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

Supplementary Material for: Endoplasmic Reticulum Stress Impairs Insulin Signaling through Mitochondrial Damage in SH-SY5Y Cells

Endoplasmic reticulum (ER) and mitochondrial stress are considered causal factors that induce neurodegenerative diseases. However, the relationship between these stresses remains poorly understood. To investigate the molecular mechanism underlying crosstalk between the ER and mitochondria in neurodegeneration, we treated SH-SY5Y human neuroblastoma cells with thapsigargin and tunicamycin, two inducers of ER stress, and atrazine, a promoter of mitochondrial stress. Each pharmacological agent caused mitochondrial dysfunction, which was characterized by reduced intracellular ATP, mitochondrial membrane potential, and endogenous cellular respiration as well as an augmentation of oxidative stress. Oligonucleotide microarray analysis followed by semiquantitative RT-PCR validation assays revealed that thapsigargin and tunicamycin downregulated the expression of most mitochondria-related genes in a manner similar to that induced by atrazine. In contrast, atrazine did not alter the expression of markers of ER stress. Three-dimensional principal component analysis showed that the gene expression profile produced by atrazine treatment was distinct from that generated by ER stress. However, all three agents impaired insulin receptor substrate-1 and Akt phosphorylation in the insulin signaling pathway. Ectopic overexpression of mitochondrial transcription factor A reversed the effects of thapsigargin on mitochondria and Akt signaling. We conclude that ER stress induces neuronal cell death through common perturbation of mitochondrial function and Akt signaling

Communist Revolution and Peasant Mobilisation in the Hinterland of North China: The Early Years

This chapter examines the depiction by populism in the domain of 'popular culture' of what purports to be its non-capitalist/non-socialist alternative: in short, the socio-economic and political structure of its 'imaginary' as this involves a symptomatic opposition between the utopic and dystopic. Using the pseudonym of Ivan Kremnev, the Russian neo-populist theoretician A. V. Chayanov wrote the utopian fiction The Journey of My Brother Alexei to the Land of Peasant Utopia. Accordingly, the utopic vision of Chayanov entails traversing time but not space; the protagonists in his narrative are projected forward into a future within the same demarcated space. Much of the populist discourse which structures the agrarian myth is present in the films of Frank Capra, who directed not only Lost Horizon but also Mr Deeds Goes to Town (1936), Mr Smith Goes to Washington (1939) and t's a Wonderful Life (1946)

Measurement of charged pion double spin asymmetries at midrapidity in longitudinally polarized p+pp+p collisions at s\sqrt {s} = 510 GeV

International audienceThe PHENIX experiment at the Relativistic Heavy Ion Collider has measured the longitudinal double spin asymmetries, ALL, for charged pions at midrapidity (|η|<0.35) in longitudinally polarized p+p collisions at s=510  GeV. These measurements are sensitive to the gluon spin contribution to the total spin of the proton in the parton momentum fraction x range between 0.04 and 0.09. One can infer the sign of the gluon polarization from the ordering of pion asymmetries with charge alone. The asymmetries are found to be consistent with global quantum-chromodynamics fits of deep-inelastic scattering and data at s=200  GeV, which show a nonzero positive contribution of gluon spin to the proton spin