Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

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

Gall disease in the alginophyte Lessonia berteroana: A pathogenic interaction linked with host adulthood in a seasonal-dependant manner

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IMC – an integrative review

This paper reviews and integrates extant work in the integrated marketing communication (IMC) literature. With this in mind, three alternative and widely disseminated conceptual frameworks proposed in the IMC literature are employed as a starting point. The review locates important points of theoretical intersection among these three frameworks, and drawing on the wider literature, develops and cross-fertilizes them into IMC constructs. The review then combines the constructs into an integrative framework by proposing theory-driven relationships and formalizing them using testable propositions. The final outcome offers a clearer synthesis and re-conceptualization of IMC

Factors driving the adoption of mobile banking app: An empirical assessment in the less digitalized economy

Financial institutions remain one of the key industries making use of information and communication technologies to transform their products and services and their business in general. As the Internet becomes pervasive, most banks, in addition to their traditional mobile banking, have introduced mobile banking apps, which ride on smart devices and the Internet to offer banking services remotely to customers. However, given some contextual factors such as unstable Internet, adoption of this innovation may be a challenge in an emerging economy. Thus, the study sought to find out the factors, which could affect the adoption of mobile banking app in a less digitalized environment. To this end, data was sourced via the intercept approach on a sample of the entire population in Ghana for the analysis. By using the partial least square structural equation modelling (PLS-SEM) technique, the study found that performance expectancy and hedonic motivation were the key factors that influence mobile banking app adoption. Contrary to our expectation, effort expectancy, perceived transaction cost, and privacy and information concerns were found to have no effect on consumers’ intention to adopt mobile banking app. Implications for further research and practice are presented and discussed. © 2020, IFIP International Federation for Information Processing

Understanding key motivations for using a hotel gamified application.

While hospitality has been one of the industries that have been keen to adopt and use various technologies, the proliferation of gamification application is still to materialise. It is therefore very interesting to investigate the potential benefits of gamified applications for both demand and supply in the area of the hospitality industry by identifying the motives of individuals’ when they use a hotel-gamified application. Since fun has become the requirement to ensure continuous demands for many products or services, companies and organizations feel the need to involve fun in their offerings to secure continuity in consumption and use. Hence, this study aims to understand the meaning of fun for individuals when they will use a hotel-gamified application. Visual material was prepared so the interviewees would have an idea of how a hotel-gamified application would look if it were in existence today based on the current definitions of gamification.N/