Tennantsimonsen2799

Background Genotypes associated with venous thromboembolism (VTE) may protect against bleeding due to a hypercoagulable state. Whether the risk of major bleeding is reduced in parallel with an increasing number of prothrombotic genotypes during anticoagulant treatment in VTE remains unknown. Objectives To investigate the association between multiple prothrombotic genotypes and risk of major bleeding in patients with VTE. Methods Patients with incident VTE (n = 676) derived from the Tromsø Study were genotyped for rs6025 (F5), rs1799963 (F2), rs8176719 (ABO), rs2066865 (FGG) and rs2036914 (F11) single nucleotide polymorphisms (SNPs). Major bleeding events were recorded during the first year after VTE according to the International Society on Thrombosis and Haemostasis criteria. Cox-regression was used to calculate hazard ratios with 95% confidence intervals (CIs) for major bleeding adjusted for age, sex and duration of anticoagulation according to individual prothrombotic SNPs and categories of risk alleles (5-SNP score; 0-1, 2, 3 and ≥4). Results In total, 50 patients experienced major bleeding (incidence rate 9.5/100 person-years, 95% CI 7.2-12.5). The individual SNPs and number of risk alleles were not associated with major bleeding risk. The hazard ratios for major bleeding per category increase of genetic risk score were 1.0 (95% CI 0.8-1.3) for the total study population and 1.1 (95% CI 0.8-1.5) when patients with active cancer were excluded. Analyses restricted to the first 3 months after VTE yielded similar results. Conclusion Our findings suggest that an increasing number of prothrombotic risk alleles is not protective against major bleeding in VTE patients during anticoagulation.The spatio-temporal complexity of groundwater storage change is a result of interconnected impact of socio-ecological factors. Previous research indicates several socio-ecological factors (e.g. human extraction, land cover change, and climate change) that may result in groundwater depletion. However, we seldom have empirical studies that provide spatio-temporally explicit information on the main drivers among these factors that determine regional groundwater change. This research explored a spatio-temporally explicit understanding on the socio-ecological determinants on the changes of groundwater storage in the Yellow River Basin (YRB) of north China. We selected this basin because the spatial heterogeneity of this basin complicates the relationship between socio-ecological factors and groundwater resources, whose changes would in turn fundamentally affect the socio-ecological system in the YRB. We collected annual (time resolution) data between 2003 and 2016 (time scope) with 1° × 1° grid (space resolution) about 18 social-ecological factors that might affect groundwater storage change in the YRB (space scope). Using this data and groundwater storage information from Gravity Recovery and Climate Experiment database, we determined best predictors, highly-performed predictive models, and dominant drivers for temporal and spatial changes of groundwater storage. Temporal changes of groundwater in the YRB between 2003 and 2016 were mainly contributed by anthropogenic factors, including population density, plantation, and irrigation water consumption over time. The spatial groundwater change across the YRB was determined by both the geographical location (e.g. indicated by longitude) and urbanization level (e.g. indicated by the domestic and industrial water consumption). The knowledge about socio-ecological determinants on groundwater dynamics in space and time in the YRB can help determine main levers to control regional change of groundwater storage and assist in a sustainable use of groundwater resource.Background COVID-19 (coronavirus disease 2019) is a new, rapidly emerging zoonotic infectious disease, that was reported to the World Health Organization for the first time on 31 December 2019. Currently, no effective pharmacological interventions or vaccines are available to treat or prevent COVID-19, therefore nonpharmacological public health measures are more in focus. Objectives The aim was to assess the effects of quarantine - alone or in combination with other measures - during coronavirus outbreaks. Methods Because of the current COVID-19 pandemic, WHO commissioned a rapid review. To save time, the method of systematic reviews was slightly and with caution modified. This publication is a summary of the most important aspects of the rapid review, translated into German by members of the WHO Collaborating Centre at the Danube University Krems (Austria). Results Overall, 29 studies were included. Ten modeling studies focused on COVID-19, 4 observational studies and 15 modeling studies focused on SARS and cision makers must continue to constantly monitor the outbreak situation and the impact of the measures they implement.Antiphospholipid syndrome (APS) is one of the more common acquired causes of hypercoagulability. Its major presentations are thrombotic (arterial, venous or microvascular) and pregnancy morbidity (miscarriages, late intrauterine fetal demise, and severe pre-eclampsia). IGF-1R inhibitor Classification criteria include three different antiphospholipid antibodies lupus anticoagulant; anticardiolipin; and anti-beta 2 glycoprotein I. Management includes both preventive strategies (low dose aspirin, hydroxychloroquine) and long-term anticoagulation after thrombosis.The World Health Organization declared the coronavirus outbreak a pandemic on March 11, 2020. Infection by the SARS-CoV2 virus leads to the COVID-19 disease which can be fatal, especially in older patients with medical co-morbidities. The impact to the US healthcare system has been disruptive, and the way healthcare services are provided has changed drastically. Here, we present a compilation of the impact of the COVID-19 pandemic on psychiatric care in the US, in the various settings outpatient, emergency room, inpatient units, consultation services, and the community. We further present effects seen on psychiatric physicians in the setting of new and constantly evolving protocols where adjustment and flexibility have become the norm, training of residents, leading a team of professionals with different expertise, conducting clinical research, and ethical considerations. The purpose of this paper is to provide examples of "how to" processes based on our current front-line experiences and research to practicing psychiatrists and mental health clinicians, inform practitioners about national guidelines affecting psychiatric care during the pandemic, and inform health care policy makers and health care systems about the challenges and continued needs of financial and administrative support for psychiatric physicians and mental health systems.