Atrial fibrillation (AF) is the most common cardiac arrhythmia. Patients with AF have up to seven-fold higher risk of suffering from ischemic stroke. Better understanding of etiologies of AF and its thromboembolic complications are required for improved patient care, as current anti-arrhythmic therapies have limited efficacy and off target effects. Accumulating evidence has implicated a potential role of oxidative stress in the pathogenesis of AF. Excessive production of reactive oxygen species (ROS) is likely involved in the structural and electrical remodeling of the heart, contributing to fibrosis and thrombosis. In particular, NADPH oxidase (NOX) has emerged as a potential enzymatic source for ROS production in AF based on growing evidence from clinical and animal studies. Indeed, NOX can be activated by known upstream triggers of AF such as angiotensin II and atrial stretch. In addition, treatments such as Statins, antioxidants, ACEI or AT1RB have been shown to prevent post-operative AF; among which ACEI/AT1RB and Statins can attenuate NOX activity. On the other hand, detailed molecular mechanisms by which specific NOX isoform(s) are involved in the pathogenesis of AF and the extent to which activation of NOX plays a causal role in AF development remains to be determined. The current review discusses causes and consequences of oxidative stress in AF with a special focus on the emerging role of NOX pathways.

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Background:This meta-analysis aimed to evaluate the efficiency and safety of the combined adductor canal block (ACB) with local infiltration anesthesia (LIA) versus LIA alone for pain control after total knee arthroplasty (TKA).Methods:We searched PubMed, Medline, Embase, Web of Science, the Cochrane Library and Google databases from inception to August 2017 to selected studies that comparing the combined ACB with LIA and LIA alone for pain control after TKA. Only randomized controlled trials (RCTs) were included. Outcomes included visual analogue scale (VAS) with rest or mobilization at 8 h, 24 h and 48 h, total morphine consumption at 6 h, 24 h and 48 h, distance walked at 24 h and 48 h and the length of hospital stay.Results:Seven randomized controlled trial (RCTs) were finally included in this meta-analysis. The present meta-analysis indicated that, compared with LIA alone, combined ACB with LIA was associated with a reduction of VAS with rest at 24 h and 48 h and VAS with mobilization at 24 h. Additionally, combined ACB with LIA was associated with an increase of the distance walked at 24 h and a reduction of the length of hospital stay.Conclusion:Combined ACB with LIA could significantly reduce pain scores and morphine consumption compared LIA alone after TKA. Further multimodal large sample RCTs are needed to identify the optimal drug of ACB and LIA.

Transit offers stop-to-stop services rather than door-to-door services. The trip from a transit hub to the final destination is often entitled as the “last-mile” trip. This study innovatively proposes a hybrid approach by combining the data mining technique and multiple attribute decision making to identify the optimal travel mode for last-mile, in which the data mining technique is applied in order to objectively determine the weights. Four last-mile travel modes, including walking, bike-sharing, community bus, and on-demand ride-sharing service, are ranked based upon three evaluation criteria: travel time, monetary cost, and environmental performance. The selection of last-mile trip modes in Chengdu, China, is taken as a typical case example, to demonstrate the application of the proposed approach. Results show that the optimal travel mode highly varies by the distance of the “last-mile” and that bike-sharing serves as the optimal travel mode if the last-mile distance is no more than 3 km, whilst the community bus becomes the optimal mode if the distance equals 4 and 5 km. It is expected that this study offers an evidence-based approach to help select the reasonable last-mile travel mode and provides insights into developing a sustainable urban transport system.