| 1. |
- Bhatt, Deepak L., et al.
(författare)
-
Rationale, design and baseline characteristics of the effect of ticagrelor on health outcomes in diabetes mellitus patients Intervention study
- 2019
-
Ingår i: Clinical Cardiology. - : Wiley. - 0160-9289 .- 1932-8737. ; 42:5, s. 498-505
-
Tidskriftsartikel (refereegranskat)abstract
- In the setting of prior myocardial infarction, the oral antiplatelet ticagrelor added to aspirin reduced the risk of recurrent ischemic events, especially, in those with diabetes mellitus. Patients with stable coronary disease and diabetes are also at elevated risk and might benefit from dual antiplatelet therapy. The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS, NCT01991795) is a Phase 3b randomized, double-blinded, placebo-controlled trial of ticagrelor vs placebo, on top of low dose aspirin. Patients >= 50 years with type 2 diabetes receiving anti-diabetic medications for at least 6 months with stable coronary artery disease as determined by a history of previous percutaneous coronary intervention, bypass grafting, or angiographic stenosis of >= 50% of at least one coronary artery were enrolled. Patients with known prior myocardial infarction (MI) or stroke were excluded. The primary efficacy endpoint is a composite of cardiovascular death, myocardial infarction, or stroke. The primary safety endpoint is Thrombolysis in Myocardial Infarction major bleeding. A total of 19 220 patients worldwide have been randomized and at least 1385 adjudicated primary efficacy endpoint events are expected to be available for analysis, with an expected average follow-up of 40 months (maximum 58 months). Most of the exposure is on a 60 mg twice daily dose, as the dose was lowered from 90 mg twice daily partway into the study. The results may revise the boundaries of efficacy for dual antiplatelet therapy and whether it has a role outside acute coronary syndromes, prior myocardial infarction, or percutaneous coronary intervention.
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
- Dalby, Lars, et al.
(författare)
-
The status of the Nordic populations of the Mallard (Anas platyrhynchos) in a changing world
- 2013
-
Ingår i: Ornis Fennica. - : Finnish Omithological Soc. - 0030-5685. ; 90:1, s. 2-15
-
Tidskriftsartikel (refereegranskat)abstract
- Dabbling ducks (Anas spp.) are importantmigratory quarry species, protected as a shared resource under international legislation. However, there is a lack of sufficient high-quality data on vital demographic rates and long-term trends in numbers to judge the conservation status of many duck populations at the flyway level. In response to reported declines in the North-West European flyway population of theMallard, we compiled available data on this species in the Nordic countries up to 2010. Generally, national breeding numbers showed increasing trends, wintering abundance showed variable trends, and productivitymeasures indicated stable or increasing trends.Major knowledge gaps were identified, namely the size of hunting bags, the influence of the released Mallards and the role of short-stopping in explaining changing patterns of wintering abundance across the North-West European flyway. Numerically the Nordic breeding population appears in “good condition”, and the wintering numbers have been either stable or increasing in the last two decades. The annual number of releases needs to be determined in order to judge the sustainability of the current levels of exploitation. Overall, none of the indicators showed alarming signs for the Mallard population in the Nordic countries when considered in isolation. However, the widespread decline in wintering numbers elsewhere across North-western Europe requires urgent pan-European action.
|
|
| 5. |
- Dalby, Lars, et al.
(författare)
-
The status of the Nordic populations of the Mallard (Anas platyrhynchos) in a changing world
- 2013
-
Ingår i: Ornis Fennica. - : University of Helsinki. - 0030-5685. ; 90:1, s. 2-15
-
Tidskriftsartikel (refereegranskat)abstract
- Dabbling ducks (Anas spp.) are important migratory quarry species, protected as a shared resource under international legislation. However, there is a lack of sufficient high-quality data on vital demographic rates and long-term trends in numbers to judge the conservation status of many duck populations at the flyway level. In response to reported declines in the North-West European flyway population of the Mallard, we compiled available data on this species in the Nordic countries up to 2010. Generally, national breeding numbers showed increasing trends, wintering abundance showed variable trends, and productivity measures indicated stable or increasing trends. Major knowledge gaps were identified, namely the size of hunting bags, the influence of the released Mallards and the role of short-stopping in explaining changing patterns of wintering abundance across the North-West European flyway. Numerically the Nordic breeding population appears in "good condition", and the wintering numbers have been either stable or increasing in the last two decades. The annual number of releases needs to be determined in order to judge the sustainability of the current levels of exploitation. Overall, none of the indicators showed alarming signs for the Mallard population in the Nordic countries when considered in isolation. However, the widespread decline in wintering numbers elsewhere across North-western Europe requires urgent pan-European action.
|
|
| 6. |
- Elmberg, Johan, 1960-, et al.
(författare)
-
Interpreting seasonal range shifts in migratory birds : a critical assessment of 'short-stopping' and a suggested terminology
- 2014
-
Ingår i: Journal of Ornithology = Journal fur Ornithologie. - 0021-8375 .- 1439-0361. ; 155:3, s. 571-579
-
Forskningsöversikt (refereegranskat)abstract
- The term 'short-stopping' is increasingly used in ecology to describe spatio-temporal changes in occurrence of migratory species. Spurred by the insight that it has been used in a variety of contexts, we reviewed its use in avian ecology. A literature search yielded 59 papers explicitly treating short-stopping in birds, most of them in peer-reviewed journals. The term was first used in 1967 to describe a northward shift in wintering Canada Geese in North America and has been used with increasing frequency to the present day. Geese dominate the short-stopping literature, which is confined to the northern hemisphere. Short-stopping has been used to describe (1) a shortened autumn migration that results in a wintering distribution closer to breeding areas, (2) a shortened spring migration that results in a breeding distribution closer to wintering areas, and (3) a delay in autumn migration that leads to a perceived reduced abundance in some part of the winter range. We advocate that short-stopping should be used only to describe (1) range shifts that involve shortening of the migratory corridor, and that they are qualified explicitly by season (i.e. breeding/winter) and degree (i.e. full or partial range shift). In other cases of breeding, wintering or entire range shifts where the migratory corridor is elongated or remains the same, we recommend using the term 'range shift', qualified by season, geography and orientation (i.e. the direction of the range shift). We also discuss the need for spatially explicit avian count monitoring mechanisms (rather than capture-recapture or hunting bag data) designed specifically to track such changes in distribution in the future.
|
|
| 7. |
- Elmberg, Johan, et al.
(författare)
-
Interpreting seasonal range shifts in migratory birds : a critical assessment of 'short-stopping' and a suggested terminology
- 2014
-
Ingår i: Journal of Ornithology = Journal fur Ornithologie. - : Springer Science and Business Media LLC. - 0021-8375. ; 155:3, s. 571-579
-
Forskningsöversikt (refereegranskat)abstract
- The term 'short-stopping' is increasingly used in ecology to describe spatio-temporal changes in occurrence of migratory species. Spurred by the insight that it has been used in a variety of contexts, we reviewed its use in avian ecology. A literature search yielded 59 papers explicitly treating short-stopping in birds, most of them in peer-reviewed journals. The term was first used in 1967 to describe a northward shift in wintering Canada Geese in North America and has been used with increasing frequency to the present day. Geese dominate the short-stopping literature, which is confined to the northern hemisphere. Short-stopping has been used to describe (1) a shortened autumn migration that results in a wintering distribution closer to breeding areas, (2) a shortened spring migration that results in a breeding distribution closer to wintering areas, and (3) a delay in autumn migration that leads to a perceived reduced abundance in some part of the winter range. We advocate that short-stopping should be usedonly to describe (1) range shifts that involve shortening of the migratory corridor, and that they are qualified explicitly by season (i.e. breeding/winter) and degree (i.e. full or partial range shift). In other cases of breeding, wintering or entire range shifts where the migratory corridor is elongated or remains the same, we recommend using the term 'range shift', qualified by season, geography and orientation (i.e. the direction of the range shift). We also discuss the need for spatially explicit avian count monitoring mechanisms (rather than capture-recapture or hunting bag data) designed specifically to track such changes in distribution in the future.
|
|
| 8. |
- Fox, Anthony D., et al.
(författare)
-
Current and potential threats to Nordic duck populations - a horizon scanning exercise
- 2015
-
Ingår i: Annales Zoologici Fennici. - 0003-455X .- 1797-2450. ; 52:4, s. 193-220
-
Tidskriftsartikel (refereegranskat)abstract
- We review the current and future threats to duck populations that breed, stage, moult and/or winter in the Nordic countries. Migratory duck species are sensitive indicators of their changing environment, and their societal value confirms the need to translate signals from changes in their distribution, status and abundance into a better understanding of changes occurring in their wetland environments. We used expert opinion to highlight 25 major areas of anthropogenic change (and touch briefly on potential mitigation measures through nature restoration and reserve management projects) that we consider key issues likely to influence Nordic duck populations now and in the near future to stimulate debate, discussion and further research. We believe such reviews are essential in contributing to development of successful management policy as well as stimulating specific research to support the maintenance of duck species in favourable future conservation status in the face of multiple population pressures and drivers.
|
|
| 9. |
- Fox, Anthony D., et al.
(författare)
-
Current and potential threats to Nordic duck populations - a horizon scanning exercise
- 2015
-
Ingår i: Annales Zoologici Fennici. - : Finnish Zoological and Botanical Publishing Board. - 0003-455X. ; 52:4, s. 193-220
-
Tidskriftsartikel (refereegranskat)abstract
- We review the current and future threats to duck populations that breed, stage, moult and/or winter in the Nordic countries. Migratory duck species are sensitive indicators of their changing environment, and their societal value confirms the need to translate signals from changes in their distribution, status and abundance into a better understanding of changes occurring in their wetland environments. We used expert opinion to highlight 25 major areas of anthropogenic change (and touch briefly on potential mitigation measures through nature restoration and reserve management projects) that we consider key issues likely to influence Nordic duck populations now and in the near future to stimulate debate, discussion and further research. We believe such reviews are essential in contributing to development of successful management policy as well as stimulating specific research to support the maintenance of duck species in favourable future conservation status in the face of multiple population pressures and drivers.
|
|
| 10. |
- Fox, Anthony D., et al.
(författare)
-
Seeking explanations for recent changes in abundance of wintering Eurasian Wigeon (Anas penelope) in northwest Europe
- 2016
-
Ingår i: Ornis Fennica. - 0030-5685. ; 93:1, s. 12-25
-
Tidskriftsartikel (refereegranskat)abstract
- We analysed annual changes in abundance of Eurasian Wigeon (Anas penelope) derived from mid-winter International Waterbird Census data throughout its northwest European flyway since 1988 using log-linear Poisson regression modelling. Increases in abundance in the north and east of the wintering range (Norway, Sweden, Denmark, Germany, Switzerland), stable numbers in the central range (Belgium, Netherlands, UK and France) and declining abundance in the west and south of the wintering range (Spain and Ireland) suggest a shift in wintering distribution consistent with milder winters throughout the range. However, because over 75% of the population of over 1 million individuals winters in Belgium, the Netherlands, UK and France, there was no evidence for a major movement in the centre of gravity of the wintering distribution. Between-winter changes in overall flyway abundance were highly significantly positively correlated (P = 0.003) with reproductive success measured by age ratios in Danish hunter wing surveys and less strongly and inversely correlated (P = 0.05) with mean January temperatures in the centre of the wintering range, suggesting that winter severity may also contribute to influence survival. However, adding winter severity to a model predicting population size based on annual reproductive success alone did not contribute to more effectively modelling the observed changes in population size. Patterns in annual reproductive success seem therefore to largely explain the recent dynamics in population size of northwest European Wigeon. Summer NAO significantly and positively explained 27% of variance in annual breeding success. Other local factors such as eutrophication of breeding sites and changes in predation pressure undoubtedly contribute to changes in the annual production of young and differences in hunting pressure as well as winter severity affect annual survival rates. However, it seems likely that the observed flyway population trend since 1988 has been mostly influenced by climate effects on the breeding grounds affecting reproductive success and marginally on the winter quarters affecting survival. We urge improved demographic monitoring of the population to better assess annual survival and reproductive success. We also recommend development of an adaptive management framework to remove uncertainties in our knowledge of Wigeon population dynamics as information is forthcoming to better inform management, especially to attempt to harmonise the harvest with annual changes in demography to ensure sustainable exploitation of this important quarry species now and in the future.
|
|
| 11. |
- Giraldez, Roberto R., et al.
(författare)
-
Prevalence and clinical outcomes of undiagnosed diabetes mellitus and prediabetes among patients with high-risk non-ST-segment elevation acute coronary syndrome
- 2013
-
Ingår i: American Heart Journal. - : Elsevier BV. - 0002-8703 .- 1097-6744. ; 165:6, s. 918-925.e2
-
Tidskriftsartikel (refereegranskat)abstract
- Background We examined the prevalence of undiagnosed diabetes or prediabetes and associations with ischemic outcomes among non-ST-segment elevation acute coronary syndrome (ACS) patients. Methods We categorized 8795 EARLY ACS trial patients into one of the following groups: "known diabetes" (n = 2860 [32.5%]; reported on the case report form), "undiagnosed diabetes" (n = 1069 [12.2%]; no diabetes history and fasting glucose >= 126 mg/dL or hemoglobin A(1c) >= 6.5%), "prediabetes" (n = 947 [10.8%]; fasting glucose >= 110 to <126 mg/dL, or " normal" (n = 3919 [44.5%]). Adjusted associations of known diabetes, undiagnosed diabetes, and prediabetes (versus normal) with 30-day and 1-year outcomes were determined. Results Undiagnosed diabetes was associated with greater 30-day death or myocardial infarction (MI) (ORadj 1.28, 95% CI 1.05-1.57), driven primarily by greater 30-day mortality (ORadj 1.65, 95% CI 1.09-2.48). Known diabetic patients had 30-day death or MI outcomes similar to those of normal patients, but 30-day mortality was higher (ORadj 1.40, 95% CI 1.01-1.93). Prediabetic patients had 30-day death or MI outcomes similar to those of normal patients. One-year mortality was greater among known diabetic patients (HRadj 1.38, 95% CI 1.13-1.67) but not among those with undiagnosed diabetes or prediabetes. Conclusions Undiagnosed diabetes and prediabetes were common among high-risk non-ST-segment elevation ACS patients. Routine screening for undiagnosed diabetes may be useful since these patients seem to have worse short-term outcomes and deserve consideration of alternative management strategies.
|
|
| 12. |
- Harrington, Robert A., et al.
(författare)
-
The Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRA.CER) trial : study design and rationale
- 2009
-
Ingår i: American Heart Journal. - : Elsevier BV. - 0002-8703 .- 1097-6744. ; 158:3, s. 327-334
-
Tidskriftsartikel (refereegranskat)abstract
- Background The protease-activated receptor 1 (PAR-1), the main platelet receptor for thrombin, represents a novel target for treatment of arterial thrombosis, and SCH 530348 is an orally active, selective, competitive PAR-1 antagonist. We designed TRA.CER to evaluate the efficacy and safety of SCH 530348 compared with placebo in addition to standard of care in patients with non-ST-segment elevation (NSTE) acute coronary syndromes (ACS) and high-risk features. Trial design TRA.CER is a prospective, randomized, double-blind, multicenter, phase III trial with an original estimated sample size of 10,000 subjects. Our primary objective is to demonstrate that SCH 530348 in addition to standard of care will reduce the incidence of the composite of cardiovascular death, myocardial infarction (MI), stroke, recurrent ischemia with rehospitalization, and urgent coronary revascularization compared with standard of care alone. Our key secondary objective is to determine whether SCH 530348 will reduce the composite of cardiovascular death, MI, or stroke compared with standard of care alone. Secondary objectives related to safety are the composite of moderate and severe GUSTO bleeding and clinically significant TIMI bleeding. The trial will continue until a predetermined minimum number of centrally adjudicated primary and key secondary end point events have occurred and all subjects have participated in the study for at least I year. The TRA.CER trial is part of the large phase III SCH 530348 development program that includes a concomitant evaluation in secondary prevention. Conclusion TRA.CER will define efficacy and safety of the novel platelet PAR-1 inhibitor SCH 530348 in the treatment of high-risk patients with NSTE ACS in the setting of current treatment strategies.
|
|
| 13. |
|
|
| 14. |
|
|
| 15. |
|
|
| 16. |
- White, Harvey D, et al.
(författare)
-
Darapladib for preventing ischemic events in stable coronary heart disease
- 2014
-
Ingår i: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 370:18, s. 1702-1711
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Elevated lipoprotein-associated phospholipase A2 activity promotes the development of vulnerable atherosclerotic plaques, and elevated plasma levels of this enzyme are associated with an increased risk of coronary events. Darapladib is a selective oral inhibitor of lipoprotein-associated phospholipase A2.METHODS:In a double-blind trial, we randomly assigned 15,828 patients with stable coronary heart disease to receive either once-daily darapladib (at a dose of 160 mg) or placebo. The primary end point was a composite of cardiovascular death, myocardial infarction, or stroke. Secondary end points included the components of the primary end point as well as major coronary events (death from coronary heart disease, myocardial infarction, or urgent coronary revascularization for myocardial ischemia) and total coronary events (death from coronary heart disease, myocardial infarction, hospitalization for unstable angina, or any coronary revascularization).RESULTS:During a median follow-up period of 3.7 years, the primary end point occurred in 769 of 7924 patients (9.7%) in the darapladib group and 819 of 7904 patients (10.4%) in the placebo group (hazard ratio in the darapladib group, 0.94; 95% confidence interval [CI], 0.85 to 1.03; P=0.20). There were also no significant between-group differences in the rates of the individual components of the primary end point or in all-cause mortality. Darapladib, as compared with placebo, reduced the rate of major coronary events (9.3% vs. 10.3%; hazard ratio, 0.90; 95% CI, 0.82 to 1.00; P=0.045) and total coronary events (14.6% vs. 16.1%; hazard ratio, 0.91; 95% CI, 0.84 to 0.98; P=0.02).CONCLUSIONS:In patients with stable coronary heart disease, darapladib did not significantly reduce the risk of the primary composite end point of cardiovascular death, myocardial infarction, or stroke. (Funded by GlaxoSmithKline; STABILITY ClinicalTrials.gov number, NCT00799903.).
|
|
| 17. |
- White, Harvey D., et al.
(författare)
-
Survival with Cardiac-Resynchronization Therapy in Mild Heart Failure
- 2014
-
Ingår i: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 370:18, s. 1702-1711
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Elevated lipoprotein-associated phospholipase A(2) activity promotes the development of vulnerable atherosclerotic plaques, and elevated plasma levels of this enzyme are associated with an increased risk of coronary events. Darapladib is a selective oral inhibitor of lipoprotein-associated phospholipase A(2). Methods: In a double-blind trial, we randomly assigned 15,828 patients with stable coronary heart disease to receive either once-daily darapladib (at a dose of 160 mg) or placebo. The primary end point was a composite of cardiovascular death, myocardial infarction, or stroke. Secondary end points included the components of the primary end point as well as major coronary events (death from coronary heart disease, myocardial infarction, or urgent coronary revascularization for myocardial ischemia) and total coronary events (death from coronary heart disease, myocardial infarction, hospitalization for unstable angina, or any coronary revascularization). Results: During a median follow-up period of 3.7 years, the primary end point occurred in 769 of 7924 patients (9.7%) in the darapladib group and 819 of 7904 patients (10.4%) in the placebo group (hazard ratio in the darapladib group, 0.94; 95% confidence interval [CI], 0.85 to 1.03; P=0.20). There were also no significant between-group differences in the rates of the individual components of the primary end point or in all-cause mortality. Darapladib, as compared with placebo, reduced the rate of major coronary events (9.3% vs. 10.3%; hazard ratio, 0.90; 95% CI, 0.82 to 1.00; P=0.045) and total coronary events (14.6% vs. 16.1%; hazard ratio, 0.91; 95% CI, 0.84 to 0.98; P=0.02). ConclusionsIn patients with stable coronary heart disease, darapladib did not significantly reduce the risk of the primary composite end point of cardiovascular death, myocardial infarction, or stroke. (Funded by GlaxoSmithKline; STABILITY ClinicalTrials.gov number, NCT00799903.)
|
|
