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 Trip to the Summit of Orizaba, The Altitudes of Orizaba and Popocatepetl Effects of High-Mountain Climbing

Manuscript reads, "Read Oct. 20, 1897," although publication date is 1898, reprinted from Appalachia, Vol. VIII, No. 4

Household composition and social differentiation. North western Portugal in the nineteenth century

The authors gratefully acknowledge the comments of Robert Rowland, Stuart Woolf, Larry Poos and Michael Redclift. The argument was greatly influenced by discussions with Richard Smith, Joäo de Pina-Cabral and Caroline Brettell. Research by Joäo Nunes was supported by a grant from the Instituto Nacional de Investigaçäo Cientifica, Lisbon.The province of Minho in the north west of Portugal has long been regarded as a differentiated cultural region of Portugal. This paper begins with a brief presentation of the evidence on household composition in this region published so far, which offers new arguments about the identification of this province's characteristics. The existence of significant proportions of complex family households is related to patterns of post-marital residence, to demographic features and to strategies of patrimony devolution. The pattern of household composition allows a degree of variation both within each community and across the region. These differences do not imply, however, that different social processes are at work., It is argued that residence should not be given too much importance, but rather be considered as one process among others. The process of household formation is then analysed in a broader social context and related to factors such as forms of labour and patterns of female employment. The authors suggest that some features of rural society in Minho raise substantial problems as far as the use of the ‘classic peasantry’ as a theoretical reference in studies of an historical nature is concerned, and point to new avenues that may help to foster our knowledge and understanding of historical rural societies in Europe.La province du Minho, au nord-ouest du Portugal, est depuis longtemps considérée commeune région culturellement différenciée. L'article commence par rappeler brièvement les traits caractéristiques des families dans cette région, ce qui caractérìse par le fait même la région elle-même. L'importance quantitative des ménages complexes est liée à des modèles de résidence post-maritale, à des faits démographiques et à des stratégies de transmission du patrimoine. Ce modèle de composition des ménages permet une grande variabilityé tant dans les collectivités qu'au plan de la région, mais cette différenciation n'implique pas que des processus différents soient àľoeuvre. Car le fait de la résidence n'est pas un fait fundamental: le processus de formation des ménages est en effet inscrit dans un contexte social plus large oùjouent aussi les formes de travail et ľempioi féminin. Les auteurs suggèrent alors que ces caractéristiques de la société rurale du Minho posent des problèmes de fond dès qu'on fait théoríquement référence à une ‘paysannerie classique’ dans une étude historique; ils indiquent de nouvelles pistes qui pourraient alimenter la connaissance des sociétés rurales européennes.Die Provinz Minho im Nordwesten Portugals ist lange als eine Region angesehen worden, die sich kulturell unterschiedlich entwickelt hat. Der Beitrag beginnt mit einer kurzen Vorstellung des bisher veröffentlichten Materials über die Zusammensetzung der Haushalte in dieser Region. Damit werden neue Belege zur Bestimmung der besonderen Kennzeichen dieser Provinz vorgelegt. Das Vorhandensein bedeutender Anteile von Groβfamilien-Haus-halten hängt zusammen mit den Mustern der Wohnstandortwahl nach der Eheschlieβung, demographischen Merkmalen und Strategien der Erbfolge. Das Muster der Haushaltszusammensetzung erlaubt eine gewisse Variation, sowohl innerhalb einer jeden Gemeinde, als auch zwischen den Regionen. Diese Unterschiede implizieren jedoch nicht, daβ unterschiedliche soziale Prozesse wirksam sind. Es wird behauptet, daβ die Wohnsitzwahl nicht von so groβer Bedeutung ist, sondern als ein Prozess unter anderen anzusehen ist. Es wird dann der Prozess der Haushaltsbildung in einem breiteren sozialen Kontext analysiert und in Beziehung gesetzt zu Faktoren wie Arbeitsfor-men und Muster der Erwerbstätigkeit von Frauen. Die Autoren weisen darauf hin, daβ einige Merkmale der ländlichen Gesellschaft des Minho, was die Benutzung des klassischen Bauerntums als theoretisches Bezugssystem bei historischen Studien anbetrifft, erhebliche Probleme aufwerfen. Sie zeigen neue Wegen auf, die helfen können, unser Wissen und unsere Kenntnis über historische ländliche Gesellschaften zu verbessern