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

Ethanol Production for Automotive Fuel Usage

The conceptual design of the 20 million gallon per year anhydrous ethanol facility a t Raft River has been completed. The corresponding geothermal gathering, extraction and reinjection systems to supply the process heating requirement were also completed. The ethanol facility operating on sugar beets, potatoes and wheat will share common fermentation and product recovery equipment. The geothermal fluid requirement will be approximately 6,000 gpm. It is anticipated that this flow will be supplied by 9 supply wells spaced at no closer than 1/4 mile in order to prevent mutual interferences. The geothermal fluid will be flashed in three stages to supply process steam at 250 F, 225 F and 205 F for various process needs. Steam condensate plus liquid remaining after the third flash will all be reinjected through 9 reinjection wells. The capital cost estimated for this ethanol plant employing all three feedstocks is $64 million. If only a single feedstock were used (for the same 20 mm gal/yr plant) the capital costs are estimated at$51.6 million, $43.1 million and$40. 5 million for sugar beets, potatoes and wheat respectively. The estimated capital cost for the geothermal system is $18 million

Ethanol production for automotive fuel usage. Final technical report, July 1979-August 1980

Production of ethanol from potatoes, sugar beets, and wheat using geothermal resources in the Raft River area of Idaho was evaluated. The south-central region of Idaho produces approximately 18 million bushels of wheat, 1.3 million tons of sugar beets, and 27 million cwt potatoes annually. A 20-million-gallon-per-year ethanol facility has been selected as the largest scale plant that can be supported with the current agricultural resources. The conceptual plant was designed to operate on each of these three feedstocks for a portion of the year, but could operate year-round on any of them. The processing facility uses conventional alcohol technology and uses geothermal energy for all process heating. There are three feedstock preparation sections, although the liquefaction and saccharification steps for potatoes and wheat involve common equipment. The fermentation, distillation, and by-product handling sections are common to all three feedstocks. Maximum geothermal fluid requirements are approximately 6000 gpm. It is anticipated that this flow will be supplied by nine production wells located on private and BLM lands in the Raft River KGRA. The geothermal fluid will be flashed from 280/sup 0/F in three stages to supply process steam at 250/sup 0/F, 225/sup 0/F, and 205/sup 0/F for various process needs. Steam condensate plus liquid remaining after the third flash will be returned to receiving strata through six injection wells