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

Production of loach (Misgurnus anguillicaudatus) germ-line chimera using transplantation of primordial germ cells isolated from cryopreserved blastomeres

An efficient procedure for cryopreservation of fish blastomeres followed by restoration through germ-line chimera formation was established. Blastomeres of the loach (Misgurnus anguillicaudatus) were cryopreserved in 250-µL straws in Eagle’s minimum essential medium (MEM) with various concentrations of dimethyl-sulfoxide (DMSO; 0, 5, 10, 15, and 20%), and the best concentration was combined with glycerol (1, 2, and 4%) and external cryoprotectants (1 or 2% sucrose; 2, 5, or 10% fetal bovine serum; 1 or 2% bovine serum albumin). Post-thaw viability of the blastomeres was used to optimize cryopreservation conditions. Donor blastomeres were injected with zebrafish GFP-nos1 3’UTR mRNA and biotin dextran prior to cryopreservation in the optimal freeze medium. Host embryos were injected with zebrafish DsRed-nos1 3’UTR mRNA and reared to the blastula stage. Donor blastomeres were thawed at 25°C for 10 s and transplanted to the host embryos either immediately or after incubation for 16 h at 20°C. Donor and host primordial germ cell migration was visualized with fluorescent imaging during the early stages of embryogenesis, and also by histology in 4-d-old embryos. Transplantation of blastomeres immediately after thawing gave lower hatching rates (~3%) and generated a low percentage of germ-line chimeras (~1.1%). In contrast, incubation of cryopreserved sample for 16 h followed by transplantation of the GFP-positive blastomeres improved the hatching rate to 90%, and successfully produced presumable germ-line chimeras at a rate of 16.5%. The improved survival rates and germ-line chimerism may be an effective method for gene banking and subsequent reconstitution of endangered fish genotypes

Experimental and numerical investigation of acoustic pressures in different liquids

In an attempt to quantify the instantaneous pressure field in cavitating liquids at large forcing signals, pressures were measured in four different liquids contained in vessels with a frequency mode in resonance with the forcing signal. The pressure field in liquid metal was quantified for the first time, with maximum pressures of the order of 10–15 MPa measured in liquid aluminium. These high pressures are presumed to be responsible for deagglomeration and fragmentation of dendritic intermetallics and other inclusions. Numerical modelling showed that acoustic shielding attenuates pressure far from the sonotrode and it is prominent in the transparent liquids studied but less so in aluminium, suggesting that aluminium behaviour is different. Due to acoustic shielding, the numerical model presented cannot adequately capture the pressure field away from the intense cavitation zone, but gives a good qualitative description of the cavitation activity. The results obtained contribute to understanding the process of ultrasonic melt treatment (UST) of metal alloys, while facilitating further the guidelines formulation and reproducible protocols for controlling UST at industrial levels