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

Time activity modelling of domestic exposures to radon

Radon gas occurs naturally in the environment with a variable distribution. In some areas radon concentrates sufficiently within the built environment that it is considered as a public health risk. It is possible, successfully, to reduce radon levels in the built environment, and it has been shown that such remediation programmes can be justified in terms of the costs and benefits accruing. However, the estimated dose received by people in their homes depends on the time spent indoors. The research presented here uses data derived from time activity surveys in Northamptonshire, together with radon data from a representative home, to model potential exposures for different population sub-groups. Average home occupancy ranged from 14.8 h (probable error 2.5 h) for students to 17.7 (3.1) h for adults; schoolchildren spent an average of 14.9 (1.2) h at home. Over a quarter of adults, however, were in the home for 22 h on more. These differences in occupancy patterns lead to substantial differences in radon exposure. In a home with an average hourly ground floor radon concentration of 467 Bq m−3, modelled hourly average exposures ranged from ca. 250 Bq m−3 for students and school children, to over 340 Bq m−3, for women based at home. Modelled exposures show a non-linear association with total time spent at home, suggesting that exposure estimates based on linear models may provide misleading estimates of health risks from radon and the potential benefits of radon remediation. Highest hourly exposures are likely to be experienced by people with highly occupancy, living in single-storey, ground floor accommodation (for example, the elderly the infirm and non-working young mothers). Since these may be least aware of radon risks, and least able to take up remediation measures, they should be specifically targeted for radon monitoring and for assistance in remediation scheme

Qualidade fisiológica de sementes de alface submetidas a diferentes temperaturas na presença e ausência de luz Physiological quality of lettuce seeds under different temperatures, in presence and ausence of light

O trabalho foi conduzido no Laboratório Didático e de Pesquisas em Sementes da Universidade Federal de Santa Maria, com o objetivo de avaliar o efeito da temperatura e da luz sobre a germinação e vigor das plântulas de alface. Foram utilizados os cultivares Elisa, Regina e Rainha de Maio e submetidos aos tratamentos de temperatura a 20; 25; 30; 35°C e 20-30°C, estabelecendo um experimento bifatorial (3x5), conduzido na presença e ausência de luz. Utilizou-se o substrato sobre papel em caixas plásticas de germinação, sob o delineamento inteiramente casualizado, com quatro repetições de 100 sementes por tratamento. Na presença de luz as sementes foram colocadas em germinador no qual se efetuou o controle fotoperiódico de 8 horas de luz e 16 horas de escuro, para cada dia. Na ausência de luz as sementes foram semeadas e mantidas no escuro, durante todo o teste, cobrindo-se as caixas plásticas de germinação com papel alumínio. As avaliações de tamanho de plântula e primeira contagem de germinação foram efetuadas no quarto dia, e a percentagem final de germinação no sétimo dia. Observou-se que, na ausência de luz, quanto menor a temperatura utilizada maiores foram a germinação e o vigor (determinado pela primeira contagem de germinação). Quando testados com luz, verificou-se, para os cultivares Elisa e Regina, que a germinação e os maiores tamanhos de plântulas não variam com as diferentes temperaturas, exceto para 35ºC, que se mostrou desaconselhável para as sementes de alface, por impedir a germinaç ão. Conclui-se que existe influência do genótipo sobre a qualidade fisioló gica das sementes. A luz é um fator limitante na germinação. Para os cultivares Elisa, Regina e Rainha de Maio, a melhor temperatura, dentre as estudadas, é de 20°C. Na presença de luz, a germinação e o desenvolvimento inicial ocorrem numa faixa ampla de temperatura (20°C a 30°C). A temperatura de 35°C induz à dormência secundária das sementes de alface.<br>The experiment on the different types of lettuce seeds, and the effects of light and temperature occured in the Didactic Laboratory of Researches in Seeds, of Santa Maria Federal University, Brazil. Elisa, Regina and Rainha de Maio, were selected and tested under the tempreatures of 20°C; 25°C; 30°C; 35°C; 20-30°C, for establish a bifactorial experiment separately conducted, with and without light. The substratum was used on paper in gerbox, with four repetitions of 100 seeds for treatment. The selected light conditions were 8 hours of light and 16 hours of darkness, for every day. For the condition without light an aluminum paper was placed over the gerboxes. The evaluations of plant size and first germination were made in the fourth day and the final percentage of germination, in the seventh day. It was observed that without light, the lower the temperature the more plants germanated. When tested with light it was found that with Elisa and Regina, the tempurature had no effect except at 35º, in which germination was impeded. In conclusion, exist influence of lettuce genotypes in physiological quality seeds. The light is a limiter factor in germination. Within the tested temperatures, it was found that 20ºC was the best for the three cultivars. In presence of light, the plants initial development occured within a wide strip of temperature (20°C to 30°C). Temperature of 35°C cause secondary dormancy in lettuce seeds