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

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities 1,2 . This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity 3�6 . Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55 of the global rise in mean BMI from 1985 to 2017�and more than 80 in some low- and middle-income regions�was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing�and in some countries reversal�of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories. © 2019, The Author(s)

Modelling Nitrogen Fluxes at the Landscape Scale

The distribution and impacts of different nitrogen pollutants are inextricably linked. To understand the problem fully, the interactions between the different pollutants need to be taken into account. This is particularly important when it comes to abatement techniques, since measures to reduce emissions of one nitrogen pollutant can often lead to an increase in another. This project represents a step towards greater understanding of these issues by linking together new and existing nitrogen flux models into a larger framework. The modelling framework has been constructed and some of the nitrogen flows between fields, farms and the atmosphere have been modelled for a UK study area for typical farm management scenario

Structural feedback for keyword-based xml retrieval

Abstract. Keyword-based queries are an important means to retrieve information from XML collections with unknown or complex schemas. Relevance Feedback integrates relevance information provided by a user to enhance retrieval quality. For keyword-based XML queries, feedback engines usually generate an expanded keyword query from the content of elements marked as relevant or nonrelevant. This approach that is inspired by text-based IR completely ignores the semistructured nature of XML. This paper makes the important step from pure content-based to structural feedback. It presents a framework that expands a keyword query into a full-fledged content-and-structure query. Extensive experiments with the established INEX benchmark and our TopX search engine show the feasibility of our approach

Development and psychometric testing of the gender misconceptions of men in nursing (GEMINI) scale among nursing students

Background Misconceptions about men in nursing may influence recruitment and retention, further perpetuating the gender diversity imbalance in the nursing workforce. Identifying misconceptions and implementing early intervention strategies to address these deep-rooted stereotypes remain challenging but is considered critical to support students who are commencing a nursing career. Objective To develop and evaluate the psychometric properties of the ‘Gender Misconceptions of meN in nursIng (GEMINI) Scale. Design Cross-sectional survey. Methods Pre-registration nursing students enrolled in undergraduate nursing programmes across 16 nursing institutions in Australia were surveyed from July to September 2021. The 17-item self-report GEMINI Scale measured the gender misconceptions of men in nursing. Results Of the 1410 completed surveys, data from 683 (45%) women were used for exploratory factor analysis showing a one factor structure, while data from 727 men (47%) were used for confirmatory factor analysis of the 17-item GEMINI Scale, which showed a good model fit. The scale demonstrated high internal consistency (Cronbach’s alpha of 0.892). Men were found to have higher gender misconceptions (p < 0.001) while respondents who: (a) identified nursing as their first career choice (p = 0.002); (b) were in their final year of programme enrolment (p = 0.016); and (c) engaged in health-related paid work (p = 0.002) had lower gender misconceptions. Conclusion The GEMINI Scale is a robust, valid, reliable, and easy to administer tool to assess misconceptions about men in nursing, which may potentially influence academic performance and retention. Identifying and addressing specific elements of misconceptions could inform targeted strategies to support retention and decrease attrition among these students

Effects of Impact Fees on Urban Form and Congestion in Florida

This study analyzes the effects of impact fees on urban form and congestion through econometric analysis. The results show that there is some evidence that impact fees might reduce congestion by creating disincentives to residential development and job creation. However, direct evidence of a negative effect of impact fees in development and job growth is not found. There is no evidence that the difference in impact fees between central cities and outer areas promotes a more compact urban form. Likewise, there is no evidence that more road impact fees decrease congestion through more investment in infrastructure. This finding might be because impact fees usually finance local roads but congestion is concentrated on freeways and arterials or because there is a spatial, temporal, or financial mismatch between the collection and investment of impact fees. There is a clear, significant, and substantial positive relationship between density and congestion; this relationship indicates a weak increase in transit use in denser environments or a potential increase in automotive travel through higher trip frequency. However, other urban form variables related to the distribution of that density have a negative effect on congestion, indicating that certain urban configurations could decrease congestion. Finally, changes in congestion are negatively correlated with the congestion levels at the beginning of the period; this finding suggests that congestion is increasing faster in those areas that used to be less congestedopen