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

Psychosocial functioning of childhood cancer survivors living in rural areas

High-dose chemotherapy currently used in the treatment of children with cancer may induce late effects on psychosocial and cognitive functioning in some of them. The aim of the study was to evaluate psychosocial functioning of childhood cancer survivors living in rural regions. In total, 29 children entered the study. The children were diagnosed as having cancer between 1993-1995 in a single centre. Each patient was examined 5 years after the completion of cancer therapy. The children had been diagnosed with leukemia and lymphoma (72.4%), and solid tumours. Self-report questionnaires, as well as standardized psychological test (WISC-R, WAIS-R-PL) were performed for the evaluation of psychosocial and cognitive functioning of the patients. Most of the studied cancer survivors living in rural areas did not reveal diffi culties with cognitive and psychosocial functioning. In some patients, however, we observed more diffi culties in verbal tasks and existing major learning diffi culties. Cancer survivors living in rural areas in our region may be more unprivileged due to poor additional supporting services

Soil contamination by PAHsin the vicinity of a heat-generating plant

The investigated object is a coal-fired heat and power generating plant which serves the needs of Radom, a medium-sized municipality in central Poland.Soil and fly-ash samples were collected in the vicinty of the plant and analyzer for the presence of PAHs.PAH concentrations were measured by the HPLC method,according to the USEPA list (16 PAH were determined ). The PAHs identified in the proximity to the plant differed from those determined in the soil samples polluted by car emissions.The soil concentrations of PAHs near the heat and power generating plant were found to be comparatively low,which means that the soil can be used for agricultural needs,as there is no risk of PAH peneration into the food chain

Urban badger setts: characteristics, patterns of use and management implications

Damage caused by badger setts is an important source of human–carnivore conflict in urban areas of the UK, yet little is known about the spatial distribution of urban badger setts or their pattern of occupation. We compared the density, spatial distribution and size of setts in four urban and two rural study areas in the UK and assessed the applicability to urban systems of distinguishing between ‘main’ and ‘outlier’ setts. In addition, we used radio-telemetry to investigate diurnal patterns of sett use in one urban area (Brighton). It was possible to distinguish between main and outlier setts in urban environments, and local sett densities were comparable in urban and rural areas. However, urban badgers used substantially fewer setts than did a nearby rural population, and they spent a smaller proportion of days in outlier setts. Social groups with larger ranges had more setts available to them and, within groups, individuals with larger ranges used more setts. Outliers appeared to serve multiple functions, including allowing efficient and safe travel to important parts of the home range. We conclude that sett densities can be high in urban habitats, suggesting significant potential for sett-related problems to arise. The fact that urban main setts can be distinguished from outliers enables management actions to be tailored accordingly. In particular, because main setts seem to represent a particularly valuable resource to urban badgers, alternatives to the closure of problem main setts need to be considere