Evidence for polar jets as precursors of polar plume formation

Observations from the Hinode/XRT telescope and STEREO/SECCHI/EUVI are utilized to study polar coronal jets and plumes. The study focuses on the temporal evolution of both structures and their relationship. The data sample, spanning April 7-8 2007, shows that over 90% of the 28 observed jet events are associated with polar plumes. EUV images (STEREO/SECCHI) show plume haze rising from the location of approximately 70% of the polar X-ray (Hinode/XRT) and EUV jets, with the plume haze appearing minutes to hours after the jet was observed. The remaining jets occurred in areas where plume material previously existed causing a brightness enhancement of the latter after the jet event. Short-lived, jet-like events and small transient bright points are seen (one at a time) at different locations within the base of pre-existing long-lived plumes. X-ray images also show instances (at least two events) of collimated-thin jets rapidly evolving into significantly wider plume-like structures that are followed by the delayed appearance of plume haze in the EUV. These observations provide evidence that X-ray jets are precursors of polar plumes, and in some cases cause brightenings of plumes. Possible mechanisms to explain the observed jet and plume relationship are discussed.Comment: 10 pages, 4 figures, accepted as APJ Lette

Auxiliary field diffusion Monte Carlo calculations of light and medium-mass nuclei with local chiral interactions

Quantum Monte Carlo methods have recently been employed to study properties of nuclei and infinite matter using local chiral effective field theory interactions. In this work, we present a detailed description of the auxiliary field diffusion Monte Carlo algorithm for nuclei in combination with local chiral two- and three-nucleon interactions up to next-to-next-to-leading order. We show results for the binding energy, charge radius, charge form factor, and Coulomb sum rule in nuclei with $3\le A\le16$. Particular attention is devoted to the effect of different operator structures in the three-body force for different cutoffs. The outcomes suggest that local chiral interactions fit to few-body observables give a very good description of the ground-state properties of nuclei up to $^{16}$O, with the exception of one fit for the softer cutoff which predicts overbinding in larger nuclei.Comment: 23 pages, 10 figure

LANDSAT TM image data quality analysis for energy-related applications

This project represents a no-cost agreement between National Aeronautic Space Administration Goddard Space Flight Center (NASA GSFC) and the Pacific Northwest Laboratory (PNL). PNL is a Department of Energy (DOE) national laboratory operted by Battelle Memorial Institute at its Pacific Northwest Laboratories in Richland, Washington. The objective of this investigation is to evaluate LANDSAT's thematic mapper (TM) data quality and utility characteristics from an energy research and technological perspective. Of main interest is the extent to which repetitive TM data might support DOE efforts relating to siting, developing, and monitoring energy-related facilities, and to basic geoscientific research. The investigation utilizes existing staff and facility capabilities, and ongoing programmatic activities at PNL and other DOE national laboratories to cooperatively assess the potential usefulness of the improved experimental TM data. The investigation involves: (1) both LANDSAT 4 and 5 TM data, (2) qualitative and quantitative use consideration, and 3) NASA P (corrected) and A (uncorrected) CCT analysis for a variety of sites of DOE interest. Initial results were presented at the LANDSAT Investigator's Workshops and at specialized LANDSAT TM sessions at various conferences

Toxicity of cancer therapy: what the cardiologist needs to know about angiogenesis inhibitors

Clinical outcomes for patients with a wide range of malignancies have improved substantially over the last two decades. Tyrosine kinase inhibitors (TKIs) are potent signalling cascade inhibitors and have been responsible for significant advances in cancer therapy. By inhibiting vascular endothelial growth factor receptor (VEGFR)-mediated tumour blood vessel growth, VEGFR-TKIs have become a mainstay of treatment for a number of solid malignancies. However, the incidence of VEGFR-TKI-associated cardiovascular toxicity is substantial and previously under-recognised. Almost all patients have an acute rise in blood pressure, and the majority develop hypertension. They are associated with the development of left ventricular systolic dysfunction (LVSD), heart failure and myocardial ischaemia and can have effects on myocardial repolarisation. Attention should be given to rigorous baseline assessment of patients prior to commencing VEGFR-TKIs, with careful consideration of baseline cardiovascular risk factors. Baseline blood pressure measurement, ECG and cardiac imaging should be performed routinely. Hypertension management currently follows national guidelines, but there may be a future role forendothelin-1 antagonism in the prevention or treatment of VEGFR-TKI-associated hypertension. VEGFR-TKI-associated LVSD appears to be independent of dose and is reversible. Patients who develop LVSD and heart failure should be managed with conventional heart failure therapies, but the role of prophylactic therapy is yet to be defined. Serial monitoring of left ventricular function and QT interval require better standardisation and coordinated care. Management of these complex patients requires collaborative, cardio-oncology care to allow the true therapeutic potential from cancer treatment while minimising competing cardiovascular effects

Association is not causation: treatment effects cannot be estimated from observational data in heart failure

Aims: Treatment ‘effects’ are often inferred from non-randomized and observational studies. These studies have inherent biases and limitations, which may make therapeutic inferences based on their results unreliable. We compared the conflicting findings of these studies to those of prospective randomized controlled trials (RCTs) in relation to pharmacological treatments for heart failure (HF). Methods and results: We searched Medline and Embase to identify studies of the association between non-randomized drug therapy and all-cause mortality in patients with HF until 31 December 2017. The treatments of interest were: angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, mineralocorticoid receptor antagonists (MRAs), statins, and digoxin. We compared the findings of these observational studies with those of relevant RCTs. We identified 92 publications, reporting 94 non-randomized studies, describing 158 estimates of the ‘effect’ of the six treatments of interest on all-cause mortality, i.e. some studies examined more than one treatment and/or HF phenotype. These six treatments had been tested in 25 RCTs. For example, two pivotal RCTs showed that MRAs reduced mortality in patients with HF with reduced ejection fraction. However, only one of 12 non-randomized studies found that MRAs were of benefit, with 10 finding a neutral effect, and one a harmful effect. Conclusion: This comprehensive comparison of studies of non-randomized data with the findings of RCTs in HF shows that it is not possible to make reliable therapeutic inferences from observational associations. While trials undoubtedly leave gaps in evidence and enrol selected participants, they clearly remain the best guide to the treatment of patients

Peripartum cardiomyopathy: diagnosis and management

No abstract available

A solar active region loop compared with a 2D MHD model

We analyzed a coronal loop observed with the Normal Incidence Spectrometer (NIS), which is part of the Coronal Diagnostic Spectrometer (CDS) on board the Solar and Heliospheric Observatory (SOHO). The measured Doppler shifts and proper motions along the selected loop strongly indicate unidirectional flows. Analysing the Emission Measure Curves of the observed spectral lines, we estimated that the temperature along the loop was about 380000 K. We adapted a solution of the ideal MHD steady equations to our set of measurements. The derived energy balance along the loop, as well as the advantages/disadvantages of this MHD model for understanding the characteristics of solar coronal loops are discussed.Comment: A&A in press, 10 pages, 6 figure

Integrating a framework for conducting public health systems research into statewide operations-based exercises to improve emergency preparedness

<p>Abstract</p> <p>Background</p> <p>Due to the uncommon nature of large-scale disasters and emergencies, public health practitioners often turn to simulated emergencies, known as “exercises”, for preparedness assessment and improvement. Under the right conditions, exercises can also be used to conduct original public health systems research. This paper describes the integration of a research framework into a statewide operations-based exercise program in California as a systems-based approach for studying public health emergency preparedness and response.</p> <p>Methods</p> <p>We developed a research framework based on the premise that operations-based exercises conducted by medical and public health agencies can be described using epidemiologic concepts. Using this framework, we conducted a survey of key local and regional medical and health agencies throughout California following the 2010 Statewide Medical and Health Exercise. The survey evaluated: (1) the emergency preparedness capabilities activated and functions performed in response to the emergency scenario, and (2) the major challenges to inter-organizational communications and information management.</p> <p>Results</p> <p>Thirty-five local health departments (LHDs), 24 local emergency medical services (EMS) agencies, 121 hospitals, and 5 Regional Disaster Medical and Health Coordinators/Specialists (RDMHC) responded to our survey, representing 57%, 77%, 26% and 83%, respectively, of target agencies in California. We found two sets of response capabilities were activated during the 2010 Statewide Exercise: a set of core capabilities that were common across all agencies, and a set of agency-specific capabilities that were more common among certain agency types. With respect to one response capability in particular, inter-organizational information sharing, we found that the majority of respondents’ comments were related to the complete or partial failure of communications equipment or systems.</p> <p>Conclusions</p> <p>Using the 2010 Statewide Exercise in California as an opportunity to develop our research framework, we characterized several aspects of the public health and medical system’s response to a standardized emergency scenario. From a research perspective, this study provides a potential new framework for conducting exercise-based research. From a practitioner’s perspective, our results provide a starting point for preparedness professionals’ dialogue about expected and actual organizational roles, responsibilities, and resource capacities within the public health system. Additionally, the identification of specific challenges to inter-organizational communications and information management offer specific areas for intervention.</p

Randomised controlled trial of specialist nurse intervention in heart failure

&lt;p&gt;Objectives. To determine whether specialist nurse intervention improves outcome in patients with chronic heart failure.&lt;/p&gt; &lt;p&gt;Design. Randomised controlled trial.&lt;/p&gt; &lt;p&gt;Setting. Acute medical admissions unit in a teaching hospital.&lt;/p&gt; &lt;p&gt;Participants. 165 patients admitted with heart failure due to left ventricular systolic dysfunction. The intervention started before discharge and continued thereafter with home visits for up to 1 year.&lt;/p&gt; &lt;p&gt;Main outcome measures. Time to first event analysis of death from all causes or readmission to hospital with worsening heart failure.&lt;/p&gt; &lt;p&gt;Results. 31 patients (37%) in the intervention group died or were readmitted with heart failure compared with 45 (53%) in the usual care group (hazard ratio=0.61, 95% confidence interval 0.33 to 0.96).Compared with usual care, patients in the intervention group had fewer readmissions for any reason (86 v 114, P=0.018), fewer admissions for heart failure (19 v 45, P&#60;0.001) and spent fewer days in hospital for heart failure (mean 3.43 v 7.46 days, P=0.0051).&lt;/p&gt; &lt;p&gt;Conclusions. Specially trained nurses can improve the outcome of patients admitted to hospital with heart failure.&lt;/p&gt