The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Shaping the clay: Pueblo pottery, cultural sponsorship and regional identity in New Mexico.

Taste--an appreciation for some things, a disdain for others--is usually understood by sociologists as playing a key role in struggles for position within closed, hierarchical status systems. Yet taste that reaches across cultural and social boundaries is a common phenomenon in a world of mobility and falling barriers to travel and access. This study argues that this expression of taste also has a political dimension, through an examination of the sponsorship of traditional Pueblo Indian pottery by Anglo newcomers to northern New Mexico in the 1920s and 1930s. The organization that these newcomers founded, the Indian Arts Fund, played an important role in building a differentiated market for Pueblo pottery, supported by an increasingly complex body of knowledge and evaluation. This intervention into the market for pottery, and into the definition of Pueblo culture, served to insert the Indian Arts Fund's members into regional society, against the resistance of older, more established elites. A visible association with Pueblo pottery linked newcomers to the transformation of the regional economy by tourism, which had shifted the source of value in northern New Mexico from natural resources to the marketing of particularity and difference. An examination of the role of pottery production, and income from pottery, in Pueblo communities reveals that the relationship between pottery and Pueblo culture was more complex, and more tangential, than the image that was being constructed in the context of the market

Computational Modeling of Nonadaptive Crowd Behaviors and Ergess Analysis: 2004-2005 CIFE Seed Project Report

Abstract: Safe egress is one of the key design issues identified by facility planners, manager and inspectors. Computational tools are now available for the simulation and design of emergency evacuation and egress. However, these tools rely heavily on assumptions about human individual and social behaviors, which have been found to be oversimplified, inconsistent and even incorrect. Furthermore, the behaviors are usually incorporated into the computational model in an ad hoc manner. This research has developed a framework for studying human and social behavior from the perspectives of human decision-making and social interaction and to incorporate such behavior systematically in a dynamic computational model suitable for emergency egress analysis

The DIVER Project : Interactive Digital Video Repurposing

Full text is available on http://ieeexplore.ieee.org/Xplore/login.jsp?url=/iel5/93/28183/01261108.pdfThe digital interactive video exploration and reflection (Diver) system lets users create virtual pathways through existing video content using a virtual camera and an annotation window for commentary. Users can post their Dives to the WebDiver server system to generate active collaboration, further repurposing, and discussion. Although our current work focuses on video records in learning research and educational practices, Diver can aid collaborative analysis of a broad array of visual data records, including simulations, 2D and 3D animations, and static works of art, photography, and text. In addition to the social and behavioral sciences, substantive application areas include medical visualization, astronomic data or cosmological models, military satellite intelligence, and ethnology and animal behavior. Diver-style user-centered video repurposing might also prove compelling for popular media with commercial application involving sports events, movies, television shows, and video gaming. Future technical development includes possible enhancements to the interface to support simultaneous display of multiple Dives on the same source content, a more fluid two-way relation between desktop Diver and WebDiver, and solutions to the current limitations on displaying and authoring time/space cropped videos in a browser context. These developments support the tool's fundamentally collaborative, communication-oriented nature