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

Heterogeneous expression of immunotherapy candidate proteins gp100, MART-1, and tyrosinase in human melanoma cell lines and in human melanocytic lesions

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The torque–velocity relationship in large human muscles: Maximum voluntary versus electrically stimulated behaviour

NOTICE: this is the author’s version of a work that was accepted for publication in the Journal of Biomechanics. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published at: http://dx.doi.org/10.1016/j.jbiomech.2012.11.052The in vivo maximum voluntary torque–velocity profile for large muscle groups differs from the in vitro tetanic profile with lower than expected eccentric torques. Using sub-maximal transcutaneous electrical stimulation has given torque–velocity profiles with an eccentric torque plateau ~1.4 times the isometric value. This is closer to, but still less than, the in vitro tetanic profiles with plateaus between 1.5 and 1.9 times isometric. This study investigated the maximum voluntary and sub-maximum transcutaneous electrical stimulated torque–angle–angular velocity profiles for the knee extensors and flexors in a group of healthy males. Fifteen male subjects performed maximum voluntary and submaximum electrically stimulated (~40% for extensors and ~20% for flexors) eccentric and concentric knee extension and flexions on an isovelocity dynamometer at velocities ranging from ±50° s-1 to ±400° s-1. The ratio of peak eccentric to peak isometric torque (Tecc/T0) was compared between the maximum voluntary and electrically stimulated conditions for both extensors and flexors, and between muscle groups. Under maximum voluntary conditions the peak torque ratio, Tecc/T0, remained close to 1 (0.9 – 1.2) while for the electrically stimulated conditions it was significantly higher (1.4 – 1.7 ; p<0.001) and within the range of tetanic values reported from in vitro studies. In all but one case there was no significant difference in ratios between the extensors and flexors. The results showed that even the largest muscle groups have an intrinsic Tecc/T0 comparable with in vitro muscle tests, and it can be ascertained from appropriate in vivo testing