2 × 2 online experiment, 336 adult respondents with self-reported investment experience, recruited through professional and academic networks, were assigned to one of four robo-advisor scenarios that varied the personalization architecture, standard versus digital twin, and the interface style, plain dashboard versus conversational AI, while holding the portfolio recommendation constant. The results show that digital-twin personalization increases perceived personalization and privacy concern, indicating that more adaptive advisory architectures may be viewed as both more relevant and more data-intensive. Conversational AI increases the perceived interactive quality of the advisory experience, while the clearest adoption-related patterns emerge when it is combined with digital-twin personalization, particularly for selected indicators of stated behavioral willingness. Given the limited internal consistency of several secondary composite measures, the findings are best interpreted as evidence of scenario-based investor responses rather than as validated evidence of actual adoption behavior or confirmed psychological mechanisms. The study contributes to behavioral FinTech research by clarifying the personalization-privacy tension in AI-enabled robo-advisory services and by offering design implications for more transparent, interactive, and responsibly personalized digital wealth management systems.

Abstract: Background/Objective: Vitamin K (VK) comprises a family of quinone compounds with potential involvement in cell death-related pathways through their redox properties. However, consistent findings have not been obtained regarding the clinical significance of VK in breast cancer (BC). Thus, we used the FDA Adverse Event Reporting System (FAERS) to examine the co-reporting patterns of BC-related adverse-event terms among VK-related reports. Methods: Reporting disproportionality analysis was conducted using FAERS data spanning the first quarter of 2004 to the third quarter of 2024. BC-related reports were defined using all valid Preferred Terms included in the relevant narrow-scope Standardized MedDRA Query (SMQ). Reporting odds ratios (RORs) and proportional reporting ratios were calculated for all VK types and each homolog, followed by exploratory comparisons with other compounds containing quinone structures. Results: In total, 32,156 VK-related reports were identified, including 136 BC-related reports. VK-related reports showed significantly lower reporting disproportionality for breast cancer-related reports (ROR = 0.486, 95% confidence interval = 0.411–0.575). In homolog-specific analyses, similar trends were observed for the quinone-type homologs phytomenadione, menatetrenone, and menadione, whereas no significant reporting disproportionality was detected for the hydroquinone-type homolog menadiol. Conclusions: The differences in reporting patterns among quinone-type VK homologs, hydroquinone-type VK, and other quinone-containing compounds suggest that differences in redox properties may be partially related to the structure of reporting disproportionality. Although this study did not demonstrate causality or clinical efficacy, it provides a hypothesis-generating basis for linking basic, epidemiological, and clinical research using FAERS data. Future validation through mechanistic research and analytical epidemiological studies with stricter control of confounding is warranted.

Abstract: Organizational resilience has become a strategic priority for firms facing environmental, economic, and institutional disruptions, particularly in emerging economies where access to financial and technological resources remains limited. This study examined the influence of organizational psychological resources on sustainable business resilience through the mediating role of green innovation in formalized firms in northern Peru. A quantitative, cross-sectional, and explanatory design was applied to data from 130 firms, each represented by a manager or coordinator. The model included three latent constructs: organizational psychological resources, green innovation, and sustainable business resilience, measured through 27 Likert-scale indicators. Data were analyzed using covariance-based structural equation modeling with the WLSMV estimator in lavaan. The results showed strong measurement quality, with standardized loadings between 0.898 and 0.988, Cronbach’s alpha values from 0.985 to 0.990, composite reliability above 0.992, and AVE above 0.929. The structural model showed satisfactory fit and confirmed that organizational psychological resources positively influenced green innovation, while green innovation positively influenced sustainable business resilience. The indirect effect was significant, indicating partial mediation. The findings suggest that psychological well-being, work engagement, and empowerment constitute key internal resources for transforming green innovation into sustainable resilience.

Abstract: The unprecedented rate of technological advances, accelerated industry disruptions and social and environmental sustainability crises are requiring very different business organizations from the traditional paradigm. The main research question for this paper is: What change (paradigm shift) is needed for organizations to be future-fit? The aim is to contribute an integrated, transdisciplinary paradigmatic model of an emerging, progressive future business organization, and an understanding of the paradigm shift required in our socially constructed reality for organizations to be future-fit. A methodology based on complexity theory and a transdisciplinary approach was developed and applied. The researcher’s transdisciplinary conceptualization of a ‘paradigm’, focusing on language-based representations, serves as the foundation. Textual analyses, including corpus linguistics, of practitioner-focused literature were used to elicit concept maps (or domain models) of the shared, societal mental models of a business organization for two periods: (1) the Traditional Business Organization, and (2) a Progressive Future Business Organization. The outcomes were compared using a novel qualitative method, resulting in a set of societal level ontological shifts required for progressive future business organizations. The study shows a paradigm shift to complexity and social responsibility, and the need for transdisciplinarity to reflect complex, integrated organizational realities.

Abstract: Background/Objectives: Following the market authorization of innovative medicinal products, continuous monitoring of safety signals is essential to ensure a favorable benefit–risk balance. This is particularly relevant for biological therapies used in oncology, where complex mechanisms of action and patient-related risk factors may contribute to rare but serious adverse events. The objective of this paper is to describe and critically evaluate the internal pharmacovigilance processes applied by a pharmaceutical company in response to a potential post-marketing safety signal of stroke associated with a newly authorized biological medicinal product for colorectal cancer. Methods: A structured signal management approach was applied in line with international regulatory guidance. The evaluation included detailed clinical assessment of reported post-marketing cases, review of safety data from completed and ongoing clinical trials, epidemiological comparison with background stroke incidence, assessment of potential risk factors, and review of the pharmacological and biological plausibility. Additional data sources, including scientific literature, safety databases, and periodic safety reports, were systematically reviewed. Multidisciplinary collaboration among pharmacovigilance, medical, and regulatory teams supported the assessment and regulatory interactions. Results: The cumulative evidence did not allow confirmation of a definitive causal relationship between the medicinal product and stroke but identified the event as a potential safety signal requiring close monitoring. The assessment supported the preparation of an evidence-based company position and informed discussions with regulatory authorities, including the European Medicines Agency. Conclusions: This case illustrates the practical implementation of structured signal management in the post-marketing setting. Timely evaluation, interdisciplinary coordination, and regulatory engagement are essential to ensure patient safety, maintain regulatory compliance, and support informed benefit–risk decision-making for innovative biological medicinal products.

Abstract: The intensification of the ecosocial crisis has revealed the structural limitations of economic paradigms based on growth. In this context, degrowth emerges as a transformative framework that proposes the deliberate reduction of production and consumption, prioritizing well-being, equity, and ecological sustainability. However, the role of education in the transition toward post-growth societies remains insufficiently developed. This article analyzes how formal educational systems reproduce growth-oriented subjectivities through human capital frameworks and neoliberal governance. Based on a critical review of the literature and a conceptual analysis, both the structural limitations of the dominant educational model and the emergence of alternative pedagogies grounded in sufficiency, care, and the commons are identified. This article proposes a reorientation of educational aims, contents and practices favouring ecosocial literacy and collective agency, with implications for educational policy and systemic transformation.

Abstract: Prior authorization in the United States relies on payer coverage policies expressed as unstructured narrative text, creating fundamental barriers to automation, consistency, and auditability. Large language model (LLM) approaches to policy interpretation suffer from hallucination, nondeterminism, and clinically unsafe outputs—we argue these failures stem not from model capability but from a representation problem: policies written for human interpretation are not inherently computable. We introduce policy computability: the representation of coverage policies in machine-interpretable forms that support deterministic execution, formal verification, provenance tracking, and reproducible reasoning. To operationalize this concept, we present a six-layer neuro-symbolic framework that transforms payer policy documents into executable policy artifacts. Neural components are constrained to language-processing tasks—document ingestion, ontology normalization, and structured rule extraction under symbolic guardrails—while all coverage determinations are executed by a symbolic verification engine using deterministic logical evaluation. The framework incorporates ontology mapping, rule-graph construction, a Python-embedded domain-specific language (DSL), logical conflict resolution, and provenance-aware reasoning traces. We validate the symbolic pipeline using a lumbar fusion prior authorization policy across six synthetic clinical scenarios, demonstrating reproducible coverage determinations with complete reasoning traces. In a preliminary evaluation of the neural extraction layer, Llama 3.2 3B achieved 100% recall on inclusion and exclusion criteria from a narrative policy document across three trials, though extraction quality depended on prompt formulation. Comparative analysis of two representative payer policies reveals clinically meaningful variation—including greater than twofold differences in required conservative therapy duration—highlighting the need for structured policy representations. This work establishes a pathway from narrative payer policies toward deterministic, transparent, and machine-executable coverage systems, providing a foundation for trustworthy automation in prior authorization.

Abstract: Background: This study evaluated the use of circulation time (Tcirc) calculated from polysomnogram (PSG) with pulse oximetry to identify poor cardiac function with low left ventricular ejection fraction (EF). Methods: Subjects over 18 years with sleep apnea (apnea-hypopnea index (AHI) >5/hr) diagnosed by PSG who had transthoracic echocardiography (TTE) within 1 year of PSG were included in this retrospective study. Tcirc of each sleep stage (N2, N3, and REM) were measured and averaged and EF was recorded. Statistical analysis was done using Wilcoxon rank sum test, logistic regression and Youden index. Results: There were 89 sub-jects who met inclusion criteria, 14 with EF ≤45% (Group A) and 75 with EF ≥ 50% (Group B). All 14 Group A subjects had prolonged overall Tcirc with a median time of 27.8 seconds (range 14.1 - 39.6 sec), compared to Group B subjects with median Tcirc of 23.5 seconds (range 14.3 – 37.6 sec), p = 0.311. The op-timal cut-point for overall sleep Tcirc with moderate discrimination (AUC = 0.6) was 28.6 sec. Those with to-tal sleep Tcirc > 28.6 sec were 2.5 x more likely to have low EF with OR =2.56 (95% CI, 0.55-11.16). Con-clusions: In sleep apnea patients, total sleep Tcirc > 28.6 seconds is associated with low ejection fraction with specificity = 0.78.