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

Origin and evolution of the Palais-Smale condition in critical point theory

In 1963–64, Palais and Smale have introduced a compactness condition, namely condition (C), on real functions of class C 1 defined on a Riemannian manifold modeled upon a Hilbert space, in order to extend Morse theory to this frame and study nonlinear partial differential equations. This condition and some of its variants have been essential in the development of critical point theory on Banach spaces or Banach manifolds, and are referred as Palais–Smale-type conditions. The paper describes their evolution

Seasonal Production and Biomass of the Seagrass, Halodule wrightii Aschers. (Shoal Grass), in a Subtropical Texas Lagoon

A study of Halodule wrightii in a shallow subtropical Texas lagoon was performed to obtain seasonal data on its physiological ecology. Leaf production and biomass dynamics of H. wrightii were intensively monitored along with the underwater light environment at a 1.2-m depth study site over a 21-month period from June 1995 to February 1997. The annual photosynthetically active radiation (PAR) flux of 6,764 mol m−2 year−1 was more than twice as high as 2,400 mol m−2 year−1, the minimum annual PAR required for maintenance of growth. As light intensity declined, blade chlorophyll a/b ratios increased suggesting that the plants were photo-adapting. Seasonal trends were evident in shoot growth and biomass. Compared to other Halodule populations in Texas, H. wrightii in LLM displayed slow growth and low biomass, high leaf tissue N content, and low C/N ratio but high N/P ratio of 38 suggesting that the plants were phosphorus-limited

Enabling organizational cultural change using systemic strategic human resource management – a longitudinal case study

Researchers report that successful cultural change in an organization is difficult to achieve. This research contends that it is more likely to be successful when a systemic approach to strategic human resource management (SHRM) is used to facilitate the change. The contention was tested in an action research case study and longitudinal assessment of change in a large Australian public sector agency. A clear finding from this research is that the cultural change had been sustained through the systemic application of SHRM.<br /