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

Determining the style and provenance of magmatic activity during the Early Aptian Oceanic Anoxic Event (OAE 1a)

International audienceLarge igneous province (LIP) volcanism has been proposed as a key trigger of several major climate and environmental perturbations during the Phanerozoic Aeon. Large-scale carbon emissions associated with one or both of magmatic degassing from the Greater Ontong-Java Plateau (G-OJP) and intrusion of organic-rich sediments by High Arctic LIP (HALIP) sills have been widely suggested as the trigger of the Early Aptian Oceanic Anoxic Event (OAE 1a: ~120 Ma). However, the respective roles of the two LIPs and associated carbon sources in causing this crisis remain debated. Here, six records of OAE 1a from the Pacific, Tethyan, Arctic, and South Atlantic realms are investigated, combining mercury (Hg) concentrations and osmium- (Os-) isotope ratios as proxies of LIP activity. Together with previously published datasets, the results indicate globally consistent Os-isotope evidence for LIP activity during OAE 1a, but geographically variable stratigraphic Hg trends. Clear mercury enrichments that match Os-isotope evidence of LIP activity, and suggest a Hg-cycle perturbation during the onset of OAE 1a, are documented at one Pacific site extremely proximal to the G-OJP, but not in Arctic, Tethyan or Atlantic records. This pattern highlights significant G-OJP volcanism during the onset of OAE 1a, and re-emphasises the limited potential for submarine LIP eruptions to cause Hg-cycle perturbations except in areas very proximal to source. The absence of clear Hg peaks in basal OAE 1a strata from the Arctic (or anywhere outside of the Pacific) does not support intense HALIP activity at that time, suggesting that the G-OJP was the more volcanically active LIP when OAE 1a commenced. Thus, G-OJP emissions of mantle carbon were more likely to have played a major role in initiating OAE 1a than thermogenic volatiles associated with the HALIP. A transient pulse of HALIP-related subaerial eruptions and/or thermogenic volatile emissions during the early–middle part of OAE 1a, potentially evidenced by more widespread Hg enrichments in strata from that time (including in the Arctic), might have prolonged the event. However, a non-volcanic cause of these later Hg influxes cannot be excluded. These findings challenge previous suggestions that magmatic CO2 emissions from LIPs were incapable of causing major carbon-cycle perturbations alone, and highlight the need for further investigations to establish whether the high volume/emplacement rate of the G-OJP (potentially an order of magnitude greater than other LIPs) made it a unique case that stands in contrast to other provinces where the role of thermogenic volatiles was likely more crucial

Avaliação em laboratório do uso de sistemas de coberturas alcalinas para prevenção da drenagem ácida de mina

A drenagem ácida de mina (DAM) é um problema ambiental em escala mundial. Ela é proveniente do processo de oxidação química de materiais da mineração que contenham minerais sulfetados expostos a condições atmosféricas com a mediação de bactérias. As águas ácidas geradas nesses ambientes podem comprometer a qualidade dos recursos hídricos. Para tentar conter essa DAM, métodos de prevenção e remediação têm sido aplicados. As coberturas secas têm sido estudadas como alternativa de prevenção, visto que a remediação tem mostrado-se de custo elevado. O objetivo deste trabalho foi avaliar o uso de coberturas alcalinas para controlar a geração de ácido proveniente do estéril da mineração de urânio, U, por meio de sistemas colunas de lixiviação. Para isso, foram estudados sistemas de coberturas que têm como agentes de neutralização a lama vermelha, o calcário e a cal. Amostras de estéril e de água foram coletadas na mina Osamu Utsumi, em Caldas, MG. Foram realizadas análises químicas e mineralógicas do estéril, da cal, do calcário e da lama vermelha. Para os testes cinéticos, foram montadas sete colunas de lixiviação: C1(estéril); C2 (estéril + cobertura de lama vermelha); C3 (estéril + cobertura de calcário); C4 (estéril + cobertura de cal); COB2 (cobertura de lama vermelha); COB3 (cobertura de calcário); e COB4 (cobertura de cal). As amostras lixiviadas foram monitoradas por 100 dias. Os resultados mostraram que a cal e a lama vermelha têm maior potencial neutralizador. No entanto, esses agentes neutralizantes oferecem o inconveniente de introduzir material solúvel no lixiviado. Dessa forma, considerando os parâmetros avaliados, foi demonstrado que o uso de mistura de lama vermelha com estéril do Bota-fora 4 (BF4) pode ser uma alternativa viável para o controle de geração de DAM associada à reciclagem de resíduos industriais alcalinos