Clinical Study on Long-Term Sinus Reversion Rate and Left Atrial Function Recovery of Mitral Valve Disease with Atrial Fibrillation under Modified Surgical Radiofrequency Ablation

We aimed to study the long-term sinus reversion rate and recovery of left atrial function after modified surgical radiofrequency ablation for permanent atrial fibrillation caused by mitral valve disease. From March 2014 to May 2020, 35 patients who underwent modified surgical radiofrequency ablation during cardiac valve surgery in our hospital were selected as the study group, and 25 normal individuals without cardiac structural changes were selected as the control group. The time of modified surgical radiofrequency ablation and long-term sinus reversion rate were measured, and left atrial anteroposterior, superoinferior, left and right diameters, left atrial ejection fraction, left atrial filling index, and left atrial ejection force were measured before and 6 months after surgery. The mean ablation time was 23.2 min, and the long-term sinus reversion rate was 80.0%. The left atrium diameter decreased and the left atrium ejection fraction increased after the operation ( P < 0.05 ). The left atrium filling index and ejection force were significantly increased in 28 patients with sinus reversion ( P < 0.05 ). The decrease in left atrial diameter and the increase in left atrial ejection fraction were correlated with sinus conversion after surgery ( P < 0.05 ). The modified operation is simple, the curative effect is definite, and the sinus reversion rate is high, which is beneficial to the restoration of left atrial structure, ejection function, and hemodynamic function.

The efficacy of synchronized direct current shock in reverting long standing persistent atrial fibrillation in to sinus rhythm. What help to achieve high success rate?

Background: Atrial fibrillation is the most frequent cardiac arrhythmia encountered in general medicine and cardiology practice. Synchronized direct current shock is a known safe and effective procedure to revert long standing persistent atrial fibrillation into sinus rhythm. Patients and Methods: Patients with long-standing atrial fibrillation who were seen at the author’s private clinic and Al-Hassani Heart Center in Sulaimanya from April 2018 to December 2020 were chosen for rhythm control subjected to synchronized direct current cardioversion under heavy sedation applying a modified anterolateral paddles position with 200J and 300J successively according to the reversion dose required. Objectives: The Objective of current study was to assess the efficacy of synchronized direct current shock in reverting long-standing persistent atrial fibrillation into sinus rhythm and recognizing factors that help in achieving high success rate. Results: In this case series study 61 patients were included thirty-one males 30 females The success rate was 89%. Even patients with atrial fibrillation duration more than 2 years showed a success rate of 84%. The recurrence rate of atrial fibrillation was 30% within a follow up period of one month to 2 years. The modified paddles position has helped in achieving high reversion rate where success increased from 62% to 85% and failure rate decreased from 38% to 15%. The shock dose needed for reversion ranged from 200J to 300 J. There was no correlation between the needed dose for reversion and body weight where patients with body weight of 71-80kg, more than 80% reverted with 200J. Pre shock antiarrhythmic drugs did not facilitate the conversion, the reversion rate in patients with or without antiarrhythmic drugs were 85% and 82% successively. No per procedure complications were seen. Conclusion: Electrical cardioversion of atrial fibrillation with modified paddles position is a safe, effective and smooth procedure with significantly high success rate and very low incidence of complications even with very long-standing atrial fibrillation.

The impact of DNA adenine methyltransferase knockout on the development of triclosan resistance and antibiotic cross-resistance in Escherichia coli

Background. DNA adenine methyltransferase (dam) has been well documented for its role in regulation of replication, mismatch repair and transposition. Recent studies have also suggested a role for dam in protection against antibiotic stress, although this is not yet fully defined. We therefore evaluated the role of dam in the development of antibiotic resistance and triclosan-associated cross-resistance. Results. A significant impact on growth rate was seen in the dam knockout compared to the parental strain. Known triclosan resistance-associated mutations in fabI were seen regardless of dam status, with an additional mutation in lrhA seen in the dam knockout. The expression of multiple antibiotic resistance-associated genes was significantly different between the parent and dam knockout post-resistance induction. Reversion rate assays showed that resistance mechanisms were stable. Conclusions. dam knockout had a significant effect on growth, but its role in the development of antibiotic resistance is likely confined to those antibiotics using acrAD-containing efflux pumps.

Factor Analysis of Metabolic Syndrome in Aged Population Undergoing Periodical Health Examinations

Background: Metabolic syndrome (MetS) is a common health problem in aged people. The cluster of diseases associated with MetS, namely, heart disease, cerebrovascular disease, diabetes, hypertensive disease and renal disease, had made a death rate of 0.17%, higher than 0.15% attributed to cancers.Aims: To investigate the prevalence, incidence and reversion rate of MetS in Aged population undergoing periodical health examinations, as well as the associated impact factors.Results: The prevalence of MetS was found to be 19.9% among all the subjects studied, to be higher in female (23.1%) than in male (18.3%). The incidence of MetS was 17.6%. In contrast, the reversion rate of MetS was 45.0%. Sex (p = 0.045) and history of hyperlipidemia (p = 0.006) were two factors found to be significantly associated with the reversion rate of MetS.Conclusion: Physical examinations may help early detect diseases and revise high risk factors timely. Compared with the ordinary older population, those undergoing periodical health examinations tended to have lower incidence of MetS, better health status and higher disease reversion rate than incidence. To sum up, individualized health education and guidance is an imperative and critical nursing intervention to ensure a healthy state for aged population.

Forecasting of the Nigeria Stock Returns Volatility Using GARCH Models with Structural Breaks

This study examines the stock returns series using Symmetric and Asymmetric GARCH models with structural breaks in the presence of some varying distribution assumptions. Volatility models of Symmetric GARCH (1,1), Asymmetric Power GARCH (1,1) and GJR-GARCH(1,1) models were considered in estimating and measuring shock persistence, leverage effects and mean reversion rate with structural breaks considering dummy variable for these structural changes and varying distributions . The skewed student-t distribution is considered best distribution for the models; moreover findings showed the high persistence of shock in returns series for the estimated models. However, when structural breaks were incorporated in the estimated models by including dummy variable in the conditional variance equations of all the models, there was significant reduction of shock persistence parameter and mean reversion rate. The study found the GJR-GARCH (1,1) with skewed student-t distribution best fit the series. The volatility was forecasted for 12 months period using GJR-GARCH (1,1) model and the values are compared with the actual values and the results indicates a continuous increase in unconditional variance.

Effects of Peanut Consumption on Cardiometabolic Risk Factors in a Chinese Population: A Randomized, Controlled Trial (P08-041-19)

Objectives To determine the effect of peanut consumption, as part of the diet on cardiometabolic risk factors and Metabolic Syndrome (MetS) in a Chinese population at risk for developing type 2 diabetes. Methods We recruited 224 participants (men and women, ages 46 ± 10 y, BMI 28.0 ± 3.1 kg/m2) with central obesity plus at least one additional MetS risk factor. In this randomized, parallel-arm, controlled study, participants were supplemented with either lightly salted peanuts, 2oz (56 g) per day or a calorie-matched control snack (refined grains) for 12 weeks. Peanuts and control snacks were consumed between meals. Anthropometric and metabolic measurements were assessed at baseline, week 6 and week 12. We used paired Student's t-tests to examine within-treatment differences and multivariable linear regression for between-treatment differences with the models adjusted for age, sex and baseline BMI (with the exception of analysis on waist circumference [WC], body weight and BMI). Multivariate logistic regression was used to calculate the reversion rate of MetS. Results The peanut group and the control group had similar energy intake (peanut: 1872 ± 433 kcal, control: 1906 ± 400 kcal). There were no differences observed between the two groups on WC, body weight, and BMI. Compared to baseline, the peanut group had small but significant reductions in WC (–0.88 ± 0.32 cm, P = 0.006), body weight (–0.41 ± 0.16 kg, P = 0.01), and BMI (–0.14 ± 0.06 kg/m2, P = 0.01) at week 12. Both groups decreased fasting glucose levels (peanut: 0.32 ± 0.06 mmol/L, P < 0.001; control: 0.28 ± 0.05 mmol/L, P < 0.001) and increased HDL-C levels (peanut: 0.05 ± 0.02 mmol/L, P = 0.001; control: 0.05 ± 0.02 mmol/L, P = 0.002) after 12 weeks. The peanut group decreased triglycerides by −0.34 ± 0.13 mmol/L (P = 0.009) at week 6. There were no effects on LDL-C, total cholesterol or blood pressure. The peanut group had a greater reversion rate of MetS compared to the control group at week 6 (31.7% vs. 17.9%, P = 0.04, Figure 1), which attenuated at week 12 (P = 0.10). Conclusions Adding 2oz of peanuts per day to the diet for 12 weeks did not promote weight gain among Chinese adults at risk for type 2 diabetes. Consumption of peanuts may help ameliorate MetS, suggesting that peanuts may be a healthful snack option relative to refined grains. Funding Sources This study was supported by the Chinese Academy of Sciences (Grant/Award Number: KJZD-EW-G20-02), and an in kind donation from the Peanut Institute. The finding source had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Supporting Tables, Images and/or Graphs

SPEED OF MEAN REVERSION: AN EMPIRICAL ANALYSIS OF KSE, LSE AND ISE INDICES

The purpose of this study is to determine the presence of mean reversion in the stock markets indices of Pakistan, moreover, to measure, and compare the speed of mean reversion of the stock markets indices across Pakistan. In order to carry out the research study, the daily data of three stock indices of Pakistan such as: KSE-100, LSE-25 and ISE-10 are collected from 2003 to 2014. After the application of tests such as ARCH and GARCH, it was found that returns series of KSE-100, LSE-25 and ISE-10 indices exhibit mean reversion, indicating that the returns revert back to their historical value after reaching an extreme value. Further, the mean reversion rate shows that KSE-100 index has the slowest mean reversion, however, the ISE-10 index has the fastest mean reversion among the three indices. Therefore, the results of the study concluded that KSE-100 index, due to the slowest mean reversion rate has higher volatility over a longer period of time. On the contrary, since, ISE-10 index has exhibited the fastest mean reversion with the lowest volatility as compared to others. But due to fast mean reversion rate, it will help investors to gain profits over a shorter period of time. Thus, it can be recommended that the investor willing to bear the risk of time and looking for long-term investment should invest in KSE-100 index. However, investors looking for higher profits in a shorter period can invest in the ISE-10 index but with higher risk-returns trade-off.