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1. Development of an electronic health message system to support recovery after stroke: Inspiring Virtual Enabled Resources following Vascular Events (iVERVE)

Author

Cadilhac DA, Busingye D, Li JC, Andrew NE, Kilkenny MF, Thrift AG, Thijs V, Hackett ML, Kneebone I, Lannin NA, Stewart A, Dempsey I, and Cameron J

Subjects
stroke, e-health, self-management, Medicine (General), R5-920
Abstract

Dominique A Cadilhac,1,2 Doreen Busingye,1 Jonathan C Li,3 Nadine E Andrew,1,4 Monique F Kilkenny,1,2 Amanda G Thrift,1 Vincent Thijs,2,5 Maree L Hackett,6,7 Ian Kneebone,8 Natasha A Lannin,9,10 Alana Stewart,11 Ida Dempsey,12 Jan Cameron,1,13 1Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia; 2Stroke Division, Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, VIC, Australia; 3Department of Electrical and Computer Systems Engineering, Monash University, Melbourne, VIC, Australia; 4Department of Medicine, Central Clinical School, Monash University, Melbourne, VIC, Australia; 5Department of Neurology, Austin Health, Melbourne, VIC, Australia; 6The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia; 7Faculty of Health and Wellbeing, University of Central Lancashire, Preston, UK; 8Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia; 9College of Science, Health and Engineering, School of Allied Health, La Trobe University, Melbourne, VIC, Australia; 10Occupational Therapy Department, Alfred Health, Melbourne, VIC, Australia; 11Stroke Foundation, Melbourne, VIC, Australia; 12Consumer Representative, Melbourne, VIC, Australia; 13Australian Centre for Heart Health, Royal Melbourne Hospital, Melbourne, VIC, Australia Purpose: Worldwide, stroke is a leading cause of disease burden. Many survivors have unmet needs after discharge from hospital. Electronic communication technology to support post-discharge care has not been used for patients with stroke. In this paper, we describe the development of a novel electronic messaging system designed for survivors of stroke to support their goals of recovery and secondary prevention after hospital discharge. Participants and methods: This was a formative evaluation study. The design was informed by a literature search, existing data from survivors of stroke, and behavior change theories. We established two working groups; one for developing the electronic infrastructure and the other (comprising researchers, clinical experts and consumer representatives) for establishing the patient-centered program. Following agreement on the categories for the goal-setting menu, we drafted relevant messages to support and educate patients. These messages were then independently reviewed by multiple topic experts. Concurrently, we established an online database to capture participant characteristics and then integrated this database with a purpose-built messaging system. We conducted alpha testing of the approach using the first 60 messages. Results: The initial goal-setting menu comprised 26 subcategories. Following expert review, another 8 goal subcategories were added to the secondary prevention category: managing cholesterol; smoking; physical activity; alcohol consumption; weight management; medication management; access to health professionals, and self-care. Initially, 455 health messages were created by members of working group 2. Following refinement and mapping to different goals by the project team, 980 health messages across the health goals and 69 general motivational messages were formulated. Seventeen independent reviewers assessed the messages and suggested adding 73 messages and removing 16 (2%). Overall, 1,233 messages (18 administrative, 69 general motivation and 1,146 health-related) were created. Conclusion: This novel electronic self-management support system is ready to be pilot tested in a randomized controlled trial in patients with stroke. Keywords: stroke, e-health, self-management, health promotion, secondary prevention

Published
2018

4. Migraine-Associated Common Genetic Variants Confer Greater Risk of Posterior vs. Anterior Circulation Ischemic Stroke☆

Author

Frid, P., Xu, H., Mitchell, B.D., Drake, M., Wasselius, J., Gaynor, B., Ryan, K., Giese, A.K., Schirmer, M., Donahue, K.L., Irie, R., Bouts, M.J.R.J., McIntosh, E.C., Mocking, S.J.T., Dalca, A.V., Giralt-Steinhauer, E., Holmegaard, L., Jood, K., Roquer, J., Cole, J.W., McArdle, P.F., Broderick, J.P., Jimenez-Conde, J., Jern, C., Kissela, B.M., Kleindorfer, D.O., Lemmens, R., Meschia, J.F., Rosand, J., Rundek, T., Sacco, R.L., Schmidt, R., Sharma, P., Slowik, A., Thijs, V., Woo, D., Worrall, B.B., Kittner, S.J., Petersson, J., Golland, P., Wu, O., Rost, N.S., and Lindgren, A.

Published
2022
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5. Features of intracranial hemorrhage in cerebral venous thrombosis

Author

Afifi, K., Bellanger, G., Buyck, P. J., Zuurbier, S. M., Esperon, C. G., Barboza, M. A., Costa, P., Escudero, I., Renard, D., Lemmens, R., Hinteregger, N., Fazekas, F., Conde, J. Jimenez, Giralt-Steinhauer, E., Hiltunen, S., Arauz, A., Pezzini, A., Montaner, J., Putaala, J., Weimar, C., Schlamann, Marc, Gattringer, T., Tatlisumak, T., Coutinho, J. M., Demaerel, P., and Thijs, V.

Published
2020
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6. Correction to: Features of intracranial hemorrhage in cerebral venous thrombosis

Author

Afifi, K., Bellanger, G., Buyck, P. J., Zuurbier, S. M., Garcia-Esperon, C., Barboza, M. A., Costa, P., Escudero, I., Renard, D., Lemmens, R., Hinteregger, N., Fazekas, F., Jimenez-Conde, J., Giralt-Steinhauer, E., Hiltunen, S., Arauz, A., Pezzini, A., Montaner, J., Putaala, J., Weimar, C., Schlamann, Marc, Gattringer, T., Tatlisumak, T., Coutinho, J. M., Demaerel, P., and Thijs, V.

Published
2020
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7. Prodromal Transient Ischemic Attack or Minor Stroke and Outcome in Basilar Artery Occlusion

Author

Weber, A.M., Donnan, G.A., Thijs, V., Peeters, A., de Freitas, G.R., Conforto, A.B., Miranda-Alves, M., Massaro, A., Ijäs, P., Bogoslovsky, T., Lindsberg, P.J., Weimar, C., Benemann, J., Kraywinkel, K., Haverkamp, C., Michalski, D., Weissenborn, K., Goertler, M., Kloth, A., Bitsch, A., Mieck, T., Machetanz, J., Möller, P., Huber, R., Kaendler, S., Rueckert, C., Audebert, H., Müller, R., Vatankhah, B., Pfefferkorn, T., Mayer, T.E., Szabo, K., Disque, C., Busse, O., Berger, C., Hacke, W., Schwammenthal, Y., Orion, D., Tanne, D., Bergui, M., Pozzati, E., Schonewille, W.J., Algra, A., Kappelle, L.J., Luijckx, G.J., Vroomen, P., Vergouwen, M.D., Roos, Y., Stam, J., Bienfait, P., de Leeuw, F.E., de Kort, P., Dippel, D., Baird, T., Muir, K., Pagola, J., Ribo, M., Molina, C., Gonzales, A., Gil-Peralta, A., Norrving, B., Arnold, M., Fischer, U., Gralla, J., Mattle, H., Schroth, G., Michel, P., Engelter, S.T., Wetzel, S., Lyrer, P., Gandjour, J., Michael, N., Baumgartner, R., Tettenborn, B., Hungerbuehler, H., Wijman, C.A.C., Finley Caulfield, A., Lansberg, M., Schwartz, N., Venkatasubramanian, C., Garami, Z., Bogaard, S., Yatzu, F., Grotta, J., Conforto, Adriana B., de Freitas, Gabriel R., Schonewille, Wouter J., Kappelle, L. Jaap, and Algra, Ale

Published
2015
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8. Contribution of Common Genetic Variants to Risk of Early Onset Ischemic Stroke

Author

Jaworek, T, Xu, H, Gaynor, BJ, Cole, JW, Rannikmae, K, Stanne, TM, Tomppo, L, Abedi, V, Amouyel, P, Armstrong, ND, Attia, J, Bell, S, Benavente, OR, Boncoraglio, GB, Butterworth, A, Cervical Artery Dissections and Ischemic Stroke Patients (CADSIP) Consortium, Carcel-Marquez, J, Chen, Z, Chong, M, Cruchaga, C, Cushman, M, Danesh, J, Debette, S, Duggan, DJ, Durda, JP, Engstrom, G, Enzinger, C, Faul, JD, Fecteau, NS, Fernandez-Cadenas, I, Gieger, C, Giese, A-K, Grewal, RP, Grittner, U, Havulinna, AS, Heitsch, L, Hochberg, MC, Holliday, E, Hu, J, Ilinca, A, INVENT Consortium, Irvin, MR, Jackson, RD, Jacob, MA, Janssen, RR, Jimenez-Conde, J, Johnson, JA, Kamatani, Y, Kardia, SL, Koido, M, Kubo, M, Lange, L, Lee, J-M, Lemmens, R, Levi, CR, Li, J, Li, L, Lin, K, Lopez, H, Luke, S, Maguire, J, McArdle, PF, McDonough, CW, Meschia, JF, Metso, T, Muller-Nurasyid, M, O'Connor, TD, O'Donnell, M, Peddareddygari, LR, Pera, J, Perry, JA, Peters, A, Putaala, J, Ray, D, Rexrode, K, Ribases, M, Rosand, J, Rothwell, PM, Rundek, T, Ryan, KA, Sacco, RL, Salomaa, V, Sanchez-Mora, C, Schmidt, R, Sharma, P, Slowik, A, Smith, JA, Smith, NL, Wassertheil-Smoller, S, Soederholm, M, Stine, OC, Strbian, D, Sudlow, CL, Tatlisumak, T, Terao, C, Thijs, V, Torres-Aguila, NP, Tregouet, D-A, Tuladhar, AM, Veldink, JH, Walters, RG, Weir, DR, Woo, D, Worrall, BB, Hong, CC, Ross, O, Zand, R, Leeuw, F-ED, Lindgren, AG, Pare, G, Anderson, CD, Markus, HS, Jern, C, Malik, R, Dichgans, M, Mitchell, BD, Kittner, SJ, and Early Onset Stroke Genetics Consortium of the International Stroke Genetics Consortium (ISGC)

Subjects
Neurology & Neurosurgery, 1103 Clinical Sciences, 1109 Neurosciences, 1702 Cognitive Sciences
Abstract

BACKGROUND AND OBJECTIVES: Current genome-wide association studies of ischemic stroke have focused primarily on late onset disease. As a complement to these studies, we sought to identifythe contribution of common genetic variants to risk of early onset ischemic stroke. METHODS: We performed a meta-analysis of genome-wide association studies of early onset stroke (EOS), ages 18-59, using individual level data or summary statistics in 16,730 cases and 599,237 non-stroke controls obtained across 48 different studies. We further compared effect sizes at associated loci between EOS and late onset stroke (LOS) and compared polygenic risk scores for venous thromboembolism between EOS and LOS. RESULTS: We observed genome-wide significant associations of EOS with two variants in ABO, a known stroke locus. These variants tag blood subgroups O1 and A1, and the effect sizes of both variants were significantly larger in EOS compared to LOS. The odds ratio (OR) for rs529565, tagging O1, 0.88 (95% CI: 0.85-0.91) in EOS vs 0.96 (95% CI: 0.92-1.00) in LOS, and the OR for rs635634, tagging A1, was 1.16 (1.11-1.21) for EOS vs 1.05 (0.99-1.11) in LOS; p-values for interaction = 0.001 and 0.005, respectively. Using polygenic risk scores, we observed that greater genetic risk for venous thromboembolism, another prothrombotic condition, was more strongly associated with EOS compared to LOS (p=0.008). DISCUSSION: The ABO locus, genetically predicted blood group A, and higher genetic propensity for venous thrombosis are more strongly associated with EOS than with LOS, supporting a stronger role of prothrombotic factors in EOS.

Published
2022

9. Posterior National Institutes of Health Stroke Scale Improves Prognostic Accuracy in Posterior Circulation Stroke

Author

Alemseged, Fana, primary, Rocco, Alessandro, additional, Arba, Francesco, additional, Schwabova, Jaroslava Paulasova, additional, Wu, Teddy, additional, Cavicchia, Leone, additional, Ng, Felix, additional, Ng, Jo Lyn, additional, Zhao, Henry, additional, Williams, Cameron, additional, Sallustio, Fabrizio, additional, Balabanski, Anna H., additional, Tomek, Ales, additional, Parson, Mark W., additional, Mitchell, Peter J., additional, Diomedi, Marina, additional, Yassi, Nawaf, additional, Churilov, Leonid, additional, Davis, Stephen M., additional, Campbell, Bruce C.V., additional, Parsons, M., additional, McDonald, A., additional, Pesavento, L., additional, Coote, S., additional, Yan, Bernard, additional, Dowling, Rick, additional, Bush, Steven, additional, Ng, F.C., additional, Thijs, V., additional, Kleinig, Timothy, additional, Drew, R., additional, Garcia Esperon, C., additional, Spratt, N., additional, Shah, D., additional, Wu, T., additional, Fink, J., additional, Di Giuliano, F., additional, Nappini, S., additional, Morotti, A., additional, Cavallini, A., additional, Boulouis, G., additional, Benhassen, W., additional, Puetz, V., additional, Kaiser, D., additional, Oxley, T.J., additional, and Fifi, J.T., additional

Published
2022
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10. Enhancing smart charging in electric vehicles by addressing paused and delayed charging problems

Author

Nico Brinkel, Thijs van Wijk, Anoeska Buijze, Nanda Kishor Panda, Jelle Meersmans, Peter Markotić, Bart van der Ree, Henk Fidder, Baerte de Brey, Simon Tindemans, Tarek AlSkaif, and Wilfried van Sark

Subjects
Science
Abstract

Abstract Smart charging of electric vehicles can alleviate grid congestion and reduce charging costs. However, various electric vehicle models currently lack the technical capabilities to effectively implement smart charging since they cannot handle charging pauses or delays. These models enter sleep mode when charging is interrupted, preventing resumption afterwards. To avoid this, they should be continuously charged with their minimum charging power, even when a charging pause would be desirable, for instance with high electricity prices. This research examines this problem to inform various stakeholders, including policymakers and manufacturers, and stimulates the adoption of proactive measures that address this problem. Here, we demonstrate through technical charging tests that around one-third of tested car models suffer from this issue. Through model simulations we indicate that eliminating paused and delayed charging problems would double the smart charging potential for all applications. Lastly, we propose concrete legal and practical solutions to eliminate these problems.

Published
2024
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11. Association of early blood-based biomarkers and six-month functional outcomes in conventional severity categories of traumatic brain injury: capturing the continuous spectrum of injuryResearch in context

Author

Lindsay Wilson, Virginia F.J. Newcombe, Daniel P. Whitehouse, Stefania Mondello, Andrew I.R. Maas, David K. Menon, Cecilia Ackerlund, Krisztina Amrein, Nada Andelic, Lasse Andreassen, Audny Anke, Anna Antoni, Gérard Audibert, Philippe Azouvi, Maria Luisa Azzolini, Ronald Bartels, Pál Barzó, Romuald Beauvais, Ronny Beer, Bo-Michael Bellander, Antonio Belli, Habib Benali, Maurizio Berardino, Luigi Beretta, Morten Blaabjerg, Peter Bragge, Alexandra Brazinova, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Andras Buki, Monika Bullinger, Manuel Cabeleira, Alessio Caccioppola, Emiliana Calappi, Maria Rosa Calvi, Peter Cameron, Guillermo Carbayo Lozano, Marco Carbonara, Ana M. Castaño-León, Simona Cavallo, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Hans Clusmann, Mark Steven Coburn, Jonathan Coles, Jamie D. Cooper, Marta Correia, Amra Čović, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire Dahyot-Fizelier, Paul Dark, Helen Dawes, Véronique De Keyser, Vincent Degos, Francesco Della Corte, Hugo den Boogert, Bart Depreitere, Đula Đilvesi, Abhishek Dixit, Emma Donoghue, Jens Dreier, Guy-Loup Dulière, Ari Ercole, Patrick Esser, Erzsébet Ezer, Martin Fabricius, Valery L. Feigin, Kelly Foks, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Pradeep George, Alexandre Ghuysen, Lelde Giga, Ben Glocker, Jagoš Golubović, Pedro A. Gomez, Johannes Gratz, Benjamin Gravesteijn, Francesca Grossi, Russell L. Gruen, Deepak Gupta, Juanita A. Haagsma, Iain Haitsma, Raimund Helbok, Eirik Helseth, Lindsay Horton, Jilske Huijben, Peter J. Hutchinson, Bram Jacobs, Stefan Jankowski, Mike Jarrett, Ji-yao Jiang, Faye Johnson, Kelly Jones, Mladen Karan, Angelos G. Kolias, Erwin Kompanje, Daniel Kondziella, Evgenios Kornaropoulos, Lars-Owe Koskinen, Noémi Kovács, Ana Kowark, Alfonso Lagares, Linda Lanyon, Steven Laureys, Fiona Lecky, Didier Ledoux, Rolf Lefering, Valerie Legrand, Aurelie Lejeune, Leon Levi, Roger Lightfoot, Hester Lingsma, Marc Maegele, Marek Majdan, Alex Manara, Geoffrey Manley, Hugues Maréchal, Costanza Martino, Julia Mattern, Catherine McMahon, Béla Melegh, Tomas Menovsky, Ana Mikolic, Benoit Misset, Visakh Muraleedharan, Lynnette Murray, Nandesh Nair, Ancuta Negru, David Nelson, Daan Nieboer, József Nyirádi, Matej Oresic, Fabrizio Ortolano, Olubukola Otesile, Aarno Palotie, Paul M. Parizel, Jean-François Payen, Natascha Perera, Vincent Perlbarg, Paolo Persona, Wilco Peul, Anna Piippo-Karjalainen, Matti Pirinen, Dana Pisica, Horia Ples, Suzanne Polinder, Inigo Pomposo, Jussi P. Posti, Louis Puybasset, Andreea Rădoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Isabel Retel Helmrich, Jonathan Rhodes, Sylvia Richardson, Sophie Richter, Samuli Ripatti, Saulius Rocka, Cecilie Roe, Olav Roise, Jonathan Rosand, Jeffrey Rosenfeld, Christina Rosenlund, Guy Rosenthal, Rolf Rossaint, Sandra Rossi, Daniel Rueckert, Martin Rusnák, Juan Sahuquillo, Oliver Sakowitz, Renan Sanchez-Porras, Janos Sandor, Nadine Schäfer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Rico Frederik Schou, Elisabeth Schwendenwein, Ranjit D. Singh, Charlie Sewalt, Toril Skandsen, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Robert Stevens, William Stewart, Ewout W. Steyerberg, Nino Stocchetti, Nina Sundström, Riikka Takala, Viktória Tamás, Tomas Tamosuitis, Mark Steven Taylor, Braden Te Ao, Olli Tenovuo, Alice Theadom, Matt Thomas, Aurore Thibaut, Dick Tibboel, Marjolijn Timmers, Christos Tolias, Tony Trapani, Cristina Maria Tudora, Andreas Unterberg, Peter Vajkoczy, Egils Valeinis, Shirley Vallance, Zoltán Vámos, Mathieu van der Jagt, Joukje van der Naalt, Gregory Van der Steen, Jeroen T.J.M. van Dijck, Inge A. van Erp, Thomas A. van Essen, Wim Van Hecke, Caroline van Heugten, Dominique Van Praag, Ernest van Veen, Roel P.J. van Wijk, Thijs Vande Vyvere, Alessia Vargiolu, Emmanuel Vega, Kimberley Velt, Jan Verheyden, Paul M. Vespa, Anne Vik, Rimantas Vilcinis, Victor Volovici, Nicole von Steinbüchel, Daphne Voormolen, Peter Vulekovic, Kevin K.W. Wang, Eveline Wiegers, Guy Williams, Stefan Winzeck, Stefan Wolf, Zhihui Yang, Peter Ylén, Alexander Younsi, Frederick A. Zeiler, Veronika Zelinkova, Agate Ziverte, and Tommaso Zoerle

Subjects
Traumatic brain injury, Blood biomarkers, GFAP, NFL, UCH-L1, Outcomes, Medicine, Medicine (General), R5-920
Abstract

Summary: Background: Traumatic brain injury is conventionally categorised as mild, moderate, or severe on the Glasgow Coma Scale (GCS). Recently developed biomarkers can provide more objective and nuanced measures of the extent of brain injury. Methods: Exposure–response relationships were investigated in 2479 patients aged ≥16 enrolled in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) prospective observational cohort study. Neurofilament protein-light (NFL), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), and glial fibrillary acidic protein (GFAP) were assayed from serum sampled in the first 24 h; concentrations were divided into quintiles within GCS severity groups. Relationships with the Glasgow Outcome Scale-Extended were examined using modified Poisson regression including age, sex, major extracranial injury, time to sample, and log biomarker concentration as covariates. Findings: Within severity groups there were associations between biomarkers and outcomes after adjustment for covariates: GCS 13–15 and negative CT imaging (relative risks [RRs] from 1.28 to 3.72), GCS 13–15 and positive CT (1.21–2.81), GCS 9–12 (1.16–2.02), GCS 3–8 (1.09–1.94). RRs were associated with clinically important differences in expectations of prognosis. In patients with GCS 3 (RRs 1.51–1.80) percentages of unfavourable outcome were 37–51% in the lowest quintiles of biomarker levels and reached 90–94% in the highest quintiles. Similarly, for GCS 15 (RRs 1.83–3.79), the percentages were 2–4% and 19–28% in the lowest and highest biomarker quintiles, respectively. Interpretation: Conventional TBI severity classification is inadequate and underestimates heterogeneity of brain injury and associated outcomes. The adoption of circulating biomarkers can add to clinical assessment of injury severity. Funding: European Union 7th Framework program (EC grant 602150), Hannelore Kohl Stiftung, One Mind, Integra LifeSciences, Neuro-Trauma Sciences, NIHR Rosetrees Trust.

Published
2024
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13. Value of treatment by comprehensive stroke services for the reduction of critical gaps in acute stroke care in Europe

Author

Webb, AJS, Fonseca, AC, Berge, E, Randall, G, Fazekas, F, Norrving, B, Nivelle, E, Thijs, V, Vanhooren, G, and initiative, Stroke Working Group of the European Brain Council Value of Treatment

Subjects
medicine.medical_specialty, Cost effectiveness, Total cost, Cost-Benefit Analysis, 03 medical and health sciences, 0302 clinical medicine, Atrial Fibrillation, medicine, media_common.cataloged_instance, Humans, 030212 general & internal medicine, European union, Intensive care medicine, Stroke, health care economics and organizations, Neurorehabilitation, Cause of death, media_common, Cost database, business.industry, medicine.disease, Markov Chains, Europe, Systematic review, Neurology, Neurology (clinical), Quality-Adjusted Life Years, business, 030217 neurology & neurosurgery
Abstract

Stroke is the second leading cause of death and dependency in Europe and costs the European Union more than €30bn, yet significant gaps in the patient pathway remain and the cost-effectiveness of comprehensive stroke care to meet these needs is unknown. The European Brain Council Value of Treatment Initiative combined patient representatives, stroke experts, neurological societies and literature review to identify unmet needs in the patient pathway according to Rotterdam methodology. The cost-effectiveness of comprehensive stroke services was determined by a Markov model, using UK cost data as an exemplar and efficacy data for prevention of death and dependency from published systematic reviews and trials, expressing effectiveness as quality-adjusted life-years (QALYs). Model outcomes included total costs, total QALYs, incremental costs, incremental QALYs and the incremental cost-effectiveness ratio (ICER). Key unmet needs in the stroke patient pathway included inadequate treatment of atrial fibrillation (AF), access to neurorehabilitation and implementation of comprehensive stroke services. In the Markov model, full implementation of comprehensive stroke services was associated with a 9.8% absolute reduction in risk of death of dependency, at an intervention cost of £9566 versus £6640 for standard care, and long-term care costs of £35 169 per 5.1251 QALYS vs. £32 347.40 per 4.5853 QALYs, resulting in an ICER of £5227.89. Results were robust in one-way and probabilistic sensitivity analyses. Implementation of comprehensive stroke services is a cost-effective approach to meet unmet needs in the stroke patient pathway, to improve acute stroke care and support better treatment of AF and access to neurorehabilitation.

Published
2021

15. Artery occlusion independently predicts unfavorable outcome in cervical artery dissection

Author

Traenka C., Grond-Ginsbach C., Goeggel Simonetti B., Metso T. M., Debette S., Pezzini A., Kloss M., Majersik J. J., Southerland A. M., Leys D., Baumgartner R., Caso V., Bejot Y., De Marchis G. M., Fischer U., Polymeris A., Sarikaya H., Thijs V., Worrall B. B., Bersano A., Brandt T., Gensicke H., Bonati L. H., Touzee E., Martin J. J., Chabriat H., Tatlisumak T., Arnold M., Engelter S. T., Lyrer P., Ferrarese C., Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Traenka, C, Grond-Ginsbach, C, Goeggel Simonetti, B, Metso, T, Debette, S, Pezzini, A, Kloss, M, Majersik, J, Southerland, A, Leys, D, Baumgartner, R, Caso, V, Bejot, Y, De Marchis, G, Fischer, U, Polymeris, A, Sarikaya, H, Thijs, V, Worrall, B, Bersano, A, Brandt, T, Gensicke, H, Bonati, L, Touzee, E, Martin, J, Chabriat, H, Tatlisumak, T, Arnold, M, Engelter, S, Lyrer, P, and Ferrarese, C

Subjects
Adult, Male, medicine.medical_specialty, Cervical Artery, medicine.medical_treatment, 030204 cardiovascular system & hematology, Revascularization, Article, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Modified Rankin Scale, Aneurysm, Dissecting, Internal medicine, Humans, Medicine, Artery occlusion, Stroke, Aged, business.industry, Odds ratio, Recovery of Function, Middle Aged, medicine.disease, 3. Good health, Aortic Dissection, Cerebrovascular Disorders, Dissection, VINTAGE, Cerebrovascular Disorder, Cardiology, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Cerebral Arterial Diseases, Neurology (clinical), business, Cerebral Arterial Disease, 030217 neurology & neurosurgery, Human
Abstract

ObjectiveTo assess the impact of dissected artery occlusion (DAO) on functional outcome and complications in patients with cervical artery dissection (CeAD).MethodsWe analyzed combined individual patient data from 3 multicenter cohorts of consecutive patients with CeAD (the Cervical Artery Dissection and Ischemic Stroke Patients [CADISP]–Plus consortium dataset). Patients with data on DAO and functional outcome were included. We compared patients with DAO to those without DAO. Primary outcome was favorable functional outcome (i.e., modified Rankin Scale [mRS] score 0–1) measured 3–6 months from baseline. Secondary outcomes included delayed cerebral ischemia, major hemorrhage, recurrent CeAD, and death. We performed univariate and multivariable binary logistic regression analyses and calculated odds ratios (OR) with 95% confidence intervals (CI), with adjustment for potential confounders.ResultsOf 2,148 patients (median age 45 years [interquartile range (IQR) 38–52], 43.6% women), 728 (33.9%) had DAO. Patients with DAO more frequently presented with cerebral ischemia (84.6% vs 58.5%, p < 0.001). Patients with DAO were less likely to have favorable outcome when compared to patients without DAO (mRS 0–1: 59.6% vs 80.1%, punadjusted < 0.001). After adjustment for age, sex, and initial stroke severity, DAO was independently associated with less favorable outcome (mRS 0–1: OR 0.65, CI 0.50–0.84, p = 0.001). Delayed cerebral ischemia occurred more frequently in patients with DAO than in patients without DAO (4.5% vs 2.9%, p = 0.059).ConclusionDAO independently predicts less favorable functional outcome in patients with CeAD. Further research on vessel patency, collateral status and effects of revascularization therapies particularly in patients with DAO is warranted.

Published
2020

16. EXPRESS: Protocol of a randomised controlled trial investigating the effectiveness of Recovery-focused Community support to Avoid readmissions and improve Participation after Stroke (ReCAPS)

Author

Cadilhac, D, Cameron, J, Kilkenny, MF, Andrew, NE, Harris, D, Ellery, F, Thrift, AG, Purvis, T, Kneebone, I, Dewey, H, Drummond, A, Hackett, ML, Grimley, R, Middleton, S, Thijs, V, Cloud, G, Carey, ML, Butler, E, Ma, H, Churilov, L, Hankey, GJ, English, CK, and Lannin, NA

Subjects
Neurology & Neurosurgery, 1103 Clinical Sciences, 1109 Neurosciences
Abstract

RationaleTo address unmet needs, electronic messages to support person-centered goal attainment and secondary prevention may avoid hospital presentations/readmissions after stroke, but evidence is limited.HypothesisCompared to control participants, there will be a 10% lower proportion of intervention participants who represent to hospital (emergency/admission) within 90 days of randomization.Methods and designMulticenter, double-blind, randomized controlled trial with intention-to-treat analysis. The intervention group receives 12 weeks of personalized, goal-centered, and administrative electronic messages, while the control group only receive administrative messages. The trial includes a process evaluation, assessment of treatment fidelity, and an economic evaluation. Participants: Confirmed stroke (modified Rankin Score: 0-4), aged ≥18 years with internet/mobile phone access, discharged directly home from hospital. Randomization: 1:1 computer-generated, stratified by age and baseline disability. Outcomes assessments: Collected at 90 days and 12 months following randomization.OutcomesPrimary outcomes include hospital emergency presentations/admissions within 90 days of randomization. Secondary outcomes include goal attainment, self-efficacy, mood, unmet needs, disability, quality-of-life, recurrent stroke/cardiovascular events/deaths at 90 days and 12 months, and death and cost-effectiveness at 12 months. Sample size: To test our primary hypothesis, we estimated a sample size of 890 participants (445 per group) with 80% power and two-tailed significance threshold of α = 0.05. Given uncertainty for the effect size of this novel intervention, the sample size will be adaptively re-estimated when outcomes for n = 668 are obtained, with maximum sample capped at 1100.DiscussionWe will provide new evidence on the potential effectiveness, implementation, and cost-effectiveness of a tailored eHealth intervention for survivors of stroke.

Published
2021

17. Games to support teaching clinical reasoning in health professions education: a scoping review

Author

Gilbert Koelewijn, Marije P. Hennus, Helianthe S. M. Kort, Joost Frenkel, and Thijs van Houwelingen

Subjects
Clinical reasoning, serious games, reflective practice, problem-solving, experimental learning, medical education, Special aspects of education, LC8-6691, Medicine (General), R5-920
Abstract

ABSTRACTIntroduction Given the complexity of teaching clinical reasoning to (future) healthcare professionals, the utilization of serious games has become popular for supporting clinical reasoning education. This scoping review outlines games designed to support teaching clinical reasoning in health professions education, with a specific emphasis on their alignment with the 8-step clinical reasoning cycle and the reflective practice framework, fundamental for effective learning.Methods A scoping review using systematic searches across seven databases (PubMed, CINAHL, ERIC, PsycINFO, Scopus, Web of Science, and Embase) was conducted. Game characteristics, technical requirements, and incorporation of clinical reasoning cycle steps were analyzed. Additional game information was obtained from the authors.Results Nineteen unique games emerged, primarily simulation and escape room genres. Most games incorporated the following clinical reasoning steps: patient consideration (step 1), cue collection (step 2), intervention (step 6), and outcome evaluation (step 7). Processing information (step 3) and understanding the patient’s problem (step 4) were less prevalent, while goal setting (step 5) and reflection (step 8) were least integrated.Conclusion All serious games reviewed show potential for improving clinical reasoning skills, but thoughtful alignment with learning objectives and contextual factors is vital. While this study aids health professions educators in understanding how games may support teaching of clinical reasoning, further research is needed to optimize their effective use in education. Notably, most games lack explicit incorporation of all clinical reasoning cycle steps, especially reflection, limiting its role in reflective practice. Hence, we recommend prioritizing a systematic clinical reasoning model with explicit reflective steps when using serious games for teaching clinical reasoning.

Published
2024
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18. Anemia in young patients with ischaemic stroke

Author

Kellert, L., Kloss, M., Pezzini, A., Metso, T. M., Metso, A. J., Debette, S., Leys, D., Caso, V., Thijs, V., Bersano, A., Touzé, E., Tatlisumak, T., Gensicke, H., Lyrer, P. A., Bösel, J., Engelter, S. T., and Grond-Ginsbach, C.

Published
2015
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19. EXPRESS: International Stroke Genetics Consortium Recommendations for Studies of Genetics of Stroke Outcome and Recovery

Author

Lindgren, A, Braun, R, Majersik, JJ, Clatworthy, P, Mainali, S, Derdeyn, CP, Maguire, JM, Jern, C, Rosand, J, Cole, JW, Lee, J-M, Khatri, P, Nyquist, PA, Debette, SP, Keat Wei, L, Rundek, T, Leifer, D, Thijs, V, Lemmens, R, Heitsch, L, Prasad, K, Jimenez-Conde, J, Dichgans, M, Rost, NS, Cramer, SC, Bernhardt, J, Worrall, BB, and Cadenas, I

Subjects
Neurology & Neurosurgery, cardiovascular diseases, 1103 Clinical Sciences, 1109 Neurosciences
Abstract

Numerous biological mechanisms contribute to outcome after stroke, including brain injury, inflammation, and repair mechanisms. Clinical genetic studies have the potential to discover biological mechanisms affecting stroke recovery in humans and identify intervention targets. Large sample sizes are needed to detect commonly occurring genetic variations related to stroke brain injury and recovery. However, this usually requires combining data from multiple studies where consistent terminology, methodology, and data collection timelines are essential. Our group of expert stroke and rehabilitation clinicians and researchers with knowledge in genetics of stroke recovery here present recommendations for harmonizing phenotype data with focus on measures suitable for multicenter genetic studies of ischemic stroke brain injury and recovery. Our recommendations have been endorsed by the International Stroke Genetics Consortium.

Published
2021

20. Burden of oral anticoagulation in embolic stroke of undetermined source without atrial fibrillation

Author

Witte, K.K. Tsivgoulis, G. Reynolds, M.R. Tsintzos, S.I. Eggington, S. Ismyrloglou, E. Lyon, J. Huynh, M. Egea, M. de Brouwer, B. Ziegler, P.D. Franco, N. Joglekar, R. Rosemas, S.C. Liu, S. Thijs, V.

Abstract

Objective: Prevention of recurrent stroke in patients with embolic stroke of undetermined source (ESUS) is challenging. The advent of safer anticoagulation in the form of direct oral anticoagulants (DOACs) has prompted exploration of prophylactic anticoagulation for all ESUS patients, rather than anticoagulating just those with documented atrial fibrillation (AF). However, recent trials have failed to demonstrate a clinical benefit, while observing increased bleeding. We modeled the economic impact of anticoagulating ESUS patients without documented AF across multiple geographies. Methods: CRYSTAL-AF trial data were used to assess ischaemic stroke event rates in ESUS patients confirmed AF-free after long-term monitoring. Anticipated bleeding event rates (including both minor and major bleeds) with aspirin, dabigatran 150 mg, and rivaroxaban 20 mg were sourced from published meta-analyses, whilst a 30% ischaemic stroke reduction for both DOACs was assumed. Cost data for clinical events and pharmaceuticals were collected from the local payer perspective. Results: Compared with aspirin, dabigatran and rivaroxaban resulted in 17.9 and 29.9 additional bleeding events per 100 patients over a patient’s lifetime, respectively. Despite incorporating into our model the proposed 30% reduction in ischaemic stroke risk, both DOACs were cost-additive over patient lifetime, as the costs of bleeding events and pharmaceuticals outweighed cost savings associated with the reduction in ischaemic strokes. DOACs added £5953–£7018 per patient (UK), €6683–€7368 (Netherlands), €4933–€9378 (Spain), AUD$5353–6539 (Australia) and $26,768–$32,259 (US) of payer cost depending on the agent prescribed. Additionally, in the U.S. patient pharmacy co-payments ranged from $2468–$12,844 depending on agent and patient plan. In all settings, cost-savings could not be demonstrated even when the modelling assumed 100% protection from recurrent ischaemic strokes, due to the very low underlying risk of recurrent ischaemic stroke in this population (1.27 per 100 patient-years). Conclusions: Anticoagulation of non-AF patients may cause excess bleeds and add substantial costs for uncertain benefits, suggesting a personalised approach to anticoagulation in ESUS patients. © 2021, The Author(s).

Published
2021

21. Global Impact of COVID-19 on Stroke Care and IV Thrombolysis

Author

Nogueira, R.G. Qureshi, M.M. Abdalkader, M. Martins, S.O. Yamagami, H. Qiu, Z. Mansour, O.Y. Sathya, A. Czlonkowska, A. Tsivgoulis, G. Aguiar de Sousa, D. Demeestere, J. Mikulik, R. Vanacker, P. Siegler, J.E. Kõrv, J. Biller, J. Liang, C.W. Sangha, N.S. Zha, A.M. Czap, A.L. Holmstedt, C.A. Turan, T.N. Ntaios, G. Malhotra, K. Tayal, A. Loochtan, A. Ranta, A. Mistry, E.A. Alexandrov, A.W. Huang, D.Y. Yaghi, S. Raz, E. Sheth, S.A. Mohammaden, M.H. Frankel, M. Bila Lamou, E.G. Aref, H.M. Elbassiouny, A. Hassan, F. Menecie, T. Mustafa, W. Shokri, H.M. Roushdy, T. Sarfo, F.S. Alabi, T.O. Arabambi, B. Nwazor, E.O. Sunmonu, T.A. Wahab, K. Yaria, J. Mohammed, H.H. Adebayo, P.B. Riahi, A.D. Sassi, S.B. Gwaunza, L. Ngwende, G.W. Sahakyan, D. Rahman, A. Ai, Z. Bai, F. Duan, Z. Hao, Y. Huang, W. Li, G. Li, W. Liu, G. Luo, J. Shang, X. Sui, Y. Tian, L. Wen, H. Wu, B. Yan, Y. Yuan, Z. Zhang, H. Zhang, J. Zhao, W. Zi, W. Leung, T.W. Chugh, C. Huded, V. Menon, B. Pandian, J.D. Sylaja, P.N. Usman, F.S. Farhoudi, M. Hokmabadi, E.S. Horev, A. Reznik, A. Sivan Hoffmann, R. Ohara, N. Sakai, N. Watanabe, D. Yamamoto, R. Doijiri, R. Tokuda, N. Yamada, T. Terasaki, T. Yazawa, Y. Uwatoko, T. Dembo, T. Shimizu, H. Sugiura, Y. Miyashita, F. Fukuda, H. Miyake, K. Shimbo, J. Sugimura, Y. Yagita, Y. Takenobu, Y. Matsumaru, Y. Yamada, S. Kono, R. Kanamaru, T. Yamazaki, H. Sakaguchi, M. Todo, K. Yamamoto, N. Sonoda, K. Yoshida, T. Hashimoto, H. Nakahara, I. Kondybayeva, A. Faizullina, K. Kamenova, S. Zhanuzakov, M. Baek, J.-H. Hwang, Y. Lee, J.S. Lee, S.B. Moon, J. Park, H. Seo, J.H. Seo, K.-D. Sohn, S.I. Young, C.J. Ahdab, R. Wan Zaidi, W.A. Aziz, Z.A. Basri, H.B. Chung, L.W. Ibrahim, A.B. Ibrahim, K.A. Looi, I. Tan, W.Y. Yahya, N.W. Groppa, S. Leahu, P. Al Hashmi, A.M. Imam, Y.Z. Akhtar, N. Pineda-Franks, M.C. Co, C.O. Kandyba, D. Alhazzani, A. Al-Jehani, H. Tham, C.H. Mamauag, M.J. Venketasubramanian, N. Chen, C.-H. Tang, S.-C. Churojana, A. Akil, E. Aykaç, Ö. Ozdemir, A.O. Giray, S. Hussain, S.I. John, S. Le Vu, H. Tran, A.D. Nguyen, H.H. Nhu Pham, T. Nguyen, T.H. Nguyen, T.Q. Gattringer, T. Enzinger, C. Killer-Oberpfalzer, M. Bellante, F. De Blauwe, S. Vanhooren, G. De Raedt, S. Dusart, A. Lemmens, R. Ligot, N. Pierre Rutgers, M. Yperzeele, L. Alexiev, F. Sakelarova, T. Bedeković, M.R. Budincevic, H. Cindric, I. Hucika, Z. Ozretic, D. Saric, M.S. Pfeifer, F. Karpowic, I. Cernik, D. Sramek, M. Skoda, M. Hlavacova, H. Klecka, L. Koutny, M. Vaclavik, D. Skoda, O. Fiksa, J. Hanelova, K. Nevsimalova, M. Rezek, R. Prochazka, P. Krejstova, G. Neumann, J. Vachova, M. Brzezanski, H. Hlinovsky, D. Tenora, D. Jura, R. Jurák, L. Novak, J. Novak, A. Topinka, Z. Fibrich, P. Sobolova, H. Volny, O. Krarup Christensen, H. Drenck, N. Klingenberg Iversen, H. Simonsen, C.Z. Truelsen, T.C. Wienecke, T. Vibo, R. Gross-Paju, K. Toomsoo, T. Antsov, K. Caparros, F. Cordonnier, C. Dan, M. Faucheux, J.-M. Mechtouff, L. Eker, O. Lesaine, E. Ondze, B. Peres, R. Pico, F. Piotin, M. Pop, R. Rouanet, F. Gubeladze, T. Khinikadze, M. Lobjanidze, N. Tsiskaridze, A. Nagel, S. Ringleb, P.A. Rosenkranz, M. Schmidt, H. Sedghi, A. Siepmann, T. Szabo, K. Thomalla, G. Palaiodimou, L. Sagris, D. Kargiotis, O. Klivenyi, P. Szapary, L. Tarkanyi, G. Adami, A. Bandini, F. Calabresi, P. Frisullo, G. Renieri, L. Sangalli, D. Pirson, A. Uyttenboogaart, M. van den Wijngaard, I. Kristoffersen, E.S. Brola, W. Fudala, M. Horoch-Lyszczarek, E. Karlinski, M. Kazmierski, R. Kram, P. Rogoziewicz, M. Kaczorowski, R. Luchowski, P. Sienkiewicz-Jarosz, H. Sobolewski, P. Fryze, W. Wisniewska, A. Wiszniewska, M. Ferreira, P. Ferreira, P. Fonseca, L. Marto, J.P. Pinho E Melo, T. Nunes, A.P. Rodrigues, M. Tedim Cruz, V. Falup-Pecurariu, C. Krastev, G. Mako, M. de Leciñana, M.A. Arenillas, J.F. Ayo-Martin, O. Cruz Culebras, A. Tejedor, E.D. Montaner, J. Pérez-Sánchez, S. Tola Arribas, M.A. Rodriguez Vasquez, A. Mayza, M. Bernava, G. Brehm, A. Machi, P. Fischer, U. Gralla, J. Michel, P.L. Psychogios, M.-N. Strambo, D. Banerjee, S. Krishnan, K. Kwan, J. Butt, A. Catanese, L. Demchuk, A.M. Field, T. Haynes, J. Hill, M.D. Khosravani, H. Mackey, A. Pikula, A. Saposnik, G. Scott, C.A. Shoamanesh, A. Shuaib, A. Yip, S. Barboza, M.A. Barrientos, J.D. Portillo Rivera, L.I. Gongora-Rivera, F. Novarro-Escudero, N. Blanco, A. Abraham, M. Alsbrook, D. Altschul, D. Alvarado-Ortiz, A.J. Bach, I. Badruddin, A. Barazangi, N. Brereton, C. Castonguay, A. Chaturvedi, S. Chaudry, S.A. Choe, H. Choi, J.H. Dharmadhikari, S. Desai, K. Devlin, T.G. Doss, V.T. Edgell, R. Etherton, M. Farooqui, M. Frei, D. Gandhi, D. Grigoryan, M. Gupta, R. Hassan, A.E. Helenius, J. Kaliaev, A. Kaushal, R. Khandelwal, P. Khawaja, A.M. Khoury, N.N. Kim, B.S. Kleindorfer, D.O. Koyfman, F. Lee, V.H. Leung, L.Y. Linares, G. Linfante, I. Lutsep, H.L. Macdougall, L. Male, S. Malik, A.M. Masoud, H. McDermott, M. Mehta, B.P. Min, J. Mittal, M. Morris, J.G. Multani, S.S. Nahab, F. Nalleballe, K. Nguyen, C.B. Novakovic-White, R. Ortega-Gutierrez, S. Rahangdale, R.H. Ramakrishnan, P. Romero, J.R. Rost, N. Rothstein, A. Ruland, S. Shah, R. Sharma, M. Silver, B. Simmons, M. Singh, A. Starosciak, A.K. Strasser, S.L. Szeder, V. Teleb, M. Tsai, J.P. Voetsch, B. Balaguera, O. Pujol Lereis, V.A. Luraschi, A. Almeida, M.S. Cardoso, F.B. Conforto, A. De Deus Silva, L. Varrone Giacomini, L. Oliveira Lima, F. Longo, A.L. Magalhães, P.S.C. Martins, R.T. Mont'alverne, F. Mora Cuervo, D.L. Costa Rebello, L. Valler, L. Zetola, V.F. Lavados, P.M. Navia, V. Olavarría, V.V. Almeida Toro, J.M. Amaya, P.F.R. Bayona, H. Corredor, A. Rivera Ordonez, C.E. Mantilla Barbosa, D.K. Lara, O. Patiño, M.R. Diaz Escobar, L.F. Dejesus Melgarejo Fariña, D.E. Cardozo Villamayor, A. Zelaya Zarza, A.J. Barrientos Iman, D.M. Rodriguez Kadota, L. Campbell, B. Hankey, G.J. Hair, C. Kleinig, T. Ma, A. Tomazini Martins, R. Sahathevan, R. Thijs, V. Salazar, D. Yuan-Hao Wu, T. Haussen, D.C. Liebeskind, D. Yavagal, D.R. Jovin, T.G. Zaidat, O.O. Nguyen, T.N. SVIN COVID-19 Global Stroke Registry SVIN COVID-19 Global Stroke Registry

Abstract

OBJECTIVE: To measure the global impact of COVID-19 pandemic on volumes of IV thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with 2 control 4-month periods. METHODS: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by their ICD-10 codes or classifications in stroke databases. RESULTS: There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95% confidence interval [CI] -11.7 to -11.3, p < 0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95% CI -13.8 to -12.7, p < 0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95% CI -13.7 to -10.3, p = 0.001). Recovery of stroke hospitalization volume (9.5%, 95% CI 9.2-9.8, p < 0.0001) was noted over the 2 later (May, June) vs the 2 earlier (March, April) pandemic months. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was noted in 3.3% (1,722/52,026) of all stroke admissions. CONCLUSIONS: The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID-19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months. © 2021 American Academy of Neurology.

Published
2021

22. Quantification of species composition in grass-clover swards using RGB and multispectral UAV imagery and machine learning

Author

Joanna Pranga, Irene Borra-Serrano, Paul Quataert, Tom De Swaef, Thijs Vanden Nest, Koen Willekens, Greet Ruysschaert, Ivan A. Janssens, Isabel Roldán-Ruiz, and Peter Lootens

Subjects
OBIA, drone, supervised classification, pasture, Lolium, Trifolium, Plant culture, SB1-1110
Abstract

IntroductionGrowing grass-legume mixtures for forage production improves both yield productivity and nutritional quality, while also benefiting the environment by promoting species biodiversity and enhancing soil fertility (through nitrogen fixation). Consequently, assessing legume proportions in grass-legume mixed swards is essential for breeding and cultivation. This study introduces an approach for automated classification and mapping of species in mixed grass-clover swards using object-based image analysis (OBIA).MethodsThe OBIA procedure was established for both RGB and ten band multispectral (MS) images capturedby an unmanned aerial vehicle (UAV). The workflow integrated structural (canopy heights) and spectral variables (bands, vegetation indices) along with a machine learning algorithm (Random Forest) to perform image segmentation and classification. Spatial k-fold cross-validation was employed to assess accuracy.Results and discussionResults demonstrated good performance, achieving an overall accuracy of approximately 70%, for both RGB and MS-based imagery, with grass and clover classes yielding similar F1 scores, exceeding 0.7 values. The effectiveness of the OBIA procedure and classification was examined by analyzing correlations between predicted clover fractions and dry matter yield (DMY) proportions. This quantification revealed a positive and strong relationship, with R2 values exceeding 0.8 for RGB and MS-based classification outcomes. This indicates the potential of estimating (relative) clover coverage, which could assist breeders but also farmers in a precision agriculture context.

Published
2024
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23. Enabling nurses’ engagement in the design of healthcare technology – Core competencies and requirements: A qualitative study

Author

Thijs van Houwelingen, Alexandra C.M. Meeuse, and Helianthe S.M. Kort

Subjects
Biomedical technology, Stakeholder participation, Equipment design, Professional competence, Quality improvement, Intersectoral collaboration, Nursing, RT1-120
Abstract

Background: Due to the globally increasing demand for care, innovation is important to maintain quality, safety, effectiveness, patient sensitivity, and outcome orientation. Health care technologies could be a solution to innovate, maintain, or improve the quality of care and simultaneously decrease nurses’ workload. Currently, nurses are rarely involved in the design of health care technologies, mostly due to time constraints with clinical nursing responsibilities and limited exposure to technology and design disciplines. To ensure that health care technologies fit into nurses’ core and routine practice, nurses should be actively involved in the design process. Objective: The aim of the present study was to explore the main requirements for nurses’ active participation in the design of health care technologies. Design: An exploratory descriptive qualitative design was used which helps to both understand and describe a phenomenon. Participants: Twelve nurses from three academic hospitals in the Netherlands participated in this study. Method: Data were collected from semistructured interviews with hospital nurses experienced in design programs and thematically analysed. Results: Four themes were identified concerning the main requirements for nurses to participate in the design of health care technologies: (1) nurses’ motivations to participate, (2) the process of technology development, (3) required competence to participate (such as assertiveness, creative thinking, problem solving skills), and (4) facilitating and organizing nurses’ participation. Conclusion: Nurses experience their involvement in the design process as essential, distinctive, and meaningful but experience few possibilities to combine this work with their current workload, flows, routines, and requirements. To participate in the design of health care technologies nurses need motivation and specific competencies. Organizations should facilitate time for nurses to acquire the required competencies and to be intentionally involved in technology design and development activities.

Published
2024
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24. Effect of air exposure time on erodibility of intertidal mud flats

Author

Floris F. van Rees, Jill Hanssen, Stefano Gamberoni, Arno M. Talmon, and Thijs van Kessel

Subjects
erodibility, intertidal mud flat, sediment strength, evaporation, numerical modelling, sediment transport dynamics, water retention, Science, General. Including nature conservation, geographical distribution, QH1-199.5
Abstract

This study investigates the influence of air exposure time on the erodibility of intertidal mud flats, emphasizing the role of evaporation in altering sediment strength and cohesion. Through a comprehensive approach combining laboratory experiments, fieldwork, and numerical modelling, it explores the dynamic interactions between sediment properties and environmental conditions. The research reveals that drying significantly reduces sediment erodibility, with pronounced effects observed during the initial hours of air exposure. Laboratory tests demonstrate a direct correlation between drying time and increased yield stress for both artificial and field-derived mud samples. Field observations further support these results, showing spatial and temporal variations in water content and shear strength across various locations on a tidal flat. The study emphasizes the critical impact of mud content on water retention and the subsequent effect on sediment stability. The incorporation of drying time into erosion formulations within a numerical model highlights the importance of considering evaporation processes in predicting the morphological evolution of tidal flats. This research contributes to a better understanding of sediment transport dynamics in intertidal zones, offering insights into the mechanisms driving the growth and stability of mud flats. It underscores the necessity of integrating evaporation effects into cohesive sediment transport models to enhance the accuracy of predictions concerning the erosion and accretion of intertidal environments.

Published
2024
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25. Quantifiable impact: monitoring landscape restoration from space. A regreening case study in Tanzania

Author

Mendy van der Vliet, Yoann Malbeteau, Darren Ghent, Sander de Haas, Karen L. Veal, Thijs van der Zaan, Rajiv Sinha, Saroj K. Dash, Rasmus Houborg, and Richard A. M. de Jeu

Subjects
ecosystem restoration, impact, monitoring, satellite observations, quantification, regreening, Environmental sciences, GE1-350
Abstract

The impact of ecosystem conservation and restoration activities are rarely monitored from a global, multidimensional and multivariable perspective. Here we present an approach to quantify the environmental impact of landscape restoration using long-term and high-resolution satellite observations. For two restoration areas in Tanzania, we can likely attribute an increase in the amount of water retained by the soil (∼0.01 m³ m⁻³, ∼13% average increase), a soil temperature drop (∼-0.5°C) and an increase in surface greenness (∼50% average increase) in 3.5 years. These datasets illuminate the impact of restoration initiatives on the landscape and support the reporting of comprehensive metrics to donors and partners. Satellite observations from commercial providers and space agencies are now achieving the frequency, resolution, and accuracy that can allow for the effective evaluation of restoration activities.

Published
2024
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26. Disrupting violence while preserving encryption

Author

Eva Nave, Stephan Raaijmakers, and Thijs Veugen

Subjects
Incitement to violence, end-to-end encryption, human rights due diligence, disruption, Electronic computers. Computer science, QA75.5-76.95
Abstract

Business models adopted by online platforms have enabled the proliferation of online hate speech. Platforms providing end-to-end encrypted (E2EE) services have been under increased scrutiny for hosting hate mongers. Legislators struggle to conceptualise the responsibilities of E2EE services to not host hate speech without infringing the users’ rights to freedom of expression, association, privacy, or data protection. This interdisciplinary article proposes a new legal minimum standard expanding corporate human rights responsibilities of E2EE services to mitigate a category of criminal hate speech - incitement to violence. We explore the regulation and application of metadata, hashing, and homomorphic encryption to disrupt incitement to violence in large groups on E2EE services in compliance with human rights.

Published
2024
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27. Intravenous alteplase for unknown time of onset stroke guided by advanced imaging: a systematic review and meta-analysis of individual patient data

Author

Thomalla, G., Boutitie, F., Ma, H., Koga, M., Ringleb, P., Schwamm, L.H., Wu, O., Bendszus, M., Bladin, C.F., Campbell, B.C.V., Cheng, B., Churilov, L., Ebinger, M., Endres, M., Fiebach, J.B., Fukuda-Doi, M., Inoue, M., Kleinig, T.J., Latour, L.L., Lemmens, R., Levi, C.R., Leys, D., Miwa, K., Molina, C., Muir, K.W., Nighoghossian, N., Parsons, M.W., Pedraza, S., Schellinger, P., Schwab, S., Simonsen, C.Z., Song, S.S., Thijs, V., Toni, D., Hsu, C., Wahlgren, N., Yamamoto, H., Yassi, N., Yoshimura, S., Warach, S., Hacke, W., Toyoda, K., Donnan, G.A., Davis, S.M., and Gerloff, C.

Abstract

Background: \ud Patients who have had a stroke with unknown time of onset have been previously excluded from thrombolysis. We aimed to establish whether intravenous alteplase is safe and effective in such patients when salvageable tissue has been identified with imaging biomarkers.\ud \ud Methods: \ud We did a systematic review and meta-analysis of individual patient data for trials published before Sept 21, 2020. Randomised trials of intravenous alteplase versus standard of care or placebo in adults with stroke with unknown time of onset with perfusion-diffusion MRI, perfusion CT, or MRI with diffusion weighted imaging-fluid attenuated inversion recovery (DWI-FLAIR) mismatch were eligible. The primary outcome was favourable functional outcome (score of 0–1 on the modified Rankin Scale [mRS]) at 90 days indicating no disability using an unconditional mixed-effect logistic-regression model fitted to estimate the treatment effect. Secondary outcomes were mRS shift towards a better functional outcome and independent outcome (mRS 0–2) at 90 days. Safety outcomes included death, severe disability or death (mRS score 4–6), and symptomatic intracranial haemorrhage. This study is registered with PROSPERO, CRD42020166903.\ud \ud Findings: \ud Of 249 identified abstracts, four trials met our eligibility criteria for inclusion: WAKE-UP, EXTEND, THAWS, and ECASS-4. The four trials provided individual patient data for 843 individuals, of whom 429 (51%) were assigned to alteplase and 414 (49%) to placebo or standard care. A favourable outcome occurred in 199 (47%) of 420 patients with alteplase and in 160 (39%) of 409 patients among controls (adjusted odds ratio [OR] 1·49 [95% CI 1·10–2·03]; p=0·011), with low heterogeneity across studies (I2=27%). Alteplase was associated with a significant shift towards better functional outcome (adjusted common OR 1·38 [95% CI 1·05–1·80]; p=0·019), and a higher odds of independent outcome (adjusted OR 1·50 [1·06–2·12]; p=0·022). In the alteplase group, 90 (21%) patients were severely disabled or died (mRS score 4–6), compared with 102 (25%) patients in the control group (adjusted OR 0·76 [0·52–1·11]; p=0·15). 27 (6%) patients died in the alteplase group and 14 (3%) patients died among controls (adjusted OR 2·06 [1·03–4·09]; p=0·040). The prevalence of symptomatic intracranial haemorrhage was higher in the alteplase group than among controls (11 [3%] vs two [

Published
2020

31. Variation in neurosurgical management of traumatic brain injury: a survey in 68 centers participating in the CENTER-TBI study

Author

van Essen T. A., den Boogert H. F., Cnossen M. C., de Ruiter G. C. W., Haitsma I., Polinder S., Steyerberg E. W., Menon D., Maas A. I. R., Lingsma H. F., Peul W. C., Cecilia A., Hadie A., Vanni A., Judith A., Krisztina A., Norberto A., Nada A., Lasse A., Azasevac A., Audny A., Anna A., Hilko A., Gerard A., Kaspars A., Philippe A., Luisa A. M., Camelia B., Rafael B., Ronald B., Pal B., Ursula B., Romuald B., Ronny B., Javier B. F., Bo-Michael B., Antonio B., Remy B., Habib B., Thierry B., Maurizio B., Luigi B., Christopher B., Federico B., Harald B., Erta B., Morten B., den Hugo B., Pierre B., Peter B., Alexandra B., Vibeke B., Joanne B., Camilla B., Andras B., Monika B., Emiliana C., Rosa C. M., Peter C., Guillermo C. L., Marco C., Elsa C., Carpenter K., Castano-Leon Ana M., Francesco C., Giorgio C., Arturo C., Giuseppe C., Maryse C., Mark C., Jonathan C., Lizzie C. -K., Johnny C., Cooper Jamie D., Marta C., Amra C., Nicola C., Endre C., Marek C., Claire D. -F., Francois D., Pierre D., Helen D., Veronique D. K., Francesco D. C., Bart D., de Ruiter Godard C. W., Dula D., Shenghao D., Diederik D., Abhishek D., Emma D., Jens D., Guy-Loup D., George E., Heiko E., Ari E., Patrick E., Erzsebet E., Martin F., Feigin Valery L., Junfeng F., Kelly F., Francesca F., Gilles F., Ulderico F., Shirin F., Alex F., Pablo G., Damien G., Dashiell G., Guoyi G., Karin G., Pradeep G., Alexandre G., Lelde G., Benoit G., Ben G., Jagos G., Gomez Pedro A., Francesca G., Gruen Russell L., Deepak G., Haagsma Juanita A., Iain H., Hartings Jed A., Raimund H., Eirik H., Daniel H., Astrid H., Stefan H., Lindsay H., Jilske H., Hutchinson Peter J., Kristine H. A., Bram J., Stefan J., Mike J., Bojan J., Ji-yao J., Kelly J., Konstantinos K., Mladen K., Ari K., Maija K., Thomas K., Riku K., Kolias Angelos G., Balint K., Erwin K., Ksenija K., Daniel K., Lars-Owe K., Noemi K., Alfonso L., Linda L., Steven L., Fiona L., Christian L., Rolf L., Valerie L., Jin L., Leon L., Roger L., Hester L., Dirk L., Angels L., Maas Andrew I. R., Stephen M. D., Marc M., Marek M., Sebastian M., Alex M., Geoffrey M., Didier M., Francisco M. L., Costanza M., Armando M., Hugues M., Alessandro M., Julia M., Charles M. F., Catherine M. M., Bela M., David M., Tomas M., Cristina M. -K., Davide M., Visakh M., Lynnette M., Holger M., Nandesh N., Ancuta N., David N., Virginia N., Daan N., Quentin N., Jozsef N., Mauro O., Annemarie O., Matej O., Fabrizio O., Aarno P., Parizel Paul M., Adriana P., Jean-Francois P., Natascha P., Vincent P., Paolo P., Wilco P., Anna P. -K., Sebastien P. F., Matti P., Horia P., Antonia P. M., Suzanne P., Inigo P., Jussi P., Louis P., Andreea R., Arminas R., Rahul R., Malinka R., Ruben R., Veronika R., Jonathan R., Samuli R., Saulius R., Cecilie R., Olav R., Gerwin R., Jeffrey R., Christina R., Guy R., Rolf R., Sandra R., Daniel R., Martin R., Marco S., Barbara S., Juan S., Oliver S., Francesca S., Renan S. -P., Janos S., Edgar S., Luminita S., Davide S., Nadine S., Inger S., Barbara S. ss., Silke S., Herbert S., Guus S., Frederik S. R., Elisabeth S., Michael S., Ozcan S., Toril S., Lidwien S., Dirk S., Peter S., Abayomi S., Emmanuel S., Simon S., Nicole S., Ana S., Robert S., William S., Steyerberg Ewout W., Nino S., Nina S., Anneliese S., Silvio T. F., Riikka T., Viktoria T., Paivi T., Steven T. M., Braden T. A., Olli T., Ralph T., Guido T., Alice T., Matt T., Dick T., Christos T., Luaba T. J. -F., Tony T., Maria T. C., Peter V., Shirley V., Egils V., der Steen Gregory V., van der Mathieu J., van der Joukje N., van Dijck Jeroen T. J. M., van Essen Thomas A., Wim V. H., van Caroline H., Dominique V. P., Thijs V. V., Julia V. W., Audrey V., Alessia V., Emmanuel V., Kimberley V., Jan V., Vespa Paul M., Anne V., Rimantas V., Giacinta V., Carmen V. -L., Victor V., Daphne V., Zoltan V., Derick W., Wang Kevin K. W., Lei W., Lars W., Eno W., Guy W., Lindsay W., Winkler Maren K. L., Stefan W., Peter Y., Alexander Y., Menashe Z., Yang Z., Agate Z., Fabrizio Z., Van Essen, T, den Boogert, H, Cnossen, M, de Ruiter, G, Haitsma, I, Polinder, S, Steyerberg, E, Menon, D, Maas, A, Lingsma, E, Peul, W, Citerio, G, CENTER-TBI Investigators and Participants, Ragauskas, Arminas, Ročka, Saulius, Vilcinis, Rimantas, Commission of the European Communities, Public Health, Neurosurgery, Menon, David [0000-0002-3228-9692], Apollo - University of Cambridge Repository, Clinicum, Department of Diagnostics and Therapeutics, Anestesiologian yksikkö, University of Helsinki, Neurokirurgian yksikkö, Doctoral Programme in Clinical Research, Centre of Excellence in Complex Disease Genetics, Aarno Palotie / Principal Investigator, Institute for Molecular Medicine Finland, Helsinki Institute for Information Technology, Biostatistics Helsinki, Samuli Olli Ripatti / Principal Investigator, University Management, Doctoral Programme in Social Sciences, HUS Perioperative, Intensive Care and Pain Medicine, Complex Disease Genetics, Genomics of Neurological and Neuropsychiatric Disorders, Statistical and population genetics, Psychology 3, Section Neuropsychology, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: FPN NPPP I, Rocka, Saulius, „Springer' grupė, van Essen, T. A., den Boogert, H. F., Cnossen, M. C., de Ruiter, G. C. W., Haitsma, I., Polinder, S., Steyerberg, E. W., Menon, D., Maas, A. I. R., Lingsma, H. F., Peul, W. C., Cecilia, A., Hadie, A., Vanni, A., Judith, A., Krisztina, A., Norberto, A., Nada, A., Lasse, A., Azasevac, A., Audny, A., Anna, A., Hilko, A., Gerard, A., Kaspars, A., Philippe, A., Luisa, A. M., Camelia, B., Rafael, B., Ronald, B., Pal, B., Ursula, B., Romuald, B., Ronny, B., Javier, B. F., Bo-Michael, B., Antonio, B., Remy, B., Habib, B., Thierry, B., Maurizio, B., Luigi, B., Christopher, B., Federico, B., Harald, B., Erta, B., Morten, B., den Hugo, B., Pierre, B., Peter, B., Alexandra, B., Vibeke, B., Joanne, B., Camilla, B., Andras, B., Monika, B., Emiliana, C., Rosa, C. M., Peter, C., Guillermo, C. L., Marco, C., Elsa, C., Carpenter, K., Castano-Leon Ana, M., Francesco, C., Giorgio, C., Arturo, C., Giuseppe, C., Maryse, C., Mark, C., Jonathan, C., Lizzie, C. -K., Johnny, C., Cooper Jamie, D., Marta, C., Amra, C., Nicola, C., Endre, C., Marek, C., Claire, D. -F., Francois, D., Pierre, D., Helen, D., Veronique, D. K., Francesco, D. C., Bart, D., de Ruiter Godard, C. W., Dula, D., Shenghao, D., Diederik, D., Abhishek, D., Emma, D., Jens, D., Guy-Loup, D., George, E., Heiko, E., Ari, E., Patrick, E., Erzsebet, E., Martin, F., Feigin Valery, L., Junfeng, F., Kelly, F., Francesca, F., Gilles, F., Ulderico, F., Shirin, F., Alex, F., Pablo, G., Damien, G., Dashiell, G., Guoyi, G., Karin, G., Pradeep, G., Alexandre, G., Lelde, G., Benoit, G., Ben, G., Jagos, G., Gomez Pedro, A., Francesca, G., Gruen Russell, L., Deepak, G., Haagsma Juanita, A., Iain, H., Hartings Jed, A., Raimund, H., Eirik, H., Daniel, H., Astrid, H., Stefan, H., Lindsay, H., Jilske, H., Hutchinson Peter, J., Kristine, H. A., Bram, J., Stefan, J., Mike, J., Bojan, J., Ji-yao, J., Kelly, J., Konstantinos, K., Mladen, K., Ari, K., Maija, K., Thomas, K., Riku, K., Kolias Angelos, G., Balint, K., Erwin, K., Ksenija, K., Daniel, K., Lars-Owe, K., Noemi, K., Alfonso, L., Linda, L., Steven, L., Fiona, L., Christian, L., Rolf, L., Valerie, L., Jin, L., Leon, L., Roger, L., Hester, L., Dirk, L., Angels, L., Maas Andrew, I. R., Stephen, M. D., Marc, M., Marek, M., Sebastian, M., Alex, M., Geoffrey, M., Didier, M., Francisco, M. L., Costanza, M., Armando, M., Hugues, M., Alessandro, M., Julia, M., Charles, M. F., Catherine, M. M., Bela, M., David, M., Tomas, M., Cristina, M. -K., Davide, M., Visakh, M., Lynnette, M., Holger, M., Nandesh, N., Ancuta, N., David, N., Virginia, N., Daan, N., Quentin, N., Jozsef, N., Mauro, O., Annemarie, O., Matej, O., Fabrizio, O., Aarno, P., Parizel Paul, M., Adriana, P., Jean-Francois, P., Natascha, P., Vincent, P., Camici, Paolo, Wilco, P., Anna, P. -K., Sebastien, P. F., Matti, P., Horia, P., Antonia, P. M., Suzanne, P., Inigo, P., Jussi, P., Louis, P., Andreea, R., Arminas, R., Rahul, R., Malinka, R., Ruben, R., Veronika, R., Jonathan, R., Samuli, R., Saulius, R., Cecilie, R., Olav, R., Gerwin, R., Jeffrey, R., Christina, R., Guy, R., Rolf, R., Sandra, R., Daniel, R., Martin, R., Marco, S., Barbara, S., Juan, S., Oliver, S., Francesca, S., Renan, S. -P., Janos, S., Edgar, S., Luminita, S., Davide, S., Nadine, S., Inger, S., Barbara, S. ss., Silke, S., Herbert, S., Guus, S., Frederik, S. R., Elisabeth, S., Michael, S., Ozcan, S., Toril, S., Lidwien, S., Dirk, S., Peter, S., Abayomi, S., Emmanuel, S., Simon, S., Nicole, S., Ana, S., Robert, S., William, S., Steyerberg Ewout, W., Nino, S., Nina, S., Anneliese, S., Silvio, T. F., Riikka, T., Viktoria, T., Paivi, T., Steven, T. M., Braden, T. A., Olli, T., Ralph, T., Guido, T., Alice, T., Matt, T., Dick, T., Christos, T., Luaba, T. J. -F., Tony, T., Maria, T. C., Peter, V., Shirley, V., Egils, V., der Steen Gregory, V., van der Mathieu, J., van der Joukje, N., van Dijck Jeroen, T. J. M., van Essen Thomas, A., Wim, V. H., van Caroline, H., Dominique, V. P., Thijs, V. V., Julia, V. W., Audrey, V., Alessia, V., Emmanuel, V., Kimberley, V., Jan, V., Vespa Paul, M., Anne, V., Rimantas, V., Giacinta, V., Carmen, V. -L., Victor, V., Daphne, V., Zoltan, V., Derick, W., Wang Kevin, K. W., Lei, W., Lars, W., Eno, W., Guy, W., Lindsay, W., Winkler Maren, K. L., Stefan, W., Peter, Y., Alexander, Y., Menashe, Z., Yang, Z., Agate, Z., and Fabrizio, Z.

Subjects
SURGERY, medicine.medical_treatment, CENTER-TBI Investigators and Participants, GUIDELINES, 3124 Neurology and psychiatry, 030218 nuclear medicine & medical imaging, law.invention, 0302 clinical medicine, Traumatic brain injury, Randomized controlled trial, Trauma Centers, law, Neurosurgeons/standards, Surveys and Questionnaires, Brain Injuries, Traumatic, Acute subdural hematoma, Neurosurgery, Practice variation, VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Neurosurgery: 786, Neuroradiology, OUTCOMES, medicine.diagnostic_test, Trauma center, Interventional radiology, 3. Good health, Europe, Monitoring, Physiologic/methods, SURGICAL-MANAGEMENT, Decompressive craniectomy, Life Sciences & Biomedicine, medicine.medical_specialty, Decompressive Craniectomy/methods, Decompressive Craniectomy, RANDOMIZED CONTROLLED-TRIALS, Comparative effectiveness research, Clinical Decision-Making, Clinical Neurology, Brain Injuries, Traumatic/surgery, 03 medical and health sciences, Original Article - Brain trauma, medicine, Humans, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Nevrokirurgi: 786, Trauma Centers/statistics & numerical data, acute subdural hematoma, neurosurgery, practice variation, traumatic brain injury, Monitoring, Physiologic, Neurology & Neurosurgery, Science & Technology, ACUTE SUBDURAL HEMATOMAS, business.industry, 3112 Neurosciences, 1103 Clinical Sciences, medicine.disease, nervous system diseases, Neurosurgeons, Emergency medicine, MODERATE, Neurology (clinical), Human medicine, Neurosciences & Neurology, business, 1109 Neurosciences, 030217 neurology & neurosurgery
Abstract

Background Neurosurgical management of traumatic brain injury (TBI) is challenging, with only low-quality evidence. We aimed to explore differences in neurosurgical strategies for TBI across Europe. Methods A survey was sent to 68 centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. The questionnaire contained 21 questions, including the decision when to operate (or not) on traumatic acute subdural hematoma (ASDH) and intracerebral hematoma (ICH), and when to perform a decompressive craniectomy (DC) in raised intracranial pressure (ICP). Results The survey was completed by 68 centers (100%). On average, 10 neurosurgeons work in each trauma center. In all centers, a neurosurgeon was available within 30 min. Forty percent of responders reported a thickness or volume threshold for evacuation of an ASDH. Most responders (78%) decide on a primary DC in evacuating an ASDH during the operation, when swelling is present. For ICH, 3% would perform an evacuation directly to prevent secondary deterioration and 66% only in case of clinical deterioration. Most respondents (91%) reported to consider a DC for refractory high ICP. The reported cut-off ICP for DC in refractory high ICP, however, differed: 60% uses 25 mmHg, 18% 30 mmHg, and 17% 20 mmHg. Treatment strategies varied substantially between regions, specifically for the threshold for ASDH surgery and DC for refractory raised ICP. Also within center variation was present: 31% reported variation within the hospital for inserting an ICP monitor and 43% for evacuating mass lesions. Conclusion Despite a homogeneous organization, considerable practice variation exists of neurosurgical strategies for TBI in Europe. These results provide an incentive for comparative effectiveness research to determine elements of effective neurosurgical care. © The Author(s) 2018 This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Published
2019

32. How Well Do Standard Stroke Outcome Measures Reflect Quality of Life?: A Retrospective Analysis of Clinical Trial Data

Author

Ali, Myzoon, Fulton, Rachael, Quinn, Terry, Brady, Marian, Lees, K. R., Alexandrov, A., Bath, P. M., Bluhmki, E., Bornstein, N., Claesson, L., Davis, S. M., Donnan, G., Diener, H. C., Fisher, M., Gregson, B., Grotta, J., Hacke, W., Hennerici, M. G., Hommel, M., Kaste, M., Lyden, P., Marler, J., Muir, K., Sacco, R., Shuaib, A., Teal, P., Wahlgren, N. G., Warach, S., Weimar, C., Brady, M., Ali, M., Ashburn, A., Barer, D., Bernhardt, J., Bowen, A., Brodie, E., Corr, S., Drummond, A., Edmans, J., English, C., Gladman, J., Godecke, E., Hoffmann, T., Kalra, L., Kuys, S., Langhorne, P., Laska, A. C., Lees, K. R., Lincoln, N., Logan, P., Jongbloed, L., Mead, G., Pollock, A., Pomeroy, V., Rodgers, H., Sackley, C., Shaw, L., Stott, D. J., Sunnerhagen, K. S., Tyson, S., van Vliet, P., Walker, M., Whiteley, W., Warach, S., Albers, G., Davis, S., Donnan, G., Fisher, M., Furlan, T., Grotta, J., Hacke, W., Kidwell, C., Koroshetz, W., Lees, K. R., Lev, M., Liebeskind, D., Sorensen, G., Thijs, V., Thomalla, G., Wardlaw, J., Wintermark, M., Hanley, D. F., Gregson, B., Davis, S., Lees, K. R., Lyden, P., Muir, K., Steiner, T., Mayer, S., Wahlgren, N. G., Molina, C., Numminen, H., Lees, K. R., Tsivgoulis, G., Weimar, C., Diener, H. -C., Hankey, G., Lees, K. R., Ovbiagele, B., and Weir, C.

Published
2013
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33. Etiology of first-ever ischaemic stroke in European young adults: the 15 cities young stroke study

Author

Barlas, Yesilot N., Putaala, J., Waje-Andreassen, U., Vassilopoulou, S., Nardi, K., Odier, C., Hofgart, G., Engelter, S., Burow, A., Mihalka, L., Kloss, M., Ferrari, J., Lemmens, R., Coban, O., Haapaniemi, E., Maaijwee, N., Rutten-Jacobs, L., Bersano, A., Cereda, C., Baron, P., Borellini, L., Valcarenghi, C., Thomassen, L., Grau, A. J., Palm, F., Urbanek, C., Tuncay, R., Tolvanen, Durukan A., van Dijk, E. J., de Leeuw, F.-E., Thijs, V., Greisenegger, S., Vemmos, K., Lichy, C., Bereczki, D., Csiba, L., Michel, P., Leys, D., Spengos, K., Naess, H., Tatlisumak, T., and Bahar, S. Z.

Published
2013
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36. The outcome of acute functional neurological disorder: a meta-analysis of stroke-mimic presentations

Author

Simhan, S. Thijs, V. Mancuso, S. Tsivgoulis, G. Katsanos, A. Alexandrov, A.V. Kanaan, R.A.

Abstract

Objective: The prognosis of motor functional neurological disorder (FND) is considered poor; however, all data come from chronic cohorts collected by specialists. The aim of this study was to determine the clinical outcome of acute FND, captured as ‘stroke-mimics’. Methods: A meta-analysis of studies with outcome data on functional stroke mimics. Authors were contacted to provide more information on their FND mimics, including baseline, discharge and follow-up stroke scales. A random effects meta-analysis of proportion of ‘good outcome’ was the primary measure of interest, with additional descriptive and statistical analysis. ‘Good outcome’ employed the usual conventions of modified Rankin Score (mRS) or National Institutes of Health Stroke Scale (NIHSS) ≤ 1. Results: Eight studies with 79 patients were identified and analysed, all of cohorts undergoing thrombolysis. The mean age at presentation was 49.7 years with a 62% female preponderance, and median NIHSS score of 4. The proportion of patients with mRS or NIHSS ≤ 1 changed significantly from admission to discharge or follow up [from 24 (30%) to 50 (63%), p < 0.001]. Meta-analysis of the synthesized data showed the pooled standardized mean change (SMC) was statistically significant (SMC = − 1.28, [95% CI = –2.25, − 0.30], p = 0.010) indicating good symptomatic outcome for acute FND patients presenting as stroke-mimics. Heterogeneity was large. Conclusion: Patients presenting with acute motor FND have good outcome of their presenting symptoms by discharge and at follow-up, following thrombolysis for presumed stroke, in contrast to specialist cohorts. Demographic differences, in addition to the thrombolysis, are possible explanations for these more favourable results. © 2020, Springer-Verlag GmbH Germany, part of Springer Nature.

Published
2020

37. Platelet function/reactivity testing and prediction of risk of recurrent vascular events and outcomes after TIA or ischaemic stroke: systematic review and meta-analysis

Author

Lim, ST, Thijs, V, Murphy, SJX, Fernandez-Cadenas, I, Montaner, J, Offiah, C, Marquardt, L, Kelly, PJ, Bath, PM, Lim, SY, Ford, GA, Norrving, B, Cox, D, Prodan, CI, Barber, PA, Werring, DJ, Perry, R, Zgaga, L, Dawson, J, and McCabe, DJH

Subjects
Meta-analysis, Transient ischaemic attack, on-treatment platelet reactivity, Systematic review, Platelet function, cardiovascular diseases, Ischaemic stroke
Abstract

Background The prevalence of ex vivo 'high on-treatment platelet reactivity (HTPR)' and its relationship with recurrent vascular events/outcomes in patients with ischaemic cerebrovascular disease (CVD) is unclear. Methods A systematic review and meta-analysis was performed in accordance with the PRISMA statement. MEDLINE, EMBASE and Cochrane Library were searched for completed manuscripts until May 2019 on TIA/ischaemic stroke patients, >= 18 years, treated with commonly-prescribed antiplatelet therapy, who had platelet function/reactivity testing and prospective follow-up data on recurrent stroke/TIA, myocardial infarction, vascular death or other cerebrovascular outcomes. Data were pooled using random-effects meta-analysis. Primary outcome was the composite risk of recurrent stroke/TIA, myocardial infarction or vascular death. Secondary outcomes were recurrent stroke/TIA, severe stroke (NIHSS > 16) or disability/impairment (modified Rankin scale >= 3) during follow-up. Results Antiplatelet-HTPR prevalence was 3-65% with aspirin, 8-56% with clopidogrel and 1.8-35% with aspirin-clopidogrel therapy. Twenty studies (4989 patients) were included in our meta-analysis. There was a higher risk of the composite primary outcome (OR 2.93, 95% CI 1.90-4.51) and recurrent ischaemic stroke/TIA (OR 2.43, 95% CI 1.51-3.91) in patients with vs. those without 'antiplatelet-HTPR' on any antiplatelet regimen. These risks were also more than twofold higher in patients with vs. those without 'aspirin-HTPR' and 'dual antiplatelet-HTPR', respectively. Clopidogrel-HTPR status did not significantly predict outcomes, but the number of eligible studies was small. The risk of severe stroke was higher in those with vs. without antiplatelet-HTPR (OR 2.65, 95% CI 1.00-7.01). Discussion Antiplatelet-HTPR may predict risks of recurrent vascular events/outcomes in CVD patients. Given the heterogeneity between studies, further prospective, multi-centre studies are warranted.

Published
2020

38. Intravenous alteplase for stroke with unknown time of onset guided by advanced imaging: systematic review and meta-analysis of individual patient data

Author

Thomalla, Götz, primary, Boutitie, Florent, additional, Ma, Henry, additional, Koga, Masatoshi, additional, Ringleb, Peter, additional, Schwamm, Lee H, additional, Wu, Ona, additional, Bendszus, Martin, additional, Bladin, Christopher F, additional, Campbell, Bruce C V, additional, Cheng, Bastian, additional, Churilov, Leonid, additional, Ebinger, Martin, additional, Endres, Matthias, additional, Fiebach, Jochen B, additional, Fukuda-Doi, Mayumi, additional, Inoue, Manabu, additional, Kleinig, Timothy J, additional, Latour, Lawrence L, additional, Lemmens, Robin, additional, Levi, Christopher R, additional, Leys, Didier, additional, Miwa, Kaori, additional, Molina, Carlos A, additional, Muir, Keith W, additional, Nighoghossian, Norbert, additional, Parsons, Mark W, additional, Pedraza, Salvador, additional, Schellinger, Peter D, additional, Schwab, Stefan, additional, Simonsen, Claus Z, additional, Song, Shlee S, additional, Thijs, Vincent, additional, Toni, Danilo, additional, Hsu, Chung Y, additional, Wahlgren, Nils, additional, Yamamoto, Haruko, additional, Yassi, Nawaf, additional, Yoshimura, Sohei, additional, Warach, Steven, additional, Hacke, Werner, additional, Toyoda, Kazunori, additional, Donnan, Geoffrey A, additional, Davis, Stephen M, additional, Gerloff, Christian, additional, Acosta, Boris Raul, additional, Aegidius, Karen, additional, Albiker, Christian, additional, Alegiani, Anna, additional, Almendrote, Miriam, additional, Alonso, Angelika, additional, Althaus, Katharina, additional, Amarenco, Pierre, additional, Amiri, Hemasse, additional, Anders, Bettina, additional, Aniculaesei, Adriana, additional, Appleton, Jason, additional, Arenillas, Juan, additional, Back, Christina, additional, Bähr, Christian, additional, Bardutzky, Jürgen, additional, Baronnet-Chauvet, Flore, additional, Bathe-Peters, Rouven, additional, Bayer-Karpinska, Anna, additional, Becerra, Juan L., additional, Beck, Christoph, additional, Belchí Guillamon, Olga, additional, Benoit, Amandine, additional, Berhoune, Nadia, additional, Bindila, Daniela, additional, Birchenall, Julia, additional, Blanc-Lasserre, Karine, additional, Blanco Gonzales, Miguel, additional, Bobinger, Tobias, additional, Bodechtel, Ulf, additional, Bodiguel, Eric, additional, Bojaryn, Urszula, additional, Bonnet, Louise, additional, Bouamra, Benjamin, additional, Bourgeois, Paul, additional, Breuer, Lorenz, additional, Breynaert, Ludovic, additional, Broughton, David, additional, Brouns, Raf, additional, Brugirard, Sébastian, additional, Bruneel, Bart, additional, Buggle, Florian, additional, Cakmak, Serkan, additional, Calleja, Ana, additional, Calvet, David, additional, Carrera, David, additional, Chen, Hsin-Chieh, additional, Cheripelli, Bharath, additional, Cho, Tae-Hee, additional, Choe, Chi-un, additional, Choy, Lillian, additional, Christensen, Hanne, additional, Ciatipis, Mareva, additional, Cloud, Geoffrey, additional, Cogez, Julien, additional, Cortijo, Elisa, additional, Crozier, Sophie, additional, Damgaard, Dorte, additional, Dani, Krishna, additional, De Coene, Beatrijs, additional, De Hollander, Isabel, additional, De Keyser, Jacques, additional, De Klippel, Nina, additional, De Maeseneire, Charlotte, additional, De Smedt, Ann, additional, del Mar Castellanos Rodrigo, Maria, additional, Deltour, Sandrine, additional, Demeestere, Jelle, additional, Derex, Laurent, additional, Desfontaines, Philippe, additional, Dittrich, Ralf, additional, Dixit, Anand, additional, Dobbels, Laurens, additional, Domigo, Valérie, additional, Dorado, Laura, additional, Druart, Charlotte, additional, Dupont, Kristina Hougaard, additional, Dusart, Anne, additional, Dziewas, Rainer, additional, Ebner, Matthias, additional, Edjali-Goujon, Myriam, additional, Eisele, Philipp, additional, El Tawil, Salwa, additional, Elhfnawy, Ahmed, additional, Etexberria, Ana, additional, Evans, Nicholas, additional, Fandler, Simon, additional, Fazekas, Franz, additional, Felix, Sandra, additional, Fiebach, Jochen B., additional, Fiehler, Jens, additional, Filipov, Alexandra, additional, Filipski, Katharina, additional, Fleischmann, Robert, additional, Foerch, Christian, additional, Ford, Ian, additional, Gaenslen, Alexandra, additional, Galinovic, Ivana, additional, Gancedo, Elena Meseguer, additional, Ganeshan, Ramanan, additional, García Esperón, Carlos, additional, Garrido, Alicia, additional, Gattringer, Thomas, additional, Geraghty, Olivia, additional, Geran, Rohat, additional, Gerner, Stefan, additional, Godon-Hardy, Sylvie, additional, Göhler, Jos, additional, Golsari, Amir, additional, Gomis, Meritxell, additional, Gorriz, David, additional, Gramse, Verena, additional, Grau, Laia, additional, Griebe, Martin, additional, Guerrero, Cristina, additional, Guerzoglu, Damla, additional, Guettier, Sophie, additional, Guiraud, Vincent, additional, Gumbinger, Christoph, additional, Gunreben, Ignaz, additional, Haertig, Florian, additional, Hametner, Christian, additional, Hanseeuw, Bernard, additional, Hansen, Andreas, additional, Hansen, Jakob, additional, Harbo, Thomas, additional, Harloff, Andreas, additional, Harmel, Peter, additional, Häusler, Karl Georg, additional, Heinen, Florian, additional, Held, Valentin, additional, Hellwig, Simon, additional, Hemelsoet, Dimitri, additional, Hennerici, Michael, additional, Herm, Juliane, additional, Hermans, Sylvia, additional, Hernández, María, additional, Hervas Vicente, Jose, additional, Hjort, Niels, additional, Hobeanu, Cristina, additional, Hobohm, Carsten, additional, Höfner, Elmar, additional, Hohenbichler, Katharina, additional, Hommel, Marc, additional, Hoppe, Julia, additional, Hornberger, Eva, additional, Hoyer, Carolin, additional, Huang, Xuya, additional, Ipsen, Nils, additional, Isern, Irina, additional, Ispierto, Lourdes, additional, Iversen, Helle, additional, Jeppesen, Lise, additional, Jimenez, Marta, additional, Jungehülsing, Jan, additional, Jüttler, Eric, additional, Kalladka, Dheeraj, additional, Kallmünzer, Bernd, additional, Kar, Arindam, additional, Kellert, Lars, additional, Kemmling, André, additional, Kessler, Tobias, additional, Khan, Usman, additional, Klein, Matthias, additional, Kleinschnitz, Christoph, additional, Klockziem, Matti, additional, Knops, Michael, additional, Koehler, Luzie, additional, Koehrmann, Martin, additional, Kohlfürst, Heinz, additional, Kollmar, Rainer, additional, Kraft, Peter, additional, Krause, Thomas, additional, Kristensen, Bo, additional, Kröber, Jan M., additional, Kurka, Natalia, additional, Ladoux, Alexandre, additional, Laloux, Patrice, additional, Lamy, Catherine, additional, Landrault, Emmanuelle, additional, Lauer, Arne, additional, Lebely, Claire, additional, Leempoel, Jonathan, additional, Lees, Kennedy, additional, Leger, Anne, additional, Legrand, Laurence, additional, Li, Lin, additional, Löbbe, Anna-Mareike, additional, London, Frederic, additional, Lopez-cancio, Elena, additional, Lorenz, Matthias, additional, Louw, Stephen, additional, Lovelock, Caroline, additional, Lozano Sánchez, Manuel, additional, Lucente, Giuseppe, additional, Lückl, Janos, additional, Luna, Alain, additional, Macha, Kosmas, additional, Machet, Alexandre, additional, Mackenrodt, Daniel, additional, Madzar, Dominik, additional, Majoie, Charles, additional, Männer, Anika, additional, Maqueda, Vicky, additional, Marstrand, Jacob, additional, Martinez, Alicia, additional, Marzina, Annika, additional, Mechthouff, Laura, additional, Meden, Per, additional, Meersman, Guy, additional, Meier, Julia, additional, Mellerio, Charles, additional, Menn, Oliver, additional, Meyer, Nadja, additional, Michalski, Dominik, additional, Michels, Peter, additional, Michelsen, Lene, additional, Millán Torne, Monica, additional, Minnerup, Jens, additional, Modrau, Boris, additional, Moeller, Sebastian, additional, Møller, Anette, additional, Morel, Nathalie, additional, Moreton, Fiona, additional, Morin, Ludovic, additional, Moulin, Thierry, additional, Moynihan, Barry, additional, Mueller, Anne K., additional, Muir, Keith W., additional, Mulero, Patricia, additional, Mundiyanapurath, Sibu, additional, Mutzenbach, Johannes, additional, Nagel, Simon, additional, Naggara, Oliver, additional, Nallasivan, Arumugam, additional, Navalpotro, Irene, additional, Nave, Alexander H., additional, Nederkoorn, Paul, additional, Neeb, Lars, additional, Neugebauer, Hermann, additional, Neumann-Haefelin, Tobias, additional, Oberndorfer, Stefan, additional, Opherk, Christian, additional, Oppel, Lorenz, additional, Oppenheim, Catherine, additional, Orthgieß, Johannes, additional, Ostergaard, Leif, additional, Paindeville, Perrine, additional, Palomeras, Ernest, additional, Panitz, Verena, additional, Patel, Bhavni, additional, Peeters, Andre, additional, Peeters, Dirk, additional, Pellisé, Anna, additional, Pelz, Johann, additional, Pereira, Anthony, additional, Pérez de la Ossa, Natalia, additional, Perry, Richard, additional, Petraza, Salvador, additional, Peysson, Stéphane, additional, Pfeilschifter, Waltraud, additional, Pichler, Alexander, additional, Pierskalla, Alexandra, additional, Pledl, Hans-Werner, additional, Poli, Sven, additional, Pomrehn, Katrin, additional, Poulsen, Marika, additional, Prats, Luis, additional, Presas, Silvia, additional, Prohaska, Elisabeth, additional, Puetz, Volker, additional, Puig, Josep, additional, Puig Alcántara, Josep, additional, Purrucker, Jan, additional, Quenardelle, Veronique, additional, Ramachandran, Sankaranarayanan, additional, Raphaelle, Soulliard, additional, Raposo, Nicolas, additional, Reiff, Tilman, additional, Remmers, Michel, additional, Renou, Pauline, additional, Ribitsch, Martin, additional, Richter, Hardy, additional, Ritter, Martin, additional, Ritzenthaler, Thomas, additional, Rodier, Gilles, additional, Rodriguez-Regent, Christine, additional, Rodríguez-Yáñez, Manuel, additional, Roennefarth, Maria, additional, Roffe, Christine, additional, Rosenbaum, Sverre, additional, Rosso, Charlotte, additional, Röther, Joachim, additional, Rozanski, Michal, additional, Ruiz de Morales, Noelia, additional, Russo, Francesca, additional, Rutgers, Matthieu, additional, Sagnier, Sharmilla, additional, Samson, Yves, additional, Sánchez, Josep, additional, Sauer, Tamara, additional, Schäfer, Jan H., additional, Schieber, Simon, additional, Schill, Josef, additional, Schlak, Dennis, additional, Schlemm, Ludwig, additional, Schmidt, Sein, additional, Schonewille, Wouter, additional, Schröder, Julian, additional, Schulz, Andreas, additional, Schurig, Johannes, additional, Schwarting, Sönke, additional, Schwarz, Alexander, additional, Schwarzbach, Christopher, additional, Seidel, Matthias, additional, Seiler, Alexander, additional, Sembill, Jochen, additional, Serena Leal, Joaquin, additional, Shetty, Ashit, additional, Sibon, Igor, additional, Simonsen, Claus Z., additional, Singer, Oliver, additional, Sivagnanaratham, Aravinth, additional, Smets, Ide, additional, Smith, Craig, additional, Soors, Peter, additional, Sprigg, Nikola, additional, Spruegel, Maximilian, additional, Stark, David, additional, Steinert, Susanne, additional, Stösser, Sebastian, additional, Stuermlinger, Markus, additional, Swinnen, Bart, additional, Tamazyan, Ruben, additional, Tembl, Jose, additional, Terceno Izaga, Mikel, additional, Thomalla, Götz, additional, Touze, Emmanuel, additional, Truelsen, Thomas, additional, Turc, Guillaume, additional, Turine, Gaetane, additional, Tütüncü, Serdar, additional, Tyrell, Pippa, additional, Ustrell, Xavier, additional, Vadot, Wilfried, additional, Vallet, Anne-Evelyne, additional, Vallet, Pauline, additional, van den Berg, Lucie, additional, van den Berg, Sophie, additional, van Eendenburg, Cecile, additional, Van Hooff, Robbert-Jan, additional, van Sloten, Isabelle, additional, Vanacker, Peter, additional, Vancaester, Evelien, additional, Vanderdonckt, Patrick, additional, Vandermeeren, Yves, additional, Vanhee, Frederik, additional, Veltkamp, Roland, additional, Vestergaard, Karsten, additional, Viguier, Alain, additional, Vilas, Dolores, additional, Villringer, Kersten, additional, Voget, Dieke, additional, von Schrader, Jörg, additional, von Weitzel, Paul, additional, Warburton, Elisabeth, additional, Weber, Claudia, additional, Weber, Jörg, additional, Wegscheider, Karl, additional, Wegscheider, Mirko, additional, Weimar, Christian, additional, Weinstich, Karin, additional, Weise, Christopher, additional, Weise, Gesa, additional, Willems, Chris, additional, Winder, Klemens, additional, Wittayer, Matthias, additional, Wolf, Marc, additional, Wolf, Martin, additional, Wolff, Valerie, additional, Wollboldt, Christian, additional, Wollenweber, Frank, additional, Wouters, Anke, additional, Yalo, Bertrand, additional, Yger, Marion, additional, Younan, Nadia, additional, Yperzeele, Laetita, additional, Zegarac, Vesna, additional, Zeiner, Pia, additional, Ziemann, Ulf, additional, Zonneveld, Thomas, additional, Zuber, Mathieu, additional, Akutsu, Tsugio, additional, Aoki, Junya, additional, Arakawa, Shuji, additional, Doijiri, Ryosuke, additional, Egashira, Yusuke, additional, Enomoto, Yukiko, additional, Furui, Eisuke, additional, Furuta, Konosuke, additional, Gotoh, Seiji, additional, Hamasaki, Toshimitsu, additional, Hasegawa, Yasuhiro, additional, Hirano, Teryuki, additional, Homma, Kazunari, additional, Ichijyo, Masahiko, additional, Ide, Toshihiro, additional, Igarashi, Shuichi, additional, Iguchi, Yasuyuki, additional, Ihara, Masafumi, additional, Ikenouchi, Hajime, additional, Inoue, Tsuyoshi, additional, Itabashi, Ryo, additional, Ito, Yasuhiro, additional, Iwama, Toru, additional, Kamiyama, Kenji, additional, Kamiyoshi, Shoko, additional, Kanai, Haruka, additional, Kanematsu, Yasuhisa, additional, Kanzawa, Takao, additional, Kimura, Kazumi, additional, Kitayama, Jiro, additional, Kitazono, Takanari, additional, Kondo, Rei, additional, Kudo, Kohsuke, additional, Kusumi, Masayoshi, additional, Kuwahara, Ken, additional, Matsumoto, Shoji, additional, Matsuoka, Hideki, additional, Mihara, Ban, additional, Minematsu, Kazuo, additional, Miura, Ken, additional, Morita, Naomi, additional, Mouri, Wataru, additional, Murata, Kayo, additional, Nagakane, Yoshinari, additional, Nakase, Taizen, additional, Ohara, Hiromi, additional, Ohara, Nobuyuki, additional, Ohnishi, Hideyuki, additional, Ohta, Hajime, additional, Ohtaki, Masafumi, additional, Ohtani, Ryo, additional, Ohtsuki, Toshiho, additional, Ohyama, Hideo, additional, Okada, Takashi, additional, Okada, Yasushi, additional, Osaki, Masato, additional, Sakai, Nobuyuki, additional, Sanbongi, Yoshiki, additional, Sasaki, Naoshi, additional, Sasaki, Makoto, additional, Sato, Shoichiro, additional, Seki, Kenta, additional, Shimizu, Wataru, additional, Shiokawa, Yoshiaki, additional, Sozu, Takashi, additional, Suzuki, Junichiro, additional, Suzuki, Rieko, additional, Takagi, Yasushi, additional, Takizawa, Shunya, additional, Tanahashi, Norio, additional, Tanaka, Eijiro, additional, Tanaka, Ryota, additional, Tateishi, Yohei, additional, Terada, Tomoaki, additional, Terasaki, Tadashi, additional, Todo, Kenichi, additional, Tokunaga, Azusa, additional, Tsujino, Akira, additional, Ueda, Toshihiro, additional, Uesaka, Yoshikazu, additional, Uotani, Mihoko, additional, Urabe, Takao, additional, Watanabe, Masao, additional, Yagita, Yoshiki, additional, Yakushiji, Yusuke, additional, Yasui, Keizo, additional, Yonehara, Toshiro, additional, Yoshimura, Shinichi, additional, Aarnio, K., additional, Alemseged, F., additional, Anderson, C., additional, Ang, T., additional, Archer, M.L., additional, Attia, J., additional, Bailey, P., additional, Balabanski, A., additional, Barber, A., additional, Barber, P.A., additional, Bernhardt, J., additional, Bivard, A., additional, Blacker, D., additional, Bladin, C.F., additional, Brodtmann, A., additional, Cadilhac, D., additional, Campbell, B.C.V., additional, Carey, L., additional, Celestino, S., additional, Chan, L., additional, Chang, W.H., additional, ChangI, A., additional, Chen, C.H., additional, Chen, C.-I., additional, Chen, H.F., additional, Chen, T.C., additional, Chen, W.H., additional, Chen, Y.Y., additional, Cheng, C.A., additional, Cheong, E., additional, Chiou, Y.W., additional, Choi, P.M., additional, Chu, H.J., additional, Chuang, C.S., additional, Chung, T.C., additional, Churilov, L., additional, Clissold, B., additional, Connelly, A., additional, Coote, S., additional, Coulton, B., additional, Cowley, E., additional, Cranefield, J., additional, Curtze, S., additional, D'Este, C., additional, Davis, S.M., additional, Day, S., additional, Desmond, P.M., additional, Dewey, H.M., additional, Ding, C., additional, Donnan, G.A., additional, Drew, R., additional, Eirola, S., additional, Field, D., additional, Frost, T., additional, Garcia-Esperon, C., additional, George, K., additional, Gerraty, R., additional, Grimley, R., additional, Guo, Y.C., additional, Hankey, G., additional, Harvey, J., additional, Ho, S.C., additional, Hogan, K., additional, Howells, D., additional, Hsiao, P.M., additional, Hsu, C.H., additional, Hsu, C.T., additional, Hsu, C.-S., additional, Hsu, J.P., additional, Hsu, Y.D., additional, Hsu, Y.T., additional, Hu, C.J., additional, Huang, C.C., additional, Huang, H.Y., additional, Huang, M.Y., additional, Huang, S.C., additional, Huang, W.S., additional, Jackson, D., additional, Jeng, J.S., additional, Jiang, S.K., additional, Kaauwai, L., additional, Kasari, O., additional, King, J., additional, Kleinig, T.J., additional, Koivu, M., additional, Kolbe, J., additional, Krause, M., additional, Kuan, C.W., additional, Kung, W.L., additional, Kyndt, C., additional, Lau, C.L., additional, Lee, A., additional, Lee, C.Y., additional, Lee, J.T., additional, Lee, Y., additional, Lee, Y.C., additional, Levi, C., additional, Levi, C.R., additional, Lien, L.M., additional, Lim, J.C., additional, Lin, C.C., additional, Lin, C.H., additional, Lin, C.M., additional, Lin, D., additional, Liu, C.H., additional, Liu, J., additional, Lo, Y.C., additional, Loh, P.S., additional, Low, E., additional, Lu, C.H., additional, Lu, C.J., additional, Lu, M.K., additional, Ly, J., additional, Ma, H., additional, Macaulay, L., additional, Macdonnell, R., additional, Mackey, E., additional, Macleod, M., additional, Mahadevan, J., additional, Maxwell, V., additional, McCoy, R., additional, McDonald, A., additional, McModie, S., additional, Meretoja, A., additional, Mishra, S., additional, Mitchell, P.J., additional, Miteff, F., additional, Moore, A., additional, Muller, C., additional, Ng, F., additional, Ng, F.C., additional, Ng, J-L., additional, O'Brian, W., additional, O'Collins, V., additional, Oxley, T.J., additional, Parsons, M.W., additional, Patel, S., additional, Peng, G.S., additional, Pesavento, L., additional, Phan, T., additional, Rodrigues, E., additional, Ross, Z., additional, Sabet, A., additional, Sallaberger, M., additional, Salvaris, P., additional, Shah, D., additional, Sharma, G., additional, Sibolt, G., additional, Simpson, M., additional, Singhal, S., additional, Snow, B., additional, Spratt, N., additional, Stark, R., additional, Sturm, J., additional, Sun, M.C., additional, Sun, Y., additional, Sung, P.S., additional, Sung, Y.F., additional, Suzuki, M., additional, Tan, M., additional, Tang, S.C., additional, Tatlisumak, T., additional, Thijs, V., additional, Tiainen, M., additional, Tsai, C.H., additional, Tsai, C.K., additional, Tsai, C.L., additional, Tsai, H.T., additional, Tsai, L.K., additional, Tseng, C.H., additional, Tseng, L.T., additional, Tsoleridis, J., additional, Tu, H., additional, Tu, H.T-H., additional, Vallat, W., additional, Virta, J., additional, Wang, W.C., additional, Wang, Y.T., additional, Waters, M., additional, Weir, L., additional, Wijeratne, T., additional, Williams, C., additional, Wilson, W., additional, Wong, A.A., additional, Wong, K., additional, Wu, T.Y., additional, Wu, Y.H., additional, Yan, B., additional, Yang, F.C., additional, Yang, Y.W., additional, Yassi, N., additional, Yeh, H.L., additional, Yeh, J.H., additional, Yeh, S.J., additional, Yen, C.H., additional, Young, D., additional, Ysai, C.L., additional, Zhang, W.W., additional, Zhao, H., additional, Zhao, L., additional, Althaus-Knaurer, Katharina, additional, Berrouschot, Jörg, additional, Bluhmki, Erich, additional, Bovi, Paolo, additional, Chatellier, Gilles, additional, Cove, Lynda, additional, Davis, Stephen, additional, Dixit, A., additional, Donnan, Geoffrey, additional, Ehrenkrona, Christina, additional, Eschenfelder, Christoph, additional, Fatar, Marc, additional, Francisco Arenillas, Juan, additional, Gruber, Franz, additional, Kala, Lalit, additional, Kapeller, Peter, additional, Kaste, Markku, additional, Kessler, Christof, additional, Köhrmann, Martin, additional, Laage, Rico, additional, Lees, Kennedy R., additional, Luna Rodriguez, Alain, additional, Mas, Jean-Louis, additional, Mikulik, Robert, additional, Molina, Carlos, additional, Muddegowda, Girish, additional, Muir, Keith, additional, Niederkorn, Kurt, additional, Nuñez, Xavier, additional, Schellinger, Peter, additional, Serena, Joaquin, additional, Sobesky, Jan, additional, Steiner, Thorsten, additional, Svenson, Ann-Sofie, additional, von Kummer, Rüdiger, additional, Wardlaw, Joanna, additional, Betensky, Rebecca A., additional, Boulouis, Gregoire, additional, Carandang, Raphael A., additional, Copen, William A., additional, Cougo, Pedro, additional, Cutting, Shawna, additional, Drake, Kendra, additional, Ford, Andria L., additional, Hallenbeck, John, additional, Harris, Gordon J., additional, Hoesch, Robert, additional, Hsia, Amie, additional, Kase, Carlos, additional, Latour, Lawrence, additional, Lev, Michael H., additional, Muzikansky, Alona, additional, Nagaraja, Nandakumar, additional, Schwamm, Lee H., additional, Searls, Eric, additional, Song, Shlee S., additional, Starkman, Sidney, additional, Yoo, Albert J., additional, and Zand, Ramin, additional

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2020
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39. Polypharmacy, functional outcome and treatment effect of intravenous alteplase for acute ischaemic stroke

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Jensen, M., primary, Boutitie, F., additional, Cheng, B., additional, Cho, T.‐H., additional, Ebinger, M., additional, Endres, M., additional, Fiebach, J. B., additional, Fiehler, J., additional, Ford, I., additional, Galinovic, I., additional, Königsberg, A., additional, Puig, J., additional, Roy, P., additional, Wouters, A., additional, Thijs, V., additional, Lemmens, R., additional, Muir, K. W., additional, Nighoghossian, N., additional, Pedraza, S., additional, Simonsen, C. Z., additional, Gerloff, C., additional, and Thomalla, G., additional

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2020
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41. Acute Cerebrovascular Disease in the Young: The Stroke in Young Fabry Patients Study

Author

Rolfs, Arndt, Fazekas, Franz, Grittner, Ulrike, Dichgans, Martin, Martus, Peter, Holzhausen, Martin, Böttcher, Tobias, Heuschmann, Peter U., Tatlisumak, Turgut, Tanislav, Christian, Jungehulsing, Gerhard J., Giese, Anne-Katrin, Putaala, Jukaa, Huber, Roman, Bodechtel, Ulf, Lichy, Christoph, Enzinger, Christian, Schmidt, Reinhold, Hennerici, Michael G., Kaps, Manfred, Kessler, Christof, Lackner, Karl, Paschke, Eduard, Meyer, Wolfgang, Mascher, Hermann, Riess, Olaf, Kolodny, Edwin, Norrving, Bo, Rolfs, A, Ginsberg, M, Hennerici, MG, Kessler, C, Kolodny, E, Martus, P, Norrving, B, Ringelstein, EB, Rothwell, PM, Venables, G, Bornstein, N, deDeyn, P, Dichgans, M, Fazekas, F, Markus, H, Rie, O, Biedermann, C, Böttcher, T, Brüderlein, K, Burmeister, J, Federow, I, König, F, Makowei, G, Niemann, D, Rolfs, A, Rösner, S, Zielke, S, Grittner, U, Martus, P, Holzhausen, M, Fazekas, F, Enzinger, C, Schmidt, R, Ropele, S, Windisch, M, Sterner, E, Bodamer, O, Fellgiebel, A, Hillen, U, Jonas, L, Kampmann, C, Kropp, P, Lackner, K, Laue, M, Mascher, H, Meyer, W, Paschke, E, Weidemann, F, Berrouschot, J, Stoll, A, Rokicha, A, Sternitzky, C, Thomä, M, DeDeyn, PP, Sheorajpanday, R, De Brabander, I, Yperzeele, L, Brouns, R, Oschmann, P, Pott, M, Schultes, K, Schultze, C, Hirsekorn, J, Jungehulsing, GJ, Villringer, A, Schmidt, W, Liman, T, Nowe, T, Ebinger, M, Wille, A, Loui, H, Objartel, A, übelacker, A, Mette, R, Jegzentis, K, Nabavi, DG, Crome, O, Bahr, D, Ebke, M, Platte, B, Kleinen, C, Mermolja Gunther, K, Heide, W, Pape, O, Hanssen, JR, Stangenberg, D, Klingelhofer, J, Schmidt, B, Schwarz, S, Schwarze, J, Frandlih, L, Iwanow, J, Steinbach, I, Krieger, D, Boysen, G, Leth Jeppesen, L, Petersen, A, Reichmann, H, Becker, U, Dzialkowski, I, Hentschel, H, Lautenschlager, C, Hanso, H, Gahn, G, Ziemssen, T, Fleischer, K, Sehr, B, McCabe, DJH, Tobin, O, Kinsella, J, Murphy, RP, Jander, S, Hartung, HP, Siebler, M, Bottcher, C, Kohne, A, Platzen, J, Brosig, TC, Rothhammer, V, Henseler, C, Neumann-Haefelin, T, Singer, OC, Ermis, U, dos Santos, IMRM, Schuhmann, C, van de Loo, S, Kaps, M, Allendorfer, J, Tanislav, C, Brandtner, M, Muir, K, Dani, K, MacDougall, N, Smith, W, Rowe, A, Welch, A, Fazekas, F, Schrotter, G, Krenn, U, Horner, S, Pendl, B, Pluta-Fuerst, A, Trummer, U, Kessler, C, Chatzopoulos, M, v Sarnowski, Bettina, Schminke, Ulf, Link, T, Khaw, A, Nieber, E, Zierz, S, Muller, T, Wegener, N, Wartenberg, K, Gaul, C, Richter, D, Rosenkranz, M, Krützelmann, AC, Hoppe, J, Choe, CU, Narr, S, Magnus, TU, Thomalla, G, Leypoldt, F, Otto, D, Lichy, C, Hacke, W, Barrows, RJ, Tatlisumak, T, Putaala, J, Curtze, S, Metso, M, Willeit, J, Furtner, M, Spiegel, M, Knoflach, MH, Prantl, B, Witte, OW, Brämer, D, Günther, A, Prell, T, Herzau, C, Aurich, K, Deuschl, G, Wodarg, F, Zimmermann, P, Eschenfelder, CC, Levsen, M, Weber, JR, Marecek, SM, Schneider, D, Michalski, D, Kloppig, W, Küppers-Tiedt, L, Schneider, M, Schulz, A, Matzen, P, Weise, C, Hobohm, C, Meier, H, Langos, R, Urban, D, Gerhardt, I, Thijs, V, Lemmens, R, Marcelis, E, Hulsbosch, C, Aichner, F, Haring, HP, Bach, E, Machado Candido, J, e Silva, AA, Lourenco, M, de Sousa, AIM, Derex, L, Cho, TH, Díez-Tejedor, E, Fuentes, B, Martínez-Sanchez, P, Pérez-Guevara, MI, Hamer, H, Metz, A, Hallenberger, K, Müller, P, Baron, P, Bersano, A, Gattinoni, M, Vella, N, Mallia, M, Jauss, M, Adam, L, Heidler, F, Gube, C, Kiszka, M, Dichgans, M, Karpinska, A, Mewald, Y, Straub, V, Dörr, A, Zollver, A, Ringelstein, EB, Schilling, M, Borchert, A, Preuth, N, Duning, T, Kuhlenbäumer, G, Schulte, D, Rothwell, PM, Marquardt, L, Schlachetzki, F, Boy, S, Mädl, J, Ertl, GM, Fehm, NPR, Stadler, C, Benecke, R, Dudesek, A, Kolbaske, S, Lardurner, G, Sulzer, C, Zerbs, A, Lilek, S, Walleczek, AM, Sinadinowska, D, Janelidze, M, Beridze, M, Lobjanidze, N, Dzagnidze, A, Melms, A, Horber, K, Fink, I, Liske, B, Ludolph, AC, Huber, R, Knauer, K, Hendrich, C, Raubold, S, Czlonkowska, A, Baranowska, A, Blazejewska-Hyzorek, B, Lang, W, Kristoferitsch, W, Ferrari, J, Ulrich, E, Flamm-Horak, A, Lischka-Lindner, A, Schreiber, W, Demarin, V, Tranjec, Z, Bosner-Puretic, M, Jurašić, MJ, Basic Kes, V, Budisic, M, and Kopacevic, L

Published
2013
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42. Interarm Blood Pressure Difference Revealing a Right-Sided Aortic Arch and Occluded Aberrant Left Subclavian Artery

Author

Inne Vanreusel, MD, Daniël De Wolf, MD, Thijs Van der Zijden, MD, and An Van Berendoncks, MD

Subjects
aberrant left subclavian artery, blood pressure difference, congenital subclavian steal, Kommerell diverticulum, right-sided aortic arch, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

We present the case of a 33-year-old patient with a rare combination of a right-sided aortic arch and occluded asymptomatic aberrant left subclavian artery diagnosed after the coincidental finding of an interarm blood pressure difference. Because there were no symptoms of local compression or subclavian steal, conservative management was suggested.

Published
2024
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43. Bacterially enhanced plant‐growing media for controlled environment agriculture

Author

Thijs Van Gerrewey, Oscar Navarrete, Maarten Vandecruys, Maaike Perneel, Nico Boon, and Danny Geelen

Subjects
Biotechnology, TP248.13-248.65
Abstract

Abstract Microbe–plant interactions in the root zone not only shape crop performance in soil but also in hydroponic cultivation systems. The biological and physicochemical properties of the plant‐growing medium determine the root‐associated microbial community and influence bacterial inoculation effectiveness, which affects plant growth. This study investigated the combined impact of plant‐growing media composition and bacterial community inoculation on the root‐associated bacterial community of hydroponically grown lettuce (Lactuca sativa L.). Ten plant‐growing media were composed of varying raw materials, including black peat, white peat, coir pith, wood fibre, composted bark, green waste compost, perlite and sand. In addition, five different bacterial community inocula (BCI S1–5) were collected from the roots of lettuce obtained at different farms. After inoculation and cultivation inside a vertical farm, lettuce root‐associated bacterial community structures, diversity and compositions were determined by evaluating 16S rRNA gene sequences. The study revealed distinct bacterial community structures among experimental replicates, highlighting the influence of raw material variations on root‐associated bacterial communities, even at the batch level. However, bacterial community inoculation allowed modulation of the root‐associated bacterial communities independently from the plant‐growing medium composition. Bacterial diversity was identified as a key determinant of plant growth performance with green waste compost introducing Bacilli and Actinobacteria, and bacterial community inoculum S3 introducing Pseudomonas, which positively correlated with plant growth. These findings challenge the prevailing notion of hydroponic cultivation systems as sterile environments and highlight the significance of proper plant‐growing media raw material selection and bacterial community inoculation in shaping root‐associated microbiomes that provide stability through microbial diversity. This study supports the concept of creating bacterially enhanced plant‐growing media to promote plant growth in controlled environment agriculture.

Published
2024
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49. Changes in work conditions and well-being among healthcare professionals in long-term care settings in the Netherlands during the COVID-19 pandemic: a longitudinal study

Author

Renée A. Scheepers, Thijs van den Broek, Jane Murray Cramm, Harry Finkenflügel, and Anna Petra Nieboer

Subjects
Medicine (General), R5-920, Public aspects of medicine, RA1-1270
Abstract

Abstract Background Healthcare professionals working in long-term care facilities reported heavy job demands and a lack of job resources during the 2019 coronavirus disease (COVID-19) pandemic. However, how job demands and resources in these facilities changed during the pandemic, and how possible changes affected professionals’ work-related well-being, remains unclear. Thus, we explored changes in job demands and resources in the face of surging COVID-19 infection rates, and investigated associations of these changes with changes in burnout and work engagement, among healthcare professionals working in long-term care facilities in the Netherlands. Methods This longitudinal study was conducted with healthcare professionals working in five long-term care facilities in the Netherlands. Data were collected in early and late 2021, when infection rates in long-term care facilities were low and high (mean, 29.1 and 275.4 infections/day), respectively. In total, 173 healthcare professionals completed the validated Job Demands and Resources Questionnaire, Copenhagen Burnout Inventory, and Utrecht Work Engagement Scale at both timepoints. We performed paired-samples t tests to examine changes in job demands and resources, and fixed-effects linear regression analyses to examine associations of within-person changes in job demands and resources with those in burnout and work engagement. Results Healthcare professionals perceived increased workloads, associated with increased burnout and decreased work engagement during the study period. Within-person increases in perceived collegial support were associated positively with work engagement and negatively with burnout symptoms. Conclusions Healthcare professionals in long-term care facilities perceived increased workloads in the wake of surging infection rates during the COVID-19 pandemic, resulting in increased burnout and decreased work engagement. These changes in burnout and work engagement were also perceived in response to declining collegial support. Efforts to protect the work-related well-being of healthcare professionals working in long-term care facilities in the pandemic context that focus on workload reduction and the promotion of collegial support may be most beneficial.

Published
2023
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50. Edoxaban for the treatment of cancer-associated venous thromboembolism

Author

Raskob, GE, van Es, N, Verhamme, P, Carrier, M, Di Nisio, M, Garcia, D, Grosso, MA, Kakkar, AK, Kovacs, MJ, Mercuri, MF, Meyer, G, Segers, A, Shi, M, Wang, TF, Yeo, E, Zhang, G, Zwicker, JI, Weitz, JI, Büller, HR, Beyer-Westendorf, J, Boda, Z, Chlumsky, Y, Gibbs, H, Kamphuizen, PW, Monreal, M, Ockleford, P, Pabinger-Fasching, I, Sinnaeve, P, Beenen, L, Gerdes, V, Laleman, W, Larrey, D, van Mechelen, R, Roos, Y, Scheerder, M, Slagboom, T, Thijs, V, Eikelboom, JW, Crowther, M, Roberts, RS, Vanassche, T, Vandenbriele, C, Debaveye, B, Dani, V, Schwocho, L, Duggal, A, Baker, R, Carroll, P, Chan, N, Coughlin, P, Crispin, P, Gallus, A, Hugman, A, Tran, H, Brodmann, M, Mathies, R, Rossmann, D, Deeren, D, Hainaut, P, Jochmans, K, Vercauter, P, Wautrecht, JC, Champion, P, Gross, P, Lee, A, Shivakumar, S, Tagalakis, V, Zed, E, Kovarova, K, Lastuvka, J, Matoska, P, Prosecky, R, Achkar, A, Aquilanti, S, Chatellain, P, Cony-Makhoul, P, Del Piano, F, Elias, A, Falvo, N, Ferrari, E, Mahé, I, Merle, P, Mismetti, P, Muron, T, Pernod, G, Quere, I, Schmidt, J, Stephan, D, Espinola-Klein, C, Horacek, T, Kröning, R, Oettler, W, Schellong, S, Schön, N, Zwemmrich, C, Farkas, K, Gurzo, M, Nyirati, G, Pecsvarady, Z, Riba, M, Becattini, C, Cattaneo, M, Falanga, A, Ghirarduzzi, A, Imberti, D, Lodigiani, C, Parisi, R, Porreca, E, Squizzato, A, Tassoni, MI, Villalta, S, Visonà, A, Beeker, A, Boersma, W, Brouwer, R, Dees, A, Huisman, M, Kuijer, P, Mairuhu, R, Meijer, K, Middeldorp, S, Otten, HM, van Marwijk-Kooy, M, van Wissen, S, Westerweel, P, Harper, P, Merriman, E, Ockelford, P, Royle, G, Smith, M, Cereto Castro, F, de Oña Navarrete, R, Font Puig, C, Gallardo Díaz, E, Garcia-Bragado Dalmau, F, Ruiz Artacho, P, Santamaria, A, Baumann Kreuziger, L, De Sancho, M, Gaddh, M, Metjian, A, Rojas Hernandez, CM, Shah, V, Smith, W, Wun, T, Xiang, Z, Raskob, G, van Es, N, Verhamme, P, Carrier, M, Di Nisio, M, Garcia, D, Grosso, M, Kakkar, A, Kovacs, M, Mercuri, M, Meyer, G, Segers, A, Shi, M, Wang, T, Yeo, E, Zhang, G, Zwicker, J, Weitz, J, Büller, H, Beyer-Westendorf, J, Boda, Z, Chlumsky, Y, Gibbs, H, Kamphuizen, P, Monreal, M, Ockleford, P, Pabinger-Fasching, I, Sinnaeve, P, Beenen, L, Gerdes, V, Laleman, W, Larrey, D, van Mechelen, R, Roos, Y, Scheerder, M, Slagboom, T, Thijs, V, Eikelboom, J, Crowther, M, Roberts, R, Vanassche, T, Vandenbriele, C, Debaveye, B, Dani, V, Schwocho, L, Duggal, A, Baker, R, Carroll, P, Chan, N, Coughlin, P, Crispin, P, Gallus, A, Hugman, A, Tran, H, Brodmann, M, Mathies, R, Rossmann, D, Deeren, D, Hainaut, P, Jochmans, K, Vercauter, P, Wautrecht, J, Champion, P, Gross, P, Lee, A, Shivakumar, S, Tagalakis, V, Zed, E, Kovarova, K, Lastuvka, J, Matoska, P, Prosecky, R, Achkar, A, Aquilanti, S, Chatellain, P, Cony-Makhoul, P, Del Piano, F, Elias, A, Falvo, N, Ferrari, E, Mahé, I, Merle, P, Mismetti, P, Muron, T, Pernod, G, Quere, I, Schmidt, J, Stephan, D, Espinola-Klein, C, Horacek, T, Kröning, R, Oettler, W, Schellong, S, Schön, N, Zwemmrich, C, Farkas, K, Gurzo, M, Nyirati, G, Pecsvarady, Z, Riba, M, Becattini, C, Cattaneo, M, Falanga, A, Ghirarduzzi, A, Imberti, D, Lodigiani, C, Parisi, R, Porreca, E, Squizzato, A, Tassoni, M, Villalta, S, Visonà, A, Beeker, A, Boersma, W, Brouwer, R, Dees, A, Huisman, M, Kuijer, P, Mairuhu, R, Meijer, K, Middeldorp, S, Otten, H, van Marwijk-Kooy, M, van Wissen, S, Westerweel, P, Harper, P, Merriman, E, Ockelford, P, Royle, G, Smith, M, Cereto Castro, F, de Oña Navarrete, R, Font Puig, C, Gallardo Díaz, E, Garcia-Bragado Dalmau, F, Ruiz Artacho, P, Santamaria, A, Baumann Kreuziger, L, De Sancho, M, Gaddh, M, Metjian, A, Rojas Hernandez, C, Shah, V, Smith, W, Wun, T, Xiang, Z, Graduate School, CCA - Cancer Treatment and Quality of Life, Vascular Medicine, ACS - Amsterdam Cardiovascular Sciences, ANS - Neurovascular Disorders, Radiology and Nuclear Medicine, Other Research, Other departments, Neurology, APH - Societal Participation & Health, APH - Quality of Care, Coronel Institute of Occupational Health, ARD - Amsterdam Reproduction and Development, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, ACS - Atherosclerosis & ischemic syndromes, ACS - Pulmonary hypertension & thrombosis, and ACS - Microcirculation

Subjects
Adult, Dalteparin, Male, Randomization, Pyridines, Hemorrhage, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, law.invention, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Randomized controlled trial, Recurrence, law, Edoxaban, Neoplasms, medicine, Humans, Aged, Intention-to-treat analysis, Heparin, business.industry, Standard treatment, Low-Molecular-Weight, Anticoagulants, Cancer, Follow-Up Studies, Heparin, Low-Molecular-Weight, Intention to Treat Analysis, Middle Aged, Thiazoles, Venous Thromboembolism, General Medicine, medicine.disease, Thrombosis, chemistry, 030220 oncology & carcinogenesis, Anesthesia, Venous Thromboembolism, cancer, thrombosis, business, medicine.drug
Abstract

BACKGROUND Low-molecular-weight heparin is the standard treatment for cancer-associated venous thromboembolism. The role of treatment with direct oral anticoagulant agents is unclear. METHODS In this open-label, noninferiority trial, we randomly assigned patients with cancer who had acute symptomatic or incidental venous thromboembolism to receive either low-molecular-weight heparin for at least 5 days followed by oral edoxaban at a dose of 60 mg once daily (edoxaban group) or subcutaneous dalteparin at a dose of 200 IU per kilogram of body weight once daily for 1 month followed by dalteparin at a dose of 150 IU per kilogram once daily (dalteparin group). Treatment was given for at least 6 months and up to 12 months. The primary outcome was a composite of recurrent venous thromboembolism or major bleeding during the 12 months after randomization, regardless of treatment duration. RESULTS Of the 1050 patients who underwent randomization, 1046 were included in the modified intention-to-treat analysis. A primary-outcome event occurred in 67 of the 522 patients (12.8%) in the edoxaban group as compared with 71 of the 524 patients (13.5%) in the dalteparin group (hazard ratio, 0.97; 95% confidence interval [CI], 0.70 to 1.36; P = 0.006 for noninferiority; P = 0.87 for superiority). Recurrent venous thromboembolism occurred in 41 patients (7.9%) in the edoxaban group and in 59 patients (11.3%) in the dalteparin group (difference in risk, -3.4 percentage points; 95% CI, -7.0 to 0.2). Major bleeding occurred in 36 patients (6.9%) in the edoxaban group and in 21 patients (4.0%) in the dalteparin group (difference in risk, 2.9 percentage points; 95% CI, 0.1 to 5.6). CONCLUSIONS Oral edoxaban was noninferior to subcutaneous dalteparin with respect to the composite outcome of recurrent venous thromboembolism or major bleeding. The rate of recurrent venous thromboembolism was lower but the rate of major bleeding was higher with edoxaban than with dalteparin. (Funded by Daiichi Sankyo; Hokusai VTE Cancer ClinicalTrials. gov number, NCT02073682.)

Published
2018

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