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

Changes in aflatoxin standards: Implications for EU border controls of nut imports

This is a pre-copyedited, author-produced version of an article accepted for publication in Applied Economic Perspectives and Policy following peer review. The version of record Garcia-Alvarez-Coque, J.-M., Taghouti, I. and Martinez-Gomez, V. (2020), Changes in Aflatoxin Standards: Implications for EU Border Controls of Nut Imports. Applied Economic Perspectives and Policy, 42: 524-541. doi:10.1093/aepp/ppy036 is available online at: https://doi.org/10.1093/aepp/ppy036.[EN] Food safety concerns about the risk of aflatoxin (AF) contamination have been growing in many regions, particularly in the European Union (EU). To protect consumers from health risks, the EU has established strict standards for maximum acceptable AF levels in food products; these standards have changed several times. This article examines the Rapid Alert System for Food and Feed (RASFF) database, which contains notifications on border controls on AF levels in tree nuts and peanuts. A count data model was used to analyze the impact of political economy considerations, past alerts, and path-dependence effects on RASFF border controls. Policy changes, including the harmonization and relaxing of the EU¿s AF standards, significantly affected the frequency of border controls, with diverse effects among exporting countries. It is believed that the present study provides some insights to the modeling of food standards for explanation or forecasting purposes.García Alvarez-Coque, JM.; Taghouti, I.; Martinez Gomez, VD. (2020). Changes in aflatoxin standards: Implications for EU border controls of nut imports. Applied Economic Perspectives and Policy. 42(3):524-541. https://doi.org/10.1093/aepp/ppy036S524541423Bagwell, K., & Staiger, R. W. (2001). Domestic Policies, National Sovereignty, and International Economic Institutions. The Quarterly Journal of Economics, 116(2), 519-562. doi:10.1162/00335530151144096Baylis, K., Martens, A., & Nogueira, L. (2009). 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Recent applications of Chemical Imaging to pharmaceutical process monitoring and quality control

Chemical Imaging (CI) is an emerging platform technology that integrates conventional imaging and spectroscopy to attain both spatial and spectral information from an object. Vibrational spectroscopic methods, such as Near Infrared (NIR) and Raman spectroscopy, combined with imaging are particularly useful for analysis of biological/pharmaceutical forms. The rapid, non-destructive and non-invasive features of CI mark its potential suitability as a process analytical tool for the pharmaceutical industry, for both process monitoring and quality control in the many stages of drug production. This paper provides an overview of CI principles, instrumentation and analysis. Recent applications of Raman and NIR-CI to pharmaceutical quality and process control are presented; challenges facing CI implementation and likely future developments in the technology are also discussed