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

Propuesta organizacional para la administraci\uf3n en la finca escolar de la Escuela T\ue9cnica Agropecuaria I.B.O.A.

En este trabajo se estudi\uf3 el problema derivado de la dificultad existente para la gesti\uf3n administrativa de la Finca Escolar de la Escuela T\ue9cnica Agropecuaria \u93Iboa\u94, por la carencia de personalidad jur\ueddica que le pide tener acceso al financiamiento p\ufablico o privado y a la comercializaci\uf3n de su producci\uf3n, as\ued como tambi\ue9n la falta de una adecuada organizaci\uf3n que le permitan utilizar eficientemente los recursos disponibles. El trabajo se realiz\uf3 utilizando estrategias y t\ue9cnicas de investigaci\uf3n del Estudio de Caso, con car\ue1cter descriptivo, haciendo uso de la informaci\uf3n bibliogr\ue1fica y de campo levantada mediante la observaci\uf3n participante, cuestionarios y tests, con \ue9nfasis para los efectos de an\ue1lisis, en los aportes de la teor\ueda del desarrollo organizacional. El an\ue1lisis de los resultados permiti\uf3 establecer los par\ue1metros para dise\uf1ar y proponer un modelo organizacional alternativo para la administraci\uf3n de la unidad objeto de estudio, utilizando desde el punto de vista operativo y funcional, la estructura funcional, la estructura matricial, teniendo como marco legal la figura de una Asociaci\uf3n Civil sin fines de lucro

[Recommendations for the prevention of organic foreign bodies aspiration]

Foreign body aspiration remains a common and potentially serious pediatric problem. Most aspirated foreign bodies are food. The education of parents and caregivers about choking hazards and how to avoid them is critical to reduce the incidence of these events. The pediatricians play a key role in promoting injury prevention. We indicate the main characteristics of hazardous food and we present recommendations on age-appropriate meals, adequate forms of food preparation and behavioral rules at mealtimes in order to reduce food choking

Coseismic stratigraphy in Holocene lacustrine sequences of San Pedro El Alto, Estate of Mexico

The Mexican Volcanic Belt contains a series of coseismic registers in lacustrian sequences in which the consequence of seismic collisions due to fault movements left deformed structures. The scope of this paper is to define the geological and biological evolution of the lacustrian depression of San Pedro el Alto, immersed in the Acambay graben. The area presents morphological evidence of current coseismic ruptures such as vertical height differences, fault edges, structural drainage control and counterslopes. The natural conditions, as well as the time and space relations in which seismic events took place will be demonstrated, underpinned by a detailed study of the area\u2019s stratigraphy and fossil diatoms. Furthermore, the fluctuations in the level of the lake can provide guidelines to understand the environmental factors linked to coseismal ruptures occurred during the Miocene

ESTIMATED OF INTENSITY PALEOSEISMIC STRUCTURES UNDER ESI2007 SCALE IN THE ACAMBAY AND IXTLAHUACA GRABEN, MEXICO

La regi\uf3n central de M\ue9xico se caracteriza por sus grandes depresiones lacustres con orientaci\uf3n E-O, las cuales son controladas por fallas normales del Cuaternario. Los grabenes de Acambay e Ixtlahuaca representan unas de las cuencas intra-arco m\ue1s grandes del Cintur\uf3n Volc\ue1nico Trans-Mexicano. La evoluci\uf3n de la regi\uf3n Acambay-Ixtlahuaca es tambi\ue9n caracterizada por eventos s\uedsmicos recurrentes moderados a fuertes, como lo constat\uf3 el sismo de Acambay el 19 de noviembre de 1912, Ms 6.9. En el presente trabajo se realiza una comparaci\uf3n de datos macros\uedsmicos publicados a partir del sismo de Acambay de 1912, Ms 6.9, con nuevos an\ue1lisis de evidencia paleos\uedsmica preservada en la estratigraf\ueda y en la geomorfolog\ueda de tres sub-cuencas lacustres del Pleistoceno-Holoceno (San Pedro El Alto y San Bartolo Lanzados, en el \ue1rea epicentral del evento de 1912; e Ixtlahuaca de Ray\uf3n, a lo largo de la falla Perales, 40 km aproximadamente al S del epicentro de 1912 y en donde no se tiene registro de sismos hist\uf3ricos y por lo tanto considerada como zona as\uedsmica) bajo la aplicaci\uf3n de la escala ESI2007. Las tres sub-cuencas estudiadas son controladas por el mismo sistema extensivo de estructuras durante el Cuaternario, las tres muestran una tect\uf3nica y caracter\uedsticas geom\uf3rficas similares, incluyendo las fallas Pastores, Acambay- Tixmadej\ue9 y el sistema Temascalcingo, las cuales rompieron durante el sismo de 1912 adem\ue1s de la falla Perales. As\ued mismo, en las tres sub-cuencas, la intensidad preliminar para los efectos paleos\uedsmicos en el ambiente es comparable y consistente con la intensidad epicentral del evento de 1912 (I0 = X en la escala de Cancani). La comparaci\uf3n de intensidades ESI2007 hist\uf3ricas y paleos\uedsmicas en las subcuencas de San Pedro El Alto y San Bartolo Lanzados, muestra que la magnitud de sismos antiguos fue similar al de 1912, de tal manera, la intensidad epicentral de las estructuras paelos\uedsmicas de la cuenca de Ixtlahuaca es del orden de IX en la escala ESI2007. No obstante, lo mismo se puede afirmar para las paleosismitas lacustres analizadas en la paleocuenca de Ixtlahuaca de Ray\uf3n; las estructuras de licuefacci\uf3n, slumps, fallamiento sinsedimentario, sugieren que las estructuras tienen un origen s\uedsmicamente inducido y que es una fuente s\uedsmica local la que ha producido algunos de los paleoeventos deformacionales observados. De acuerdo a lo anterior, sugerimos que dentro de tal paisaje s\uedsmico, la intensidad ESI2007 manejada para las caracter\uedsticas paleos\uedsmicas en la paleocuenca de Ixtlahuaca indica un potencial s\uedsmico del orden de Mw 7 para la falla Perales,equivalente al demostrado por las fallas maestras del graben de Acambay

ESI2007 ASSESSMENT OF PALEOSEISMIC FEATURES IN THE ACAMBAY AND IXTLAHUACA GRABEN, MEXICO: EVIDENCE FOR CAPABILITY ALONG THE PERALES FAULT

We compare published macroseismic data from the Nov. 19th, 1912, Ms 6.9 Acambay earthquake with new analyses of paleoseismic evidence preserved in the stratigraphy and geomorphology of three Mid-Pleistocene to Holocene lacustrine subbasins (San Pedro El Alto and San Bartolo Lanzados, in the epicentral area of the 1912 event; and Ixtlahuaca de Ray\uf3n, along the Perales Fault, ca. 40 km S of the 1912 epicenter) using the ESI 2007 scale. In the Ixtlahuaca paleobasin (Mid Pleistocene?), liquefaction, megaslumping features, and synsedimentary surface faulting are genetically associated, suggesting A) a seismically induced origin, and B) a local earthquake source, at least for some of the observed deformational paleoevents. In the studied subbasins, the preliminary intensity assessment from the paleoseismic environmental effects is comparable, and consistent with the epicentral intensity of the 1912 event (Io = X in the Cancani scale). The three sub-basins are controlled by the growth of the same system of extensional structures during the Quaternary, showing very similar tectonic and geomorphic features. This includes the Pastores, Temascalcingo and Acambay-Tixmadej\ue9 faults, which ruptured during the 1912 earthquake, and the Perales Fault. We argue that within such a coherent seismic landscape the ESI 2007 intensity assessed from paleoseismic features in the Ixtlahuaca paleobasin indicates a seismic potential in the order of Mw 7 for the Perales Fault, equivalent to the one demonstrated by the master faults of the Acambay graben