Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe

Drinking water purity – a UK perspective

Water purity is a vague term often interpreted in a subjective manner. When applied to drinking water quality, the emphasis of “pure” can mean free from all types of bacteria and viruses when defined by the EPA in the United States, or being wholesome as defined by drinking water legislation in the UK. These legal definitions have significant economic, practical and potential health implications that are of concern to the Water Science Forum (WSF) of the Royal Society of Chemistry. This brief outlines a UK-based perspective on the meaning of water purity based on relevant literature and consultation with our member

Basic astronomy as part of a general higher education in the developing world

This paper describes a new initiative in support of the aim of Commission 46 of the IAU to develop and improve astronomy education at all levels throughout the world. This paper discusses the ideal specification of a facility to support basic astronomy within education programmes which are delivered to students who have access to the Internet. The available robotic telescopes are discussed against this specification and it is argued that the Bradford Robotic Telescope, uniquely, can support many thousands of users in the area of basic astronomy education, and the resource is free. Access to the Internet is growing in the developing world and this is true in education programmes. This paper discusses the serious problems of delivering to large numbers of students a web based astronomy education programme supported by a robotic telescope as part of a general education. It examines the problems of this form of teaching for teachers who have little experience of working with IT and little knowledge of basic astronomy and proposes how such teachers can be supported. The current system (http://www.telescope.org/) delivers astronomy education in the language, culture and traditions of England. The paper discusses the need to extend this to other languages, cultures and traditions, although for trainee teachers and undergraduates, it is argued that the current system provides a unique and valuable resource