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Article: Individualising Anticoagulant Therapy in Atrial Fibrillation Patients.

Alings, Marco

2016 Volume 5, Issue 2, Page(s) 102–109

Abstract: Non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) have emerged as alternatives to VKAs for the prevention of stroke in patients with non-valvular atrial fibrillation. Four NOACS: dabigatran, apixaban, rivaroxaban and edoxaban, have received ... ...

Abstract	Non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) have emerged as alternatives to VKAs for the prevention of stroke in patients with non-valvular atrial fibrillation. Four NOACS: dabigatran, apixaban, rivaroxaban and edoxaban, have received regulatory approval in Europe from the European Medicines Agency. Numerous factors can influence the decision to prescribe a NOAC, the most important of which are assessment of stroke and bleeding risks. Given the variation in design of the pivotal phase III clinical trials investigating the efficacy and safety of NOACs, and in the absence of head-to-head comparative data, it is impossible to recommend one NOAC over the other. However, NOACS offer the opportunity for individualised therapy based on factors such as renal function, age or patient/doctor preference for once- or twice-daily dosing regimens. Dose reduction of some NOACS should be considered in at-risk patient populations.
Language	English
Publishing date	2016-05-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2813970-7
ISSN	2050-3377 ; 2050-3369
ISSN (online)	2050-3377
ISSN	2050-3369
DOI	10.15420/AER.2016.20.3
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Article ; Online: Andexanet Alfa and its Clinical Application.

Noordergraaf, Fauve A / Alings, Marco

Heart international

2020 Volume 14, Issue 1, Page(s) 20–23

Abstract: Factor Xa (FXa) inhibitors are widely used for stroke prevention in patients with nonvalvular atrial fibrillation, and for the treatment and prevention of deep venous thrombosis and pulmonary embolism. Compared with warfarin, individual FXa inhibitors ... ...

Abstract	Factor Xa (FXa) inhibitors are widely used for stroke prevention in patients with nonvalvular atrial fibrillation, and for the treatment and prevention of deep venous thrombosis and pulmonary embolism. Compared with warfarin, individual FXa inhibitors are associated with a lower risk of major bleeding. Nevertheless, bleeding remains a feared complication of any anticoagulant therapy. Despite their demonstrated safety, implementation of FXa inhibitors in clinical practice may have been limited by the lack of a specific antidote. Recently, however, the United States Food and Drug Administration and the European Medicines Agency approved andexanet alfa for reversal of anticoagulation in patients treated with rivaroxaban or apixaban who have life-threatening or uncontrolled bleeding. This review will discuss andexanet alfa's mode of action, indication for use and efficacy, with a focus on its appropriate use in clinical practice. Unnecessary usage should be prevented as this may compromise patient safety. Assessment of potentially suitable patients by a multidisciplinary team, use according to the institutional protocol and central storage, all contribute to proper use of andexanet alfa. A practical tool to direct appropriate use of andexanet alfa is proposed.
Language	English
Publishing date	2020-06-19
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2514156-9
ISSN	2036-2579 ; 2036-2579
ISSN (online)	2036-2579
ISSN	2036-2579
DOI	10.17925/HI.2020.14.1.20
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Article ; Online: Antistolling zinvol bij kortdurend atriumfibrilleren?

Seelig, Jaap / Pisters, Ron / Alings, A M W Marco / Hemels, Martin E W

Nederlands tijdschrift voor geneeskunde

2023 Volume 167

Abstract: In patients with short episodes of clinical, non-triggered AF is the evidence for long-term anticoagulation based on the CHA2DS2-VASc score strong. In situations where a temporary trigger for AF is observed (e.g. after surgery or an infection), or when ... ...

Title translation	Anticoagulation useful in short episodes of atrial fibrillation?
Abstract	In patients with short episodes of clinical, non-triggered AF is the evidence for long-term anticoagulation based on the CHA2DS2-VASc score strong. In situations where a temporary trigger for AF is observed (e.g. after surgery or an infection), or when AF is only detected on a cardiac implantable electronic device (CIED) or smartwatch, the evidence for anticoagulation is less well established. Despite the short duration of the AF episode(s), both patients with subclinical or triggered AF are often at an inherently increased risk of stroke or thromboembolism. In some of these cases long-term anticoagulation can be considered, especially when other cardiovascular risk factors are present. Important considerations when deciding to start with long-term anticoagulation are the individually estimated risk of thrombosis and bleeding, the implementation of shared decision making, and the optimization of the overall cardiovascular risk management.
MeSH term(s)	Humans ; Atrial Fibrillation/drug therapy ; Atrial Fibrillation/complications ; Risk Factors ; Anticoagulants/adverse effects ; Stroke/epidemiology ; Stroke/etiology ; Stroke/prevention & control ; Hemorrhage/chemically induced ; Risk Assessment
Chemical Substances	Anticoagulants
Language	Dutch
Publishing date	2023-02-08
Publishing country	Netherlands
Document type	English Abstract ; Journal Article
ZDB-ID	82073-8
ISSN	1876-8784 ; 0028-2162
ISSN (online)	1876-8784
ISSN	0028-2162
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Article: Effects of a stepwise, structured LDL-C lowering strategy in patients post-acute coronary syndrome.

Omar Khader, Aaram / van Trier, Tinka / van der Brug, Sander / Liem, An-Ho / Groenemeijer, Bjorn E / Schut, Astrid / Jorstad, Harald T / Martens, Fabrice M A C / Alings, Marco A M W

Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation

2024 Volume 32, Issue 5, Page(s) 206–212

Abstract: Objective: Low-density lipoprotein cholesterol (LDL-C) lowering constitutes a cornerstone of secondary prevention of atherosclerotic cardiovascular disease (ASCVD), yet a considerable number of patients do not achieve guideline-recommended LDL‑C targets. ...

Abstract	Objective: Low-density lipoprotein cholesterol (LDL-C) lowering constitutes a cornerstone of secondary prevention of atherosclerotic cardiovascular disease (ASCVD), yet a considerable number of patients do not achieve guideline-recommended LDL‑C targets. The 2016 European guidelines recommended titration of LDL‑C lowering medication in a set number of steps, starting with oral medication. We aimed to investigate the effects of this stepwise approach in post-acute coronary syndrome (ACS) patients. Methods: In a multicentre, prospective, non-randomised trial, we evaluated a three-step strategy aiming to reduce LDL‑C to ≤ 1.8 mmol/l in post-ACS patients with prior ASCVD and/or diabetes mellitus. Steps, undertaken every 4-6 weeks, included: 1) start high-intensity statin (HIST); 2) addition of ezetimibe; 3) addition of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i). The primary outcome was the proportion of patients achieving LDL-C ≤ 1.8 mmol/l after Steps 1 and 2 (using oral medications alone). Secondary outcomes examined the prevalence of meeting the target throughout all steps ( https://onderzoekmetmensen.nl/nl/trial/21157 ). Results: Out of 999 patients, 84% (95% confidence intervals (CI): 81-86) achieved the LDL‑C target using only statin and/or ezetimibe. In an intention-to-treat analysis, the percentages of patients meeting the LDL‑C target after each step were 69% (95% CI: 67-72), 84% (95% CI: 81-86), and 87% (95% CI: 85-89), respectively. There were protocol deviations for 23, 38 and 23 patients at each respective step. Conclusion: Through stepwise intensification of lipid-lowering therapy, 84% of very high-risk post-ACS patients achieved an LDL‑C target of ≤ 1.8 mmol/l with oral medications alone. Addition of PCSK9i further increased this rate to 87% (95% CI: 85-89).
Language	English
Publishing date	2024-01-26
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2211468-3
ISSN	1876-6250 ; 1568-5888 ; 0929-7456
ISSN (online)	1876-6250
ISSN	1568-5888 ; 0929-7456
DOI	10.1007/s12471-023-01851-7
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Article ; Online: Studio BLITZ-AF Cancer: un progetto di ricerca osservazionale internazionale sui pazienti con fibrillazione atriale e cancro.

Gulizia, Michele Massimo / Turazza, Fabio Maria / Ameri, Pietro / Alings, Marco / Collins, Ronan / De Luca, Leonardo / Di Nisio, Marcello / Lucci, Donata / Gabrielli, Domenico / Janssens, Stefan / Parrini, Iris / Pinto, Fausto J / Zamorano, Jose Luis / Colivicchi, Furio

Giornale italiano di cardiologia (2006)

2024 Volume 25, Issue 5, Page(s) 340–345

Abstract: Background: Cancer is an important condition associated with the development of atrial fibrillation (AF). The objectives of the BLITZ-AF Cancer study were to collect real-life information on the clinical profile and use of antithrombotic drugs in ... ...

Title translation	BLITZ-AF Cancer study: an international observational research project on patients with atrial fibrillation and cancer.
Abstract	Background: Cancer is an important condition associated with the development of atrial fibrillation (AF). The objectives of the BLITZ-AF Cancer study were to collect real-life information on the clinical profile and use of antithrombotic drugs in patients with AF and cancer to improve clinical management, as well as the evaluation of the association between different antithrombotic treatments (or their absence) and the main clinical events. Methods: European multinational, multicenter, prospective, non-interventional study conducted in patients with AF (electrocardiographically confirmed) and cancer occurring within 3 years. The CHA2DS2-VASc and the HAS-BLED scores were calculated in all enrolled patients. Results: From June 2019 to July 2021, 1514 patients were enrolled, 36.5% women, from 112 cardiology departments in 6 European countries (Italy, Belgium, the Netherlands, Spain, Portugal and Ireland). Italy enrolled 971 patients in 77 centers. Average age of patients was 74 ± 9 years, of which 20.9% affected by heart failure, 18.1% by ischemic heart disease, 9.8% by peripheral arterial disease and 38.5% by valvular diseases; 41.5% of patients had a CHA2DS2-VASc score ≥4. The most represented cancer sites were lung (14.9%), colorectal tract (14.1%), prostate (8.8%), or non-Hodgkin's lymphoma (8.1%). Before enrollment, 16.6% of patients were not taking antithrombotic therapy, while 22.7% were on therapy with antiplatelet agents and/or low molecular weight heparin. After enrollment these percentages decreased to 7.7% and 16.6%, respectively and, at the same time, the percentage of patients on direct oral anticoagulant (DOAC) therapy increased from 48.4% to 68.4%, also to the detriment of those on vitamin K antagonist therapy. Conclusions: The BLITZ-AF Cancer study, which enrolled patients diagnosed with AF and cancer, highlights that the use of DOACs by cardiologists in this clinical context has increased, even though the guidelines on AF do not give accurate indications about oral anticoagulant therapy in patients with cancer.
MeSH term(s)	Male ; Humans ; Female ; Aged ; Aged, 80 and over ; Atrial Fibrillation/complications ; Atrial Fibrillation/drug therapy ; Atrial Fibrillation/diagnosis ; Fibrinolytic Agents/therapeutic use ; Prospective Studies ; Anticoagulants ; Neoplasms/complications ; Stroke/complications ; Risk Factors
Chemical Substances	Fibrinolytic Agents ; Anticoagulants
Language	Italian
Publishing date	2024-04-19
Publishing country	Italy
Document type	Multicenter Study ; English Abstract ; Journal Article
ZDB-ID	2272414-X
ISSN	1972-6481 ; 1827-6806
ISSN (online)	1972-6481
ISSN	1827-6806
DOI	10.1714/0000.42096
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Article: Predictive Value of the

Zwaan, Eva / Cheung, Elena / IJsselmuiden, Alexander / Holtzer, Carlo / Schreuders, Ton / Kofflard, Marcel / Alings, Marco / Coert, J Henk

Patient related outcome measures

2022 Volume 13, Page(s) 145–155

Abstract: Purpose: The use of the Disability of the Arm, Shoulder and Hand (DASH) questionnaire and its shortened version, the : Patients and methods: This study was a diagnostic retrospective analysis of the ARCUS study, of whom 440 underwent TR-PCI and 62 ... ...

Abstract	Purpose: The use of the Disability of the Arm, Shoulder and Hand (DASH) questionnaire and its shortened version, the Patients and methods: This study was a diagnostic retrospective analysis of the ARCUS study, of whom 440 underwent TR-PCI and 62 control patients were treated via the transfemoral approach. All participants completed the DASH and Results: At each follow-up moment, the area under the curve (AUC) showed a poor ability of the DASH and Conclusion: The DASH and
Language	English
Publishing date	2022-06-27
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2586660-6
ISSN	1179-271X
ISSN	1179-271X
DOI	10.2147/PROM.S353895
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Article ; Online: Comparing adolescent- and adult-onset unexplained cardiac arrest: Results from the Dutch Idiopathic VF Registry.

Verheul, Lisa M / Hoeksema, Wiert F / Groeneveld, Sanne A / Mulder, Bart A / Bootsma, Marianne / Alings, Marco / Evertz, Reinder / Blank, Andreas C / Kammeraad, Janneke A E / Clur, Sally-Ann B / Yap, Sing-Chien / Postema, Pieter G / Wilde, Arthur A M / Volders, Paul G A / Hassink, Rutger J

Heart rhythm

2024

Abstract: Background: Current cohorts of patients with idiopathic ventricular fibrillation (IVF) primarily include adult-onset patients. Underlying causes of sudden cardiac arrest vary with age; therefore, underlying causes and disease course may differ for ... ...

Abstract	Background: Current cohorts of patients with idiopathic ventricular fibrillation (IVF) primarily include adult-onset patients. Underlying causes of sudden cardiac arrest vary with age; therefore, underlying causes and disease course may differ for adolescent-onset vs adult-onset patients. Objective: The purpose of this study was to compare adolescent-onset with adult-onset patients having an initially unexplained cause of VF. Methods: The study included 39 patients with an index event aged ≤19 years (adolescent-onset) and 417 adult-onset patients from the Dutch Idiopathic VF Registry. Data on event circumstances, clinical characteristics, change in diagnosis, and arrhythmia recurrences were collected and compared between the 2 groups. Results: In total, 42 patients received an underlying diagnosis during follow-up (median 7 [2-12] years), with similar yields (15% adolescent-onset vs 9% adult-onset; P = .16). Among the remaining unexplained patients, adolescent-onset patients (n = 33) had their index event at a median age of 17 [16-18] years, and 72% were male. The youngest patient was aged 13 years. In comparison with adults (n = 381), adolescent-onset patients more often had their index event during exercise (P <.01). Adolescent-onset patients experienced more appropriate implantable cardioverter-defibrillator (ICD) therapy during follow-up compared with adults (44% vs 26%; P = .03). Inappropriate ICD therapy (26% vs 17%; P = .19), ICD complications (19% vs 14%; P = .41), and deaths (3% vs 4%; P = 1) did not significantly differ between adolescent-onset and adult-onset patients. Conclusion: IVF may occur during adolescence. Adolescent-onset patients more often present during exercise compared with adults. Furthermore, they are more vulnerable to ventricular arrhythmias as reflected by a higher incidence of appropriate ICD therapy.
Language	English
Publishing date	2024-03-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	2229357-7
ISSN	1556-3871 ; 1547-5271
ISSN (online)	1556-3871
ISSN	1547-5271
DOI	10.1016/j.hrthm.2024.03.031
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Article ; Online: Economic evaluation of remote monitoring of patients with an implantable cardiac defibrillator (REMOTE-CIED study).

de Graaf, Gimon / Timmermans, Ivy / Meine, Mathias / Alings, Marco / Pedersen, Susanne S / Mabo, Philippe / Zitron, Edgar / Redekop, Ken / Versteeg, Henneke

Journal of telemedicine and telecare

2022 , Page(s) 1357633X221129176

Abstract: Introduction: Remote patient monitoring (RPM) of heart failure patients has the potential to reduce healthcare resource use and costs, but current evidence has been inconclusive. This study aims assess the impact of RPM of heart failure patients with an ...

Abstract	Introduction: Remote patient monitoring (RPM) of heart failure patients has the potential to reduce healthcare resource use and costs, but current evidence has been inconclusive. This study aims assess the impact of RPM of heart failure patients with an implantable cardioverter defibrillator on medical resource use, direct medical costs, quality-adjusted life years (QALYs), and travel time of patients, and to estimate its commercial headroom in the Netherlands and Germany. Methods: Data from the REMOTE-CIED randomized controlled trial were used to calculate differences in length of hospital stay, outpatient clinic visits, telephone consults, emergency room visits, and travel time between patients on in-clinic follow-up and RPM in the Netherlands, Germany, and France. Incremental cardiac-related healthcare costs and QALYs were calculated and used to calculate the commercial headroom of RPM in the Netherlands and Germany. The impact of imputation, parameter, and case-mix uncertainty on these outcomes was explored using probabilistic analysis. Results: Length of hospitalization, number of unscheduled admissions, and number of outpatient visits were lower in the remote monitoring group in all three countries. Number of hospital admissions was higher, and number of calls was lower in the Netherlands and Germany but not in France. Costs were lower in both the Netherlands (-€1041, 95% confidence interval (CI): -€3308, €1005) and Germany (-€2865, 95% CI: -€7619, €1105), while incremental effectiveness differed: -0.003 (95% CI: -0.114, 0.107) QALY in the Netherlands and +0.086 (95% CI: -0.083, 0.256) in Germany. Commercial headroom was estimated at €881 (95% CI: -€5430, €7208) in the Netherlands and €5005 (95% CI: -€1339, €11,960) in Germany. Discussion: RPM was found to result in reduced medical resource use and travel time. Whether it is cost saving or cost effective strongly depends on the costs of remote monitoring. Trial registration number and trial register: ClinicalTrials.gov: NCT01691586.
Language	English
Publishing date	2022-10-17
Publishing country	England
Document type	Journal Article
ZDB-ID	1340281-x
ISSN	1758-1109 ; 1357-633X
ISSN (online)	1758-1109
ISSN	1357-633X
DOI	10.1177/1357633X221129176
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Article ; Online: Direct Oral Anticoagulants for Stroke Prevention in Patients With Device-Detected Atrial Fibrillation: A Study-Level Meta-Analysis of the NOAH-AFNET 6 and ARTESiA Trials.

McIntyre, William F / Benz, Alexander P / Becher, Nina / Healey, Jeffrey S / Granger, Christopher B / Rivard, Lena / Camm, A John / Goette, Andreas / Zapf, Antonia / Alings, Marco / Connolly, Stuart J / Kirchhof, Paulus / Lopes, Renato D

Circulation

2023 Volume 149, Issue 13, Page(s) 981–988

Abstract: ... the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation framework ...

Abstract	Background: Device-detected atrial fibrillation (also known as subclinical atrial fibrillation or atrial high-rate episodes) is a common finding in patients with an implanted cardiac rhythm device and is associated with an increased risk of ischemic stroke. Whether oral anticoagulation is effective and safe in this patient population is unclear. Methods: We performed a systematic review of MEDLINE and Embase for randomized trials comparing oral anticoagulation with antiplatelet or no antithrombotic therapy in adults with device-detected atrial fibrillation recorded by a pacemaker, implantable cardioverter defibrillator, cardiac resynchronization therapy device, or implanted cardiac monitor. We used random-effects models for meta-analysis and rated the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation framework (GRADE). The review was preregistered (PROSPERO CRD42023463212). Results: From 785 citations, we identified 2 randomized trials with relevant clinical outcome data: NOAH-AFNET 6 (Non-Vitamin K Antagonist Oral Anticoagulants in Patients With Atrial High Rate Episodes; 2536 participants) evaluated edoxaban, and ARTESiA (Apixaban for the Reduction of Thrombo-Embolism in Patients With Device-Detected Sub-Clinical Atrial Fibrillation; 4012 participants) evaluated apixaban. Meta-analysis demonstrated that oral anticoagulation with these agents reduced ischemic stroke (relative risk [RR], 0.68 [95% CI, 0.50-0.92]; high-quality evidence). The results from the 2 trials were consistent (I Conclusions: The results of the NOAH-AFNET 6 and ARTESiA trials are consistent with each other. Meta-analysis of these 2 large randomized trials provides high-quality evidence that oral anticoagulation with edoxaban or apixaban reduces the risk of stroke in patients with device-detected atrial fibrillation and increases the risk of major bleeding.
MeSH term(s)	Humans ; Administration, Oral ; Anticoagulants/adverse effects ; Anticoagulants/therapeutic use ; Atrial Fibrillation/drug therapy ; Embolism/etiology ; Hemorrhage/prevention & control ; Ischemic Stroke ; Pyridines ; Stroke/epidemiology ; Stroke/prevention & control ; Thiazoles ; Treatment Outcome ; Randomized Controlled Trials as Topic
Chemical Substances	Anticoagulants ; edoxaban (NDU3J18APO) ; Pyridines ; Thiazoles
Language	English
Publishing date	2023-11-12
Publishing country	United States
Document type	Systematic Review ; Meta-Analysis ; Journal Article
ZDB-ID	80099-5
ISSN	1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
ISSN (online)	1524-4539
ISSN	0009-7322 ; 0069-4193 ; 0065-8499
DOI	10.1161/CIRCULATIONAHA.123.067512
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Article ; Online: A global survey of health care workers' awareness of non-alcoholic fatty liver disease: The AwareNASH survey.

Driessen, Stan / de Jong, Vivian D / van Son, Koen C / Klompenhouwer, Tatiana / Colardelle, Yann / Alings, Marco / Moreno, Cristophe / Anker, Stefan D / Castro Cabezas, Manuel / Holleboom, Adriaan G / Grobbee, Diederick E / Tushuizen, Maarten E

United European gastroenterology journal

2023 Volume 11, Issue 7, Page(s) 654–662

Abstract: Background: The estimated global prevalence and burden of non-alcoholic fatty liver disease (NAFLD) and its advanced stage, non-alcoholic steatohepatitis (NASH), is increasing. Yet, NAFLD remains largely underdiagnosed. In addition to hepatic morbidity ... ...

Abstract	Background: The estimated global prevalence and burden of non-alcoholic fatty liver disease (NAFLD) and its advanced stage, non-alcoholic steatohepatitis (NASH), is increasing. Yet, NAFLD remains largely underdiagnosed. In addition to hepatic morbidity and mortality, NAFLD is associated with increased cardiovascular complications, warranting a multidisciplinary approach. Despite its rapidly increasing prevalence, knowledge of NAFLD among healthcare workers is limited, especially with specialists outside the field of hepatology and gastroenterology. Objectives: To investigate knowledge, practice and opinions/attitudes of healthcare workers towards diagnosis and management of NAFLD/NASH. Methods: The survey was designed in collaboration with a multidisciplinary scientific committee established especially for this study. The survey was disseminated to healthcare workers from seven different disciplines through four collaborating societies, social media and at a cardiology-themed conference from February to June 2022. Median and interquartile range were mentioned for numeric responses and proportions for categorical responses or responses on a Likert scale. Likert scale responses were treated as ordinal data and analysed with the appropriate tests. Results: The full dataset included 613 respondents from 88 different countries (including 488 physicians). 64% of the surveyed physicians underestimated the prevalence of NAFLD. General practitioners and cardiologists underestimated the prevalence most often (74% and 77%, respectively). Compared to the other disciplines, cardiologists were least familiar with the symptoms and diagnostic criteria and felt least confident in diagnosing and managing NAFLD. Overall, 65% of physicians reported regularly using evidence-based guidelines for managing NAFLD, yet 72% reported challenges in providing lifestyle recommendations. A lack of awareness was the most common reported reason for the lack of screening for NAFLD (68% respectively). Conclusions: Despite the growing burden of NAFLD, there is a significant gap in awareness, knowledge, and management among physicians treating patients with cardiometabolic comorbidities, particularly cardiologists. Hepatologists and gastroenterologists could play a role in educating their fellow physicians.
MeSH term(s)	Humans ; Non-alcoholic Fatty Liver Disease/diagnosis ; Non-alcoholic Fatty Liver Disease/epidemiology ; Non-alcoholic Fatty Liver Disease/therapy ; Surveys and Questionnaires ; Comorbidity ; Health Personnel
Language	English
Publishing date	2023-08-10
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2728585-6
ISSN	2050-6414 ; 2050-6406
ISSN (online)	2050-6414
ISSN	2050-6406
DOI	10.1002/ueg2.12445
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