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

Protocol for a partially nested randomised controlled trial to evaluate the effectiveness of the scleroderma patient-centered intervention network COVID-19 home-isolation activities together (SPIN-CHAT) program to reduce anxiety among at-risk scleroderma patients

Objective: Contagious disease outbreaks and related restrictions can lead to negative psychological outcomes, particularly in vulnerable populations at risk due to pre-existing medical conditions. No randomised controlled trials (RCTs) have tested interventions to reduce mental health consequences of contagious disease outbreaks. The primary objective of the Scleroderma Patient-centered Intervention Network COVID-19 Home-isolation Activities Together (SPIN-CHAT) Trial is to evaluate the effect of a videoconference-based program on symptoms of anxiety. Secondary objectives include evaluating effects on symptoms of depression, stress, loneliness, boredom, physical activity, and social interaction.Methods: The SPIN-CHAT Trial is a pragmatic RCT that will be conducted using the SPIN-COVID-19 Cohort, a sub-cohort of the SPIN Cohort. Eligible participants will be SPIN-COVID-19 Cohort participants without a positive COVID-19 test, with at least mild anxiety (PROMIS Anxiety 4a v1.0 T-score >= 55), not working from home, and not receiving current counselling or psychotherapy. We will randomly assign 162 participants to intervention groups of 7 to 10 participants each or waitlist control. We will use a partially nested RCT design to reflect dependence between individuals in training groups but not in the waitlist control. The SPIN-CHAT Program includes activity engagement, education on strategies to support mental health, and mutual participant support. Intervention participants will receive the 4-week (3 sessions per week) SPIN-CHAT Program via video-conference. The primary outcome is PROMIS Anxiety 4a score immediately post-intervention.Ethics and dissemination: The SPIN-CHAT Trial will test whether a brief videoconference-based intervention will improve mental health outcomes among at-risk individuals during contagious disease outbreak

Aspectos socioeconómicos y biofísicos de la desertificación

La desertificación es uno de los principales problemas ambientales a los que se enfrentan los países situados en zonas de clima árido, semiárido y seco-subhúmedo. Pese a su importancia y al ingente esfuerzo investigador realizado en las últimas décadas, existen numerosas incertidumbres en distintos aspectos que rodean a este complejo fenómeno. Buena parte de esta problemática tiene su origen en el hecho de que las dimensiones biofísicas y socioeconómicas de la desertificación han sido tradicionalmente estudiadas separadamente por científicos de las ciencias naturales y sociales, así como en la falta de un marco conceptual apropiado para analizar este fenómeno teniendo en cuenta ambas dimensiones simultáneamente. En el presente artículo se revisan los principales temas que rodean a la degradación de la tierra y la desertificación, se presenta un marco conceptual recientemente desarrollado para abordar sus dimensiones biofísicas y socioeconómicas simultáneamente, se revisan algunas de las principales medidas que se llevan a cabo para gestionar las áreas desertificadas y se discuten algunos de los principales retos a los que se enfrenta la investigación en este área.Land degradation and desertification are among the most important environmental issues being faced by drylands. Despite its importance and the enormous research effort devoted to it in the last decades, desertification is a topic surrounded by controversy and disagreement. This controversy is rooted in the traditional separation of the biophysical and socio-economic dimensions of desertification, which have been studied separately by scientists from both the natural and the social sciences. This separation has been fueled by the lack of a conceptual and synthethic framework suited to deal with both dimensions simultaneously. In this article we review the main topics surrounding desertification, introduce a new conceptual framework designed to study the biophysical and socio-economic dimensions of desertification simultaneously, review some of the measures being carried out to manage desertified lands and discuss some of the main challenges ahead in the research and management arenas.National Science Foundation (NSF-DEB-02-34186); Centro para el Estudio Integrado de las Dimensiones Humanas del Cambio Global mediante un acuerdo entre la National Science Foundation (SBR-9521914) y la universidad Carnegie Mellon. El trabajo de F.T. Maestre ha sido financiado por una beca Fulbright, financiada por la Secretaría de Estado de Universidades y el Fondo Social Europeo

Low Frequency Scattering by Rectangular Dielectric Particles

http://deepblue.lib.umich.edu/bitstream/2027.42/20941/2/rl0629.0001.001.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/20941/1/rl0629.0001.001.tx

The Scleroderma Patient-Centered Intervention Network Cohort: Baseline clinical features and comparison with other large scleroderma cohorts

Contains fulltext : 194824.pdf (publisher's version ) (Closed access)Objectives: The Scleroderma Patient-centered Intervention Network (SPIN) Cohort is a web-based cohort designed to collect patient-reported outcomes at regular intervals as a framework for conducting trials of psychosocial, educational, self-management and rehabilitation interventions for patients with SSc. The aim of this study was to present baseline demographic, medical and patient-reported outcome data of the SPIN Cohort and to compare it with other large SSc cohorts. Methods: Descriptive statistics were used to summarize SPIN Cohort characteristics; these were compared with published data of the European Scleroderma Trials and Research (EUSTAR) and Canadian Scleroderma Research Group (CSRG) cohorts. Results: Demographic, organ involvement and antibody profile data for SPIN (N = 1125) were generally comparable with that of the EUSTAR (N = 7319) and CSRG (N = 1390) cohorts. There was a high proportion of women and White patients in all cohorts, though relative proportions differed. Scl70 antibody frequency was highest in EUSTAR, somewhat lower in SPIN, and lowest in CSRG, consistent with the higher proportion of interstitial lung disease among dcSSc patients in SPIN compared with in CSRG (48.5 vs 40.3%). RNA polymerase III antibody frequency was highest in SPIN and remarkably lower in EUSTAR (21.1 vs 2.4%), in line with the higher prevalence of SSc renal crisis (4.5 vs 2.1%) in SPIN. Conclusion: Although there are some differences, the SPIN Cohort is broadly comparable with other large prevalent SSc cohorts, increasing confidence that insights gained from the SPIN Cohort should be generalizable, although it should be noted that all three cohorts include primarily White participants.9 p