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

Achieving Information Dominance: Unleashing the Ozone Widget Framework

Presented at the 18th International Command & Control Research & Technology Symposium (ICCRTS) held 16-19 June, 2014 in Alexandria, VA.One of the key lessons learned from analysis of Joint operations is the information that was available to operations planners was not discovered and therefore not utilized ? impeding the flow from data, to information, to knowledge, and typically leading to suboptimal results. This challenge is exacerbated when information could ? and should ? be drawn from multiple enclaves from NIPRNET, to SIPRNET, to JWICS. Sharing this information DoD- and agency-wide has been an ongoing challenge. We will share details of emerging research currently underway in a collaboration between the Naval Postgraduate School and the Space and Naval Warfare Systems Center, Pacific to make essential information residing in multiple classification enclaves discoverable, accessible, widely shared, and understandable by those who need the information. The current approach utilizes SWIF (Secure Web Integration Framework) and employs OWF ? utilizing widgets for data input and retrieval ? to make products viewable and retrievable by the DoD community, and ultimately the interagency community, both on the high and low side. The design approach creates an accredited software program for NIPRNET, to SIPRNET, to JWICS and a web-based approach that enables users to access multiple databases. This approach is being beta-tested at the Naval Postgraduate School and involves a process to make classified student theses and other Naval Postgraduate School research products available to a wide-range of users who previously did not have access to these products. Once this small beta-test is complete, Space and Naval Warfare Systems Center, Pacific engineers will expand the use case to the Office of the Secretary of Defense and the Joint Staff, ultimately making tailored information more discoverable, accessible, widely shared, and understandable by the end-users

Geografia comunitária e educação de jovens e adultos : os educadores flâneurs sem terra do Assentamento Paulo César Vinha – Conceição da Barra/ES

O ano de 2015 é um marco histórico dos 30 anos do fim da Ditadura Militar no Brasil. Comemoram-se também os 30 anos do Movimento dos Trabalhadores Rurais Sem Terra (MST) no Estado do Espírito Santo. Nesse contexto, o presente estudo tem como objetivo problematizar as conexões entre as experiências geográficas de formação de educadores de jovens e adultos sem terra do Assentamento Paulo César Vinha, vividas com os territórios do campo, da “roça”, da “rua” e da cidade, e suas práxis nos territórios da Reforma Agrária. Tendo como referência as categorias de Experiência, Narrativa, Memória, Lembrança Encobridora e Práxis, nas perspectivas de Walter Benjamin, Sánchez Vázquez, Paulo Freire, Milton Santos, Edward Thompson, Eric Dardel, Sigmund Freud, entre outros, a pesquisa foi realizada com oito educadores sem terra que atuam na Modalidade da Educação de Jovens e Adultos (EJA) da Escola Córrego do Cedro, no Assentamento Paulo César Vinha, que possui vinculação com o MST e está localizado no município de Conceição da Barra, Território Norte do Espírito Santo. Para tanto, o estudo se beneficiou da Observação Participante, na perspectiva dialético-materialista. No processo investigativo, constatou-se que as experiências geográficas de alienação, de negação, de inconformismo e de idealização dos educadores sem terra são unificadas e transformadas nas práxis do MST, configurando-se como experiências geográficas das práxis nas perspectivas de recriar e (re)experienciar as Geografias Comunitárias Camponesas Sem Terra habitacional, econômica, educacional, religiosa, do lazer e da saúde. Dessa forma, os educadores transformam a si mesmos nessa experiência geográfica inconformista de recriação das geografias alienadas, perdidas ou idealizadas. A pesquisa apontou também para a possibilidade de superação das concepções e práticas restritas de formação inicial e formação continuada na Educação de Jovens e Adultos do campo e da cidade, por meio da constituição da formação comunitária, que não apenas considera e valoriza as experiências de educadores, mas que também concebe a sua transformação nas práxis, voltando-se para o atendimento aos anseios, demandas e interesses dos sujeitos da EJA na ótica da Educação Popular.L'année 2015 est un point de repère du 30e anniversaire de la fin de la Dictature Militaire au Brésil. Ils célèbrent aussi le 30e anniversaire du Mouvement des Travailleurs Ruraux Sans Terre (MST) dans l'État de L´Espírito Santo. Dans ce contexte, l'objectif de la présente recherche consiste à problématiser les connexions entre les expériences géographiques de la formation des éducateurs de jeunes et des adultes sans terre de l´Assentamento Paulo César Vinha, qu' ont été vécues avec des territoires du champ, la “ferme”, la “rue” et ville, et sa praxis dans les territoires de la réforme agraire. Parmi les catégories d'expérience, la narratif, la mémoire, le souvenir écran et la Praxis, les perspectives de Walter Benjamin, Sánchez Vázquez, Paulo Freire, Milton Santos, Edward Thompson, Eric Dardel, Sigmund Freud, entre autres, la recherche a été menée avec huit éducateurs sans terre qui travaillent dans la L´Éducation des Jeunes et des Adultes (EJA) de l´école Córrego do Cedro, dans la Communauté de l´Assentamento Paulo César Vinha, qui est lié avec le MST et est située dans la municipalité de Conceição da Barra, Territoire Nord du Espírito Santo. Par conséquent, l'étude a bénéficié de l'observation participante, dans la perspective dialectique matérialiste. Dans le processus d'enquête, il a été constaté que les expériences collectives géographiques de l'aliénation, déni, de non-conformité et de l'idéalisation des éducateurs sans terre sont unifiés et transformé dans les práxis du MST, devenant comme des expériences géographiques de la praxis des points de vue de (re)créer et (re)découvrir les Géographies Paysan Communautaires Sans Terre de l´habitation, économique, éducatif, religieuse, les loisirs et la santé; ainsi, les éducateurs se transforment. La recherche a également souligné la possibilité de surmonter les conceptions et pratiques de formation initiale limitées de la formation continue pour l´Éducation des Jeunes et des Adultes dans la campagne et la ville, à travers le renforcement de la formation de la communauté qui non seulement examine et évalue les expériences des éducateurs, mais qui conçoit sa transformation dans la praxis, se tournant pour répondre aux souhaits et les intérêts des sujets de l´Éducation des Jeunes et des Adultes dans la perspective de l'éducation populaire

Evaluation of care access and hypertension control in a community health worker driven non-communicable disease programme in rural Uganda: the chronic disease in the community project

Abstract The burden of non-communicable diseases continues to grow throughout the developing world. Health systems in low- and middle-income regions face significant human resource shortages, which limit the ability to meet the growing need for non-communicable disease care. Specially trained community health workers may be useful in filling that provider gap. This study aimed to evaluate consistency of access to care and quality of hypertension control in a community health worker led, decentralized non-communicable disease programme operating in rural Uganda. Days between clinical evaluations and average systolic blood pressure were described for programme patients; these markers were also compared with patients seen in a central, hospital-based clinic. In 2013, community health worker programme patients were seen every 35.6 days and significantly more often than clinic patients (50.8 days, P < 0.001). From October to December 2013, hypertensive patients in the community health worker programme had a mean systolic blood pressure of 147.8 mmHg. This was lower than the average systolic pressure of clinic patients (156.7 mmHg, P < 0.001). Programme patients’ blood pressures were also more frequently measured at below goal than clinic patients (71.2 vs 59.8%, P = 0.048). Decentralizing care and shifting significant clinical management responsibilities to community health workers improved consistency of access to care and did not come with a demonstrable cost in quality of hypertension control. Community health workers may have the potential to bridge the provider gap in low-income nations, providing expanded non-communicable disease care

Absolute Paleolatitude of Northern Zealandia From the Middle Eocene to the Early Miocene

The absolute position during the Cenozoic of northern Zealandia, a continent that lies more than 90% submerged in the southwest Pacific Ocean, is inferred from global plate motion models, because local paleomagnetic constraints are virtually absent. We present new paleolatitude constraints using paleomagnetic data from International Ocean Discovery Program Site U1507 on northern Zealandia and Site U1511 drilled in the adjacent Tasman Sea Basin. After correcting for inclination shallowing, five paleolatitude estimates provide a trajectory of northern Zealandia past position from the middle Eocene to the early Miocene, spanning geomagnetic polarity chrons C21n to C5Er (∼48–18 Ma). The paleolatitude estimates support previous works on global absolute plate motion where northern Zealandia migrated 6° northward between the early Oligocene and early Miocene, but with lower absolute paleolatitudes, particularly in the Bartonian and Priabonian (C18n–C13r). True polar wander (solid Earth rotation with respect to the spin axis), which only can be resolved using paleomagnetic data, may explain the discrepancy. This new paleomagnetic information anchors past latitudes of Zealandia to Earth's spin axis, with implications not only for global geodynamics, but also for addressing paleoceanographic and paleoclimate problems, which generally require precise paleolatitude placement of proxy data

Paleomagnetic directions, anisotropy of magnetic susceptibility, and anisotropy of anhysteretic remanent magnetization from IODP Sites 371-U1507 and 371-U1511, Tasman Sea

We present here paleomagnetic and magnetic anisotropy data from discrete samples collected in the middle Eocene to early Miocene sediment recovered in International Ocean Discovery Program (IODP) Sites U1507 and U1511 (Expedition 371, Tasman Sea, 27 July to 26 September 2017). Data consists of three tables (Table S2, S3, S4). Table S2 contains the paleomagnetic directions from discrete specimens collected in both Hole U1507B and Hole U1511B. The samples were measured for their paleomagnetic signal at the University of Bremen (Germany) between 2019 and 2021. Paleomagnetic inclinations are listed before and after correction for inclination shallowing. Table S3 contains the anisotropy of magnetic susceptibility (AMS) of representative specimens from Hole U1507B. Table S4 contains the anisotropy of anhysteretic remanent magnetization (AARM) of representative specimens from Hole U1507B. Both the AMS and AARM data of tables S3 and S4 were acquired at the University of Turin (Italy) between 2020 and 2021. These data were used for determining the absolute paleolatitude of northern Zealandia between the middle Eocene and the early Miocene (Dallanave et al., 2022; doi:10.1029/2022JB024736)