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Gender differences,outcomes and trends among nonagenarian with atrial fibrillation:insight from National Inpatient Sample database

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Journal of Geriatric Cardiology 2021年第2期18卷 114-122页

作者： Dinesh Voruganti Ghanshyam Shantha Sushma Dugyala Alexander Bolton Ala Mohsen Subodh Devabhaktuni Hakan Paydak jawahar l mehta Division of Cardiovascular Medicine University of Arkansas for Medical SciencesArkansasUSA Division of Cardiovascular Medicine Wake Forest Medical CenterNorth CarolinaUSA Division of Internal Medicine University of AlabamaAlabamaUSA Department of Internal Medicine Unity Point HealthIowaUSA Division of Cardiovascular Medicine Louisiana State UniversityLouisianaUSA

BACKGROUND Nonagenarians(NG),individuals aged≥90 years,constitute an increasing proportion of hospitalizations presenting with atrial fibrillation(AF).However,not much is known about demographics,clinical outcomes,and trends of hospitalizations.Therefore,we analyzed data about hospitalizations and clinical outcomes among NGs with AF over ten years from 2005 to 2014 using a publically available database,the National Inpatient Sample.METHODS All hospitalizations and major outcomes of subjects≥90 years with a primary diagnosis of AF(ICD-9-CM code 427.31)over a ten-year period were assessed in this study by multivariate logistic regression analysis.RESUlTS There were more females than males(176,268 females,51,384 males)in this analysis.The number of hospitalizations for AF among NG increased by 50%(17,295 in 2005 to 25,830 in 2014).Males were more likely to undergo cardioversion(6.14%of males vs.5.06%of females,Pl mortality declined from 3.21%in 2005 to 2.38%in 2014(P=0.0041),with higher in-hospital mortality in males(3.23%in males vs.2.76%in females,P=0.0138),mean length of hospitalization decreased from 4.53 days to 4.13 days(Plence of congestive heart failure fell from 0.48%to 0.23%(P=0.0257),and the use of anticoagulation increased from 6.09%to 14.54%(Pltivariate analysis,hospital admission on the weekend,Elixhauser comorbidity index,CHA2DS2VASc score,acute respiratory failure,and the length of hospital stay were associated with a higher risk of in-hospital mortality.CONClUSIONS From 2005 to 2014,AF-related hospitalizations among NGs increased,more so in in females population,mortality trends improved,rates of anticoagulation increased,and cardioversions increased.Despite the decreasing trend of in-hospital mortality since 2005,the relatively high mortality rate in males warrants further studies.

关键词： mortality fibrillation analysis.

噻唑烷二酮类胰岛素增敏药和lOX-1对心脏成纤维细胞功能的调节作用(英文)

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中南大学学报（医学版） 2011年第10期36卷 939-948页

作者：陈家伟胡长平 jawahar l.mehta Gene Therapy Program Division of Cardiovascular MedicineUniversity of Arkansas for Medical Sciences and VA Medical CenterAR 72205USA 复旦大学附属肿瘤医院麻醉科中南大学药学院药理学系

心脏成纤维细胞在心脏重构中起重要作用。在各种促纤维化因素(如前炎症因子、缺氧-复氧、压力超负荷、衰老)刺激下,心脏成纤维细胞增殖、迁移、激活,导致细胞基质成分的积聚、心脏肥厚和僵硬。过氧化物酶增殖体激活受体γ(PPAR-γ)的配... 详细信息

心脏成纤维细胞在心脏重构中起重要作用。在各种促纤维化因素(如前炎症因子、缺氧-复氧、压力超负荷、衰老)刺激下,心脏成纤维细胞增殖、迁移、激活,导致细胞基质成分的积聚、心脏肥厚和僵硬。过氧化物酶增殖体激活受体γ(PPAR-γ)的配体,特别是噻唑烷二酮类胰岛素增敏药,在病理条件下可调节心脏成纤维细胞的功能以及心脏重构的发展,然而未发现噻唑烷二酮类胰岛素增敏药对心脏衰竭的有益作用。噻唑烷二酮类胰岛素增敏药调节心脏成纤维细胞功能和心脏重构的确切信号通路未完全阐明,现有证据提示涉及氧化应激及相关信号途径。此外,PPAR-γ和植物凝集素样氧化型低密度脂蛋白受体-1(lOX-1)在其中起重要作用。

关键词：心脏成纤维细胞噻唑烷二酮类胰岛素增敏药植物凝集素样氧化型低密度脂蛋白受体-1 过氧化物酶增殖体激活受体γ

Mitochondrial Autophagy and NlRP3 Inflammasome in Pulmonary Tissues from Severe Combined Immunodeficient Mice after Cardiac Arrest and Cardiopulmonary Resuscitation

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Chinese Medical Journal 2018年第10期131卷 1174-1184页

作者： Jing-Jun lyu jawahar l mehta Yi li lu Ye Sheng-Nan Sun Hong-Shuang Sun Jia-Chang li Dong-Mei Zhang Jie Wei Department of Emergency Renmin Hospital o1 Wuhan University Wuhan Hubei 430060 China Department of Medicine Central Arkansas Veterans Healthcare System University of Arkansas for Medical Sciences Little Rock AR 72205 USA Department of Emergency Peking Union Medical College Hospital Beijing 100032 China

Background：The incidence of cancer,diabetes,and autoimmune diseases has been increasing.Furthermore,there are more and more patients with solid organ transplants.The survival rate of these immunocompromised individuals is extremely low when they are severely hit-on.In this study,we established cardiac arrest cardiopulmonary resuscitation （CPR） model in severe combined immunodeficient （SCID） mice,analyzed the expression and activation of mitochondrial autophagy and NlRP3 inflammasome/caspase-1,and explored mitochondrial repair and inflammatory injury in immunodeficiency individual during systemic ischemia-reperfusion injury.Methods：A potassium chloride-induced cardiac arrest model was established in C57Bl/6 and nonobese diabetic/SCID （NOD/SCID） mice.One hundred male C57Bl/6 mice and 100 male NOD/SCID mice were randomly divided into five groups （control,2 h post-CPR,12 h post-CPR,24 h post-CPR,and 48 h post-CPR）.A temporal dynamic view of alveolar epithelial cells,macrophages,and neutrophils from bronchoalveolar lavage fluid （BAlF） was obtained using Giemsa staining.Spatial characterization ofphenotypic analysis of macrophages in the lung interstitial tissue was analyzed by flow cytometry.The morphological changes ofmitochondria 48 h after CPR were studied by transmission electron microscopy and quantified according to the Flameng grading system.Western blotting analysis was used to detect the expression and activation of the markers of mitochondrial autophagy,NlRP3 inflammasome,and caspase-1.Results：（1） In NOD/SCID mice,macrophages were disintegrated in BAlF,and many alveolar epithelial cells were shed at 48 h after resuscitation.Compared with C57Bl/6 mice,the ratio of macrophages/total cells peaked at 12 h and was significantly higher in NOD/SCID mice （31.17 ± 4.13 vs.49.69 ± 2.43,t =14.46,P =0.001）.After 24 h,the results showed a downward trend.Furthermore,a large number of macrophages were disintegrated in the BAlF.（2） Mitochondrial autophagy was present in both C57Bl/6 and NOD/SCID mice after CPR,but it began

关键词： Autophagy Cardiopulmonary Resuscitation Immunodeficiency Macrophage Mitochondria NlRP3 Inftammasome

Aspirin resistance: Fact or fiction? A point of view

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World Journal of Cardiology 2010年第9期2卷 280-288页

作者： jawahar l mehta Bhavna Mohandas Division of Cardiovascular Medicine University of Arkansas for Medical Sciences and VA Medical Center Little Rock AR 72205 United States

Aspirin is a wonder drug that has been used for well over 100 years for its analgesic and antipyretic effects. For the past three decades, it has increasingly been used for the prevention of primary and secondary cardiovascular events. lately, it has been suggested that a significant number of individuals taking aspirin have become resistant to this drug. The phenomenon of "aspirin resistance" is based on the observation of clinical events in some patients taking aspirin, and/or a diminished platelet aggregation inhibitory response to aspirin therapy. Unfortunately, laboratory assays used to monitor the efficacy of aspirin are far from accurate and the results are not reproducible. Furthermore, results of different platelet function tests are often not congruent. In addition, platelet aggregation studies show marked interindividual and intra-individual variability. Patients with coronary heart disease take many drugs that interfere with the effect of aspirin on platelet aggregation. Besides inhibiting formation of thromboxane A2 from arachidonic acid, aspirin has a host of platelet-independent effects that complement its platelet inhibitory effects. laboratory assays designed to measure platelet function do not take into account these pleiotropic effects of aspirin. In our view, use of the term "aspirin resistance" based on inadequate knowledge of imperfect laboratory tests does a disservice to physicians and patients.

关键词： Aspirin Cardiovascular diseases Drug resistance Treatment outcome

Role of genomics in cardiovascular medicine

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World Journal of Cardiology 2010年第12期2卷 428-436页

作者： Giuseppe Novelli Irene M Predazzi Ruggiero Mango Francesco Romeo jawahar l mehta Department of Biopathology and Diagnostic Imaging Section of Medical Genetics School of MedicineTor Vergata University Department of Internal Medicine University of Arkansas for Medical Sciences Centro Neurolesi"Bonino Pulejo" 98100 Messina Italy Department of Internal Medicine University of Rome Tor Vergata

As all branches of science grow and new experimental techniques become readily accessible,our knowledge of medicine is likely to increase exponentially in the coming years.Recently developed technologies have revolutionized our analytical capacities,leading to vast knowledge of many genes or genomic regions involved in the pathogenesis of congenital heart diseases,which are often associated with other genetic syndromes,coronary artery disease and non-ischemic cardiomyopathies and channelopathies.The knowledge-base of the genesis of cardiovascular diseases is likely going to be further revolutionized in this new era of genomic medicine.Here,we review the advances that have been made over the last several years in this field and discuss different genetic mechanisms that have been shown to underlie a variety of cardiovascular diseases.

关键词： Genomics Polymorphisms Mutations Complex diseases Atherosclerosis

凝集素样氧化低密度脂蛋白受体清除调节系统和局部炎症反应以减弱急性心肌缺血诱导的肾损伤（英文）

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凝集素样氧化低密度脂蛋白受体清除调节系统和局部炎症反应以减弱...

E-voting system using cloud-based hybrid blockchain technology

《中华急诊医学杂志》第十一届组稿会暨第四届急诊医学青年...

作者：吕菁君魏捷 Wang Xianwei jawahar l.mehta 武汉大学人民医院急诊科 Central Arkansas Veterans Healthcare System University of Arkansas for Medical Sciences Departments of Internal Medicine and Pathology Cardiovascular DivisionUniversity of Arkansas for Medical Sciences

ObjectiveTo It is assumed,but never proven,that acute myocardial infarction affects renal function.We tested this phenomenon in mice subjected to left coronary artery(lCA)ligation.Further,we tested the hypothesis that lOX-1 abrogation may inhibit systemic inflammation,collagen accumulation and attenuate renal dysfunction following lCA occlusion.Methods Wild-type(WT)and lOX-1 KO.mice were subjected to permanent lCA ligation resulting in extensive myocardial infarction.Cardiac function was analyzed by echocardiography on Day 3 and on Day 21 post-surgery.Renal function and morphology were assessed at the same time points.The pro-inflammatory signals and markers of fibrosis were measured in the serum and kidney.ResultsSoon after lCA ligation,there was a marked in rise in proinflammatory cytokines and MDA levels in circulation in the WT mice.On Day 3,renal function assessment showed a marked decline in association with swelling of gomeruli and tubules and mild fibrosis(PlCA ligation).There was a significant increase in the expression lOX-1,Il-1βand VCAM-1,TBARS levels,and markers of fibrosis(collagenⅣand procollagen-Ⅰ)in the kidney.On Day 21,renal function showed some recovery,but there was extensive fibrosis in the kidneys accompanied with worse lV function.lOX-1 KO mice subjected to total lCA ligation showed much less increase in systemic and renal pro-inflammatory cytokines and MDA levels,and much less structural alterations and functional decline than the WT mice(all Pl rate were better in the lOX-1 KO mice than in the WT mice(PlusionsWe demonstrate for the first time that severe myocardial ischemia results in renal dysfunction and histologic abnormalities reminiscent of acute renal injury.lOX-1 deletion by reducing pro-inflammatory and pro-oxidant signals results in significantly less renal abnormality and dysfunction.This study suggests that lOX-1 is a key modulator among the multiple mechanisms underlying cardio-renal syndrome.

关键词： lOX-1 inflammation myocardium infarction renal function

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Journal of Safety Science and Resilience 2024年第1期5卷 102-109页

作者： Beulah Jayakumari S lilly Sheeba Maya Eapen Jani Anbarasi Vinayakumar Ravi A.Suganya Malathy jawahar Department of Information Technology Tagore Engineering College Chennai India School of Computer Science and Engineering SRM Institute of Science and Technology Ramapuram ChennaiIndia Department of Information Technology Jerusalem College of Engineering ChennaiIndia School of Computer Science and Engineering Vellore Institute of Technology Chennai India Center for Artificial Intelligence Prince Mohammad Bin Fahd UniversityKhobarSaudi Arabia leather Process Technology Division CSIR-Central leather Research Institute ChennaiIndia

With the invention of Internet-enabled devices,cloud and blockchain-based technologies,an online voting system can smoothly carry out election processes.During pandemic situations,citizens tend to develop panic about mass gatherings,which may influence the decrease in the number of votes.This urges a reliable,flexible,transparent,secure,and cost-effective voting system.The proposed online voting system using cloud-based hybrid blockchain technology eradicates the flaws that persist in the existing voting system,and it is carried out in three phases:the registration phase,vote casting phase and vote counting phase.A timestamp-based authentication protocol with digital signature validates voters and candidates during the registration and vote casting phases.Using smart contracts,third-party interventions are eliminated,and the transactions are secured in the blockchain network.Finally,to provide accurate voting results,the practical Byzantine fault tolerance(PBFT)consensus mechanism is adopted to ensure that the vote has not been modified or corrupted.Hence,the overall performance of the proposed system is significantly better than that of the existing system.Further performance was analyzed based on authentication delay,vote alteration,response time,and latency.

关键词： E-voting Cloud Blockchain Smart contract Consensus mechanism

High linear Voltage Gain in QZNC Through Synchronizing Switching Circuits

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Intelligent Automation & Soft Computing 2023年第4期36卷 895-910页

作者： S.Harika R.Seyezhai A.jawahar Department of EEE REC LabSSN College of EngineeringChennai603110Tamil NaduIndia Department of ECE SSN College of EngineeringChennai603110Tamil NaduIndia

The solar powered systems require high step-up converter for efﬁcient energy transfer.For this,quasi-impedance network converter has been introduced.The quasi-impedance network converter(QZNC)is of two types:type-1 and type-2 conﬁguration.Both the type-1 and type-2 QZNC conﬁgurations have drooping voltage gain proﬁle due to presence of high switching noise.To overcome this,a new quasi-impedance network converter synchronizing the switching circuit with low frequency noise has been proposed.In this paper,the proposed QZNC con-ﬁguration utilizes the current controlling diode to prevent the output voltage drop.Thus,the suggested topology provides linear high voltage gain proﬁle,low load voltage ripple,and reduced impedance network stress and device stress.There-fore,the efﬁciency of proposed QZNC has been improved.The topology descrip-tion,working principle,parameter design and comparison with traditional converters are illustrated.Andﬁnally,both simulation and practical results are presented to conﬁrm the converter characteristics and performance.From the results,it has been found that the performance of the suggested topology is better as it achieves a higher efﬁciency of 81%and hence,it is suitable for high power applications.

关键词： Quasi impedance network converter(QZNC) voltage ripple network stress device stress and efﬁciency

Analysis of vibration signal responses on pre induced tunnel defects in friction stir welding using wavelet transform and empirical mode decomposition

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Defence Technology（防务技术） 2019年第6期15卷 885-896页

作者： J.Rabi T.Balusamy R.Raj jawahar Vinayaka Mission’s Kirupananda Variyar Engineering College SalemIndia Department of Mechanical Engineering Government College of EngineeringSalemIndia Department of Mechanical Engineering Dynamech Design SolutionsChennaiIndia

Among many condition-monitoring systems in welding operation,Defect identification is an important method to ensure the precision in finishing operation.Friction stir welding is a solid state welding process used to join two metals without the use of electrode at lower temperatures.The aim of this present work is to identify and localize the tunnel defect in aluminum alloy and measure the distance of the defect zone in the time domain of the vibration signal during Friction stir welding.The vibration signals are captured from the experiments and the burst in the vibration signal is focused in the analysis.A signal-processing scheme is proposed to filter the noise and to measure the dimensional parameters of the defect area.The proposed technique consists of discrete wavelet transform(DWT),which is used to decompose the signal.The enveloping technique is applied on the decomposed zero padded signal.The continuous wavelet transform(CWT) has been implemented on detailed signal followed by a time marginal integration(TMI) of the CWT scalogram.Empirical mode decomposition(EMD) is used to replace the detailing coefficients from DWT with Intrinsic Mode Function(IMF).Statistical parameters such as mean,kurtosis,S.D and crest factor have been extracted from the final filtered signal for validating the defect welds from the control defect free welds.Results produced were found to be that kurtosis is 7.4402 for tunnel defect induced weld and 3.3862 for defect free welds.As the increase in kurtosis value predicts the defect zone impact in the signal.The measurement of the defect zone of the cut 1(voids) and cut 2(tunnel grooves) in correlation with the processed signal is found to produce a much redundant results with an error rate of 0.02.

关键词： welding friction alloy