21 research outputs found

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

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    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.

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    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

    The James Webb Space Telescope Mission

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    Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least 4m4m. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the 6.5m6.5m James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

    Assessment of the Role of Local Strawberry Rhizosphere—Associated Streptomycetes on the Bacterially—Induced Growth and Botrytis cinerea Infection Resistance of the Fruit

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    The future need for sustainable agriculture will be met in part by wider use of biological control of plant pathogens over conventional fungicides hazardous to the environment and to public health. Control strategies involving both (i) direct use of microorganisms antagonistic to the phytopathogen, and (ii) use of bioactive compounds (secondary metabolites/antibiotic compounds) from microorganisms on the phytopathogen were both adapted in order to investigate the ability of streptomycetes isolated from the rhizosphere of strawberry plants to promote the growth of the fruit and suppress Botrytis cinerea causing strawberry rot on the Sunshine Coast, Queensland, Australia. In vitro studies showed that 25/39 streptomycetes isolated from strawberry field soils inhibited B. cinerea growth by antifungal activity, ranging from antibiosis to volatile compound production. However, when non-volatile antifungal compounds were extracted and applied aerially to the actively growing strawberry fruits infected with B. cinerea, a significant disease reduction was not recorded. On the other hand, plant and fruit growth was promoted by the presence of actively growing streptomycetes in container media. Findings might indicate that live streptomycete inoculum can be used as growth promoting agent in container media for this economically important crop.strawberry; Botrytis cinerea ; streptomycetes; biological control; growth promotion

    Assessment of the Role of Local Strawberry Rhizosphere—Associated Streptomycetes on the Bacterially—Induced Growth and Botrytis cinerea Infection Resistance of the Fruit

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    The future need for sustainable agriculture will be met in part by wider use of biological control of plant pathogens over conventional fungicides hazardous to the environment and to public health. Control strategies involving both (i) direct use of microorganisms antagonistic to the phytopathogen, and (ii) use of bioactive compounds (secondary metabolites/antibiotic compounds) from microorganisms on the phytopathogen were both adapted in order to investigate the ability of streptomycetes isolated from the rhizosphere of strawberry plants to promote the growth of the fruit and suppress Botrytis cinerea causing strawberry rot on the Sunshine Coast, Queensland, Australia. In vitro studies showed that 25/39 streptomycetes isolated from strawberry field soils inhibited B. cinerea growth by antifungal activity, ranging from antibiosis to volatile compound production. However, when non-volatile antifungal compounds were extracted and applied aerially to the actively growing strawberry fruits infected with B. cinerea, a significant disease reduction was not recorded. On the other hand, plant and fruit growth was promoted by the presence of actively growing streptomycetes in container media. Findings might indicate that live streptomycete inoculum can be used as growth promoting agent in container media for this economically important crop

    Risk factors for death, stroke, and bleeding in 28,628 patients from the GARFIELD-AF registry: Rationale for comprehensive management of atrial fibrillation

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    International trends in clinical characteristics and oral anticoagulation treatment for patients with atrial fibrillation: Results from the GARFIELD-AF, ORBIT-AF I, and ORBIT-AF II registries

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    Background Atrial fibrillation (AF) is the most common cardiac arrhythmia in the world. We aimed to provide comprehensive data on international patterns of AF stroke prevention treatment

    Early Risks of Death, Stroke/Systemic Embolism, and Major Bleeding in Patients With Newly Diagnosed Atrial Fibrillation Results From the GARFIELD-AF Registry

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    BACKGROUND: Atrial fibrillation is associated with increased risks of death, stroke/systemic embolism, and bleeding (incurred by antithrombotic therapy), which may occur early after diagnosis
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