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

Consistent patterns of common species across tropical tree communities

Trees structure the Earth’s most biodiverse ecosystem, tropical forests. The vast number of tree species presents a formidable challenge to understanding these forests, including their response to environmental change, as very little is known about most tropical tree species. A focus on the common species may circumvent this challenge. Here we investigate abundance patterns of common tree species using inventory data on 1,003,805 trees with trunk diameters of at least 10 cm across 1,568 locations1,2,3,4,5,6 in closed-canopy, structurally intact old-growth tropical forests in Africa, Amazonia and Southeast Asia. We estimate that 2.2%, 2.2% and 2.3% of species comprise 50% of the tropical trees in these regions, respectively. Extrapolating across all closed-canopy tropical forests, we estimate that just 1,053 species comprise half of Earth’s 800 billion tropical trees with trunk diameters of at least 10 cm. Despite differing biogeographic, climatic and anthropogenic histories7, we find notably consistent patterns of common species and species abundance distributions across the continents. This suggests that fundamental mechanisms of tree community assembly may apply to all tropical forests. Resampling analyses show that the most common species are likely to belong to a manageable list of known species, enabling targeted efforts to understand their ecology. Although they do not detract from the importance of rare species, our results open new opportunities to understand the world’s most diverse forests, including modelling their response to environmental change, by focusing on the common species that constitute the majority of their trees

Isolation, molecular characterization and differentiation of porcine cardiac mesangioblasts

Isolation, molecular characterization and differentiation of porcine cardiac mesangioblast

An integrated multi-study analysis of intra-subject variability in cerebrospinal fluid amyloid-beta concentrations collected by lumbar puncture and indwelling lumbar catheter

Contains fulltext : 154021.pdf (publisher's version ) (Open Access)INTRODUCTION: Amyloid-beta (Abeta) has been investigated as a diagnostic biomarker and therapeutic drug target. Recent studies found that cerebrospinal fluid (CSF) Abeta fluctuates over time, including as a diurnal pattern, and increases in absolute concentration with serial collection. It is currently unknown what effect differences in CSF collection methodology have on Abeta variability. In this study, we sought to determine the effect of different collection methodologies on the stability of CSF Abeta concentrations over time. METHODS: Grouped analysis of CSF Abeta levels from multiple industry and academic groups collected by either lumbar puncture (n=83) or indwelling lumbar catheter (n=178). Participants were either placebo or untreated subjects from clinical drug trials or observational studies. Participants had CSF collected by lumbar puncture or lumbar catheter for quantitation of Abeta concentration by enzyme linked immunosorbent assay. Data from all sponsors was converted to percent of the mean for Abeta40 and Abeta42 for comparison. Repeated measures analysis of variance was performed to assess for factors affecting the linear rise of Abeta concentrations over time. RESULTS: Analysis of studies collecting CSF via lumbar catheter revealed tremendous inter-subject variability of Abeta40 and Abeta42 as well as an Abeta diurnal pattern in all of the sponsors' studies. In contrast, Abeta concentrations from CSF samples collected at two time points by lumbar puncture showed no significant differences. Repeated measures analysis of variance found that only time and draw frequency were significantly associated with the slope of linear rise in Abeta40 and Abeta42 concentrations during the first 6 hours of collection. CONCLUSIONS: Based on our findings, we recommend minimizing the frequency of CSF draws in studies measuring Abeta levels and keeping the frequency standardized between experimental groups. The Abeta diurnal pattern was noted in all sponsors' studies and was not an artifact of study design. Averaging Abeta concentrations at each time point is recommended to minimize the effect of individual variability. Indwelling lumbar catheters are an invaluable research tool for following changes in CSF Abeta over 24-48 hours, but factors affecting Abeta concentration such as linear rise and diurnal variation need to be accounted for in planning study designs

Habitats, population densities, and social structure of capybaras (Hydrochaeris Hydrochaeris, Rodentia) in the Pantanal, Brazil

(1) The Pantanal is the central portion of a sunken flat plain bordering the upper Paraguay river, with an area of 140,000 km². Seasonal floods begin in January and end in April. From May to October the land dries out and campos (grassland formations) and scattered pools appear. (2) Typical capybara habitat in the Pantanal is composed of three components: the water, a patch of forest, and a grass field for foraging. Highest densities of capybaras (14 individuals/km²) were found during the rainy season when the available space for capybaras was reduced due to the flooding. Areas without ponds or creeks presented low densities (from 0.38 to 0.84 capybaras/km²). Group sizes ranged from 2 to 49 individuals (x = 9.48). (3) Reproduction occurred year-round and young of different ages were seen throughout the year. However, the principal recruitment of young to the population was observed in July-August. While the females took turns in caring for young of different ages, probably the offspring of mothers who are sisters in the same social groups, the males competed intensively with each other for access to breeding females. The male's reproductive success appears to be limited to the number of breeding females that males have access to in the social group