| 1. |
- Mendoza, Pablo A, et al.
(författare)
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Oral anticoagulation for patients with atrial fibrillation in the ED : RE-LY AF registry analysis.
- 2022
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Ingår i: Journal of Thrombosis and Thrombolysis. - : Springer Nature. - 0929-5305 .- 1573-742X. ; 53:1, s. 74-82
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Tidskriftsartikel (refereegranskat)abstract
- Oral anticoagulation (OAC) reduces stroke risk in patients with atrial fibrillation (AF). We sought to determine predictors of OAC initiation in AF patients presenting to the emergency department (ED). Secondary analysis of the RE-LY AF registry which enrolled individuals from 47 countries between 2007 and 2011 who presented to an ED with AF and followed them for 1 year. A total of 4149 patients with AF as their primary diagnosis who were not already taking OAC and had a CHA2DS2-VASc ≥ 1 for men or ≥ 2 for women were included in this analysis. Of these individuals, 26.8% were started on OAC (99.2% vitamin K antagonists) in the ED and 29.8% were using OAC one year later. Factors associated with initiating OAC in the ED included: specialist consultation (relative risk [RR] 1.84, 95%CI 1.44-2.36), rheumatic heart disease (RR 1.60, 95%CI 1.29-1.99), persistence of AF at ED discharge (RR 1.33, 95%CI 1.18-1.50), diabetes mellitus (RR 1.32, 95%CI 1.19-1.47), and hospital admission (RR 1.30, 95%CI 1.14-1.47). Heart failure (RR 0.83, 95%CI 0.74-0.94), antiplatelet agents (RR 0.77, 95%CI 0.69-0.84), and dementia (RR 0.61, 95%CI 0.40-0.94) were inversely associated with OAC initiation. Patients taking OAC when they left the ED were more likely using OAC at 1-year (RR 2.81, 95%CI 2.55-3.09) and had lower rates of death (RR 0.55, 95%CI 0.38-0.79) and stroke (RR 0.59, 95%CI 0.37-0.96). In patients with AF presenting to the ED, prompt initiation of OAC and specialist involvement are associated with a greater use of OAC 1 year later and may result in improved clinical outcomes.
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| 2. |
- Morgan, L. A., et al.
(författare)
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The dynamic floor of Yellowstone Lake, Wyoming, USA : The last 14 k.y. of hydrothermal explosions, venting, doming, and faulting
- 2023
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Ingår i: Bulletin of the Geological Society of America. - 0016-7606. ; 135:3-4, s. 547-574
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Tidskriftsartikel (refereegranskat)abstract
- Hydrothermal explosions are significant potential hazards in Yellowstone National Park, Wyoming, USA. The northern Yellowstone Lake area hosts the three largest hydrothermal explosion craters known on Earth empowered by the highest heat flow values in Yellowstone and active seismicity and deformation. Geological and geochemical studies of eighteen sublacustrine cores provide the first detailed synthesis of the age, sedimentary facies, and origin of multiple hydrothermal explosion deposits. New tephrochronology and radiocarbon results provide a four-dimensional view of recent geologic activity since recession at ca. 15–14.5 ka of the >1-km-thick Pinedale ice sheet. The sedimentary record in Yellowstone Lake contains multiple hydrothermal explosion deposits ranging in age from ca. 13 ka to ~1860 CE. Hydrothermal explosions require a sudden drop in pressure resulting in rapid expansion of high-temperature fluids causing fragmentation, ejection, and crater formation; explosions may be initiated by seismicity, faulting, deformation, or rapid lake-level changes. Fallout and transport of ejecta produces distinct facies of subaqueous hydrothermal explosion deposits. Yellowstone hydrothermal systems are characterized by alkaline-Cl and/or vapor-dominated fluids that, respectively, produce alteration dominated by silica-smectite-chlorite or by kaolinite. Alkaline-Cl liquids flash to steam during hydrothermal explosions, producing much more energetic events than simple vapor expansion in vapor-dominated systems. Two enormous explosion events in Yellowstone Lake were triggered quite differently: Elliott’s Crater explosion resulted from a major seismic event (8 ka) that ruptured an impervious hydrothermal dome, whereas the Mary Bay explosion (13 ka) was triggered by a sudden drop in lake level stimulated by a seismic event, tsunami, and outlet channel erosion.
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