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

Solution of the field equations for 2-D electromagnetic direct implicit plasma simulation

A direct implicit particle-in-cell (PIC) simulation model with full electromagnetic (EM) effects has been implemented in 2-D Cartesian geometry. The model, implemented with the D/sub 1/ time differencing scheme, was first implemented in a 1-D electrostatic (ES) version to gain some experience with spatial differencing in forms suitable for extension to the full EM field in two dimensions. The implicit EM field solve is considerably different from the implicit ES code. The EM field calculation requires an inductive part as well as the electrostatic and the B field must be self-consistently advanced

Round-robin test of split Hopkinson pressure bar

A Round-Robin test using split Hopkinson pressure bars (SHPBs) has been conducted by four universities: Swinburne University of Technology (SUT), Australia; University of São Paulo (USP), Brazil; University of Cape Town (UCT), South Africa; and Nanyang Technological University (NTU), Singapore. Each university had different sets of SHPBs and data acquisition systems. The bars were made of maraging 350 (SUT), SAE 1055 (USP), stainless steel 17–4 pH (UCT), and stainless steel 304 (NTU), respectively. The bar diameters were in a range of 12.7 to 24.99 mm and the lengths of the pressure bars were from 700 mm to 2000 mm. Compressive SHPB tests have been conducted on four metals: commercially pure copper, stainless steel grade 316 (SS316), aluminium alloy 1100 and magnesium alloy. The strain signals and stress-strain curves for each material measured by four universities have been compared and discussed. The results showed that the flow stress fluctuated in a range of ± 9.9% for copper, ± 3.3% for SS316, ± 6.7% for aluminium and ± 15.6% for magnesium. Specific strain rate or final true strains were not targeted in this study. Hence the strain rates ranged from 987 to 2690 s^−1, and final true strains varied from 0.12 to 0.38. This international collaboration attempts to provide evidence for the possible standardization of SHPB tests in the future

Recommandations for a Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS)

Background: Cognitive impairment in MS impacts negatively on many patients at all disease stages and in all subtypes. Full clinical cognitive assessment is expensive, requiring expert staff and special equipment. Test versions and normative data are not available for all languages and cultures. Objective: To recommend a brief cognitive assessment for multiple sclerosis (MS) that is optimized for small centers, with one or few staff members, who may not have neuropsychological training and constructed to maximize international use. Methods: An expert committee of twelve members representing the main cultural groups that have so far contributed considerable data about MS cognitive dysfunction was convened. Following exhaustive literature review, peer-reviewed articles were selected to cover a broad spectrum of cultures and scales that targeted cognitive domains vulnerable to MS. Each was rated by two committee members and candidates scales were rated on psychometric qualities (reliability, validity, and sensitivity), international application, ease of administration, feasibility in the specified context, and acceptability to patients. Results: The committee recommended the Symbol Digit Modalities Test, if only 5 minutes was available, with the addition of the California Verbal Learning Test – Second Edition and the Brief Visuospatial Memory Test – Revised learning trials if a further 10 minutes could be allocated for testing. Conclusions: A brief cognitive assessment for MS has been recommended. A validation protocol has been prepared for language groups and validation studies have commenced