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

Proceedings of a roundtable event ‘Workplace Diet and Health – priorities for researchers and practitioners’

Understanding how the work environment impacts health behaviours is essential to a life course approach in public health nutrition. A roundtable event ‘Workplace Diet and Health – priorities for researchers and practitioners’ was held by the Nutrition Society in October 2022. The overarching aims of the roundtable event were to consider (i) the relevance of nutritional wellbeing for employers and organisations, (ii) the research priorities for workplace diet and health and (iii) how researchers and practitioners can work with stakeholders in the development and testing of workplace diet and health interventions and nutritional education. Participants represented a range of stakeholders including dietetic and nutrition professionals working in workplace health, academics and science communication with an interest in workplace diet and health, non-governmental organisations and providers of workplace nutritional health and wellbeing programmes. All roundtable participants agreed that good nutrition and access to healthy food at work was part of corporate responsibility comparable to that of health and safety provision. It was recognised that nutritional wellbeing was not seen as a priority by many companies due to the complexity and wide range of employee health and wellbeing options available and the perceived lack of clear financial benefit. Three priority areas were identified and agreed upon by roundtable participants: (1) strengthening the evidence base to demonstrate the tangible benefit of nutritional wellbeing interventions in the workplace, (2) creating a knowledge exchange hub to share best practices and experiences of working across sectors and (3) expand stakeholder engagement in workplace nutritional wellbeing

Morfologia do fruto, da semente e morfo-anatomia da pl\ue2ntula de Vitex megapotamica (Spreng.) Moldenke (Lamiaceae)

Vitex megapotamica (tarumã) é espécie arbórea, decídua, com ocorrência, no Brasil, desde Minas Gerais até o Rio Grande do Sul. Visando à caracterização morfológica do fruto, da semente e morfo-anatômica da plântula, frutos desta espécie foram coletados e as sementes postas para germinar em laboratório. As plântulas foram coletadas desde a protrusão da raiz até o desenvolvimento do primeiro par de eofilo. Foram realizadas medições e pesagem de frutos, e contagem do número de sementes por frutos. As características morfológicas do fruto e da semente são aqui descritas e ilustradas, assim como a morfo-anatomia da plântula. O fruto é drupóide, nuculânio, tetralocular, contendo apenas uma ou duas sementes com fina camada de endosperma e embrião axial, foliáceo. O diásporo (pirênio) é constituído pelo endocarpo mais a semente. O endocarpo lenhoso parece exercer restrição sobre a germinação das sementes desta espécie. A plântula é epigea, fanerocotiledonar, com paracotilédones elípticos, com margem inteira, e eofilos opostos, simples, elípticos, com margem serreada, apresentando tricomas tectores. Tanto o paracotilédone quanto o eofilo apresentam mesofilo heterogêneo, dorsiventral, feixe colateral em forma de arco e estômatos anomocíticos. A raiz é poliarca, com córtex parênquimático; o hipocótilo possui tricomas glandulares e não-glandulares, colo distinto, e com cerca de 20 dias encontra-se em início de crescimento secundário. Diversas das características da plântula de Vitex megapotamica estão relacionadas à sua condição de espécie heliófila

Arquitetura, anatomia e histoquímica das folhas de Gomphrena arborescens L.f. (Amaranthaceae) Architecture, anatomy and histochemistry of the leaves of Gomphrena arborescens L.f. (Amaranthaceae)

As folhas de Gomphrena arborescens L.f., nativa do Cerrado, são utilizadas contra dismenorréia na medicina popular. As investigações morfológica, anatômica e histoquímica das folhas visam fornecer elementos para taxonomia, para controle de qualidade de drogas e identificação microscópica de fitoterápicos. Folhas foram coletadas em Brasília, DF, nas áreas de Cerrado do Centro Olímpico da Univesidade de Brasília e na Reserva Ecológica do IBGE. Foram efetuadas análises morfológicas, anatômicas e histoquímicas. Os estudos de arquitetura foliar, densidade estomática e de vênulas terminais foram efetuados em folhas diafanizadas, apresentando médias de 42,39&plusmn;15,50 estômatos mm-2 e 11,7&plusmn;3,55 vênulas terminais mm². As folhas apresentaram duas formas de tricomas tectores. O mesofilo bilateral apresenta tecido clorenquimático disposto radialmente à bainha parenquimática completa que envolve os feixes vasculares, características da síndrome Kranz associada ao ciclo fotossintético C4. O amido concentra-se na bainha parenquimática. As folhas são ricas em celulose, drusas de oxalato de cálcio, proteínas, lignina e outros compostos fenólicos, entre eles os flavonóides. As folhas apresentam morfologia variável, mas o padrão anatômico e de venação são constantes.<br>Leaves of the Brazilian Cerrado plant Gomphrena arborescens L.f. are used against dismenorea in popular medicine. The morphological, anatomical and histochemical investigation aims to help taxonomy, quality control of drugs and microscopical identification of phytotherapics. The leaves have been collected in Brasília, DF, in the Olympical Center of the University of Brasilia and in the Ecological Reserve of IBGE. The leaf architecture, stomatal and veinlet densities have been studied in clarified leaves, presenting average of 42,39&plusmn;15,50 stomata mm² and 11,7&plusmn;3,55 veinlet mm-2. Leaves presented two forms of tector trichomes. The bilateral mesophyll surrounds the complete bundle sheat, features of the Kranz syndrome associated with C4 photosynthetic pathway. The starch is concentrated in the bundle sheat cells. Leaves are rich in cellulose, calcium oxalate druses, proteins, lignin and other phenolic compounds, such as flavonoids. Leaves present variable morphology, but steady pattern of anatomy and veination