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

Desempenho de pintos de corte alimentados com rações contendo milho pré-gelatinizado Performance of broiler chicks fed pre-gelatinized corn in pre-starter and starter feed

Foram conduzidos três experimentos para avaliar o valor nutricional do milho pré-gelatinizado para frangos de corte de 1 a 21 dias de idade. No primeiro experimento, avaliou-se o metabolismo do milho pré-gelatinizado, do amido e do gérmen de milho pelo método da colheita total de excretas no período de 4 a 7 dias de idade para determinação dos valores de energia metabolizável aparente e aparente corrigida, que foram de 3.370, 3.379,7, 3.259,1 kcal/kg de EMA e 3.299,8, 3.369,7 e 3.051,6 kcal/kg de EMAn, para o milho pré-gelatinizado, o amido de milho e o gérmen de milho integral, respectivamente. No segundo e terceiro experimentos, utilizaram-se 200 pintos alimentados com rações pré-iniciais (fase de 1 a 7 dias de idade) e iniciais com 0, 20, 40 ou 60% de milho pré-gelatinizado em substituição ao milho-grão. O desempenho dos frangos no período de 1 a 7 dias não foi afetado pelos níveis de milho pré-gelatinizado na ração. Houve nesse período efeito quadrático sobre o coeficiente de digestibilidade da matéria seca (ponto de mínima de 28,6%) e do nitrogênio (ponto de mínima de 31,7%) e efeito linear negativo sobre o coeficiente de digestibilidade do extrato etéreo. No período de 8 a 21 dias de idade, para os níveis de milho pré-gelatinizado, houve efeito linear negativo sobre o peso final, o ganho de peso e o consumo de ração e efeito quadrático sobre a conversão alimentar (ponto de máxima de 34,3%). Os coeficientes de digestibilidade da matéria seca, do nitrogênio e do extrato etéreo indicaram efeito linear positivo dos níveis de substituição do milho-grão moído pelo pré-gelatinizado. O milho pré-gelatinizado é uma boa alternativa para alimentação de pintos de corte na fase pré-inicial, porém, apesar do melhor aproveitamento nutricional da ração, piora o desempenho na fase de 8 a 21 dias de idade.<br>Three experiments were carried out to evaluate the performance and nutritional value of the extruded corn for broilers from one to 21 days of age. In the first experiment, the metabolism of pre-gelatinized corn, corn starch and corn germ meal was assessed by the total excreta collection method from 4 to 7 days of age and values of apparent (AME) and corrected metabolizable energy (CAME) and the results were, respectively: 3370, 3379.7, 3259.1 kcal/kg de AME and 3299.8, 3369.7, 3051.6 kcal/kg for CAME. The inclusion level of pre-gelatinized corn was evaluated in pre-starter (1 to 7 days of age - Experiment 2) and starter (8 to 21 days of age - Experiment 3) broiler rations. Broiler performance from one to seven days of age was not affected by pre-gelatinized corn in the feed. A quadratic effect for the dry matter digestibility coefficient (minimum point of 28.6% inclusion) and nitrogen (minimum point of 31.7% inclusion) and negative linear negative on the ether extract digestibility coefficient. From 8 to 21 days of age, broiler performance was affected linearly and negatively for final weight, weight gain and feed intake and quadratic for feed-to-gain ratio (maximum point of 34.3% inclusion). For the dry matter, nitrogen and ether extract digestibility coefficients, there was a positive linear effect for pre-gelatinized corn included in substitution of corn. Pre-gelatinized corn was a good alternative for pre-starter ration, but, in spite of the better digestibility coefficient results, performance got worse as pre-gelatinized corn increased in diets from 8 to 21 days of age. Pre-gelatinized corn was a good alternative as energetic ingredient for first week chick feed, but, in the starter phase it did not promote good performance despite the good digestibility indexes obtained

Requirements of digestible methionine + cystine for broiler chickens at 1 to 42 days of age Exigências de metionina + cistina digestível para frangos de corte de 1 a 42 dias de idade

The objective of this work was to estimate requirements of digestible methionine + cystine for broiler chickens from 1 to 42 days of age. It was carried out four experiments for each one of the following phases: pre-initial, initial, growing and final. The birds were distributed in a completely randomized experimental design, with six treatments and six replicates. Treatments consisted of a basal feed for each phase, deficient in digestible methionine + cystine and supplemented with DL-methionine to supply six levels of digestible methionine + cystine, resulting in different digestible methionine + cystine:digestible lysine ratios. In the pre-initial phase, levels of digestible methionine + cystine did not influence feed intake and feed conversion. However, weight gain responded in a quadratic way. In the initial phase, levels of digestible methionine + cystine had decreasing linear effect on feed intake whereas weight gain and feed conversion were influenced in a quadratic manner. In the growth and final phases, feed intake was not influenced by levels of digestible methionine + cystine, but weight gain and feed conversion presented quadratic response. The levels of 0.873; 0.755; 0.748 and 0.661% of digestible methionine + cystine in the diet or the daily intake of 183; 575; 1,104 and 1,212 mg of digestible methionine + cystine are recommended for the pre-initial, initial, growth and final phases, respectively, which corresponds to the ratios of 71; 70; 76 and 72% of digestible methionine + cystine to digestible lysine.<br>Objetivou-se estimar as exigências de metionina + cistina digestível para frangos de corte machos de 1 a 42 dias de idade. Foram realizados quatro experimentos para cada uma das fases: pré-inicial, inicial, crescimento e final. As aves foram distribuídas em delineamento inteiramente casualizado, com seis tratamentos e seis repetições. Os tratamentos consistiram de uma ração basal para cada fase, deficiente em metionina + cistina e suplementada com DL-metionina para fornecer seis níveis de metionina + cistina digestível, resultando em diferentes relações metionina + cistina digestível:lisina digestível. Na fase pré-inicial, os níveis de metionina + cistina digestível não influenciaram o consumo de ração e a conversão alimentar. No entanto, o ganho de peso respondeu de forma quadrática. Na fase inicial, os níveis de metionina + cistina digestível tiveram efeito linear decrescente sobre o consumo de ração, enquanto o ganho de peso e a conversão alimentar foram influenciados de forma quadrática. Nas fases de crescimento e final, o consumo de ração não foi influenciado pelos níveis de metionina + cistina digestível, porém o ganho de peso e a conversão alimentar apresentaram resposta quadrática. Recomendam-se os níveis de 0,873; 0,755; 0,748 e 0.661% de metionina + cistina na dieta ou o consumo diário de 183, 575, 1.104 e 1.212 mg de metionina + cistina digestível nas fases pré-inicial, inicial, crescimento e final, respectivamente, que correspondem às relações de 71, 70, 76 e 72% de metionina + cistina digestível:lisina digestível

Adição de complexo multienzimático em dietas à base de soja extrusada: valores energéticos e digestibilidade de nutrientes em pintos de corte Effects of feeding multienzymatic complex addition and different extruded soybean on energy values and nutrient digestibility in broiler chicks

O experimento foi realizado com o objetivo de avaliar os efeitos da adição de complexo multienzimático (CM) e do nível de processamento da soja sobre os valores energéticos e os coeficientes de digestibilidade dos nutrientes de rações para pintos de corte. Foram utilizados 288 pintos de corte machos da linhagem Avian Farms, com oito dias de idade, em arranjo fatorial 3 x 2 (rações à base de soja extrusada subprocessada, normal e superprocessada, suplementadas ou não com complexo multienzimático), totalizando seis tratamentos, com oito repetições de seis aves por unidade experimental. As excretas foram coletadas e pesadas durante cinco dias consecutivos, utilizando-se os métodos de coleta total e de coleta ileal. A adição do CM (protease, amilase e celulase) promoveu aumento médio dos coeficientes de digestibilidade ileal aparente de matéria seca, proteína, energia e gordura das dietas de 4,8; 1,3; 4,8 e 6,0%, respectivamente. Entretanto, os maiores aumentos nos valores de digestibilidade ileal proporcionados pelo CM foram obtidos com as rações contendo soja extrusada subprocessada: 10,7% MS, 4,2% PB, 11,4% EB e 17,6% gordura. A adição do CM melhorou a digestibilidade ileal de FDN, FDA e HEM, em média, 10,60; 23,05 e 6,39%, respectivamente. As aves alimentadas com dietas contendo soja extrusada normal apresentaram maiores coeficientes de digestibilidade ileal dos nutrientes e valores de EM que aquelas alimentadas com sojas extrusadas sub e superprocessadas.<br>This experiment was conducted to evaluate the effect of multienzymatic complex (MC) addition in diets with different types of extruded soybeans on the energy values and nutrient digestibility coefficients for broiler chicks. A total of 288 Avian Farms males broiler chicks averaging eight days old was allotted to a 3 x 2 factorial arrangement (under, standard and over processed extruded full fat soybean-based diets with and without MC, in a total of six treatments with eight replicates and six birds per experimental unit. Feces were collected and weighed during five days. It was observed that the MC addition (composed by cellulase, amylase and protease) increased the coefficients of dietary ileal apparent digestibility of DM, CP, GE, and fat by 4.8, 1.3, 4.8, and 6%, respectively. However, under processed extruded full fat soybean-based diets, with MC, increased most the ileal digestibility: 10.7% (DM), 4.2% (CP), 11.4%, (GE), and 17.55% fat. The MC addition increased the ileal digestibilility of NDF, ADF, and hemicelullose at average 10.60, 23.05, and 6.39%, respectively. The birds fed diets with standard processed extruded full fat soybean showed higher values of coefficients of nutrient ileal digestibility and of metabolizable energy than those fed extruded under and over processed full fat soybean-based diet

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora