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

Effect Of Mold Surface Roughness On The Interfacial Heat Transfer Coefficient During Solidification Of Solder Alloys

Solder joints are strongly dependent on how well the solder alloy can wet the substrate. One of the parameters which can be used to characterize the wettability of solder alloys on a substrate is the heat transfer coefficient at the interface alloy/substrate, hi. This study focus on the effect of the surface roughness of the substrate on the interfacial heat transfer coefficient during solidification of solder alloys. A comparative study is carried out with two lead-free solders alternatives and the traditional Sn-Pb solder (Sn 0.7wt%Cu, Sn 3.5 wt%Ag and Sn 38wt%Pb, respectively). These alloys were directionally solidified using a solidification apparatus having a water cooled bottom made of low carbon steel with two different surface finishing: machined and polished. The experimental thermal data collected by thermocouples positioned along the casting length were used as input information into an Inverse Heat Transfer Code implemented in this work in order to determine the hi variation in time. A power-law function given by m hi at =-m (where a and m are constants which depend on the alloy composition, substrate and melt superheat and t is the time) which is based on both theoretical and experimental analyses is proposed. The transient hi profile has a typical drastic reduction from a high initial value due to the development of an air gap, followed by a recovery to an essentially constant value. The literature generally reports a decrease in hi with increasing surface roughness. However, in the present work an opposite behavior has been detected, which is explained based on contact interactions between alloy and substrate that are subjected to thermal contraction and thermal expansion during the soldering process, respectively. © (2013) Trans Tech Publications, Switzerland.730-732751756Portuguese Materials Society- SPM,School of Engineering of the University of Minho,CT2M - Centre for Mechanical and Materials Technologies,Institute for Polymers and Composites/I3N,3B's Res. Group on Biomater., Biodegradables and BiomimeticsLi, X., Zhang, F., Zu, F., Lv, X., Zhao, Z., Yang, D., Effect of liquid-liquid structure transition on solidification and wettability of Sn-0.7Cu solder (2010) J. Alloys Compd, 505, pp. 472-475Griffiths, W.D., Kayikci, R., The effect of varying chill surface roughness on interfacial heat transfer during casting solidification (2007) J. Mater. Sci, 42, pp. 4036-4043Loulou, T., Artyukhin, E.A., Bardon, J.P., Estimation of thermal contract resistance during the first stages of metal solidification process: II-experimental setup and results (1999) Int. J. Heat Mass Tran, 42, pp. 2129-2142Kamal, M., El-Ashram, T., Microcreep of rapidly solidified Sn-0.7 wt.% Cu-In solder alloys (2007) Mater. Sci. Eng. A, 456, pp. 1-4Shen, J., Liu, Y., Han, Y., Gao, H., Wei, C., Yang, Y., Effects of cooling rates on microstructure and microhardness of lead-free Sn-3.5% Ag solders (2006) Trans. Nonferrous Met. Soc. China, 16, pp. 59-64Telang, A.U., Bieler, T.R., Characterization of microstructure and crystal orientation of the tin phase in single shear lap Sn-3.5Ag solder joint specimens (2005) Scripta Mater, 52, pp. 1027-1031Yu, D.Q., Wang, L., Wu, C.M.L., Law, C.M.T., The formation of nano-Ag3Sn particles on the intermetallic compounds during wetting reaction (2005) J. Alloys Compd, 389, p. 153Cheung, N., Ferreira, I.L., Pariona, M.M., Quaresma, J.M.V., Garcia, A., Melt characteristics and solidification growth direction with respect to gravity affecting the interfacial heat transfer coefficient of chill castings (2009) Mater. Design, 30, pp. 3592-3601Hwang, J.C., Chuang, H.T., Jong, S.H., Hwang, W.S., Measurement of heat transfer coefficient at metal/mould interface during casting (1994) AFS Trans, 102, pp. 877-883Krishnan, M., Sharma, D.G.R., Determination of the interfacial heat transfer coefficient h in unidirectional heat flow by Beck's non linear estimation procedure (1996) Int. Commun. Heat Mass Transfer, 23, pp. 203-214Beck, J.V., Nonlinear estimation applied to the nonlinear inverse heat conduction problem (1970) Int. J. Heat Mass Tran, 13, pp. 703-716Ho, K., Pehlke, R.D., Transient methods for determination of metal - mold interfacial heat transfer (1983) AFS Trans, 91, pp. 689-698Siqueira, C.A., Cheung, N., Garcia, A., The columnar to equiaxed transition during solidification of Sn-Pb alloys (2003) J. Alloys Compd, 351, pp. 126-134Goulart, P.R., Spinelli, J.E., Cheung, N., Ferreira, I.L., Garcia, A., Cellular growth during transient directional solidification of hypoeutectic Al-Fe alloys (2009) J. Alloys Compd, 470, pp. 589-59

Transmission of visceral leishmaniasis in dogs in a risk area of the metropolitan region of Belo Horizonte, Minas Gerais, Brazil

ABSTRACT Visceral leishmaniasis (VL) has spread rapidly across cities in the metropolitan region of Belo Horizonte. The aim of this study was to investigate VL dynamics in a prospective cohort study of dogs in Juatuba, between 2010 and 2011, to confirm the incidence of Leishmania infantum, and to assess possible risk factors associated with infection. An observational and prospective closed cohort study was performed using serology testing in dogs, randomly selected from the whole municipality. All seronegative dogs, or dogs with inconclusive results were monitored using indirect immunofluorescence (IIF) at 6-month intervals. The dog's owners completed a semi-structured questionnaire to assess possible causal factors of seroconversion, and the responses were assessed using logistic regression. The canine incidence coefficient was 206/1,000 dogs per year (CI: 178-238), and a cluster was identified in an area with a high concentration of seropositive dogs, but a low overall canine population. Large dogs were identified as a risk factor and the following variables were identified as protection factors: dogs aged over 4 years, daily peridomicile cleaning, and better socioeconomic conditions. VL is spreading over a large area in Juatuba in a short period of time

Young head and neck cancer patients are at increased risk of developing oral mucositis and trismus

Objectives: To evaluate cancer treatment–related toxicities in young head and neck cancer (HNC) patients. Material and methods: A total of 44 patients were included in the present retrospective cohort study, which was designed to access oral toxicities of cancer treatment in young ( 58 years of age, Group II, n = 22) HNC patients with similar tumor stage and treatment protocols. Oral mucositis (OM), xerostomia, dysphagia, dysgeusia, trismus, and radiodermatitis were assessed during days 7th, 21st, and 35th of head and neck radiotherapy (HNRT) according to previously validated scales (World Health Organization criteria and the National Cancer Institute and Common Terminology Criteria for Adverse Events version 4.0). Results: Patients from both groups showed high incidence and severity of oral toxicities by the end of the HNRT with OM (81.9% (Group I); 63.6% (Group II)) and xerostomia (72.6% (Group I); 77.2% (Group II)) being the most prevalent toxicities. No differences regarding xerostomia, dysphagia, dysgeusia, and radiodermatitis incidences or severity could be observed between groups. However, higher incidences and severity of OM at 21st and 35th fractions (odds ratio = 2.22 and 5.71, respectively) and trismus at 21st and 35th fractions (odds ratio = 6.17 and 14.5, respectively) were observed throughout the treatment in young patients when compared to older patients (p < 0.01 and p < 0.05, respectively). Conclusion: Young HNC patients are more affected by cancer treatment–related OM and trismus despite the similarities in clinical staging and treatment protocols with elderly patients.CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPSem informaçãoSem informação2018/02233-6; 2016/22862-2; 2013/18402-8; 2012/06138-