Net Benefit of Early Anticoagulation for Stroke With Atrial Fibrillation: Post Hoc Analysis of the ELAN Randomized Clinical Trial.

Importance: The net clinical effect of early vs later direct oral anticoagulant (DOAC) initiation after atrial fibrillation-associated ischemic stroke is unclear.

Objective: To investigate whether early DOAC treatment is associated with a net clinical benefit (NCB).

Design, Setting, And Participants: This was a post hoc analysis of the Early Versus Late Initiation of Direct Oral Anticoagulants in Post-Ischaemic Stroke Patients With Atrial Fibrillation (ELAN) open-label randomized clinical trial conducted across 103 sites in 15 countries in Europe, the Middle East, and Asia between November 6, 2017, and September 12, 2022, with a 90-day follow-up.

Evaluation of the initial rollout of the physical activity referral standards policy in Scotland: a qualitative study.

Objectives: Physical activity referral schemes (PARS) allow healthcare professionals to refer patients for physical activity support. Evidence of effectiveness is equivocal. Public Health Scotland has developed 'physical activity referral standards' that aim to enhance quality, reduce variability in design and delivery and build further evidence of what works.

Nitrogen fixation may not alleviate stoichiometric imbalances that limit primary production in eutrophic lake ecosystems.

Ecosystem-scale primary production may be proximately limited by nitrogen (N) but ultimately limited by phosphorus (P) because N fixation contributes new N that accumulates relative to P at ecosystem scales. However, the duration needed to transition between proximate N limitation and ultimate P limitation remains unknown for most ecosystems, including lakes. Here we present the results of a fully replicated, multi-annual lake mesocosm experiment that permitted full air-water-sediment interactions that mimicked lake ecosystem ecology.

In Other Journals.

Editors' selections from the current scientific literature.