Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

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

Sequence stratigraphy and controls on gas hydrate occurrence in the eastern Nankai Trough, Japan

The first offshore gas hydrate production test was conducted within the gas-hydrate-concentrated zone (reservoir) of the eastern Nankai Trough, which is considered to be a stratigraphic accumulation. However, the accumulation mechanism for this concentrated zone was not yet well understood. We used core and geophysical log data sets to determine the subsurface geologic architecture and stratigraphic evolution most likely responsible for the stratigraphic accumulation of gas hydrate in the eastern Nankai Trough. Seven depositional sequences were identified based on grain size, bed thickness, sedimentary structure, and stacking patterns. The sequence boundaries were also identified by terminations of seismic reflection. These sequences were attributed to a fourth to fifth-order eustatic sea-level changes because the stacking pattern cycle was in phase with global oxygen isotope curves; the cycle was also identified in the onshore formation during the same period. The reservoir was interpreted as falling-stage systems tract (FSST) and lowstand systems tract (LST). FSST and LST consisted mostly of trough-fill channel deposits. The deposits were represented by alternations of very fine- to fine-grained sand and silt. The reservoir is located in association with the structural wing of the Daini-Atsumi Knoll. The uplift of the knoll was strongly controlled by tectonic events associated with subduction of the pacific plate during Pleistocene time. The muddy deposits above the reservoir were interpreted as condensed section. We identified channel facies pinched out against structural highs, and together, these result in stratigraphic traps. Consequentially, the gas hydrate trapping system was constrained by sedimentary facies, systems tracts, and geographic and tectonic setting. Concepts and data generated in this study can be used for gas hydrate petroleum system analysis such as basin simulation

Topography, image, and flow model data for experimental density currents, St. Anthony Falls Laboratory, 2015-2017,

Submarine channels convey turbidity currents, the primary means for distributing sand and coarser sediments to the deep ocean. In some cases, submarine channels have been shown to braid, similarly to rivers. Yet the strength of the analogy between the subaerial and submarine braided channels is incompletely understood. This data set includes topography, image, and flow model data for six experiments with subaqueous density currents and two experiments with subaerial rivers. The experiments were conducted to quantify (1) submarine channel kinematics, and (2) the responses of channel and bar geometry to subaerial versus submarine basin conditions, inlet conditions, and the ratio of flow-to-sediment discharge (Qw/Qs).The data set accompanies a 2018 publication in the journal Sedimentology

Geometry and dynamics of braided channels and bars under experimental density currents

International audienc

Topography, image, and flow model data for experimental density currents, St. Anthony Falls Laboratory, 2015-2017,

Submarine channels convey turbidity currents, the primary means for distributing sand and coarser sediments to the deep ocean. In some cases, submarine channels have been shown to braid, similarly to rivers. Yet the strength of the analogy between the subaerial and submarine braided channels is incompletely understood. This data set includes topography, image, and flow model data for six experiments with subaqueous density currents and two experiments with subaerial rivers. The experiments were conducted to quantify (1) submarine channel kinematics, and (2) the responses of channel and bar geometry to subaerial versus submarine basin conditions, inlet conditions, and the ratio of flow-to-sediment discharge (Qw/Qs).The data set accompanies a 2018 publication in the journal Sedimentology