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

Partizipation im Übergangsmanagement von Kitas und Schulen: Eltern als Ressource

Bundesweit wurden in Deutschland 749 Eltern mit und ohne Migrationshintergrund zu ihren Erfahrungen und zur erfahrenen Unterstützung in ihrem Übergang zu Eltern eines Schulkindes interviewt. Aus den Ergebnissen werden diejenigen vorgestellt, die für die Frage relevant sind, inwieweit andere Eltern im Rahmen des Transitionsmanagements eine Ressource zur Unterstützung angehender Eltern eines Schulkindes sein können. Konsequenzen für eine verstärkte Partizipation von Eltern im Transitionsmanagement werden vorgestellt. (DIPF/Orig.

Security device for use in gripping jaw of e.g. pneumatic parallel gripper of robot to prevent squeezing or jamming of human extremities caused by machine during accident, has sensors detecting tipping of surface element

Die Erfindung befasst sich mit einer Sicherheitsvorrichtung zur Verhinderung von Unfällen mit Personenschäden durch Maschinen, die ein Flächenelement enthält, welches auf der Oberfläche des Bereichs des Roboters, innerhalb dessen ein Unfall verhindert werden soll, durch ein Gelenk beweglich angeordnet ist. Des Weiteren weist die Sicherheitsvorrichtung Sensoren auf, die unter dem Flächenelement angeordnet sind und die Verkippung des Flächenelements erfassen.The device (1) has a surface element (2) movably arranged on a surface area of a region of a machine. The surface element is hung up in a joint (3) that is selected from ball-and-socket joints or hinges. A set of sensors (4) is arranged under the surface element to detect tipping of the surface element. The sensors are operated by tipping of the joint or force effect of the surface element with the tipping of the surface element, where the sensors are selected from switches, valves, force transducers, piezo elements or pressure gauges

Internal differentiation as an integration pedagogical measure

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Overview and evaluation of a workshop series for fostering the interest in entrepreneurship and STEM

Many opportunities exist for young people if they engage themselves in entrepreneurship and/or the various domains of STEM (science, technology, engineering, and mathematics). However, it is a common phenomenon in industrialized countries that the interest in pursuing a career in the STEM domains or taking the risk of becoming an entrepreneur is rather limited. Consequently, more young people need to become aware of the opportunities in entrepreneurship and STEM while being empowered with the required skills. This paper presents a series of workshops tackling various topics of entrepreneurship and STEM for inspiring young people towards engineering and technology. The workshop formats also focus on collaboration, which is an important 21 st century skill. Also the results of an evaluation are presented and discussed, which was performed when carrying out the workshops with several school classes

Melt pool turbulence effects on the interface between dissimilar materials maufactured by directed energy deposition with laser and powder

International audienceLaser powder deposition allows for the manufacturing of multi-metallic near net shape structures, with control over the feedstock composition and intense liquid mixing of elements. To better understand the multi-physical aspects of the melt pool and strive towards local composition prediction, we developed within Comsol Multiphysics® a 3D finite element model of an interface between chromium and stainless steel, with a beam spot size close to 1.3 mm. A modified v2-f model is implemented to investigate the effect of turbulence on heat, momentum, and species transport. To minimize the domain size, the model is constructed in the moving frame of the laser. Overlapping on previous tracks is accounted for by updating the upstream face boundary conditions with the composition and free-surface shape of the calculated molten cross-section. This allows for the fast computation of the steady-state solution of the current pass. Simulation results are compared to the elemental and microstructural analysis of a part containing an interface between chromium and stainless steel manufactured by a controlled atmosphere LENS® system. Mixing effects induced by turbulence thicken the melt pool and homogenizes the core of the melt pool, which is consistent with the experimental results. Nonetheless, chemical heterogeneities can be seen at the interface with the substrate and are reviewed in light of the simulation results

Continuous bi-metallic structures by DED: towards controlled transitions between crystal structures

International audienceLaser deposition of metallic powder allows the formation of high quality coatings with metallurgic bonds, low dilution and fine dense microstructures. In recent years, the technology has been refined to allow near net shape 3D constructions and in-situ alloying, by controlling the mixing of different powders in the molten pool. This enables the manufacturing of continuous multimaterial structures with enhanced performances [1]. We present here the design and fabrication of Cr-Ni bimetallic samples, featuring a BCC to FCC transition, through controlled projection and fusion of dissimilar metallic powders.Two powder feeders allow the controlled mixing and projection of pure Cr and Ni powders, fused by a 3kW fiber laser, to create various coatings including vertical compositional gradients. With analysis of layers dimensions, chemical distribution, microstructures and hardness, we investigate the influence of process characteristics and compositional sequence. We specifically examined the in-situ alloying of the two powders, as well as the compositional and crystal structure gradients, with regard to laser velocity, melt pool size and nature of previous layers. In particular, lack of fusion frequently occur when coating a metal with a more refractory one, hence the need to optimize the deposition. Tracks aspect ratio greatly affects defects, dilution, and microstructural morphologies. Laser power needs to be successively adapted to maintain a desired track width; this can be facilitated by adequate methods, involving numerical process simulations.By varying the ratio of projected powders to create a chemical gradient, abrupt changes in microstructures and properties between the miscible metals can be effectively smoothed. If a tailored gradient is to be made to maximize the coating performances, the effect of successive dilutions is to be anticipated, thus there is a strong need for reliable multimaterial numerical modeling