Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

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

A giant exoplanet orbiting a very-low-mass star challenges planet formation models

Surveys have shown that super-Earth and Neptune-mass exoplanets are more frequent than gas giants around low-mass stars, as predicted by the core accretion theory of planet formation. We report the discovery of a giant planet around the very-low-mass star GJ 3512, as determined by optical and near-infrared radial-velocity observations. The planet has a minimum mass of 0.46 Jupiter masses, very high for such a small host star, and an eccentric 204-day orbit. Dynamical models show that the high eccentricity is most likely due to planet-planet interactions. We use simulations to demonstrate that the GJ 3512 planetary system challenges generally accepted formation theories, and that it puts constraints on the planet accretion and migration rates. Disk instabilities may be more efficient in forming planets than previously thought

CARMENES: high-resolution spectra and precise radial velocities in the red and infrared

SPIE Astronomical Telescopes + Instrumentation (2018, Austin, Texas, United States

Synthesis and characterization of new types of aluminum and gallium complexes stabilized by bifunctional ligands

CONACYT [54151, 155247

A Study of Culture, Festival and Experiential Tourism: A Case of the Sky Lantern Festival in Pingxi

[[abstract]]基於「臺灣觀光年曆」的推動已經歷經104年與 105年，為了要瞭解「臺灣觀光年曆」是否可以利用節慶活動品牌行銷國際，同時對於推動經濟發展、保存文化傳統與藝術、彰顯地方特色能夠創造實際效益，本研究受限於時間、人力等技術的事實考量後，於是經過研究者與三位觀光學者專家的深度討論，並因此決定選擇以具有不可替性，全球知名度、國際級並且是中央與地方主管機關、觀光產業共同參與舉辦之文化節慶新北市平溪天燈節為例，針對新北市平溪天燈節過去現在發展的所有可收集與揭露之資料。104 年與105年交通部觀光局觀光年曆相關考核評鑑資料，藉由內容解讀與分析： 1. 從文化體驗觀光之角度具體檢視平溪天燈節的產品、活動、服務、體驗的專業考量與實際操作。 2. 從政府、產業、居民與遊客角度輔以全面的SWOT 分析法，判斷平溪天燈節舉辦之本身優勢（strength）與劣勢（weakness），以及外部環境的機會（opportunity）與威脅（threat）來擬定其適當發展策略[[abstract]]The “Taiwan Tourism Calendar” has been promoted through the year 2015 and the year 2016. In order to understand whether the “Taiwan Tourism Calendar” can make good use of international marketing of festival events，whether it is also possible to promote economic development, preserve cultural traditions and arts, and highlight local characteristics to create actual benefits. This research limited by the factual operational considerations of time, manpower was done through in-depth discussions between the researchers and three tourism scholars and experts in the beginning, and therefore decided to choose the irreplaceable, global reputation, international level, the Pingxi Sky Lantern Festival in the New Taipei City, a cultural festival organized by local authorities and the tourism industry to carry out the study. It was organized to cover all the information that can be collected and disclosed in the past. In additional, the related assessment data of the Tourism Bureau in the year 2105 and the year 2106 of tourism calendar was added to do the following thorough content interpretation and analysis: 1. From the perspective of cultural experience and tourism, this study has examined the professional considerations and practical operations on the products, activities, services, and experience of the Pingxi Sky Festival. 2. From the perspective of stakeholders including government, industry, residents, and tourists, with a comprehensive SWOT analysis, this study has determined the internal strengths and weaknesses of Pingxi Sky Lantern Festival itself, as well as the opportunities and threats of the external environment. It is intended to formulate its appropriate development strategy for the Pingxi Sky Lantern Festival.[[note]]碩