Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Retrieving sub-pixel land cover composition through an effective integration of the spatial, spectral and temporal dimensions of MERIS imagery

A computer code (acronym 5S) has been developed that allows estimation of the solar radiation backscattered by the Earth-surface-atmosphere system, as it is observed by a satellite sensor. Given the Lambertian ground reflectance, the apparent reflectance of the observed pixel is estimated by taking into account the effects of gaseous absorption, scattering by molecules and aerosols and, to some extent, inhomogeneity in the ground reflectance. The input parameters (observation geometry, atmosphere model, ground reflectance and spectral band) can be either selected from some proposed standard conditions (e.g. spectral bands of a satellite sensor) or user-defined. Besides the pixel apparent reflectance, the code provides the gaseous transmittance, the irradiance at the surface and the different contributions to the satellite signal according to the origin of the measured radiance. Some complementary results are also available; among others, benchmark calculations permit assessment of the code accuracy

Retrieving sub-pixel land cover composition through an effective integration of the spatial, spectral and temporal dimensions of MERIS imagery

A computer code (acronym 5S) has been developed that allows estimation of the solar radiation backscattered by the Earth-surface-atmosphere system, as it is observed by a satellite sensor. Given the Lambertian ground reflectance, the apparent reflectance of the observed pixel is estimated by taking into account the effects of gaseous absorption, scattering by molecules and aerosols and, to some extent, inhomogeneity in the ground reflectance. The input parameters (observation geometry, atmosphere model, ground reflectance and spectral band) can be either selected from some proposed standard conditions (e.g. spectral bands of a satellite sensor) or user-defined. Besides the pixel apparent reflectance, the code provides the gaseous transmittance, the irradiance at the surface and the different contributions to the satellite signal according to the origin of the measured radiance. Some complementary results are also available; among others, benchmark calculations permit assessment of the code accuracy

Horisontaalisten ja vertikaalisten liiketoimintamallien ristiriita: Käsitteellinen malli avaintekijöiden analysointiin

In highly turbulent business environment of the 21 sf century one of the widely used term is and has been horizontal business models and horizontalisation in contrast to vertical business models. There is a definite obscurity in used terms and also a conflict of opinions when which kind of operational structure should be pursued. Mobile telecommunication device industry is one of the industries that are possibly facing the process of horizontalisation like some other industries, for example computer industry, has already gone through. In the era of fierce competition and breath-taking development of technology, processes and available services decisive measures should be pursued but this cannot be done blindfold. This thesis studies the concepts of key parameters that contribute to viability of strategic choices on mixed business models based on the contemporary literature. From literature definitions of relevant basic concepts are extracted and some theories of industry evolution are introduced. Based on identified general building blocks of business environment three different independent horizontal models and drivers as well as drawbacks of vertical integration for a manufacturing company are identified and discussed. From these ingredients a conceptual framework of horizontal and vertical business is sketched. The framework divides parameters under four main topics: Technology issues, Organisational fit and agility, Size of business and State of the industry. In order to validate the developed conceptual framework a business case of a completely different industry is presented and superficially analysed. The mobile telecommunication device industry is introduced and also compared to computer industry in the search of similarities or differences. Mobile telecommunication device industry is reflected against developed conceptual framework to find how the near future of the industry may look.Liiketoimintaympäristön nopean muuttumisen mukana 2000-luvun alussa usein käytettyjä termejä ovat horisontalisoituminen ja horisontaalit liiketoimintamallit vastakohtana vertikaaleille liiketoimintamalleille. Nämä termit ovat kaikkea muuta kuin yksiselitteisiä ja aiheuttavat helposti sekaannuksia. Mielipide-eroja on myös siitä millaisissa olosuhteissa tulisi muuttaa yrityksen toimintamallia jompaankumpaan suuntaan, enemmän horisontaaliksi tai vertikaaliksi. Matkapuhelinala on yksi niistä aloista, jotka ovat suurella todennäköisyydellä lähiaikoina kohtaamassa horisontalisoitumisen haasteet. Tämä on jo tapahtunut esimerkiksi tietokoneteollisuudessa. Tässä työssä tarkastellaan kirjallisuuteen perustuen käsitteellisellä tasolla niitä avaintekijöitä, jotka osaltaan vaikuttavat strategisten valintojen tekemiseen ja toteuttamiskelpoisuuteen käsiteltäessä liiketoimintamalleja, joissa sekoittuvat horisontaali- ja vertikaalimallit. Kirjallisuuteen nojautuen esitellään aiheeseen oleellisesti liittyvien peruskäsitteiden määritelmiä ja teollisuuden kehittymistä kuvaavia teorioita. Näihin tukeutuen työssä löydettiin ja tarkastellaan kolmea erilaista tapaa kuvata horisontaali liiketoimintamalli sekä yleinen vertikaalinen integraatio keskittyen näiden etuihin ja varjopuoliin korkean teknologian kappaletavaratuotannon silmin. Tähän tarkasteluun pohjautuen hahmotellaan käsitteellinen malli horisontaalisten ja vertikaalisten liiketoimintamallien analysointiin. Malli jakaantuu neljään osaan: teknologiasta riippuvaiset tekijät, organisaation soveltuvuus, toimialan koko ja toimialan yleinen tila. Mallin yleistettävyyttä tarkastellaan esittelemällä ja analysoimalla täysin eri liiketoimialalta löytyvä case. Työssä esitellään matkapuhelinala ja tätä verrataan tietokoneteollisuuteen etsittäessä yhdistäviä tekijöitä. Kehitettyä käsitteellistä mallia verrataan käsittelyssä olevaan alaan arvioitaessa miltä alan lähitulevaisuus saattaisi näyttää

Aspectos psicosomáticos implicados en las lesiones deportivas

El objetivo del presente estudio fue evaluar la influencia de un conjunto de variables físicas y psicológicas como la ansiedad, el estado de ánimo y el apoyo social en la ocurrencia de lesiones deportivas. Formaron parte de la investigación un total de 48 participantes, todas chicas, practicantes de balonmano. El procedimiento consistió en la cumplimentación de cuatro cuestionarios (SCAI-2R, POMS, STAI-E/R y Cuestionario de Apoyo Social) y un instrumento diseñado para la ocasión (el “autorregistro de lesiones deportivas”), con el fin de evaluar un conjunto de variables, registradas por parte de las deportistas, a lo largo de toda la temporada (Noviembre de 2010 a Mayo de 2011). Se realizó un análisis de “regresión logística por pasos” para conocer la capacidad explicativa de un conjunto de variables predictoras de lesión. Los resultados indicaron una predicción del 88,89% de las variables seleccionadas. Asimismo cuando se analizaron sólo tres variables psicológicas (ansiedad/rasgo, apoyo social y ansiedad competitiva) mediante análisis de regresión por pasos, los resultados mostraron una capacidad predictiva del 75,51%. Sería de interés el desarrollo de nuevas investigaciones para confirmar los resultados obtenidos en el presente estudi

Validation of a standardized method for enumerating circulating endothelial cells and progenitors: flow cytometry and molecular and ultrastructural analyses

Purpose: Antigenic overlap among circulating endothelial cells (CEC) and progenitors (CEP), platelets, and other blood cells led to the need to develop a reliable standardized method for CEC and CEP quantification. These cells are emerging as promising preclinical/clinical tools to define optimal biological doses of antiangiogenic therapies and to help stratify patients in clinical trials. Experimental Design: We report the experimental validation of a novel flow cytometry method that precisely dissects CEC/CEP from platelets and other cell populations and provides information about CEC/CEP viability. Results: Sorted DNA/Syto16 +CD45 -CD31 +CD146 + CECs, investigated by electron microscopy, were found to be bona fide endothelial cells by the presence of Weibel-Palade bodies. More than 75% of the circulating mRNAs of the endothelial-specific gene, VE-cadherin, found in the blood were present in the sorted population. CECs were 140 \ub1 171/mL in healthy subjects (n = 37) and 951 \ub1 1,876/mL in cancer patients (n - 78; P \uab 0.0001). The fraction of apoptotic/necrotic CECs was 77 \ub1 14% in healthy subjects and 43 \ub1 23% in cancer patients (P \uab 0.0001). CEPs were 181 \ub1 167/mL in healthy donors and 429 \ub1 507/mL in patients (P = 0.00019). Coefficients of variation were 4 \ub1 4% (intrareader), 17 \ub1 4% (interreader), and 17 \ub1 7% (variability over 0-72 h), respectively. Parallel samples were frozen by a standardized protocol. After thawing, coefficients of variation were 12 \ub1 8% (intrareader), 16 \ub1 10% (interreader), and 26 \ub1 16% (variability over 0-14 days of frozen storage), respectively. Conclusions: This procedure enumerates a truly endothelial cell population with limited intrareader and interreader variability. It appears possible to freeze samples for large-scale CEC enumeration during clinical trials. This approach could be enlarged to investigate other angiogenic cell populations as well