Results of the ESO-SEST Key Programme on CO in the Magellanic Clouds. IX. The giant LMC HII region complex N11

We present maps and a catalogue containing the J=1-0 12CO parameters of 29 individual molecular clouds in the second-brightest LMC star formation complex, N11. In the southwestern part of N11, molecular clouds occur in a ring or shell surrounding the major OB star association LH9. In the northeastern part, a chain of molecular clouds delineates the rim of one of the so-called supergiant shells in the LMC. The well-defined clouds have dimensions close to those of the survey beam (diameters of 25 pc or less). Some of the clouds were also observed in J=2-1 12CO, and in the lower two transitions of 13CO. Clouds mapped with a twice higher angular resolution in J=2-1 12CO show substructure with dimensions once again comparable to those of the mapping beam. The few clouds for which we could model physical parameters have fairly warm (T(kin) = 60 - 150 K) and moderately dense (n(H2) = 3000 cm-3) gas. The northeastern chain of CO clouds, although lacking in diffuse intercloud emission, is characteristic of the more quiescent regions of the LMC and appears to have been subject to relatively little photo-processing. The clouds forming part of the southwestern shell or ring, however, are almost devoid of diffuse intercloud emission and also exhibit other characteristics of an extreme photon-dominated region (PDR).Comment: 14 pages; accepted for publication in A&

Results of the ESO-SEST Key Programme on CO in the Magellanic Clouds X. CO emission from star formation regions in LMC and SMC

We present J=1-0 and J=2-1 12CO maps of several star-forming regions in both the Large and the Small Magellanic Cloud, and briefly discuss their structure. Many of the detected molecular clouds are relatively isolated and quite small with dimensions of typically 20 pc. Some larger complexes have been detected, but in all cases the extent of the molecular clouds sampled by CO emission is significantly less than the extent of the ionized gas of the star-formation region. Very little diffuse extended CO emission was seen; diffuse CO in between or surrounding the detected discrete clouds is either very weak or absent. The majority of all LMC lines of sight detected in 13CO has an isotopic emission ratio I(12CO)/I(13CO) of about 10, i.e. twice higher than found in Galactic star-forming complexes. At the lowest 12CO intensities, the spread of isotopic emission ratios rapidly increases, low ratios representing relatively dense and cold molecular gas and high ratios marking CO photo-dissociation at cloud edges.Comment: 13 pages, accepted by Astronomy and Astrophysic

Leisure Attitude, Self-Rated Health, and Psychological Well-Being in Older Adults: A Moderated Mediation Model

Francisco Rodríguez-Cifuentes,1,* M Angeles López-Gonzalez,1,* Fernando Rubio-Garay,2,* Gabriela Topa,3,* Pedro Belo,4,* Ricardo Pocinho,5,* Silvia Silva,6,* Juan José Fernández-Muñoz1,* 1Psychology Department, Faculty of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; 2Associated Center in Albacete, Universidad Nacional de Educación a Distancia, Albacete, Spain; 3Department of Social and Organizational Psychology, Faculty of Psychology, Universidad Nacional de Educación a Distancia, Madrid, Spain; 4Instituto Politécnico de Setúbal, Setúbal, Portugal; 5Instituto Politécnico de Leira- CICS NOVA, Leira, Portugal; 6Escola Superior de Educação e Ciências Sociais Instituto Politécnico de Leiria, Leiria, Portugal*These authors contributed equally to this workCorrespondence: M Angeles López-Gonzalez, Psychology Department, Faculty of Health Sciences, Universidad Rey Juan Carlos, Av. de Atenas, s/n, Alcorcón, Madrid, 28922, Spain, Email [email protected]: A positive leisure attitude among older adults may have a beneficial effect on psychological well-being, both directly and indirectly by fostering a more positive perception of one’s health. This paper presents a correlational design that explores associations among leisure attitude, self-rated health, and psychological well-being, and analyzes the potential moderating role of gender in these relationships.Patients and Methods: The sample was selected using simple random probability sampling (N= 409; 61.9% female; Mean age = 72.9; SD = 8.43¸ Range of age 53 to 93 years). Diverse sociodemographic information was collected, and leisure attitudes, self-perceived health, and psychological well-being (positive affect and emotional ties) were assessed.Results: The results revealed a positive effect of leisure attitude on self-rated health and psychological well-being, with self-rated health fully mediating the association between the behavioral component of leisure attitude and psychological well-being. Furthermore, the moderating effect of gender on the relationship between self-rated health and psychological well-being was stronger among men.Conclusion: Positive cognitive and emotional perceptions of leisure among older adults seem to benefit psychological well-being and improve self-rated health, thereby contributing to healthy ageing.Keywords: ageing, older adults, gender, attitudes to leisure, psychological well-being, emotional tie

Opportunistic infections in immunosuppressed patients with juvenile idiopathic arthritis: analysis by the Pharmachild Safety Adjudication Committee

Background To derive a list of opportunistic infections (OI) through the analysis of the juvenile idiopathic arthritis (JIA) patients in the Pharmachild registry by an independent Safety Adjudication Committee (SAC). Methods The SAC (3 pediatric rheumatologists and 2 pediatric infectious disease specialists) elaborated and approved by consensus a provisional list of OI for use in JIA. Through a 5 step-procedure, all the severe and serious infections, classified as per MedDRA dictionary and retrieved in the Pharmachild registry, were evaluated by the SAC by answering six questions and adjudicated with the agreement of 3/5 specialists. A final evidence-based list of OI resulted by matching the adjudicated infections with the provisional list of OI. Results A total of 772 infectious events in 572 eligible patients, of which 335 serious/severe/very severe non-OI and 437 OI (any intensity/severity), according to the provisional list, were retrieved. Six hundred eighty-two of 772 (88.3%) were adjudicated as infections, of them 603/682 (88.4%) as common and 119/682 (17.4%) as OI by the SAC. Matching these 119 opportunistic events with the provisional list, 106 were confirmed by the SAC as OI, and among them infections by herpes viruses were the most frequent (68%), followed by tuberculosis (27.4%). The remaining events were divided in the groups of non-OI and possible/patient and/or pathogen-related OI. Conclusions We found a significant number of OI in JIA patients on immunosuppressive therapy. The proposed list of OI, created by consensus and validated in the Pharmachild cohort, could facilitate comparison among future pharmacovigilance studies

Association between loop diuretic dose changes and outcomes in chronic heart failure: observations from the ESC-EORP Heart Failure Long-Term Registry

[Abstract] Aims. Guidelines recommend down-titration of loop diuretics (LD) once euvolaemia is achieved. In outpatients with heart failure (HF), we investigated LD dose changes in daily cardiology practice, agreement with guideline recommendations, predictors of successful LD down-titration and association between dose changes and outcomes. Methods and results. We included 8130 HF patients from the ESC-EORP Heart Failure Long-Term Registry. Among patients who had dose decreased, successful decrease was defined as the decrease not followed by death, HF hospitalization, New York Heart Association class deterioration, or subsequent increase in LD dose. Mean age was 66±13 years, 71% men, 62% HF with reduced ejection fraction, 19% HF with mid-range ejection fraction, 19% HF with preserved ejection fraction. Median [interquartile range (IQR)] LD dose was 40 (25–80) mg. LD dose was increased in 16%, decreased in 8.3% and unchanged in 76%. Median (IQR) follow-up was 372 (363–419) days. Diuretic dose increase (vs. no change) was associated with HF death [hazard ratio (HR) 1.53, 95% confidence interval (CI) 1.12–2.08; P = 0.008] and nominally with cardiovascular death (HR 1.25, 95% CI 0.96–1.63; P = 0.103). Decrease of diuretic dose (vs. no change) was associated with nominally lower HF (HR 0.59, 95% CI 0.33–1.07; P = 0.083) and cardiovascular mortality (HR 0.62 95% CI 0.38–1.00; P = 0.052). Among patients who had LD dose decreased, systolic blood pressure [odds ratio (OR) 1.11 per 10 mmHg increase, 95% CI 1.01–1.22; P = 0.032], and absence of (i) sleep apnoea (OR 0.24, 95% CI 0.09–0.69; P = 0.008), (ii) peripheral congestion (OR 0.48, 95% CI 0.29–0.80; P = 0.005), and (iii) moderate/severe mitral regurgitation (OR 0.57, 95% CI 0.37–0.87; P = 0.008) were independently associated with successful decrease. Conclusion. Diuretic dose was unchanged in 76% and decreased in 8.3% of outpatients with chronic HF. LD dose increase was associated with worse outcomes, while the LD dose decrease group showed a trend for better outcomes compared with the no-change group. Higher systolic blood pressure, and absence of (i) sleep apnoea, (ii) peripheral congestion, and (iii) moderate/severe mitral regurgitation were independently associated with successful dose decrease

Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry

Aims: This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results: Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P\ua0 64 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P\ua0=\ua00.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P\ua075 years. Conclusions: There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF 6445%