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

Which Emotion Regulation Strategies are Most Associated with Trait Emotion Dysregulation? A Transdiagnostic Examination

Although definitions of emotion dysregulation infer difficulties in selecting and implementing emotion regulation (ER) strategies, surprisingly few studies have examined the relationship between trait emotion dysregulation and a wide range of specific ER strategies. The present study used a data-driven approach to assess trait- and state-related ER strategy use in 99 women (aged 18-55) recruited from the community with varying levels of trait emotion dysregulation. Participants completed self-report questionnaires assessing habitual ER strategy implementation and self-ratings of ER strategy use in vivo during negative mood inductions. Principal components analysis revealed four self-report questionnaire-based and three mood-induction-based groupings comprising both optimal and suboptimal strategies. After adjusting for demographic and clinical variables, results from self-report questionnaires indicated that trait emotion dysregulation was significantly associated with higher endorsements of suboptimal strategies in two groupings (e.g., self-criticism, rumination, and social withdrawal; catastrophizing and blaming others) and lower endorsements of optimal ER strategies in one grouping (e.g., cognitive reappraisal and problem solving). In the context of mood induction, trait emotion dysregulation was significantly associated with higher endorsements of suboptimal ER strategies from one cluster only (e.g., expressive suppression, thought avoidance, and self-criticism). Such transdiagnostic, data-driven approaches can uncover how the application of specific ER strategies both habitually and during negative mood states is associated with trait emotion dysregulation

Social Anxiety Monitoring Mobile Intervention

SAMM

Daily associations between cannabis use and alcohol use in young adults: The moderating role of self-report and behavioral measures of impulsivity

Although impulsivity has been implicated in cannabis and alcohol use, its role in alcohol and cannabis co-use behavior use requires further study. We examined the moderating role of self-report and behavioral measures of impulsivity in the daily-level relationships between cannabis use and both (a) likelihood of same-day alcohol use and (b) number of drinks consumed on the same day. Young adults (N=153) completed a 90-day Timeline Follow Back assessing the amount of cannabis smoked (in grams), other forms of cannabis (e.g., oils, edibles), and number of standard drinks consumed each day. Participants also completed a structured interview of Alcohol and Cannabis Use Disorders (AUD/CUD), and both self-report (UPPS impulsivity scales) and behavioral (behavioral disinhibition and delay discounting) measures of impulsivity. Zero-inflated multilevel modelling revealed that negative urgency, delay discounting, and disinhibition were significant, unique moderators of the daily relationship between cannabis and alcohol consumption, after controlling for AUD/CUD symptoms and other covariates. Specifically, individuals high (but not low) on negative urgency and delay discounting showed a positive association between grams of cannabis used on a given day and same-day number of standard drinks consumed. Contrary to expectations, individuals low on negative urgency and low in disinhibition showed a stronger relationship between grams of cannabis consumed and odds of engaging in any drinking on the same day. Results extend research on moderators of within-person, daily-level associations between cannabis and alcohol use, suggesting that several impulsivity-related constructs may contribute to complementary use of cannabis and alcohol among young adults.This research was supported by the Caskey/Francis Family Award in Clinical Research awarded by the Centre for Addiction and Mental Health Foundation (PIs: Jeffrey D. Wardell & Christian S. Hendershot) and by a grant from the Canadian Institutes for Health Research (Award Number: PJT-159754; PIs: Jeffrey D. Wardell & Christian S. Hendershot)

A standardized workflow for long-term longitudinal actigraphy data processing using one year of continuous actigraphy from the CAN-BIND Wellness Monitoring Study

Abstract Monitoring sleep and activity through wearable devices such as wrist-worn actigraphs has the potential for long-term measurement in the individual’s own environment. Long periods of data collection require a complex approach, including standardized pre-processing and data trimming, and robust algorithms to address non-wear and missing data. In this study, we used a data-driven approach to quality control, pre-processing and analysis of longitudinal actigraphy data collected over the course of 1 year in a sample of 95 participants. We implemented a data processing pipeline using open-source packages for longitudinal data thereby providing a framework for treating missing data patterns, non-wear scoring, sleep/wake scoring, and conducted a sensitivity analysis to demonstrate the impact of non-wear and missing data on the relationship between sleep variables and depressive symptoms. Compliance with actigraph wear decreased over time, with missing data proportion increasing from a mean of 4.8% in the first week to 23.6% at the end of the 12 months of data collection. Sensitivity analyses demonstrated the importance of defining a pre-processing threshold, as it substantially impacts the predictive value of variables on sleep-related outcomes. We developed a novel non-wear algorithm which outperformed several other algorithms and a capacitive wear sensor in quality control. These findings provide essential insight informing study design in digital health research

Crystallization, morphology, and dynamic mechanical behavior of supramolecular [60]fullerene-containing poly(ethylene-co-acrylic acid)

10.1081/FST-120014733Fullerenes Nanotubes and Carbon Nanostructures103183-19