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

Opinion forming in the digital age: Fake news, echo chambers and populism - Key themes, concerns & recommendations for European research and innovation

Contains fulltext : 198976.pdf (publisher's version ) (Open Access)The Internet provides fast and ubiquitous communication that enables all kinds of communities and provides citizens with easy access to vast amounts of information, although the information is not necessarily verified and may present a distorted view of real events or facts. The Internet's power as an instant source of mass information can be used to influence opinions, which can have far-reaching consequences. This report's purpose is to provide input into the advisory processes that determine European support for research into the effects and management of Fake News (e.g. deliberate misinformation), Echo Chambers (e.g. closed communities where biases can be reinforced through lack of diversity in opinions), and the Internet's influence on social and political movements such as Populism; to provide insight into how innovation that takes these aspects into account can be supported. To address this aim, this report concerns socio-technical implications of the Internet related to the impact of closed communities and misinformation and makes recommendations derived from a consultation with domain experts concerning the research needed to address specific challenges. This study has used the Delphi Method, an iterative consultation mechanism aimed at consensus building within a targeted panel of experts. Three rounds of iteration were undertaken and a total of fourteen experts participated in all three rounds. The result of the consultation is 67 assertion statements that reached consensus amongst the experts in five broad themes, and these are presented in this report and summarised into key recommendations. The key overarching recommendation is that we need to understand how opinions are formed and are influenced in the current digital age. Investigations are needed to understand the underlying cognitive and emotional processes that enable peoples’ opinions to be influenced in the context of a hybrid media system that mixes online and offline channels and broadcast and interactive social media.75 p