University of Groningen

About: University of Groningen is a education organization based out in Groningen, Groningen, Netherlands. It is known for research contribution in the topics: Population & Context (language use). The organization has 36346 authors who have published 69116 publications receiving 2940370 citations. The organization is also known as: Rijksuniversiteit Groningen & RUG.

Treatment of Anemia with Darbepoetin Alfa in Systolic Heart Failure

Abstract: A b s t r ac t Background Patients with systolic heart failure and anemia have worse symptoms, functional capacity, and outcomes than those without anemia. We evaluated the effects of dar be­ po e tin alfa on clinical outcomes in patients with systolic heart failure and anemia. Methods In this randomized, double­blind trial, we assigned 2278 patients with systolic heart failure and mild­to­moderate anemia (hemoglobin level, 9.0 to 12.0 g per deciliter) to receive either dar be po e tin alfa (to achieve a hemoglobin target of 13 g per deci­ liter) or placebo. The primary outcome was a composite of death from any cause or hospitalization for worsening heart failure. Results The primary outcome occurred in 576 of 1136 patients (50.7%) in the dar be po e tin alfa group and 565 of 1142 patients (49.5%) in the placebo group (hazard ratio in the dar be po e tin alfa group, 1.01; 95% confidence interval, 0.90 to 1.13; P = 0.87). There was no significant between­group difference in any of the secondary outcomes. The neutral effect of dar be po e tin alfa was consistent across all prespecified subgroups. Fatal or nonfatal stroke occurred in 42 patients (3.7%) in the dar be po e tin alfa group and 31 patients (2.7%) in the placebo group (P = 0.23). Thromboembolic adverse events were reported in 153 patients (13.5%) in the dar be po e tin alfa group and 114 patients (10.0%) in the placebo group (P = 0.01). Cancer­related adverse events were similar in the two study groups. Conclusions Treatment with dar be po e tin alfa did not improve clinical outcomes in patients with systolic heart failure and mild­to­moderate anemia. Our findings do not support the use of dar be po e tin alfa in these patients. (Funded by Amgen; RED­HF ClinicalTrials .gov number, NCT00358215.)

Models for Dynamics

Abstract: The purpose of this paper is to give a tutorial exposition of what we consider to be the basic mathematical concepts in the theory of dynamical systems.

The oceanic sink for anthropogenic CO2 from 1994 to 2007

Abstract: We quantify the oceanic sink for anthropogenic carbon dioxide (CO 2 ) over the period 1994 to 2007 by using observations from the global repeat hydrography program and contrasting them to observations from the 1990s. Using a linear regression–based method, we find a global increase in the anthropogenic CO 2 inventory of 34 ± 4 petagrams of carbon (Pg C) between 1994 and 2007. This is equivalent to an average uptake rate of 2.6 ± 0.3 Pg C year −1 and represents 31 ± 4% of the global anthropogenic CO 2 emissions over this period. Although this global ocean sink estimate is consistent with the expectation of the ocean uptake having increased in proportion to the rise in atmospheric CO 2 , substantial regional differences in storage rate are found, likely owing to climate variability–driven changes in ocean circulation.

Screening for Atrial Fibrillation: A Report of the AF-SCREEN International Collaboration

Abstract: Approximately 10% of ischemic strokes are associated with atrial fibrillation (AF) first diagnosed at the time of stroke. Detecting asymptomatic AF would provide an opportunity to prevent these strokes by instituting appropriate anticoagulation. The AF-SCREEN international collaboration was formed in September 2015 to promote discussion and research about AF screening as a strategy to reduce stroke and death and to provide advocacy for implementation of country-specific AF screening programs. During 2016, 60 expert members of AF-SCREEN, including physicians, nurses, allied health professionals, health economists, and patient advocates, were invited to prepare sections of a draft document. In August 2016, 51 members met in Rome to discuss the draft document and consider the key points arising from it using a Delphi process. These key points emphasize that screen-detected AF found at a single timepoint or by intermittent ECG recordings over 2 weeks is not a benign condition and, with additional stroke factors, carries sufficient risk of stroke to justify consideration of anticoagulation. With regard to the methods of mass screening, handheld ECG devices have the advantage of providing a verifiable ECG trace that guidelines require for AF diagnosis and would therefore be preferred as screening tools. Certain patient groups, such as those with recent embolic stroke of uncertain source (ESUS), require more intensive monitoring for AF. Settings for screening include various venues in both the community and the clinic, but they must be linked to a pathway for appropriate diagnosis and management for screening to be effective. It is recognized that health resources vary widely between countries and health systems, so the setting for AF screening should be both country- and health system-specific. Based on current knowledge, this white paper provides a strong case for AF screening now while recognizing that large randomized outcomes studies would be helpful to strengthen the evidence base.