Comparative effectiveness and safety of non-vitamin K antagonists for atrial fibrillation in clinical practice: GLORIA-AF Registry

Background and purpose: Prospectively collected data comparing the safety and effectiveness of individual non-vitamin K antagonists (NOACs) are lacking. Our objective was to directly compare the effectiveness and safety of NOACs in patients with newly diagnosed atrial fibrillation (AF). Methods: In GLORIA-AF, a large, prospective, global registry program, consecutive patients with newly diagnosed AF were followed for 3 years. The comparative analyses for (1) dabigatran vs rivaroxaban or apixaban and (2) rivaroxaban vs apixaban were performed on propensity score (PS)-matched patient sets. Proportional hazards regression was used to estimate hazard ratios (HRs) for outcomes of interest. Results: The GLORIA-AF Phase III registry enrolled 21,300 patients between January 2014 and December 2016. Of these, 3839 were prescribed dabigatran, 4015 rivaroxaban and 4505 apixaban, with median ages of 71.0, 71.0, and 73.0 years, respectively. In the PS-matched set, the adjusted HRs and 95% confidence intervals (CIs) for dabigatran vs rivaroxaban were, for stroke: 1.27 (0.79–2.03), major bleeding 0.59 (0.40–0.88), myocardial infarction 0.68 (0.40–1.16), and all-cause death 0.86 (0.67–1.10). For the comparison of dabigatran vs apixaban, in the PS-matched set, the adjusted HRs were, for stroke 1.16 (0.76–1.78), myocardial infarction 0.84 (0.48–1.46), major bleeding 0.98 (0.63–1.52) and all-cause death 1.01 (0.79–1.29). For the comparison of rivaroxaban vs apixaban, in the PS-matched set, the adjusted HRs were, for stroke 0.78 (0.52–1.19), myocardial infarction 0.96 (0.63–1.45), major bleeding 1.54 (1.14–2.08), and all-cause death 0.97 (0.80–1.19). Conclusions: Patients treated with dabigatran had a 41% lower risk of major bleeding compared with rivaroxaban, but similar risks of stroke, MI, and death. Relative to apixaban, patients treated with dabigatran had similar risks of stroke, major bleeding, MI, and death. Rivaroxaban relative to apixaban had increased risk for major bleeding, but similar risks for stroke, MI, and death. Registration: URL: https://www.clinicaltrials.gov. Unique identifiers: NCT01468701, NCT01671007. Date of registration: September 2013

Anticoagulant selection in relation to the SAMe-TT2R2 score in patients with atrial fibrillation. the GLORIA-AF registry

Aim: The SAMe-TT2R2 score helps identify patients with atrial fibrillation (AF) likely to have poor anticoagulation control during anticoagulation with vitamin K antagonists (VKA) and those with scores >2 might be better managed with a target-specific oral anticoagulant (NOAC). We hypothesized that in clinical practice, VKAs may be prescribed less frequently to patients with AF and SAMe-TT2R2 scores >2 than to patients with lower scores. Methods and results: We analyzed the Phase III dataset of the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF), a large, global, prospective global registry of patients with newly diagnosed AF and ≥1 stroke risk factor. We compared baseline clinical characteristics and antithrombotic prescriptions to determine the probability of the VKA prescription among anticoagulated patients with the baseline SAMe-TT2R2 score >2 and ≤ 2. Among 17,465 anticoagulated patients with AF, 4,828 (27.6%) patients were prescribed VKA and 12,637 (72.4%) patients an NOAC: 11,884 (68.0%) patients had SAMe-TT2R2 scores 0-2 and 5,581 (32.0%) patients had scores >2. The proportion of patients prescribed VKA was 28.0% among patients with SAMe-TT2R2 scores >2 and 27.5% in those with scores ≤2. Conclusions: The lack of a clear association between the SAMe-TT2R2 score and anticoagulant selection may be attributed to the relative efficacy and safety profiles between NOACs and VKAs as well as to the absence of trial evidence that an SAMe-TT2R2-guided strategy for the selection of the type of anticoagulation in NVAF patients has an impact on clinical outcomes of efficacy and safety. The latter hypothesis is currently being tested in a randomized controlled trial. Clinical trial registration: URL: https://www.clinicaltrials.gov//Unique identifier: NCT01937377, NCT01468701, and NCT01671007

Study on the Coexistence of Offshore Wind Farms and Cage Culture

In this study, a hydrodynamic model was used that includes the effects of wave–current interactions to simulate the wave and current patterns before and after offshore wind turbine installation in western Taiwan. By simulating the waves and currents after the offshore wind turbine was established, the waves and currents caused by the wind turbine were seen to have a limited range of influence, which is probably within an area about four to five times the size of the diameter (12–15 m) of the foundation structure. Overall, the analysis of the simulation results of the wave and current patterns after the offshore wind turbines were established shows that the underwater foundation only affected the local area near the pile structure. The wind farm (code E) of the research case can be equipped with about 720 cage cultures; if this is extended to other wind farms in the western sea area, it should be possible to produce economic-scale farming operations such as offshore wind power and fisheries. However, this study did not consider the future operation of the entire offshore wind farm. If the operation and maintenance of offshore wind farms are not affected, and if the consent of the developer is obtained, it should be possible to use this method to provide economically large-scale farming areas as a mutually beneficial method for offshore wind power generation and fisheries

Livestock-associated methicillin-resistant Staphylococcus aureus ST9 in pigs and related personnel in Taiwan.

BACKGROUND: A livestock-associated (LA) methicillin-resistant Staphylococcus aureus (MRSA) strain sequence type 398 (ST398) is found related to animals and humans in Europe and North America. To evaluate the nasal carriage of MRSA among pigs and related workers in Taiwan, we conducted this study. METHODS: From June 25 to October 1 2012, a total of 641 and 100 nasal swabs were obtained from pigs and related workers, respectively, from 22 pig farms nationwide and 2 pig auction markets in Taiwan. All MRSA isolates were molecularly characterized. RESULTS: Overall, the nasal carriage rate of MRSA was 14.4% for pigs and 13% for humans. The carriage rate for pigs younger than 3 months was significantly higher than those older than 3 months (25.4% vs. 5.8%, p<.001). Percentage of MRSA-positive pig farms was 59.1% (13/22). The carriage rate for pigs in large-scale herds (≥ 10000 pigs) was significantly higher than that in small-scale (34.3% vs. 7.0%, p<.001) and that in auction markets (3.8%). The carriage rate was 19.2% (10/52) for pig farm workers, and the rate in large-scale farms was significantly higher than that in small-scale (36.8% vs. 9.1%, p = .014). Except for 3 isolates from humans, the other 99 isolates belonged to sequence type (ST) 9. 83 of 89 isolates from pigs shared a common pulsotype, which was also shared by 6 isolates from humans. CONCLUSION: More than 10% of pigs and related workers in Taiwan carried LA-MRSA ST9 in nares and cross-species transmission of LA-MRSA was documented by molecular methods

Effects of different annealing temperatures on the physical, optical, and electrical characteristics and chemical bonds of Ga and F Co-doped ZnO films

In this study, we would investigate the effect of annealing temperature on the physical, optical, and electrical characteristics and chemical bonds of F- and Ga-co-doped ZnO (FGZO) Films. At first, 3 wt% Ga2O3 was mixed with 97 wt% ZnO to form the Ga-doped ZnO ceramic target, and the radio frequency (RF) magnetron sputtering method was used to deposit FGZO films. 0.2% CF4 flow rate (CF4/Ar) was controlled using the mixing gas of CF4 and pure Ar, and the mixing gas was introduced during the deposition process, which acted as the source of F− ions. FGZO films were deposited on the EagleXG glass and the films’ thickness was about 300 nm by controlling the deposition time. After FGZO films were deposited, they were annealed at 200, 300, and 400 °C. A comparative study of composition of FGZO films was investigated using secondary-ion mass spectrometry (SIMS) to analyze the distributions of F, Zn, Ga, and C elements, respectively, as the annealing temperature was changed. Another comparative study of FGZO films was that we proposed a modified Burstein-Moss (BM) equation to investigate the relationship between the carrier concentration and the shift of optical energy bandgap. Third comparative study of surfaces of FGZO films were investigated using X-ray photoelectron spectroscopy (XPS) to find the variations of the chemical bonds

Molecular characteristics of 102 MRSA isolates, categorized by pulsed-field gel electrophoresis (PFGE) patterns.

<p>UT: untypeable, SCC: staphylococcal chromosome cassette, PVL: Panton-Valentine leukocidin, MLST: multilocus sequence type.</p

Comparison of nasal methicillin-resistant <i>Staphylococcus aureus</i> carriage among 536 pigs and 52 related workers in 22 pig farms in Taiwan by different cultivation scales.

<p>*The carriage rate for pigs in large-scale herds (raising ≥10000 pigs) was significantly higher than that in small-scale ones (34.3% vs. 7.0%, p<.001, OR: 6.88 [95% CI 4.13–11.45]).</p><p>#The carriage rate for humans in large-scale herds was significantly higher than that in small-scale ones (36.8% vs. 9.1%, <i>p</i> = 0.014, OR: 5.83 [95%CI 1.29–26.38]).</p

MRSA prevalence among related workers in aspect of demographic and clinical data.

<p>OR: odds ratio; CI: confidence interval.</p><p>*Full demographic and clinical data were not available for all participants.</p><p>Female is the only risk factor found among these demographic and clinical data, the odd ratio of which is 4.26 (95% CI1.18–15.39) with <i>p</i> value 0.027.</p

Methicillin-resistant <i>Staphylococcus aureus</i> prevalence among different groups of pigs and humans in Taiwan.

<p>* Samples coming from 10 grower pigs in the subdivision were excluded due to insufficient information of definite age.</p