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

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time, and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space. While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes, vast areas of the tropics remain understudied. In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity, but it remains among the least known forests in America and is often underrepresented in biodiversity databases. To worsen this situation, human-induced modifications may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge, it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Sound Field Radiated By A Spherical Loudspeaker Array Using A Flexible Membrane Model

Two approaches for sound field prediction of a spherical loudspeaker array operation are presented and compared to experimental measurements. In the first, real membrane modes from experimental modal analysis are used as input for BEM vibroacoustic simulations using LMS Virtual.Lab® software. In the second, an analytical solution based on the spherical harmonic expansion of an idealized velocity pattern over the spherical array is used. Results are presented in terms of sound power and directivity patterns, showing that the former has the same trend in all comparisons for the low frequency range, and that the analytical solution cannot be used for the high frequency range since it does not include the effect of the flexible membrane modes. Directivity patterns, however, show a good degree of similarity in all cases, and are not strongly affected by the flexible membrane modes.757675776Gerzon, M.A., Periphony: With-height sound reproduction (1973) Journal of the Audio Engineering Society, 21 (1), pp. 2-10Berkhout, A.J., De Vries, D., Vogel, P., Acoustic control by wave field synthesis Journal of the Acoustical Society of America, 93 (5), pp. 2764-2778Caussé, R., Bresciani, J.F., Warusfel, O., Radiation of musical instruments and control of reproduction with loudspeakers (1992) Proceedings of the International Symposium on Musical Acoustics, , Tokyo, JapanKassakian, P., Wessel, D., Characterization of spherical loudspeaker arrays (2004) Proceedings of the 117 th Audio Engineering Society Convention, , San Francisco, USA, paper number 6283Warusfel, O., Misdariis, N., Sound source radiation synthesis: From stage performance to domestic rendering (2004) Proceedings of the 116 th Audio Engineering Society Convention, , Berlin, Germany, paper number 6018Zotter, F., Sontacchi, A., Höldrich, R., Modeling a spherical loudspeaker system as multipole source (2007) Proceedings of the 33 rd German Annual Conference on Acoustics, , Stuttgart, GermanyZotter, F., (2009) Analysis and Synthesis of Sound-radiation with Spherical Arrays, , PhD dissertation, University of Music and Performing Arts, Institute of Electronic Music and Acoustics, Graz, AustriaAvizienis, R., Freed, A., Kassakian, P., Wessel, D., A compact 120 independent element spherical loudspeaker array with programmable radiation patterns (2006) Proceedings of the 120 th Audio Engineering Society Convention, , Paris, France, paper number 6783Pollow, M., Behler, G.K., Variable directivity for platonic sound sources based on spherical harmonics optimization (2009) Acta Acustica United with Acustica, 95 (6), pp. 1082-1092Pasqual, A.M., Arruda, J.R.F., Herzog, P., Application of acoustic radiation modes in the directivity control by a spherical loudspeaker array (2010) Acta Acustica United with Acustica, 96 (1), pp. 32-42Meyer, P.S., Meyer, J.D., Multi acoustic prediction program (MAPP): Recent results (2000) Tech. Rep. Presented at the Institute of Acoustics, , Meyer Sound Laboratories Inc., Stratford upon Avon, UKPasqual, A.M., (2010) Sound Directivity Control in a 3D Space by a Compact Spherical Loudspeaker Array, , PhD dissertation, State University of Campinas- Unicamp, Faculty of Mechanical Engineering, CampinasLeuridan, J., Peeters, B., Lowet, G., Van Der Auweraer, H., A new procedure for modal parameter estimation (2004) Journal of Sound and Vibration, pp. 24-28. , JanuaryVon Estorff, O., (2000) Boundary Element Acoustics- Advances & Applications, , WIT Press, Southampton (UK), 1 st Editio

Securitização da dívida rural brasileira: o caso do Banco do Brasil de 1995 a 2008

No começo da década de 90, produtores rurais estavam endividados e não conseguiriam pagar seus financiamentos se não tivesse havido a renegociação desses débitos, a denominada securitização de dívidas rurais. O Banco do Brasil tinha impactos negativos nos seus resultados ocasionados pela inadimplência dos produtores, principalmente por ser a instituição mais importante em termos de crédito rural. Após um longo processo de negociações, foi aprovada a Lei n. 9.138, de 1995, que deu início à denominada securitização das dívidas. A partir da interpretação das leis sobre a securitização e da análise dos dados contidos nos relatórios contábeis-financeiros do Banco do Brasil, fez-se uma análise detalhada sobre o comportamento econômico-financeiro dessa instituição e constatou-se que a securitização foi essencial para o banco reverter seus prejuízos em lucros