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

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Predicting the photocurrent–composition dependence in organic solar cells

Dataset complementario en Digital.CSIC: https://digital.csic.es/handle/10261/223231 (10.20350/digitalCSIC/12719)The continuous development of improved non-fullerene acceptors and deeper knowledge of the fundamental mechanisms governing performance underpin the vertiginous increase in efficiency witnessed by organic photovoltaics. While the influence of parameters like film thickness and morphology are generally understood, what determines the strong dependence of the photocurrent on the donor and acceptor fractions remains elusive. Here we approach this problem by training artificial intelligence algorithms with self-consistent datasets consisting of thousands of data points obtained by high-throughput evaluation methods. Two ensemble learning methods are implemented, namely a Bayesian machine scientist and a random decision forest. While the former demonstrates large descriptive power to complement the experimental high-throughput screening, the latter is found to predict with excellent accuracy the photocurrent–composition phase space for material systems outside the training set. Interestingly, we identify highly predictive models that only employ the materials band gaps, thus largely simplifying the rationale of the photocurrent–composition space.This work was supported by the Spanish Ministerio de Ciencia e Innovación under Grants PGC2018-095411-B-I00, FIS2016-78904-C3-1-P, and SEV-2015-0496 in the framework of the Spanish Severo Ochoa Centre of Excellence. We acknowledge financial support from the European Research Council through project ERC CoG 648901 and the H2020 Marie Curie actions through the SEPOMO project (grant number 722651). X. R.-M., E. P.-S.-J. and M. C.-Q. thank Dr Bernhard Dörling for designing the doctor blade controller and Mr Martí Gibert-Roca for designing the multiplexer/switcher. X. R.-M. acknowledges the departments of Physics, Chemistry and Geology of the Autonomous University of Barcelona (UAB) as coordinators of the PhD program in Materials Science. M. H. acknowledges the Royal Society and the Wolfson Foundation. The authors thank Dr Mathieu Linares and Dr Jasper Michels for inspiring discussions at the early stages of this work. We acknowledge support of the publication fee by the CSIC Open Access Publication Support Initiative through its Unit of Information Resources for Research (URICI).Peer reviewe

Estudios preliminares del efecto del paisaje sobre la entomofauna edáfica en producciones de frambuesa en valles cordilleranos

Variables de paisaje como la distancia a áreas naturales o el tamaño de lote cultivado afectan la biodiversidad de artrópodos del sistema. Conocer la respuesta de los distintos órdenes de artrópodos podría generar información útil ante adversidades. El objetivo de este trabajo fue realizar una evaluación preliminar del efecto de variables de paisaje y de lote sobre la biodiversidad entomológica del suelo en producciones de frambuesas. En 16 chacras de frambuesa se colectaron artrópodos edáficos mediante la utilización de trampas de caída y se midió la distancia a áreas naturales (DAN) y el tamaño de cuadro de cultivo (TC). Se encontró una relación negativa entre la biodiversidad entomológica y la DAN, mientras que no se observó relación con el TC. Los órdenes Araneae y Collembola fueron los más afectados por la DAN, disminuyendo su abundancia relativa con la lejanía a áreas naturales en el primer caso y aumentando en el segundo.Landscape variables such as the distance to natural areas or the size of the cultivated field affect the arthropod biodiversity of the system. Knowing the response of the different orders of arthropods could generate useful information in the face of adversity. The objective of this study was to carry out a preliminary evaluation of the effect of landscape and field variables on the entomological biodiversity of the soil in fruit production systems. In 16 raspberry farms, edaphic arthropods were collected using fall traps, and the distance to natural areas (DNA) and the size of the cultivation plot (CP) were measured. A negative relationship was found between entomological biodiversity and DNA, while no relationship was observed with TC. The Araneae and Collembola orders were the most affected by DAN, decreasing its relative abundance with distance from natural areas in the first case and increasing in the second.Fil: Szudruk Pascual, María Noel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones En Recursos Naturales, Agroecología y Desarrollo Rural. - Universidad Nacional de Rio Negro. Instituto de Investigaciones En Recursos Naturales, Agroecología y Desarrollo Rural; ArgentinaFil: Garibaldi, Lucas Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones En Recursos Naturales, Agroecología y Desarrollo Rural. - Universidad Nacional de Rio Negro. Instituto de Investigaciones En Recursos Naturales, Agroecología y Desarrollo Rural; ArgentinaFil: Amoroso, Mariano Martin. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones En Recursos Naturales, Agroecología y Desarrollo Rural. - Universidad Nacional de Rio Negro. Instituto de Investigaciones En Recursos Naturales, Agroecología y Desarrollo Rural; Argentina2° Congreso Argentino de AgroecologíaResistenciaArgentinaUniversidad Nacional de MisionesSociedad Argentina de Agroecologí

Indicadores de sustentabilidad en sistemas fruti-hortícolas de la Comarca Andina del Paralelo 42

La Comarca Andina del Paralelo 42 es un territorio complejo y heterogéneo. Esto ha llevado a diagnósticos sectorizados por actividad, mayormente de tipo económico, sin un abordaje sistémico entre la diversidad de esquemas de manejo agrícola y escalas. Por su parte, poco se conoce respecto de los impactos ecológicos y socio-económicos en estos sistemas. El objetivo de la presente propuesta fue desarrollar un diagnóstico y una metodología que permita elaborar herramientas para evaluar el grado de sustentabilidad de establecimientos fruti-hortícola de diferente escala de producción en la Comarca Andina. Se obtuvieron 11 indicadores para diferentes dimensiones (ecológicos, socio-culturales y económico-productivos). Los indicadores socioeconómicos difirieron entre las escalas de producción analizadas, no así en cuanto a los ecológicos. El índice de sustentabilidad general es alto y uniforme en todas las escalas.Fil: Amoroso, Mariano Martin. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones En Recursos Naturales, Agroecología y Desarrollo Rural. - Universidad Nacional de Rio Negro. Instituto de Investigaciones En Recursos Naturales, Agroecología y Desarrollo Rural; ArgentinaFil: Rezzano, Carlos Abraham. Universidad Nacional de Río Negro; ArgentinaFil: Vercelli, Federico. Universidad Nacional de Río Negro; ArgentinaFil: Szudruk Pascual, María Noel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones En Recursos Naturales, Agroecología y Desarrollo Rural. - Universidad Nacional de Rio Negro. Instituto de Investigaciones En Recursos Naturales, Agroecología y Desarrollo Rural; Argentina2° Congreso Argentino de AgroecologíaResistenciaArgentinaUniversidad Nacional de MisionesSociedad Argentina de Agroecologí

Respuesta funcional de enemigos naturales a controles en paisajes agrícolas

Los artrópodos representan un nodo clave para la contribución al control de plagas. Sin embargo, su dinámica en función de las estructuras del paisaje es altamente variable dependiendo de la escala de análisis y las historias de vida de los enemigos naturales (EN). Este trabajo evaluó el efecto de variables a nivel de paisaje y de predio sobre comunidades de EN en sistemas agrícolas de pequeña escala. Se consideraron los rasgos funcionales para lograr un mayor entendimiento de los mecanismos de respuesta. Artrópodos depredadores y parasitoides fueron capturados en trece chacras de frambuesas para estimar la diversidad funcional, la complementariedad y la redundancia. No se encontraron efectos de la heterogeneidad del paisaje, el hábitat local ni de prácticas de manejo sobre la diversidad funcional de los EN. La complementariedad fue alta en la mayoría de los sitios y no fue afectada por las variables del paisaje o local. Sin embargo, la redundancia fue afectada por dos prácticas de manejo: el control de malezas disminuyó la abundancia de EN totales, así como la abundancia de depredadores generalistas caminadores y parasitoides especialistas voladores, mientras que la riqueza agrícola afectó negativamente los depredadores generalistas voladores. Estos resultados destacan la importancia del manejo predial cuando la matriz del paisaje es heterogénea, la cual respalda una diversa comunidad de enemigos.Fil: Szudruk Pascual, María Noel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones En Recursos Naturales, Agroecología y Desarrollo Rural. - Universidad Nacional de Rio Negro. Instituto de Investigaciones En Recursos Naturales, Agroecología y Desarrollo Rural; ArgentinaFil: Chillo, María Verónica. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Patagonia Norte. Estación Experimental Agropecuaria San Carlos de Bariloche. Instituto de Investigaciones Forestales y Agropecuarias Bariloche. - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones Forestales y Agropecuarias Bariloche; ArgentinaFil: Garibaldi, Lucas Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones En Recursos Naturales, Agroecología y Desarrollo Rural. - Universidad Nacional de Rio Negro. Instituto de Investigaciones En Recursos Naturales, Agroecología y Desarrollo Rural; ArgentinaFil: Amoroso, Mariano Martin. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto de Investigaciones En Recursos Naturales, Agroecología y Desarrollo Rural. - Universidad Nacional de Rio Negro. Instituto de Investigaciones En Recursos Naturales, Agroecología y Desarrollo Rural; ArgentinaXXX Reunión Argentina de EcologíaSan Carlos de BarilocheArgentinaInstituto de Investigaciones en Biodiversidad y MedioambienteAsociación Argentina de EcologíaInstituto de Investigaciones Forestales y Agropecuarias Bariloch