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

Foxes and forestry

SIGLEAvailable from British Library Document Supply Centre-DSC:4005.030(23) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

A forest habitat network for the Cairngorms

SIGLEAvailable from British Library Document Supply Centre-DSC:8313.903(114) / BLDSC - British Library Document Supply CentreGBUnited Kingdo

1H and 13C solution- and solid-state NMR investigation into wax products from the Fischer-Tropsch process

(1)H and (13)C solid- and solution-state NMR have been used to characterise waxes produced in the Fischer-Tropsch reaction, using Co-based catalysts either unpromoted or promoted with approximately 1 wt% of either cerium or rhenium. The aim was to measure average structural information at the submolecular level of the hydrocarbon waxes produced, along with identification of the minor products, such as oxygenates and olefins, which are typically observed in these waxes. A parameter of key interest is the average number of carbon atoms within the hydrocarbon chain (N(C)). A wax prepared using an unpromoted Co/Al(2)O(3) catalyst had N(C)similar to 20, whilst waxes made using rhenium- or cerium-promoted Co/Al(2)O(3) catalysts were found to have N(C)similar to 21. All three samples contained small amounts of oxygenates and alkenes. The subtle differences found in the waxes, in particular the minor species produced, demonstrate that the different promoters have different effects during the reaction, with the Re-promoted catalyst producing the fewest by-products. It is shown in (13)C solid-state NMR spectra that for that for longer chain (compared to the lengths of chain in previous studies) waxes that the lack of resolution and the complexities added by the differential cross-polarisation (CP) dynamics mean that it is difficult to accurately determine N(C) from this approach. However the N(C) determined by (13)C CP magic angle spinning NMR is broadly consistent with the more accurate solution approaches used and suggest that the wax characteristics do not change in solution. On this basis an alternative approach for determining N(C) is suggested based on (1)H solution state NMR that provides a higher degree of accuracy of the chain length as well as information on the minor constituents

Consumptive and non-consumptive values of wild mammals in Britain

1. Wildlife make an important contribution to the rural economy; generating jobs, income and profits from food and sporting enterprises, and contributing in less direct ways by bringing pleasure from viewing and learning. This paper reviews the literature regarding the contribution made by wildlife to the rural economy and to British society more widely. The review focuses on UK studies published in peer-reviewed journals and official web-based sources in the last 20 years. 2. Traditional activities such as deer stalking remain an important source of wealth and employment, but their overall contribution is declining relative to non-consumptive uses such as wildlife tourism. 3. Much of the literature focuses on the negative impacts of mammals on commercial activities such as agriculture and forestry, even though these impacts are relatively insignificant in economic terms at both regional and national levels. 4. Wild meat provides a niche in the contemporary food market, but, although demand is growing, growth is handicapped by a fragmented supply chain and lack of marketing. 5. In comparison with other rural resources such as farming, the contribution made by wild mammals to the rural economy appears small, even in relatively remote regions, but this may partly reflect gaps in the literature regarding their contribution via less formal markets, hobby activities, and in supporting ecosystem equilibrium