The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Le nuove chiese della diocesi di Milano 1945-1993

Il volume \ue8 l\u2019esito di una capillare ricerca che ha censito tutte le chiese della Diocesi Ambrosiana costruite tra il 1945 e il 1993. Il lavoro, svolto su richiesta e in accordo con l\u2019Ufficio Nuove Chiese della Curia milanese, ha rilevato di ogni architettura ecclesiastica la denominazione, il progettista, l\u2019anno di costruzione, la descrizione della pianta, le misure, i materiali impiegati, la storia e le circostanze della costruzione, le opere degli artisti che sono entrate nello spazio sacro, la bibliografia specifica. La ricostruzione del corpus delle chiese sorte sul territorio ambrosiano, pi\uf9 di 300 nel periodo considerato, ha permesso una serie di conoscenze e indagini importanti rendendo possibile individuare linee di tendenza architettoniche ed ecclesiali, disciplinari e pastorali che derivano da caratteristiche peculiari, fra cui quella di essere dotata di un suo rito liturgico. I saggi che corredano il catalogo delle chiese si articolano in diverse pertinenze: il rapporto tra architettura e liturgia, le questioni della progettazione, il ruolo della committenza e lo svolgimento storico-critico in tre saggi secondo le cadenze degli episcopati che lo qualificano, quindi un testo sulla presenza di interventi artistici all\u2019interno dell\u2019architettura ecclesiale nel suo dibattito problematico. Il saggio storico-critico che riguarda il periodo degli episcopati di Schuster e Montini (1945-1963) \ue8 volto ad evidenziare lo svolgimento del tema architettonico segnato dall\u2019emergenza dell\u2019immediato dopoguerra, ma non di meno dall\u2019intensit\ue0 e dalla ricchezza del dibattito teorico e disciplinare allora rilanciato a tutte le componenti della cultura contemporanea. Le piste del Movimento liturgico internazionale in dialogo con le opzioni degli architetti vengono soprattutto attivate dall\u2019arcivescovo Giovanni Battista Montini, futuro papa Paolo VI, che coinvolge i pi\uf9 bei nomi del professionismo milanese. Ne nasce una interessantissima sperimentazione che contribuisce alla definizione del pensiero contemporaneo in tema di architettura sacra e connesse strutture assistenziali. Progettazione che prepara il Concilio Vaticano II e che avr\ue0 un\u2019importanza significativo per gli aggiornamenti dovuti alla riforma liturgica.The volume is the outcome of an extensive research that has recorded all the churches built between 1945 and 1993 in the Ambrosian Diocese. The work, done upon request and in accordance with the Office of New Churches of the Curia of Milan, for every ecclesiastic architecture found the name, the designer, the year of construction, the description of the layout, the measurements, the materials used, the history and circumstances of the construction, the works of the artists who entered the sacred space, the specific bibliography. The reconstruction of the body of more than 300 churches built in the territory Ambrosian over the period, has allowed a number of important surveys and knowledge, enabling to identify architectural and ecclesiastical, disciplinary and pastoral trends derived from specific characteristics, including that of be equipped with its own liturgical rite. The essays part of the catalog of the churches are divided into different pertinences: the relationship between architecture and liturgy, the design issues, the role of patronage and historical-critical conduct in three essays according the cadences of the relative bishops, then a text on the presence of artistic interventions within the architecture of the Church in its problematic debate. The historical-critical essay, which covers the period during the bishops of Schuster and Montini (1945-1963), wants to highlight the development of the architectural theme marked by the emergence of the immediate post-war period, but nevertheless also by the intensity and richness of the theoretical and disciplinary debate raised in that period to regulate all the aspects of contemporary culture. The tracks of the International Liturgical Movement in dialogue with the options of architects are mainly activated by Archbishop Giovanni Battista Montini, the future Pope Paul VI, who involves the most important names of professionals in Milan. The result is an interesting experimentation that contributes to the definition of the contemporary thought regarding the sacred architecture and the care facilities connected. This plan prepares the Second Vatican Council and will have a significant importance for the upgrades due to the liturgical reform

The management of acute venous thromboembolism in clinical practice - study rationale and protocol of the European PREFER in VTE Registry

Background: Venous thromboembolism (VTE) is a major health problem, with over one million events every year in Europe. However, there is a paucity of data on the current management in real life, including factors influencing treatment pathways, patient satisfaction, quality of life (QoL), and utilization of health care resources and the corresponding costs. The PREFER in VTE registry has been designed to address this and to understand medical care and needs as well as potential gaps for improvement. Methods/design: The PREFER in VTE registry was a prospective, observational, multicenter study conducted in seven European countries including Austria, France Germany, Italy, Spain, Switzerland, and the UK to assess the characteristics and the management of patients with VTE, the use of health care resources, and to provide data to estimate the costs for 12 months treatment following a first-time and/or recurrent VTE diagnosed in hospitals or specialized or primary care centers. In addition, existing anticoagulant treatment patterns, patient pathways, clinical outcomes, treatment satisfaction, and health related QoL were documented. The centers were chosen to reflect the care environment in which patients with VTE are managed in each of the participating countries. Patients were eligible to be enrolled into the registry if they were at least 18 years old, had a symptomatic, objectively confirmed first time or recurrent acute VTE defined as either distal or proximal deep vein thrombosis, pulmonary embolism or both. After the baseline visit at the time of the acute VTE event, further follow-up documentations occurred at 1, 3, 6 and 12 months. Follow-up data was collected by either routinely scheduled visits or by telephone calls. Results: Overall, 381 centers participated, which enrolled 3,545 patients during an observational period of 1 year. Conclusion: The PREFER in VTE registry will provide valuable insights into the characteristics of patients with VTE and their acute and mid-term management, as well as into drug utilization and the use of health care resources in acute first-time and/or recurrent VTE across Europe in clinical practice. Trial registration: Registered in DRKS register, ID number: DRKS0000479

Guidelines for the use and interpretation of assays for monitoring autophagy

In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. A key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process vs. those that measure flux through the autophagy pathway (i.e., the complete process); thus, a block in macroautophagy that results in autophagosome accumulation needs to be differentiated from stimuli that result in increased autophagic activity, defined as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (in most higher eukaryotes and some protists such as Dictyostelium) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the field understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field

Search for heavy resonances in the W/Z-tagged dijet mass spectrum in pp collisions at 7 TeV

A search has been made for massive resonances decaying into a quark and a vector boson, qW or qZ, or a pair of vector bosons, WW, WZ, or ZZ, where each vector boson decays to hadronic final states. This search is based on a data sample corresponding to an integrated luminosity of 5.0 fb 121 of proton\u2013proton collisions collected in the CMS experiment at the LHC in 2011 at a center-of-mass energy of 7 TeV. For sufficiently heavy resonances the decay products of each vector boson are merged into a single jet, and the event effectively has a dijet topology. The background from QCD dijet events is reduced using recently developed techniques that resolve jet substructure. A 95% CL lower limit is set on the mass of excited quark resonances decaying into qW (qZ) at 2.38 TeV (2.15 TeV) and upper limits are set on the cross section for resonances decaying to qW, qZ, WW, WZ, or ZZ final states