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

Development and mechanistic investigation of the dehydrogenation of alcohols with an iron(iii) salen catalyst

The iron(iii) salen complex (R,R)-N,N′-bis(salicylidene)-1,2-cyclohexanediamineiron(iii) chloride has been developed as a catalyst for the acceptorless dehydrogenation of alcohols. The complex catalyzes the direct synthesis of imines in good yields from different primary alcohols and amines with the liberation of hydrogen gas. The mechanism has been investigated experimentally with labelled substrates and theoretically with density functional theory calculations. In contrast to the corresponding manganese(iii) salen-catalyzed dehydrogenation, it has not been possible to identify a homogeneous catalytic pathway with the iron complex. Instead, poisoning experiments with trimethylphosphine and mercury indicated that the catalytically active species are heterogeneous small iron particles.</p

Does Caffeine Consumption Modify Cerebrospinal Fluid Amyloid-β Levels in Patients with Alzheimer&apos;s Disease?

Caffeine may be protective against Alzheimer&apos;s disease (AD) by modulating amyloid-β (Aβ) metabolic pathways. The present work aimed to study a possible association of caffeine consumption with the cerebrospinal fluid (CSF) biomarkers, particularly Aβ. The study included 88 patients with AD or mild cognitive impairment. The consumption of caffeine and theobromine was evaluated using a validated food questionnaire. Quantification of caffeine and main active metabolites was performed with liquid chromatography coupled to tandem mass spectrometry. The levels of Aβ1-42, total tau, and phosphorylated tau in the CSF were determined using sandwich ELISA methods and other Aβ species, AβX-38, AβX-40, and AβX-42, with the MSD Aβ Triplex assay. The concentration of caffeine was 0.79±1.15 μg/mL in the CSF and 1.20±1.88 μg/mL in the plasma. No correlation was found between caffeine consumption and Aβ42 in the CSF. However, a significant positive correlation was found between the concentrations of theobromine, both in the CSF and in the plasma, with Aβ42 in the CSF. Theobromine in the CSF was positively correlated with the levels of other xanthines in the CSF, but not in the plasma, suggesting that it may be formed by central metabolic pathways. In conclusion, caffeine consumption does not modify the levels of CSF biomarkers, and does not require to be controlled for when measuring CSF biomarkers in a clinical setting. Since theobromine is associated with a favorable Aβ profile in the CSF, the possibility that it might have a protective role in AD should be further investigated. © 2015 - IOS Press and the authors. All rights reserved

Influence of perches and footpad dermatitis on tonic immobility and heterophil to lymphocyte ratio of chickens

The purpose of the present study was to analyze the effect of perches and footpad dermatitis on stress and fear levels of chickens. In experiment 1 heterophil to lymphocyte ratio and tonic immobility duration were measured in 36-wk-old hens (36 birds) from 2 Spanish breeds of chickens (Black Menorca and Quail Castellana) housed in pens with or without perches from 20 wk of age. There was a significant difference in the heterophil to lymphocyte ratio between perch treatments (P < 0.05), the ratio of hens with perches being lower than that of hens without perches. Hens with perches had significant lymphophilia (P < 0.05). There was no significant difference for the duration of tonic immobility between hens with or without perches. Thus, hens with perches were less stressed than hens without perches, as indicated by the heterophil to lymphocyte ratio. Heterophil to lymphocyte ratio and heterophil number for Black Menorcas were significantly smaller (P < 0.001) than for Quail Castellanas, whereas lymphocyte number was greater in Black Menorcas. The Black Menorca hens had significantly (P < 0.01) shorter tonic immobility duration. In experiment 2 heterophil to lymphocyte ratio and tonic immobility duration were measured in 52-wk-old cocks (36 birds) of each of two different Spanish breeds of chickens (Black Barred Andaluza and Red Barred Vasca) housed in cages from 36 wk of age and showing or not showing footpad dermatitis. There was no significant effect of footpad dermatitis on the heterophil to lymphocyte ratio, its numerator, or its denominator, whereas there was significant effect on tonic immobility duration (P < 0.05) with tonic immobility of cocks with footpad dermatitis being longer than that of cocks without footpads. Thus, cocks with footpad dermatitis were more fearful than cocks without footpad dermatitis, as indicated by the tonic immobility duration. Heterophil to lymphocyte ratio and heterophil number were significantly smaller (P < 0.05) for Black Barred Andaluzas than for the Red Barred Vascas. ©2005 Poultry Science Association, Inc

Everyday Legitimacy in Post-Conflict Spaces: The Creation of Social Legitimacy in Bosnia-Herzegovina’s Cultural Arenas

The international community has long been criticized for its lack of social legitimacy in BiH and thus for its failure to create a sustainable social contract in which people can identify with the version of peace that is being implemented in the country. This is, to a large extent, due to the dysfunctionality of the public space in the light of people’s everyday experiences of peace. Although it has often been argued that there is hardly any legitimacy at all in post-war BiH, this paper claims that legitimacy has been moved from the public space to semi-public spaces, arenas where the public and the private are interrelated. One example of locations of displaced legitimacy are local cultural arenas, where hopes emerging in people’s everyday life are projected onto alternative visions of peace and a corresponding social contract. In that sense, cultural agencies have served as alternative social locations of legitimacy - as opposed to the lack of formal political legitimacy - due to their closer connection to people’s lives and needs