The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Impact of the charging conditions on the discharge performance of rechargeable iron-anodes for alkaline iron-air batteries

Pressed-plate carbonyl iron electrodes for rechargeable iron–air batteries have recently been described to undergo a considerable electrochemical formation before they attain a stable and competitive discharge capacity in concentrated alkaline electrolyte. In this study, the impact of the charging conditions on the discharge performance due to electrochemical formation was investigated. Based on the results, it is demonstrated that the preset charge capacity mainly determines the resulting discharge capacities of the porous electrodes in the steady state at the end of the formation period. Furthermore, the present study elucidates the electrode processes behind formation and expands the existing phenomenological model that has recently been established to explain the evolution of the discharge capacity. Finally, feasible criteria for the comparison of different anode architectures are discussed

Electrode thickness-dependent formation of porous iron electrodes for secondary alkaline iron-air batteries

Secondary iron-air batteries re-gained considerable scientific attention due to their excellent energy densities, pronounced environmental friendliness and exceptional reversibility compared to other metal-air batteries. In order to exploit the energy density of iron on full-cell level, the ratio between anode- and overall battery material should be as large as possible, aiming at practically competitive iron-air battery performances in the future. Therefore, here, we report the investigation of comparatively thick, pressed-plate, carbonyl iron-anodes and the distinctive attempt to further elucidate the processes behind the electrochemical formation. In order to do so, the electrode thickness-dependent charge-/discharge performance, the wetting behavior and the specific surface area of the electrodes were examined. In addition to the established dissolution and precipitation mechanism of iron, we propose that a gradually increasing number of electrochemically active carbonyl iron particles may be an additional source of active iron surface for the steeply increasing discharge capacity during the formation, which is particularly relevant for thick rather than thin electrodes. Furthermore, substantiated by cross-section SEM-images, we propose that the increasing number of active carbonyl iron particles is induced by microstructural changes of the electrode, hypothetically driven by hydrogen evolution during the formation period. Bound to the access of electrolyte, the process suggests the presence of active material on the outside and inactive, since non-wetted, material on the inside of porous carbonyl iron-anodes depending on their state of formation