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The endoplasmic reticulum (ER) is responsible for protein synthesis and calcium storage. ER stress, reflected by protein unfolding and calcium handling abnormalities, has been studied as a pathogenic factor in cardiovascular diseases. The aim of this study is to examine the effects of ER stress on mechanical and electrophysiological functions in the heart and explore the underlying molecular mechanisms. A total of 30 rats were randomly divided into control, ER stress inducer (tunicamycin[TN]) and ER stress inhibitor (tunicamycin+4‐phenylbutyric acid [4‐PBA]) groups. ER stress induction led to significantly systolic and diastolic dysfunction as reflected by maximal increasing/decreasing rate of left intraventricular pressure (±dp/dt), left ventricular peaksystolic pressure(LVSP) and LV end‐diastolic pressure(LVEDP). Epicardial mapping performed in vivo revealed reduced conduction velocity and increased conduction heterogeneity associated with the development of spontaneous ventricular tachycardia. Masson's trichrome staining revealed marked fibrosis in the myocardial interstitial and sub‐pericardial regions, and thickened epicardium. Western blot analysis revealed increased pro‐fibrotic factor transforming growth factor‐β1 (TGF‐β1), decreased mitochondrial biogenesis protein peroxlsome proliferator‐activated receptor‐γ coactlvator‐1α （PGC‐1a）, and decreased mitochondrial fusion protein mitofusin‐2 (MFN2). These changes were associated with mitochondria dysfunction and connexin 43(CX43)translocation to mitochondria. These abnormalities can be partially prevented by the ER stress inhibitor 4‐PBA. Our study shows that ER stress induction can produce cardiac electrical and mechanism dysfunction as well as structural remodelling. Mitochondrial function alterations are contributed by CX43 transposition to mitochondria. These abnormalities can be partially prevented by the ER stress inhibitor 4‐PBA. [ABSTRACT FROM AUTHOR]

Aims: Previous trials on the effectiveness of genotype‐guided warfarin dosing vs. conventional dosing have been inconclusive. We conducted a systematic review and meta‐analysis of randomized trials comparing genotype‐guided to conventional dosing strategies. Methods: PubMed and the Cochrane Library were searched up to 23 October 2017. Results: A total of 76 and 94 entries were retrieved were retrieved from PubMed and the Cochrane Library, respectively. A total of 2626 subjects in the genotype‐guided dosing (mean age 63.3 ± 5.8 years; 46% male) and 2604 subjects in the conventional dosing (mean age 64.7 ± 6.1 years; 46% male) groups (mean follow‐up duration 64 days) from 18 trials were included. Compared with conventional dosing, genotype‐guided dosing significantly shortened the time to first therapeutic international normalized ratio (INR) (mean difference 2.6 days, standard error 0.3 days; P < 0.0001; I2 0%) and time to first stable INR (mean difference 5.9 days, standard error 2.0 days; P < 0.01; I2 94%). Genotype‐guided dosing also increased the time in therapeutic range (mean difference 3.1%, standard error 1.2%; P < 0.01; I2 80%) and reduced the risks of both excessive anticoagulation, defined as INR ≥4 [risk ratio (RR) 0.87; 95% confidence interval (CI) 0.78, 0.98; P < 0.05; I2: 0%), and bleeding (RR 0.82; 95% CI 0.69, 0.98; P < 0.05; I2 31%). No difference in thromboembolism (RR 0.84; 95% CI 0.56, 1.26; P = 0.40; I2 0%) or mortality (RR 1.16; 95% CI 0.46, 2.91; P = 0.76; I2 0%) was observed between the two groups. Conclusions: Genotype‐guided warfarin dosing offers better safety with less bleeding compared with conventional dosing strategies. No significant benefit on thromboembolism or mortality was evident. [ABSTRACT FROM AUTHOR]

Abstract: Background: Corrected QT interval (QTc) on the electrocardiogram is a marker of ventricular repolarization. Recent studies have examined its value in predicting the occurrence of atrial fibrillation (AF). Methods and results: We conducted a meta‐analysis to determine whether alterations in QTc interval are associated with an increased risk of incident AF. The PUBMED and EMBASE databases were searched for all studies that evaluated the incident AF associated with prolonged QTc interval published before December 2016. Sensitivity and subgroup analysis were subsequently performed. A total of six studies including eight data sets for prolonged QTc interval were eligible. Subjects with prolonged QTc interval as a categorical variable had a significantly higher risk of AF during follow‐up (hazard ratio [HR]: 1.16; 95% confidence interval [CI], 1.09–1.24, I2 = 90%) based on Bazett formula. In continuous variable analysis, we found a statistically significant risk for AF (HR, 1.17; 95% CI, 1.09–1.25; I2 = 0) every 10‐ms prolongation in QTc. AF type, QTc cut‐off value, geographical location, follow‐up duration, and study population may be the possible reasons for the significant heterogeneity among the studies. Conclusions: Prolonged QTc interval is associated with an increased risk of AF. And the potential mechanisms underlying this cause‐and‐effect relationship need further investigation. [ABSTRACT FROM AUTHOR]

The recovery of spent lithium-ion batteries and the treatment of phenol wastewater are both environmental and social issues. In this study, the enhanced recovery of spent lithium-ion batteries and the efficient treatment of phenol wastewater are smartly coupled via a "treating waste with waste" strategy. Under optimal conditions, the leaching process involving phenol achieves 98% and 96% efficiency for Co and Li, respectively. After precipitation, Co and Li could be recovered as Co(OH) 2 and Li 2 CO 3 , and the precipitated Co(OH) 2 was further calcined to generate Co 3 O 4. Furthermore, the organic contaminants that remained in the waste-leaching solution could be removed by a spent graphite-activating peroxymonosulfate (PMS) process. It is noteworthy that the total organic carbon (TOC) in the waste-leaching solution could be removed using fewer PMS compared with the original phenol wastewater owing to the pre-oxidation of phenol during the leaching process, further confirming the advantage of this "treating waste with waste" strategy. Herein, enhanced recovery of valuable metals from spent lithium-ion batteries and efficient treatment of phenol-wastewater are smartly coupled with a 'treating waste with waste' strategy. [Display omitted] • Phenol wastewater is used to enhance the recovery of valuable metals from spent cathode material. • Li and Co have maximum leaching efficiencies of 98% and 96%, respectively. • The organic residues in the waste solution are removed more efficiently by the spent graphite activating PMS process. [ABSTRACT FROM AUTHOR]

Background Frailty has been identified as a risk factor for adverse clinical outcomes after cardiac intervention or surgery. However, whether it increases the risk of adverse outcomes in patients undergoing left ventricular assist device (LVAD) therapy has been controversial. Therefore, we conducted a systematic review and meta-analysis of the frailty measures and clinical outcomes of length of stay and mortality in this setting. Methods PubMed and Embase were searched until September 11, 2017, for studies evaluating the association between frailty and clinical outcomes in advanced heart failure patients undergoing LVAD implantation. Results A total of 46 and 79 entries were retrieved from our search strategy. A total of 13 studies involving 3435 patients were included in the final meta-analysis (mean age: 57.7 ± 15.3 years; 79% male, follow-up duration was 13 ± 14 months). Compared to nonfrail patients (n = 2721), frail patients (n = 579) had significantly longer time-to-extubation (n = 3; mean difference: 45 ± 6 hours; I 2 : 0%) and hospital length of stay (n = 4; mean difference: 2.9 ± 1.2 days; P = .001; I 2 : 21%). Frailty was not a predictor of inpatient or short-term mortality [n = 3; hazard ratio (HR): 1.22, 95% confidence interval (CI): 0.66-2.26; P > .05; I 2 : 0%] but predicted long-term mortality (n = 7; HR: 1.44, 95% CI: 1.15-1.80; P = .001; I 2 : 0%). Conclusions Frailty leads to significantly longer time to extubation, hospital length of stay, and long-term mortality in advanced heart failure patients who have undergone LVAD implantation. Older patients being considered for LVAD implantation should therefore be assessed for frailty status. The risk and benefit of the procedure should be explained to the patient, emphasizing that frailty increases the likelihood of adverse clinical outcomes. [ABSTRACT FROM AUTHOR]

Background Frailty has been identified as a risk factor for mortality. However, whether frailty increases mortality risk in patients undergoing percutaneous coronary intervention (PCI) has been controversial. Therefore, we conducted a systematic review and meta-analysis of the frailty measures and mortality outcomes in this setting. Methods PubMed and EMBASE were searched until July 23, 2017 for studies evaluating the association between frailty measures and mortality in individuals who have undergone PCI. Results A total of 141 entries were retrieved from our search strategy. A total of 8 studies involving 2332 patients were included in the final meta-analysis (mean age: 69 years; 68% male, follow-up duration was 30 ± 28 months). Frailty was a significant predictor of all-cause mortality after PCI, with a hazard ratio (HR) of 2.97 [95% confidence interval (CI) 1.56–5.66, P = .001]. This was substantial heterogeneity present ( I 2 : 79%). Subgroup analysis using the Fried score reduced I 2 to 68% without altering the pooled HR (2.78, 95% CI 1.02–7.76; P < .05). Using the Canadian Study of Health and Aging Clinical Frailty Scale reduced I 2 to 0% while preserving the pooled HR (5.99, 95% CI 2.77–12.95, P < .001). Conclusions Frailty leads to significantly higher mortality rates in patients who have undergone PCI. Both the Fried score and Canadian Study of Health and Aging Clinical Frailty Scale are powerful predictors of mortality. These findings may support the notion that an alternative to invasive strategy should be considered in frail patients who are indicated for revascularization. [ABSTRACT FROM AUTHOR]

The persistence of maladaptive heroin‐associated memory, which is triggered by drug‐related stimuli that remind the individual of the drug's pleasurable and rewarding effects, can impede abstinence efforts. Cyclin‐dependent kinase 5 (Cdk5), a neuronal serine/threonine protein kinase that plays a role in multiple neuronal functions, has been demonstrated to be involved in drug addiction and learning and memory. Here, we aimed to investigate the role of cdk5 activity in the basolateral amygdala (BLA) in relapse to heroin seeking, using a self‐administration rat model. Male rats underwent 10 days of heroin self‐administration training, during which an active nose poke resulted in an intravenous infusion of heroin that was accompanied by a cue. The rats then underwent nose poke extinction for 10 days, followed by subsequent tests of heroin‐seeking behaviour. We found that intra‐BLA infusion of β‐butyrolactone (100 ng/side), a Cdk5 inhibitor, administered 5 min after reactivation, led to a subsequent decrease in heroin‐seeking behaviour. Further experiments demonstrated that the effects of β‐butyrolactone are dependent on reactivated memories, temporal‐specific and long‐lasting on relapse of heroin‐associated memory. Results provide suggestive evidence that the activity of Cdk5 in BLA is critical for heroin‐associated memory and that the specific inhibitor, β‐butyrolactone, may hold potential as a substance for the treatment of heroin abuse. [ABSTRACT FROM AUTHOR]

Background and objectives Inter-atrial block (IAB) is characterized by a delay of inter-atrial conduction and is defined electrocardiographically by a P-wave duration (PWD) > 120 ms. Several studies have implicated IAB in the development of new onset atrial fibrillation (AF), whereas others have reported no significant associations. Moreover, there has been no systematic evaluation of the predictive value of IAB in AF recurrence. Therefore, we conducted a systematic review and meta-analysis to examine whether IAB predicts new onset AF or AF recurrence. Methods PubMed and Embase databases were searched through 30th July 2017 for studies investigating the relationship between IAB and AF. Results The initial search identified 260 studies, of which 16 studies met the inclusion criteria. This meta-analysis included 18,204 patients (mean age 56 ± 13, 48% male) with a mean follow-up period of 15.1 years. IAB significantly predicted new onset AF (hazard ratio [HR]: 2.42, 95% confidence interval [CI]: 1.44 to 4.07, P = 0.001; 84%). For partial IAB, the risk of new onset AF did not reach statistical significance (HR: 1.42, 95% CI: 0.85 to 2.34; P = 0.18; I 2 = 13%). Contrastingly, advanced IAB was a significant predictor of new onset AF with a pooled HR of 2.58 (95% CI: 1.35 to 4.96; P < 0.01; I 2 = 67%). IAB also predicted AF recurrence after ablation (HR: 2.59, 95% CI: 1.35 to 4.96; P < 0.01; I 2 = 67%). Conclusions IAB is a significant predictor of both new onset AF and AF recurrence. [ABSTRACT FROM AUTHOR]

This paper aims to investigate the impact of space weather on China's electricity market. Based on data products provided by NOAA and the National Energy Administration in China, this paper uses solar wind velocity as a solar weather indicator and the disturbance storm time index as a magnetospheric weather indicator to match monthly Chinese electricity market data over 10 years. Based on a VAR model, we found that (1) space weather increases the demand for electricity in China, and solar wind speed and the geomagnetic index increase the electricity consumption of the whole of Chinese society, as space weather mainly increases the electricity consumption of the secondary and industrial sectors. (2) The geomagnetic index significantly promotes power station revenue. (3) Space weather is associated with increased energy consumption. The geomagnetic index significantly increases the coal consumption rate of fossil power plants in China, but the solar wind speed has nothing to do with the coal consumption rate of fossil power plants. [ABSTRACT FROM AUTHOR]

Abstract Objective Frailty is a known risk factor for adverse outcomes after cardiac interventions. However, the extent to which it increases the likelihood of adverse outcomes in heart failure (HF) patients remains unexplored. Therefore, we conducted this systematic review and meta-analysis to quantify the impact of frailty on prognosis in this patient population. Design Meta-analysis. Setting and Participants PubMed and Embase were searched for studies that investigated the relationship between frailty and outcomes in patients with HF. The search period was from the beginning of the databases through to December 3, 2017. Measures A total of 342 and 919 entries were retrieved from PubMed and Embase, respectively. Of these, 20 met our inclusion criteria and were therefore included. Results Frailty significantly increased the risk of all-cause mortality [hazard ratio (HR) = 1.59, 95% confidence interval (CI) = 1.39-1.82, P <.0001, I2 = 55%] and hospitalizations (HR = 1.31, 95% CI = 1.21-1.42, P <.0001, I2 = 0%). Moreover, it was predictive of all-cause mortality after ventricular assist device implantation for advanced HF (HR = 1.62, 95% CI = 1.35-1.94, P <.0001, I2 = 2%). Conclusions/Implications: Frailty is a significant predictor of all-cause mortality and hospital readmissions in HF. Assessment and close monitoring of frailty status of heart failure patients can potentially better guide clinical management of this population. [ABSTRACT FROM AUTHOR]

Background. Use of amiodarone (AMIO) in atrial fibrillation (AF) has significant side effects over prolonged periods. Wenxin Keli (WXKL), a Chinese herb extract, has been shown to be effective in atrial-selective inhibiting peak INa and hence beneficial in treating atrial arrhythmias, including atrial fibrillation. The aim of this randomized controlled trial was to evaluate potential effects of AMIO plus WXKL on conversion rate and time in patients with recent-onset AF. Methods. A total of 41 patients (71 ± 12 years, 44% male) with recent-onset (<48 h) AF eligible for conversion were randomized to receive either intravenous amiodarone (loading dose 5 mg/kg in 1 hour followed by 50 mg/h; n=21) or amiodarone with same dosage plus oral WXKL 18 g thrice daily (n=20) for 24 hours. Results. Conversion rate at 24 hours was of no difference between the two groups (75.0% vs. 81.0%, P=0.72); however, conversion time was markedly shorter in the AMIO + WXKL group compared to the AMIO group (291 ± 235 minutes vs. 725 ± 475 minutes, P=0.003). There were no serious adverse events during the study. Conclusion. Administration of amiodarone plus WXKL for recent-onset AF conversion was safe and effective, with faster sinus rhythm restoration compared with amiodarone alone. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus is an important risk factor for atrial fibrillation (AF) development. Sodium–glucose co-transporter-2 (SGLT-2) inhibitors are used for the treatment of type 2 diabetes mellitus (T2DM). Their cardioprotective effects have been reported but whether they prevent AF in T2DM patients are less well-explored. We tested the hypothesis that the SGLT-2 inhibitor, empagliflozin, can prevent atrial remodeling in a diabetic rat model. Methods: High-fat diet and low-dose streptozotocin (STZ) treatment were used to induce T2DM. A total of 96 rats were randomized into the following four groups: (i) control (ii) T2DM, (iii) low-dose empagliflozin (10 mg/kg/day)/T2DM; and (iv) high-dose empagliflozin (30 mg/kg/day)/T2DM by the intragastric route for 8 weeks. Results: Compared with the control group, left atrial diameter, interstitial fibrosis and the incidence of AF inducibility were significantly increased in the DM group. Moreover, atrial mitochondrial respiratory function, mitochondrial membrane potential, and mitochondrial biogenesis were impaired. Empagliflozin treatment significantly prevented the development of these abnormalities in DM rats, likely via the peroxisome proliferator-activated receptor-c coactivator 1α (PGC-1α)/nuclear respiratory factor-1 (NRF-1)/mitochondrial transcription factor A (Tfam) signaling pathway. Conclusions: Empagliflozin can ameliorate atrial structural and electrical remodeling as well as improve mitochondrial function and mitochondrial biogenesis in T2DM, hence may be potentially used in the prevention of T2DM-related atrial fibrillation. [ABSTRACT FROM AUTHOR]