A Principal Component Analysis Control Chart Method for Catenary Status Evaluation and Diagnosis

To make accurate and comprehensive evaluation of the catenary and diagnose the causes of the catenary fault, a method of catenary state evaluation and diagnosis based on the principal component analysis control chart was proposed, which can make full use of the multidimensional detection parameters of the catenary. The principal component analysis was used to reduce the dimension of catenary parameters, the principal component T2 control chart was calculated to show the change of principal component of catenary state data, the residual SPE control chart was calculated to show the change of their correlation, and the contribution rate control chart was calculated to show the cause of abnormal state data. The method can not only transform the multidimensional detection parameters of the catenary into a statistic to realize the simple and intuitive evaluation of the catenary state but also can accurately determine the cause of the abnormal state, so as to provide technical support for the targeted condition-based maintenance of the catenary.

Popeye Domain-Containing Protein 1 Scaffolds a Complex of Adenylyl Cyclase 9 and the Two-Pore-Domain Potassium Channel TREK-1 in Heart

The establishment of macromolecular complexes by scaffolding proteins such as A-kinase anchoring proteins is key to the local production of cAMP by anchored adenylyl cyclase (AC) and the subsequent cAMP signaling necessary for many cardiac functions. We have identified herein a novel AC scaffold, the Popeye domain-containing (POPDC) protein. Unlike other AC scaffolding proteins, POPDC1 binds cAMP with high affinity. The POPDC family of proteins are important for cardiac pacemaking and conduction, due in part to their cAMP-dependent binding and regulation of TREK-1 potassium channels. TREK-1 binds the AC9:POPDC1 complex and co-purifies in a POPDC1-dependent manner with AC9-associated activity in heart. Although the interaction of AC9 and POPDC1 is cAMP independent, TREK-1 association with AC9 and POPDC1 is reduced in an isoproterenol-dependent manner, requiring an intact cAMP binding Popeye domain and AC activity within the complex. We show that deletion of Adcy9 (AC9) gives rise to bradycardia at rest and stress-induced heart rate variability. The phenotype for deletion of Adcy9 is milder than previously observed upon loss of Popdc1, but similar to loss of Kcnk2 (TREK-1). Thus, POPDC1 represents a novel scaffolding protein for AC9 to regulate heart rate control.

Management of Adults with Newly Diagnosed Atrial Fibrillation With and Without Chronic Kidney Disease

Background: Atrial fibrillation (AF) is highly prevalent in chronic kidney disease (CKD) and is associated with worse cardiovascular and kidney outcomes. Limited data exist on use of AF pharmacotherapies and AF-related procedures by CKD status. We examined a large "real-world" contemporary population of incident AF to study the association of CKD with management of AF. Methods: We identified patients with newly diagnosed AF between 2010-2017 from two large, integrated healthcare delivery systems. Estimated glomerular filtration rate (eGFR) (≥60, 45-59, 30-44, 15-29, <15 ml/min/1.73 m2) was calculated from a minimum of two ambulatory serum creatinine measures separated by ≥90 days. AF medications and procedures were identified from electronic health records. We performed multivariable Fine-Gray subdistribution hazards regression to test the association of CKD severity with receipt of targeted AF therapies. Results: Among 115,564 incident AF patients, 34% had baseline CKD. In multivariable models, compared to those with eGFR>60 ml/min/1.73 m2, patients with eGFR 30-44 (adjusted hazard ratio [aHR] 0.91, 95%CI:0.99-0.93), 15-29 (aHR 0.78, 95%CI:0.75-0.82) and <15 ml/min/1.73 m2 (HR 0.64, 95%CI:0.58-0.70) had lower use of any AF therapy. Patients with eGFR 15-29 ml/min/1.73 m2 had lower adjusted use of rate control agents (aHR 0.61, 95%CI:0.56-0.67), warfarin (aHR 0.89, 95%CI:0.84-0.94) and DOACs (aHR 0.23, 95% CI:0.19-0.27) compared to patients with eGFR>60 ml/min/1.73 m2. These associations were even stronger for eGFR <15 ml/min/1.73 m2. There was also a graded association between CKD severity and receipt of AF-related procedures (vs. eGFR>60 ml/min/1.73 m2): eGFR 30-44 ml/min/1.73 (aHR 0.78, 95%CI:0.70-0.87), eGFR 15-29 ml/min/1.73 m2 (aHR 0.73, 95%CI:0.61-0.88) and eGFR<15 ml/min/1.73 m2 (aHR 0.48, 95%CI:0.31-0.74). Conclusions: In adults with newly diagnosed AF, CKD severity was associated with lower receipt of rate control agents, anticoagulation and AF procedures. Additional data on efficacy and safety of AF therapies in CKD populations are needed to inform management strategies.

Comparative Effectiveness of Early Rhythm Control Versus Rate Control for Cardiovascular Outcomes in Patients With Atrial Fibrillation

Background Rhythm control is associated with better cardiovascular outcomes than usual care among patients with recently diagnosed atrial fibrillation (AF). This study investigated the effects of rhythm control compared with rate control on the incidence of stroke, heart failure, myocardial infarction, and cardiovascular death stratified by timing of treatment initiation. Methods and Results We conducted a retrospective population‐based cohort study including 22 635 patients with AF newly treated with rhythm control (antiarrhythmic drugs or ablation) or rate control in 2011 to 2015 from the Korean National Health Insurance Service database. Propensity overlap weighting was used. Compared with rate control, rhythm control initiated within 1 year of AF diagnosis decreased the risk of stroke. The point estimates for rhythm control initiated at selected time points after AF diagnosis are as follows: 6 months (hazard ratio [HR], 0.76; 95% CI, 0.66–0.87), 1 year (HR, 0.78; 95% CI, 0.66–0.93), and 5 years (HR, 1.00; 95% CI, 0.45–2.24). The initiation of rhythm control within 6 months of AF diagnosis reduced the risk of hospitalization for heart failure: 6 months (HR, 0.84; 95% CI, 0.74–0.95), 1 year (HR, 0.96; 95% CI, 0.82–1.13), and 5 years (HR, 2.88; 95% CI, 1.34–6.17). The risks of myocardial infarction and cardiovascular death did not differ between rhythm and rate control regardless of treatment timing. Conclusions Early initiation of rhythm control was associated with a lower risk of stroke and heart failure–related admission than rate control in patients with recently diagnosed AF. The effects were attenuated as initiating the rhythm control treatment later.

A novel Confidential Consortium Blockchain framework for peer to peer energy trading

The vital dependence of peer to peer (P2P) energy trading frameworks on creative Internet of Things (IoT) has been making it more vulnerable against a wide scope of attacks and performance bottlenecks like low throughput, high latency, high CPU, memory use, etc. This hence compromises the energy exchanging information to store, share, oversee, and access. Blockchain innovation as a feasible solution, works with the rule of untrusted members. To alleviate this threat and performance issues, this paper presents a Blockchain based Confidential Consortium (CoCo) P2P energy trading system that works on the trust issues among the energy exchanging networks and limits performance parameters. It reduces the duplicate validation by creating a trusted network on nodes, where participants identities are known and controlled. A Java-script-based smart contract is sent over the Microsoft CoCo system with Proof of Elapsed Time (PoET) consensus protocol. Also, a functional model is designed for the proposed framework and the performance bench-marking has been done considering about latency, throughput, transaction rate control, success and fail transaction, CPU and memory usage, network traffic. Additionally, it is shown that PoET’s performance is superior to proof of work (PoW) for multi-hosting conditions. The measured throughput and latency moving toward database speeds with more flexible, business-specific confidentiality models, network policy management through distributed governance, support for non-deterministic transactions, and reduced energy consumption.