60 research outputs found

    The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

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    Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

    Beyond GDP: Measuring and achieving global genuine progress

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    While global Gross Domestic Product (GDP) has increased more than three-fold since 1950, economic welfare, as estimated by the Genuine Progress Indicator (GPI), has actually decreased since 1978. We synthesized estimates of GPI over the 1950-2003 time period for 17 countries for which GPI has been estimated. These 17 countries contain 53% of the global population and 59% of the global GDP. We compared GPI with Gross Domestic Product (GDP), Human Development Index (HDI), Ecological Footprint, Biocapacity, Gini coefficient, and Life Satisfaction scores. Results show a significant variation among these countries, but some major trends. We also estimated a global GPI/capita over the 1950-2003 period. Global GPI/capita peaked in 1978, about the same time that global Ecological Footprint exceeded global Biocapacity. Life Satisfaction in almost all countries has also not improved significantly since 1975. Globally, GPI/capita does not increase beyond a GDP/capita of around 7000/capita.Ifwedistributedincomemoreequitablyaroundtheplanet,thecurrentworldGDP(7000/capita. If we distributed income more equitably around the planet, the current world GDP (67. trillion/yr) could support 9.6. billion people at $7000/capita. While GPI is not the perfect economic welfare indicator, it is a far better approximation than GDP. Development policies need to shift to better account for real welfare and not merely GDP growth. © 2013 Elsevier B.V

    Monte Carlo modelling and comparison with experiment of the nuclide production in thick stony targets isotropically irradiated with 600 mev protons : Cologne, collaboration of the experiment CERN SC96

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    Depth profiles for the production of stable and radioactive nuclides have been measured for a large variety of target elements in three thick spherical stony targets with radii of 5, 15 and 25 cm isotropically irradiated with 600 MeV protons at the CERN synchrocyclotron. These irradiation experiments (CERN SC96) were intended to simulate the irradiation of meteoroids by galactic cosmic ray protons. In order to combine this experimental approach with a theoretical one the intra-and internuclear cascades were calculated using Monte Carlo techniques via the high energy transport code HET/KFA 1. Together with transport calculations for low energy neutrons by the MORSE-CG code the depth dependent spectra of primary and secondary protons and of secondary neutrons were derived. On the basis of these spectra and a set of evaluated experimental excitation functions for p-induced reactions and of theoretical ones for n-induced reactions, calculated by the code ALICE LIVERMORE 82, theoretical depth profiles for the production of stable and radioactive nuclides in the three thick targets were calculated. This report is a comprehensive survey on all those target/ product combinations for which both experimental and theoretical data are available. It provides the basis for a detailed discussion of the various production modes of residual nuclides and on the depth and size dependence of their production rates in thick stony targets, serving as a simulation of the galactic cosmic ray irradiation of meteoroids in space. On the other hand the comparison of the experimental and theoretical depth profiles validates the high energy transport calculations, making them a promissing tool for further model calulations of the interactions of cosmic rays with matter
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