The ALMA Frontier Fields Survey - IV. Lensing-corrected 1.1 mm number counts in Abell 2744, MACSJ0416.1-2403 and MACSJ1149.5+2223

[abridged] Characterizing the number counts of faint, dusty star-forming galaxies is currently a challenge even for deep, high-resolution observations in the FIR-to-mm regime. They are predicted to account for approximately half of the total extragalactic background light at those wavelengths. Searching for dusty star-forming galaxies behind massive galaxy clusters benefits from strong lensing, enhancing their measured emission while increasing spatial resolution. Derived number counts depend, however, on mass reconstruction models that properly constrain these clusters. We estimate the 1.1 mm number counts along the line of sight of three galaxy clusters, i.e. Abell 2744, MACSJ0416.1-2403 and MACSJ1149.5+2223, which are part of the ALMA Frontier Fields Survey. We perform detailed simulations to correct these counts for lensing effects. We use several publicly available lensing models for the galaxy clusters to derive the intrinsic flux densities of our sources. We perform Monte Carlo simulations of the number counts for a detailed treatment of the uncertainties in the magnifications and adopted source redshifts. We find an overall agreement among the number counts derived for the different lens models, despite their systematic variations regarding source magnifications and effective areas. Our number counts span ~2.5 dex in demagnified flux density, from several mJy down to tens of uJy. Our number counts are consistent with recent estimates from deep ALMA observations at a 3$\sigma$ level. Below $\approx$ 0.1 mJy, however, our cumulative counts are lower by $\approx$ 1 dex, suggesting a flattening in the number counts. In our deepest ALMA mosaic, we estimate number counts for intrinsic flux densities $\approx$ 4 times fainter than the rms level. This highlights the potential of probing the sub-10 uJy population in larger samples of galaxy cluster fields with deeper ALMA observations.Comment: 19 pages, 14 figures, 3 tables. Accepted for publication in A&

Los sistemas de pago por servicios ambientales entre la adicionalidad y la subsidiariedad: aplicación a la belleza escénica en el pantano de San Juan, Madrid, España

A payment for environmental services (PES) based on the beauty of the San Juan dam landscape is proposed containing two innovative aspect in regard to previous PES systems: the elaboration of a diagnosis oriented to obtain a shared vision of the area based in a participative process including all relevant local stakeholders, and the integration of the PES mechanism into the regional public environmental policy. The proposed system also identifies the offer and the demand of the environmental service. It shows the main problems associated to the preservation of the service and proposes management plans oriented to its conservation. Finally, the economic viability of the system is studied comparing three different scenarios according to the grade of integration of the PES model into the regional conservation public policy. This paper shows how a PES system can be used to guarantee public investments in nature conservation through a private management.Se plantea un sistema de pago por servicios ambientales (PSA) basado en la valoración de la belleza escénica en la zona del pantano de San Juan, Madrid, con dos aspectos novedosos respecto a estudios PSA previos: la elaboración de un diagnóstico basado en un proceso participativo que involucra a todos los actores sociales locales y cuyo fin es el de obtener una visión compartida sobre el área, y la integración del mecanismo PSA en la gestión pública regional de la conservación de la naturaleza. El sistema propuesto además identifica los oferentes y demandantes del servicio ambiental, muestra los principales problemas asociados a la conservación del servicio y plantea programas de gestión orientados a contribuir a su conservación. Se estudia, por último, la viabilidad económica del sistema comparando tres escenarios hipotéticos en función del grado de integración del sistema PSA en las políticas públicas de conservación de la naturaleza regionales. El trabajo muestra como un sistema PSA puede servir para garantizar las inversiones públicas en conservación a través de la gestión privada

The ALMA Frontier Fields Survey

CONTEXT: Dusty star-forming galaxies are among the most prodigious systems at high redshift (z > 1), characterized by high star-formation rates and huge dust reservoirs. The bright end of this population has been well characterized in recent years, but considerable uncertainties remain for fainter dusty star-forming galaxies, which are responsible for the bulk of star formation at high redshift and thus play a key role in galaxy growth and evolution. AIMS: In this first paper of our series, we describe our methods for finding high redshift faint dusty galaxies using millimeter observations with ALMA. METHODS: We obtained ALMA 1.1 mm mosaic images for three strong-lensing galaxy clusters from the Frontier Fields Survey, which constitute some of the best studied gravitational lenses to date. The ≈2′ × 2′ mosaics overlap with the deep HST WFC3/IR footprints and encompass the high magnification regions of each cluster for maximum intrinsic source sensitivity. The combination of extremely high ALMA sensitivity and the magnification power of these clusters allows us to systematically probe the sub-mJy population of dusty star-forming galaxies over a large surveyed area. RESULTS: We present a description of the reduction and analysis of the ALMA continuum observations for the galaxy clusters Abell 2744 (z = 0.308), MACS J0416.1-2403 (z = 0.396) and MACS J1149.5+2223 (z = 0.543), for which we reach observed rms sensitivities of 55, 59 and 71 μJy beam-1 respectively. We detect 12 dusty star-forming galaxies at S/N ≥ 5.0 across the three clusters, all of them presenting coincidence with near-infrared detected counterparts in the HST images. None of the sources fall close to the lensing caustics, thus they are not strongly lensed. The observed 1.1 mm flux densities for the total sample of galaxies range from 0.41 to 2.82 mJy, with observed effective radii spanning ≲0.̋05 to 0.̋37 ± 0.̋21 . The lensing-corrected sizes of the detected sources appear to be in the same range as those measured in brighter samples, albeit with possibly larger dispersion

The ALMA Frontier Fields Survey. II. Multiwavelength Photometric analysis of 1.1 mm continuum sources in Abell 2744, MACSJ0416.1-2403 and MACSJ1149.5+2223

CONTEXT: The Hubble and Spitzer Space Telescope surveys of the Frontier Fields provide extremely deep images around six massive, strong-lensing clusters of galaxies. The ALMA Frontier Fields survey aims to cover the same fields at 1.1 mm, with maps reaching (unlensed) sensitivities of <70 μJy, in order to explore the properties of background dusty star-forming galaxies. AIMS: We report on the multi-wavelength photometric analysis of all 12 significantly detected (>5σ) sources in the first three Frontier Fields clusters observed by ALMA, based on data from Hubble and Spitzer, the Very Large Telescope and the Herschel Space Observatory. METHODS: We measure the total photometry in all available bands and determine the photometric redshifts and the physical properties of the counterparts via SED-fitting. In particular, we carefully estimate the far-infrared (FIR) photometry using 1.1 mm priors to limit the misidentification of blended FIR counterparts, which strongly affect some flux estimates in previous FIR catalogs. Due to the extremely red nature of these objects, we used a large range of parameters (e.g. 0.0 <Av< 20.0) and templates (including AGNs and ULIRGs models). RESULTS: We identify robust near-infrared (NIR) counterparts for all 11 sources with Ks detection, the majority of which are quite red, with eight having F814W − Ks ≳ 4 and five having F160W − [ 4.5 ] ≳ 3. From the FIR point of view, all our objects have zphot ~ 1–3, whereas based on the optical SED one object prefers a high-z solution (z ≥ 7). Five objects among our sample have spectroscopic redshifts from the GLASS survey for which we can reproduce their SEDs with existing templates. This verification confirms the validity of our photometric redshift methodology. The mean redshift of our sample is zphot = 1.99 ± 0.27. All 1.1 mm selected objects are massive (10.0 < log  [ M⋆(M⊙) ] < 11.5), with high star formation rates (⟨ log [ SFR(M⊙/ yr) ] ⟩ ≈ 1.6) and high dust contents (8.1 < log  [ Mdust(M⊙) ] < 8.8), consistent with previous ALMA surveys

Choice of the initial antiretroviral treatment for HIV-positive individuals in the era of integrase inhibitors

BACKGROUND: We aimed to describe the most frequently prescribed initial antiretroviral therapy (ART) regimens in recent years in HIV-positive persons in the Cohort of the Spanish HIV/AIDS Research Network (CoRIS) and to investigate factors associated with the choice of each regimen. METHODS: We analyzed initial ART regimens prescribed in adults participating in CoRIS from 2014 to 2017. Only regimens prescribed in >5% of patients were considered. We used multivariable multinomial regression to estimate Relative Risk Ratios (RRRs) for the association between sociodemographic and clinical characteristics and the choice of the initial regimen. RESULTS: Among 2874 participants, abacavir(ABC)/lamivudine(3TC)/dolutegavir(DTG) was the most frequently prescribed regimen (32.1%), followed by tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC)/elvitegravir(EVG)/cobicistat(COBI) (14.9%), TDF/FTC/rilpivirine (RPV) (14.0%), tenofovir alafenamide (TAF)/FTC/EVG/COBI (13.7%), TDF/FTC+DTG (10.0%), TDF/FTC+darunavir/ritonavir or darunavir/cobicistat (bDRV) (9.8%) and TDF/FTC+raltegravir (RAL) (5.6%). Compared with ABC/3TC/DTG, starting TDF/FTC/RPV was less likely in patients with CD4100.000 copies/mL. TDF/FTC+DTG was more frequent in those with CD4100.000 copies/mL. TDF/FTC+RAL and TDF/FTC+bDRV were also more frequent among patients with CD4<200 cells//muL and with transmission categories other than men who have sex with men. Compared with ABC/3TC/DTG, the prescription of other initial ART regimens decreased from 2014-2015 to 2016-2017 with the exception of TDF/FTC+DTG. Differences in the choice of the initial ART regimen were observed by hospitals' location. CONCLUSIONS: The choice of initial ART regimens is consistent with Spanish guidelines' recommendations, but is also clearly influenced by physician's perception based on patient's clinical and sociodemographic variables and by the prescribing hospital location

Impact of renal impairment on atrial fibrillation: ESC-EHRA EORP-AF Long-Term General Registry

Background: Atrial fibrillation (AF) and renal impairment share a bidirectional relationship with important pathophysiological interactions. We evaluated the impact of renal impairment in a contemporary cohort of patients with AF. Methods: We utilised the ESC-EHRA EORP-AF Long-Term General Registry. Outcomes were analysed according to renal function by CKD-EPI equation. The primary endpoint was a composite of thromboembolism, major bleeding, acute coronary syndrome and all-cause death. Secondary endpoints were each of these separately including ischaemic stroke, haemorrhagic event, intracranial haemorrhage, cardiovascular death and hospital admission. Results: A total of 9306 patients were included. The distribution of patients with no, mild, moderate and severe renal impairment at baseline were 16.9%, 49.3%, 30% and 3.8%, respectively. AF patients with impaired renal function were older, more likely to be females, had worse cardiac imaging parameters and multiple comorbidities. Among patients with an indication for anticoagulation, prescription of these agents was reduced in those with severe renal impairment, p&nbsp;&lt;.001. Over 24&nbsp;months, impaired renal function was associated with significantly greater incidence of the primary composite outcome and all secondary outcomes. Multivariable Cox regression analysis demonstrated an inverse relationship between eGFR and the primary outcome (HR 1.07 [95% CI, 1.01–1.14] per 10&nbsp;ml/min/1.73&nbsp;m2 decrease), that was most notable in patients with eGFR &lt;30&nbsp;ml/min/1.73&nbsp;m2 (HR 2.21 [95% CI, 1.23–3.99] compared to eGFR ≥90&nbsp;ml/min/1.73&nbsp;m2). Conclusion: A significant proportion of patients with AF suffer from concomitant renal impairment which impacts their overall management. Furthermore, renal impairment is an independent predictor of major adverse events including thromboembolism, major bleeding, acute coronary syndrome and all-cause death in patients with AF

Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation: a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry

Background: Clinical complexity is increasingly prevalent among patients with atrial fibrillation (AF). The ‘Atrial fibrillation Better Care’ (ABC) pathway approach has been proposed to streamline a more holistic and integrated approach to AF care; however, there are limited data on its usefulness among clinically complex patients. We aim to determine the impact of ABC pathway in a contemporary cohort of clinically complex AF patients. Methods: From the ESC-EHRA EORP-AF General Long-Term Registry, we analysed clinically complex AF patients, defined as the presence of frailty, multimorbidity and/or polypharmacy. A K-medoids cluster analysis was performed to identify different groups of clinical complexity. The impact of an ABC-adherent approach on major outcomes was analysed through Cox-regression analyses and delay of event (DoE) analyses. Results: Among 9966 AF patients included, 8289 (83.1%) were clinically complex. Adherence to the ABC pathway in the clinically complex group reduced the risk of all-cause death (adjusted HR [aHR]: 0.72, 95%CI 0.58–0.91), major adverse cardiovascular events (MACEs; aHR: 0.68, 95%CI 0.52–0.87) and composite outcome (aHR: 0.70, 95%CI: 0.58–0.85). Adherence to the ABC pathway was associated with a significant reduction in the risk of death (aHR: 0.74, 95%CI 0.56–0.98) and composite outcome (aHR: 0.76, 95%CI 0.60–0.96) also in the high-complexity cluster; similar trends were observed for MACEs. In DoE analyses, an ABC-adherent approach resulted in significant gains in event-free survival for all the outcomes investigated in clinically complex patients. Based on absolute risk reduction at 1 year of follow-up, the number needed to treat for ABC pathway adherence was 24 for all-cause death, 31 for MACEs and 20 for the composite outcome. Conclusions: An ABC-adherent approach reduces the risk of major outcomes in clinically complex AF patients. Ensuring adherence to the ABC pathway is essential to improve clinical outcomes among clinically complex AF patients

Baseline characteristics of patients in the reduction of events with darbepoetin alfa in heart failure trial (RED-HF)

&lt;p&gt;Aims: This report describes the baseline characteristics of patients in the Reduction of Events with Darbepoetin alfa in Heart Failure trial (RED-HF) which is testing the hypothesis that anaemia correction with darbepoetin alfa will reduce the composite endpoint of death from any cause or hospital admission for worsening heart failure, and improve other outcomes.&lt;/p&gt; &lt;p&gt;Methods and results: Key demographic, clinical, and laboratory findings, along with baseline treatment, are reported and compared with those of patients in other recent clinical trials in heart failure. Compared with other recent trials, RED-HF enrolled more elderly [mean age 70 (SD 11.4) years], female (41%), and black (9%) patients. RED-HF patients more often had diabetes (46%) and renal impairment (72% had an estimated glomerular filtration rate &#60;60 mL/min/1.73 m2). Patients in RED-HF had heart failure of longer duration [5.3 (5.4) years], worse NYHA class (35% II, 63% III, and 2% IV), and more signs of congestion. Mean EF was 30% (6.8%). RED-HF patients were well treated at randomization, and pharmacological therapy at baseline was broadly similar to that of other recent trials, taking account of study-specific inclusion/exclusion criteria. Median (interquartile range) haemoglobin at baseline was 112 (106–117) g/L.&lt;/p&gt; &lt;p&gt;Conclusion: The anaemic patients enrolled in RED-HF were older, moderately to markedly symptomatic, and had extensive co-morbidity.&lt;/p&gt

Impact of clinical phenotypes on management and outcomes in European atrial fibrillation patients: a report from the ESC-EHRA EURObservational Research Programme in AF (EORP-AF) General Long-Term Registry

Background: Epidemiological studies in atrial fibrillation (AF) illustrate that clinical complexity increase the risk of major adverse outcomes. We aimed to describe European AF patients\u2019 clinical phenotypes and analyse the differential clinical course. Methods: We performed a hierarchical cluster analysis based on Ward\u2019s Method and Squared Euclidean Distance using 22 clinical binary variables, identifying the optimal number of clusters. We investigated differences in clinical management, use of healthcare resources and outcomes in a cohort of European AF patients from a Europe-wide observational registry. Results: A total of 9363 were available for this analysis. We identified three clusters: Cluster 1 (n = 3634; 38.8%) characterized by older patients and prevalent non-cardiac comorbidities; Cluster 2 (n = 2774; 29.6%) characterized by younger patients with low prevalence of comorbidities; Cluster 3 (n = 2955;31.6%) characterized by patients\u2019 prevalent cardiovascular risk factors/comorbidities. Over a mean follow-up of 22.5 months, Cluster 3 had the highest rate of cardiovascular events, all-cause death, and the composite outcome (combining the previous two) compared to Cluster 1 and Cluster 2 (all P &lt;.001). An adjusted Cox regression showed that compared to Cluster 2, Cluster 3 (hazard ratio (HR) 2.87, 95% confidence interval (CI) 2.27\u20133.62; HR 3.42, 95%CI 2.72\u20134.31; HR 2.79, 95%CI 2.32\u20133.35), and Cluster 1 (HR 1.88, 95%CI 1.48\u20132.38; HR 2.50, 95%CI 1.98\u20133.15; HR 2.09, 95%CI 1.74\u20132.51) reported a higher risk for the three outcomes respectively. Conclusions: In European AF patients, three main clusters were identified, differentiated by differential presence of comorbidities. Both non-cardiac and cardiac comorbidities clusters were found to be associated with an increased risk of major adverse outcomes