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

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time, and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space. While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes, vast areas of the tropics remain understudied. In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity, but it remains among the least known forests in America and is often underrepresented in biodiversity databases. To worsen this situation, human-induced modifications may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge, it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Diversity and distribution Patterns of the infralittoral green macroalgae from Potiguar basin, Rio Grande do Norte, Northeastern Brazil

Diversity and distribution pattern of the infralittoral green macroalgae at Potiguar basin, Rio Grande do Norte, Northeastern Brazil were analyzed from material collected at depths varying from 2 to 100 m. Collections were carried out with two types of dredges during four campaigns: July 2002, May and November 2003 and May 2004 at 43 stations. Chlorophyta is represented by 54 species, five varieties and three forms. The most representative family is Caulerpaceae, and the most diverse genus is Caulerpa, with 11 species. The results showed that most taxa (89%) are rare, and 10% are present at low frequencies. The most frequent species was Caulerpaprolifera (Forssk.) J.V. Lamour. occurring at almost all coastal and inner shelf stations, recorded in all campaigns. Species distribution by depth range showed that higher species number occurred on the inner shelf from 10 to 20 m, and a wide vertical distribution pattern was registered for Anadyomenestellata (Wulfen in Jacq.) C. Agardh,Chamaedoris peniculum (J. Ellis &amp; Solander) Kuntze, Codium isthmocladum Vickers, Microdictyon sp., Udoteaoccidentalis A. Gepp &amp; E. Gepp and Ventricaria ventricosa (J. Agardh) J.L. Olsen &amp; J.A. West. Four species, Cladophoracoelothrix Kütz., C.ordinata (Børgensen) C. Hoek, Caulerpellaambigua (Okamura) Prud'homme &amp; Lokhorst and Halimedasimulans M. Howe, were recorded for the first time in Rio Grande do Norte