Familial atrial fibrillation is an inherited abnormality of the heart's normal rhythm. Atrial fibrillation is characterized by episodes of uncoordinated electrical activity (fibrillation) in the heart's upper chambers (the atria), which cause a fast and irregular heartbeat AF is strongly age-dependent, affecting 4% of individuals older than 60 years and 8% of persons older than 80 years. Approximately 25% of individuals aged 40 years and older will develop AF during.. features of familial AF (any familial AF, premature familial AF [onset65 years old],number of affected relatives, and youngest age of onset in a relative) into a risk modelfor new-onset AF We have sought to minimize misclassification by excluding twins born before 1912, resulting in a maximum age of 65 years at the time of onset of registration in the NPR According to the CDC, the median age for men with atrial fibrillation is 66.8 years, and for women it's 74.6 years. Pavlovic says that advancing age is a risk factor because with age comes.
The term lone atrial fibrillation refers to people with atrial fibrillation who do not have structural heart disease or other diseases, like diabetes or high blood pressure, which increase the risk of developing AFib. They have early onset atrial fibrillation, with the majority having their first episode at less than 60 year of age Even with optimal compliance, patients using warfarin are within the therapeutic range (2 to 3 for nonvalvular atrial fibrillation) only 55% to 66% of the time.40, 41 Studies have shown that low. Atrial fibrillation is the most common atrial arrhythmia, reported in 10-15%. In a study of 220 patients with defibrillators, median age 46 years (range 7-75 years), atrial fibrillation was documented in 23 (10%). Age of onset was not reported Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia seen in clinical practice with prevalence in excess of 33 million worldwide. Although often asymptomatic and until recently considered a benign arrhythmia, it is now appreciated that thromboembolism resulting from AF results in significant morbidity and mortality predominantly due to stroke
Familial AF occurred among 1185 participants (26.8%) and premature familial AF occurred among 351 participants (7.9%). Atrial fibrillation occurred more frequently among participants with familial AF than without familial AF (unadjusted absolute event rates of 5.8% and 3.1%, respectively) Atrial fibrillation (AF) is the most common clinical arrhythmia and a major risk factor for stroke. To investigate the role of genetic factors in a typical clinical population, we determined the extent of familial aggregation in patients with lone AF. To estimate the relative risk to family members, the prevalence of AF for each class of relative was compared to the prevalence in the. The percentage of people with AF increases with age with 0.1% under 50 years old, 4% between 60 and 70 years old, and 14% over 80 years old being affected. A-fib and atrial flutter resulted in 193,300 deaths in 2015, up from 29,000 in 1990. The first known report of an irregular pulse was by Jean-Baptiste de Sénac in 1749 The prevalence of atrial fibrillation (AF), already the most common sustained cardiac arrhythmia, is constantly rising, even after adjusting for age and presence of structural heart disease. AF increases the risk of stroke sixfold and is associated with a twofold increase in mortality, which remains above 1.5-fold after adjusting for co-morbidity, predominantly caused by cerebrovascular events.
Parental atrial fibrillation as a risk factor for atrial fibrillation in offspring. JAMA 291, 2851-2855 (2004). CAS Article Google Scholar 11. Oyen, N. et al. Familial aggregation of lone atrial. It has an overall population prevalence of ∼1%, but the prevalence increases markedly with age. 1 On the other hand, risk estimates of early-onset AF (diagnosed prior to 60 years of age) are only 3% for males and 1% for females. 2 In up to 30% of AF cases no predisposing condition can be identified and the disease has traditionally been classified as lone AF.
Everybody has a higher risk for developing atrial fibrillation with increasing age. However it is observed that in some families the risk of atrial fibrillation is higher, even at a young age or without any other medical conditions. This is called familial atrial fibrillation Familial atrial fibrillation is an inherited heart condition that disrupts the heart's rhythm. It is characterized by erratic electrical activity in the heart's upper chambers (the atria), causing an irregular response in the heart's lower chambers (the ventricles)
Atrial fibrillation is much more common in older adults. Atrial fibrillation can occur at any age, but when it develops in younger people, it's usually associated with other heart conditions. As you age, your risk of developing other conditions that can increase the risk of atrial fibrillation — such as high blood pressure, coronary artery. The prevalence of atrial fibrillation (AF) in the young (age <50 years) is 0.1%, or 1:1,000 persons. Mutations in KCNQ1-, KCNH2-, and KCNA5-encoded potassium channels and SCN5A-encoded sodium channels have been reported in familial AF. A mechanism of atrial torsade has been suggested to occur in patients with congenital long QT syndrome (LQTS) For those >65 years of age, of a genetic locus for familial atrial fibrillation. 1997;336:905-911. for converting recent-onset atrial fibrillation to sinus rhythm in patients without.
Are you at risk for atrial fibrillation? (AFib or AF) Any person, ranging from children to adults, can develop atrial fibrillation. Because the likelihood of AFib increases with age and people are living longer today, medical researchers predict the number of AFib cases will rise dramatically over the next few years Association Between Familial Atrial Fibrillation and Risk of New-Onset Atrial Fibrillation. JAMA: The Journal of the American Medical Association , 2010; DOI: 10.1001/jama.2010.1690 Cite This Page Atrial fibrillation is an irregular and often rapid heart rate that can increase your risk of strokes, heart failure and other heart-related complications. During atrial fibrillation, the heart's two upper chambers (the atria) beat chaotically and irregularly — out of coordination with the two lower chambers (the ventricles) of the heart A subset amounting to 7.9% of the total had premature familial AF--the first-degree relative developed AF at 65 or younger. In an age- and sex-adjusted analysis, familial AF raised the risk of new. KCNE1 are associated with early-onset familial atrial fibrillation Proband 1 (female, age 45, G25V) had onset of paroxysmal AF at the age of 39 years. Proband 2 (G60D) was diagnosed with lone AF at the age of 33 years. The patient has inherited the mutation from his mother, who also has AF. Both probands had no mutation
Lubitz SA, Yin X, Fontes JD, et al. Association between familial atrial fibrillation and risk of new-onset atrial fibrillation. JAMA. 2010 Nov 24. 304 (20):2263-9. . Xu D, Murakoshi N, Sairenchi T, et al. Anemia and reduced kidney function as risk factors for new onset of atrial fibrillation (from the Ibaraki prefectural health study) The incidence of familial atrial fibrillation and the percentage of cases attributable to the 10q22-q24 locus remain to be determined. Nevertheless, families with familial atrial fibrillation. Thyroid pathology is a common etiology of new onset atrial fibrillation. 1 Warfarin is the drug of choice for stable patients > 75 years of age, those with a history of HTN, those with impaired LV systolic function (EF ≤ 35%), or patients with DM. Atrial Fibrillation (AF) Guidelines (2010, 2012, 2014, 2016, and 2018). In rare cases of apparent familial AF (particularly with onset at a young age) with additionnal features of conduction disease, Brugada syndrome or cardiomyopathy. • Familial / Genetic factor Lubitz SA, Yin X, Fontes JD, et al. Association between familial atrial fibrillation and risk of new-onset atrial fibrillation. JAMA 2010; 304:2263. Darbar D, Herron KJ, Ballew JD, et al. Familial atrial fibrillation is a genetically heterogeneous disorder. J Am Coll Cardiol 2003; 41:2185
New-onset atrial fibrillation in critically ill patients. Canadian respiratory journal 22.3 (2015): 179-182. Herzog, Eyal, et al. Pathway for the Management of Atrial Fibrillation and Atrial Flutter. Critical pathways in cardiology16.2 (2017): 47-52 Atrial fibrillation is a common type of cardiac rhythm disturbance occurring in 1-2% of the general population and 5-15% of patients over 75 years of age The inclusion criteria were an age of 18 to 75 years, emergency room intervention for an episode of electrocardiographically documented atrial fibrillation of recent onset (<48 hours earlier), a.
Background. Atrial fibrillation (AF) is the most common arrhythmia. The potassium current I Ks is essential for cardiac repolarization. Gain-of-function mutations in K V 7.1, the pore-forming α-subunit of the I Ks channel, have been associated with AF. We hypothesized that early-onset lone AF is associated with mutations in the I Ks channel regulatory subunit KCNE1 Introduction. Atrial fibrillation (AF) is a cardiac arrhythmia that increases the risk of serious adverse events, such as stroke, heart failure, cognitive impairment, and death. 1 Million of people worldwide are affected, and efforts have been made to optimize risk assessment and treatment strategies. 2 Over the past 33 years of professor Crijns' career as a cardiologist, the management of. Atrial Fibrillation Detection and management Dr. S K Agarwal MBBS, MD, DM,FACC, CBCCT Consultant Interventional Cardiologist Rashid hospital Dubai @skacardio 2. CV morbidity and mortality associated with AF Event Association with AF Death Increased mortality, especially CV mortality due to sudden death, heart failure or stroke Aims Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in man, causing substantial morbidity and mortality with a major worldwide public health impact. It is increasingly recognized as a highly heritable condition. This study aimed to determine genetic risk factors for early-onset AF. Methods and results We sequenced the whole genomes of 8453 Icelanders and imputed. age - Afib is more common in older people In many cases, the cause of atrial fibrillation is not known. If you develop Afib before the age of 60 without any structural heart disease, you may have idiopathic (or lone) atrial fibrillation. Researchers have identified a handful of genes that predispose families to idiopathic Afib
In genetic association analyses, unstratified and stratified according to age of onset of AF and unaffected age >50 years, there was a highly statistically significant association between the presence of both common (rs2200733 and rs10033464) and rare variants and AF (unstratified p = 1 × 10-8, stratified [age of onset <50 years and unaffected. Atrial fibrillation is common and accounts for one third of all strokes in people over 65 years of age. A rare familial form has been recognized. Treatment by radio frequency ablation using a catheter in a pulmonary vein is usually effective in controlling the disorder. Fibrillation of recent onset can usually be stopped by a single oral. With early-onset AFib, which we defined in our research as younger than age 65, the likelihood that AFib is genetic, or familial in its cause, is much higher, Darbar said
Atrial fibrillation (AF), the most common arrhythmia, is a growing epidemic with substantial morbidity and economic burden. Mechanisms underlying vulnerability to AF remain poorly understood, which contributes to the current lack of highly effective therapies. Recognizing mechanistic subtypes of AF may guide an individualized approach to patient management. Here, we describe a family with a. Atrial fibrillation is common and accounts for one third of all strokes in people over 65 years of age. A rare familial form has been recognized. Treatment by radio frequency ablation using a catheter in a pulmonary vein is usually effective in controlling the disorder. Fibrillation of recent onset can usually be stopped by a single oral dose.
Lubitz SA, Yin X, Fontes JD, et al. Association between familial atrial fibrillation and risk of new-onset atrial fibrillation. JAMA. 2010;304:2263-9. CAS PubMed PubMed Central Article Google Scholar 60. Ellinor PT, Yoerger DM, Ruskin JN, et al. Familial aggregation in lone atrial fibrillation . She had an uncle who died of a sudden cardiac arrest at the age of 30 and a sister who died in infancy from presumed sudden infant death syndrome Onset Neonate-Onset. The. Association of Rare Genetic Variants and Early-Onset Atrial Fibrillation in Ethnic Minority Individuals JAMA Cardiol 2021 May 05;[EPub Ahead of Print], B Chalazan, D Mol, FA Darbar, A Ornelas-Loredo, B Al-Azzam, Y Chen, D Tofovic, A Sridhar, Z Alzahrani, P Ellinor, D Darbar From MEDLINE®/PubMed®, a database of the U.S. National Library of.
Millones de Productos que Comprar! Envío Gratis en Pedidos desde $59 The prevalence of atrial fibrillation increases with age, and the associated cost of medical Onset and duration the patient and their families about risks and benefits . Compared with people who had no parental history of atrial fibrillation, those who had at least one parent with atrial fibrillation would have 85% increased risk of atrial fibrillation
Atrial fibrillation is the most common type of SVT, affecting more than 3 million people in the United States alone. Atrial fibrillation is most common in people over the age of 50, especially white men, and in those who have other types of heart disease. Sometimes atrial fibrillation occurs in young, otherwise healthy individuals Atrial fibrillation, or A-fib, is a common type of arrhythmia, or irregular rhythm. The heart beats too fast and its upper and lower chambers do not work together. Learn about symptoms, risk factors, treatments, and clinical trials nisms of paroxysmal atrial fibrillation have been de-scribed (neurogenic atrial fibrillation), 11 as have familial forms of the condition. 12 Lone atrial fi-brillation (i.e., that occurring in the absence of a cardiac or other explanation) is common, particu-larly in patients with paroxysmal atrial fibrillation Lubitz SA, Yin X, Fontes JD, et al. Association between familial atrial fibrillation and risk of new-onset atrial fibrillation. JAMA 2010; 304:2263. Brugada R, Tapscott T, Czernuszewicz GZ, et al. Identification of a genetic locus for familial atrial fibrillation. N Engl J Med 1997; 336:905
Dan Carter, ND This article offers a succinct review of atrial fibrillation (AF). It also presents approaches to decrease the risk factors and to treat AF by nonpharmaceutical means. Atrial fibrillation is caused by a malfunction in the heart's electrical system and is the most common cardiac arrhythmia. By age 80 years, average lifetime risks [ Introduction. Atrial fibrillation (AF) is the most common clinical arrhythmia with a rapidly increasing prevalence ().By 2050, the prevalence of AF is expected to rise to 5.6-15.6 million in the USA (2, 3).AF is associated with an increased risk of complications such as stroke and heart failure ().Many risk factors are related to the incidence of AF such as age, sex, valvular heart diseases. Lubitz SA, Magnani JW, Villalon ML, Pencina MJ, Levy D, Larson MG, et al. Association between familial atrial fibrillation and risk of new-onset atrial fibrillation. JAMA. 2010;304(20):2263-9. CAS Article Google Scholar 16. Bentz BG, Erkert RS, Blaik MA. Evaluation of atrial fibrillation in horses What is it that we at Framingham, and other people—Iceland, Dr. Ellinor at Mass General, and people at the Mayo Clinic—have published, that there is a familial component to atrial fibrillation. I think all of us know there are those kind of unusual families where everybody has atrial fibrillation at a young age with no heart disease
Aims: Clinicians increasingly encounter patients with young-onset atrial fibrillation (AF). Aim is to study clinical profile, AF progression, and outcome of patients with young-onset AF. Methods and results: A total of 468 patients with paroxysmal or persistent AF starting <60 years of age were included Although multiple patient-related factors predisposing to POAF exist, increased age is the most important 25 and the incidence of AF increases with age. 44 Atrial fibrosis is more common in the aging heart and forms a substrate for the development of AF. 45 Race impacts the development of new-onset POAF, with African Americans having a lower. Introduction. Atrial fibrillation (AF) is the most common sustained heart rhythm disorder and is estimated to affect more than 30 million individuals worldwide ().The lifetime risk of individuals older than 55 years of age is 37%, and AF is associated with an increased risk of stroke, dementia, heart failure, and death ().Many studies have investigated the risk factors for AF to improve. Patients with neuromuscular presentation experienced first symptoms earlier in life (11 vs 39 years; p < 0.0001) and developed atrial fibrillation/flutter (AF) and required pacemaker implantation at a younger age (28 vs 41 years [p = 0.013] and 30 vs 44 years [p = 0.086] respectively), despite a similar overall prevalence of AF (57% vs 65%; p. With the increasing age of the population, AF is becoming more prevalent in the community. Familial atrial fibrillation. Source: Medi, C, Hankey, G, Freedman, S (2007) Pharmacological cardioversion effectively restores sinus rhythm in approximately 50% of patients with recent-onset atrial fibrillation
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in clinical practice and leads to twice the mortality of that among people in sinus rhythm.1 The prevalence of AF rises with age from 0·05% among people aged 25-35 years to more than 5% among those older than 69 years.2 AF is more common among men than women, but data for non-white patients are scarce During 50 years of observation (202 417 person-years), 1544 cases of new-onset atrial fibrillation occurred (of whom 723 [47%] were women). Between 1958-67 and 1998-2007, age-adjusted prevalence of atrial fibrillation quadrupled from 20·4 to 96·2 cases per 1000 person-years in men and from 13·7 to 49·4 cases per 1000 person-years in women; age-adjusted incidence increased from 3·7 to. Reynolds MR, Lavelle T, Essebag V, et al., Influence of age, sex, and atrial fibrillation recurrence on quality of life outcomes in a population of patients with new-onset atrial fibrillation: the Fibrillation Registry Assessing Costs, Therapies, Adverse events and Lifestyle (FRACTAL) study, Am Heart J, 2006;152:1097-1103 Atrial fibrillation, commonly shortened to AFib or AF, is the most common type of cardiac arrhythmia, occurring in middle-aged women.While the term arrhythmia signifies any deviations from the normal heart rate, such slow, fast, or irregular pulse, atrial fibrillation is characterized by a rapid, disorganized heartbeat.It occurs when there is a sudden disruption in the electrical system of the.
Atrial fibrillation (AF) is the most common cardiac dysrhythmia, with a lifetime risk of 1 in 4 among older adults .Development of AF has been associated with stroke, myocardial infarction, heart failure, and death .In the intensive care unit (ICU), patients often present with pre-existing AF; however, some ICU patients may develop new-onset AF (NOAF) in the context of critical illness  Atrial Fibrillation Online Medical Reference - from diagnosis to potential outcomes. Authored by Daniel J. Cantillon MD of the Cleveland Clinic. Atrial fibrillation is the most common sustained tachyarrhythmia. Therapy for atrial fibrillation is centered around three goals: minimize stroke risk, control ventricular rate, and control the atrial rhythm Atrial fibrillation (AF) is a major public health problem because of its increasing prevalence and because it is associated with increased morbidity and mortality [1, 2].Many risk factors for AF have been described and they include, e.g., old age, cardiomyopathy, valvular disease, ischemic heart disease, heart failure, thyroid disease, hypertension and diabetes mellitus [1-3] Although this procedure can reduce atrial fibrillation symptoms, it does not cure the condition. Because the patient will continue to have atrial fibrillation, an anticoagulant medication is prescribed to reduce the risk of stroke. Important note: Due to better treatment alternatives, AV node ablation is rarely used to treat atrial fibrillation
Download the guidelines . Atrial fibrillation (AF) is the most common recurring arrhythmia faced in clinical practice. It's estimated that AF is prevalent in two to four per cent of the population in developed nations, such as Australia, and causes substantial morbidity and mortality Atrial fibrillation (AF) is the most common sustained arrhythmia, with the incidence of 3.1 cases in men and 1.9 cases in women per 1000 person-years in the population younger than 64 years, rising to 19.2 per 1000 person-years in those 65 to 74 years, and as high as 31.4 to 38 in octogenarians. 1 A rising proportion of the older population. The estimated 8-year risk of atrial fibrillation (AF) is increased by 40% among individuals with a first-degree relative with atrial fibrillation as compared with those without familial atrial fibrillation. (Adapted with permission from Lubitz et al. 7 Gelder Abstract Atrial fibrillation (AF), the most common arrhythmia, is associated with an unfavorable prognosis. 1, 2 The majority of patients have AF in association with underlying (cardiac) diseases. 3 In 15-30% of the patients, however, a known etiology [link.springer.com Objectives Atrial fibrillation (AF) is associated with increased morbidity and mortality in patients with hypertrophic cardiomyopathy (HCM). The primary aim of this study (HCM Risk-AF) was to determine the predictors of AF in a large multicentre cohort of patients with HCM. Exploratory analyses were performed to investigate the association between AF and survival and the efficacy of.
Atrial fibrillation (AF) is a type of arrhythmia, which means that the heart beats fast and irregularly. The risk of AF increases markedly with age. Some of the known causes of AF include chronic high blood pressure, heart valve diseases and hyperthyroidism. Treatment includes medication to slow and stabilise the heart rate and reduce the risk. Atrial fibrillation (AF) : causes, symptoms and treatments. Atrial fibrillation (AF) is a common abnormal heart rhythm or arrhythmia. It causes your heart to beat abnormally, which might feel like your heart is fluttering. AF means the top chambers of your heart (the atria) quiver or twitch, which is known as fibrillation CONTEXT: Atrial fibrillation (AF) is the most common cardiac dysrhythmia in the United States. Whereas rare cases of familial AF have been reported, it is unknown if AF among unselected individuals is a heritable condition. OBJECTIVE: To determine whether parental AF increases the risk for the development of offspring AF
Atrial fibrillation (AF) is the most frequent sustained arrhythmia and a common cause for stroke and heart failure ().Increasing physical activity has convincingly shown to reduce the risk of AF in the general population ().However, a growing body of literature supports a U-shaped relation between lifetime-accumulated high-intensity endurance training and AF in middle-aged men () More than 2 million people in the U.S. have atrial fibrillation. In AFib, the heartbeat is irregular and rapid due to disorganized signals from the heart's electrical system. The upper chambers of the heart may beat as often as 300 - 400 times a minute, about four times faster than normal. Though AFib isn't life threatening, it can lead to other rhythm problems, feeling tired all the time. A frameshift deletion in the sarcomere gene MYL4 causes early-onset familial atrial fibrillation. Eur Heart J. 2017;38:27-34 23. Tucker NR, Mahida S, Ye J, Abraham EJ, Mina JA, Parsons VA, McLellan MA, Shea MA, Hanley A, Benjamin EJ, Milan DJ, Lin H, Ellinor PT. Gain-of-function mutations in GATA6 lead to atrial fibrillation. Heart Rhythm
o 'Lone' Atrial Fibrillation - age < 65 years, isolated episode, no structural heart disease or associated medical conditions. o Paroxysmal - self-terminating within 7 days of recognized onset o Persistent - not self-terminating within 7 days or is terminated electrically or pharmacologicall 1.1 Paroxysmal Atrial Fibrillation Cardiac arrhythmic disorders have been known for over a hundred years, and atrial fibrillation(AF) in particular has now been recognized as the most common of all arrhythmias. Though comprehensive statistics are not available, best estimates reveal that it is probably present in more than 1% of the population
Association between familial atrial fibrillation and risk of new-onset atrial fibrillation. JAMA. 2010;304:2263-9 18. Mahida S, Lubitz SA, Rienstra M, Milan DJ, Ellinor PT. Monogenic atrial fibrillation as pathophysiological paradigms. Cardiovasc Res. 2011;89:692-700 19. Li RG, Wang Q, Xu YJ, Zhang M, Qu XK, Liu X, Fang WY, Yang YQ AimsAtrial fibrillation (AF) is the most common cardiac arrhythmia, and early-onset lone AF has been linked to mutations in genes encoding ion channels. Mutations in the pore forming subunit KV4.3 leading to an increase in the transient outward potassium current (Ito) have previously been associated with the Brugada Syndrome. Here we aim to determine if mutations in KV4.3 or in the auxiliary. A randomized active-controlled study comparing the efficacy and safety of vernakalant to amiodarone in recent-onset atrial fibrillation. J Am Coll Cardiol 2011;57:313-321 . Share via
f longer hospitalization. Patients and methods: All patients with acute AF, either of new onset or recurrent, admitted to our hospital during a 12-month period were included in the study. Hospital records were reviewed retrospectively. The success of conversion to sinus rhythm was recorded in association with a series of clinical and laboratory factors. Results: Sixty-seven patients (39 men. About. What is covered. This NICE Pathway covers diagnosing and managing atrial fibrillation in people aged 18 and over with new-onset or acute atrial fibrillation or chronic atrial fibrillation, including paroxysmal (recurrent), persistent and permanent atrial fibrillation A prespecified exploratory analysis of the FIDELIO-DKD study demonstrates that finerenone may significantly reduce the risk of new onset atrial fibrillation or flutter (AFF) in patients with CKD and T2D versus placebo when added to standard of care / This analysis also concluded that finerenone reduced the risk of kidney or cardiovascular events with no significant difference in the effect of. CPG management of atrial fibrillation. 1. MOH/P/PAK/259.12 (GU) 2. STATEMENT OF INTENTThis guideline is meant to be a guide for clinical practice, based on the bestavailable evidence at the time of development. Adherence to this guideline maynot necessarily guarantee the best outcome in every case. Every health careprovider is responsible for. Treatment of Atrial Fibrillation. MichaelS: I've been diagnosed with paroxysmal a-fib with about two episodes per year over the last six years. How long should I wait to go to the emergency room? I usually convert within 90 minutes to 12 hours of onset and do not go to the ER
Ventricular fibrillation (V-fib or VF) is an abnormal heart rhythm in which the ventricles of the heart quiver instead of pumping normally. It is due to disorganized electrical activity. Ventricular fibrillation results in cardiac arrest with loss of consciousness and no pulse. This is followed by death in the absence of treatment. Ventricular fibrillation is initially found in about 10% of. Read the latest articles of Heart Rhythm at ScienceDirect.com, Elsevier's leading platform of peer-reviewed scholarly literatur