Three-dimensional submerged wall jets and their transition to density flows: Morphodynamics and implications for the depositional record

Jets that expand from an orifice into an ambient water body represent a basic flow model for depositional environments related to expanding flows. Momentum-dominated jets evolve into gravity-dominated density flows. To understand this transition and its sedimentological relevance, three-dimensional tank experiments with submerged wall jets were conducted, systematically varying parameters such as the initial density difference, bed slope, grain size and sediment supply. Bedform successions could be subdivided into those related to the jet and those related to the density flow. Jet deposits included early-stage bedforms, scours and mouth bars. Early-stage bedforms are asymmetrical dunes that spread concentrically from the orifice. Sediment entrainment by eddies from the expanding jets led to the formation of scours and mouth bars. Flows with lesser initial density difference produced more elongate scours. Conversely, scours became deeper for denser incoming flows. Coarser-grained sediment caused the formation of higher and steeper mouth bars and vice versa. The transition from momentum-dominated jets to gravity-dominated density flows occurred approximately at the mouth-bar crest. Hydraulic jumps were absent in the expanding jet regions and at the transitions to density flows. Instead, complex flow patterns and circulations were inferred from the velocity measurements within the scour and at the mouth-bar crests. Bedform trains related to the density flow were controlled by the grain size and sediment supply. Coarse-grained sediment and high supply rates caused strong mouth-bar aggradation and flow splitting, leading to the formation of bedform trains laterally adjacent to the mouth bar. Fine-grained sediment and low supply rates caused the formation of bedform trains downflow of the mouth bar. The symmetrical bedforms deposited by the density flows always displayed an in-phase relationship with the flow, indicating that they were antidunes. The experimental jet deposits resemble successions known from subaqueous ice-contact fans and deep water channel-lobe transition zones

Re-examining models of shallow-water deltas: Insights from tank experiments and field examples

Shallow-water deltas remain enigmatic in terms of placing the observed facies within a coherent process-based depositional model. Here we report tank experiments on mouth-bar formation from shallow water pure and stratified jets that, combined with recent flume experiments on bedforms, suggest new interpretations of field observations from shallow-water delta outcrops. Our experiments imply that the height, geometry and bedforms of the mouth bars depend on the jet properties and grain size of the supplied sediment. Pure jets with very coarse-grained sediment formed a high and steep mouth bar that is characterised by steep angle-of-repose cross bedding with related avalanche processes (grain flows) on the lee side. The experiments with stratified jets imply that mouth-bar deposition and growth are dominated by supercritical density flows that evolve from the initial jets on the lee side of the growing mouth bar. In stratified jets with very coarse-grained sediment, deposition on the mouth-bar lee side was both from grain-flow avalanches and density flows. While deposition on the upper lee slope was dominated by grain flows, a concentric field of low relief, asymmetric, downflow-migrating bedforms evolved on the lower slope and beyond the mouth bar. In the stratified jet with medium-grained sediment a very low relief mouth bar formed within a concentric field of low, asymmetric, downflow-migrating bedforms covering the entire lee slope and the area beyond. Many previous field studies show that mouth bars deposited from dense stratified jets (hyperpycnal flows) are characterised by a distinct facies assemblage of coarse-grained cross-stratified or low-angle cross-stratified sandstone passing downslope into finer-grained plane-parallel, or “quasi-parallel” laminated sand and into climbing-ripple cross-laminated sandstone. Comparison to flume and tank experiments suggests that the proximal coarse-grained planar and trough cross-stratified sandstones could represent deposition by supercritical dunes that pass downslope into antidunes, characterised by sinusoidal stratification and/or low-angle cross stratification. The repeated vertical transition between antidune deposits and climbing-ripple cross-laminated sandstone may indicate the superposition of ripples onto antidunes in finer-grained sediments, indicating ripple formation under supercritical flow conditions. Similar bedforms/sedimentary structures have previously been interpreted as hummocky cross-stratification or swaley cross-stratification and attributed to combined flows in storm-dominated settings, which probably in some cases must be revised

Repetitive levosimendan infusions for patients with advanced chronic heart failure in the vulnerable post-discharge period

Hospitalization for acute heart failure (HF) is associated with a substantial morbidity burden and with associated healthcare costs and an increased mortality risk. However, few if any major medical innovations have been witnessed in this area in recent times. Levosimendan is a first-in-class calcium sensitizer and potassium channel opener indicated for the management of acute HF. Experience in several clinical studies has indicated that administration of intravenous levosimendan in intermittent cycles may reduce hospitalization and mortality rates in patients with advanced HF; however, none of those trials were designed or powered to give conclusive insights into that possibility. This paper describes the rationale and protocol of LeoDOR (levosimendan infusions for patients with advanced chronic heart failure), a randomized, double-blind, placebo-controlled, international, multicentre trial that will explore the efficacy and safety of intermittent levosimendan therapy, in addition to optimized standard therapy, in patients following hospitalization for acute HF. Salient features of LeoDOR include the use of two treatment regimens, in order to evaluate the effects of different schedules and doses of levosimendan during a 12 week treatment phase, and the use of a global rank primary endpoint, in which all patients are ranked across three hierarchical groups ranging from time to death or urgent heart transplantation or implantation of a ventricular assist device to time to rehospitalization and, lastly, time-averaged proportional change in N-terminal pro-brain natriuretic peptide. Secondary endpoints include changes in HF symptoms and functional status at 14 weeks

Solitary waves for linearly coupled nonlinear Schrodinger equations with inhomogeneous coefficients

Motivated by the study of matter waves in Bose-Einstein condensates and coupled nonlinear optical systems, we study a system of two coupled nonlinear Schrodinger equations with inhomogeneous parameters, including a linear coupling. For that system we prove the existence of two different kinds of homoclinic solutions to the origin describing solitary waves of physical relevance. We use a Krasnoselskii fixed point theorem together with a suitable compactness criterion.Comment: 16 page

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase&nbsp;1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation&nbsp;disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age&nbsp; 6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score&nbsp; 652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc&nbsp;= 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N&nbsp;= 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in&nbsp;Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in&nbsp;Asia&nbsp;and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Enabling planetary science across light-years. Ariel Definition Study Report

Ariel, the Atmospheric Remote-sensing Infrared Exoplanet Large-survey, was adopted as the fourth medium-class mission in ESA's Cosmic Vision programme to be launched in 2029. During its 4-year mission, Ariel will study what exoplanets are made of, how they formed and how they evolve, by surveying a diverse sample of about 1000 extrasolar planets, simultaneously in visible and infrared wavelengths. It is the first mission dedicated to measuring the chemical composition and thermal structures of hundreds of transiting exoplanets, enabling planetary science far beyond the boundaries of the Solar System. The payload consists of an off-axis Cassegrain telescope (primary mirror 1100 mm x 730 mm ellipse) and two separate instruments (FGS and AIRS) covering simultaneously 0.5-7.8 micron spectral range. The satellite is best placed into an L2 orbit to maximise the thermal stability and the field of regard. The payload module is passively cooled via a series of V-Groove radiators; the detectors for the AIRS are the only items that require active cooling via an active Ne JT cooler. The Ariel payload is developed by a consortium of more than 50 institutes from 16 ESA countries, which include the UK, France, Italy, Belgium, Poland, Spain, Austria, Denmark, Ireland, Portugal, Czech Republic, Hungary, the Netherlands, Sweden, Norway, Estonia, and a NASA contribution

Climate seasonality limits leaf carbon assimilation and wood productivity in tropical forests

The seasonal climate drivers of the carbon cycle in tropical forests remain poorly known, although these forests account for more carbon assimilation and storage than any other terrestrial ecosystem. Based on a unique combination of seasonal pan-tropical data sets from 89 experimental sites (68 include aboveground wood productivity measurements and 35 litter productivity measurements), their associated canopy photosynthetic capacity (enhanced vegetation index, EVI) and climate, we ask how carbon assimilation and aboveground allocation are related to climate seasonality in tropical forests and how they interact in the seasonal carbon cycle. We found that canopy photosynthetic capacity seasonality responds positively to precipitation when rainfall is  < 2000 mm yr⁻¹ (water-limited forests) and to radiation otherwise (light-limited forests). On the other hand, independent of climate limitations, wood productivity and litterfall are driven by seasonal variation in precipitation and evapotranspiration, respectively. Consequently, light-limited forests present an asynchronism between canopy photosynthetic capacity and wood productivity. First-order control by precipitation likely indicates a decrease in tropical forest productivity in a drier climate in water-limited forest, and in current light-limited forest with future rainfall  < 2000 mm yr⁻¹

Contourite channels: facies model and channel evolution

[EN] Despite the rise in published evidence of deep-marine bottom current processes and associated deposits there are still very few documented outcrop examples. Herein are reported results of a contourite channel system related to the late Miocene palaeo-Mediterranean Outflow Water in the Rifian Corridor, Morocco. This work aims to unravel the sedimentary evolution and facies distribution based on the study of large morphological features related to contourite channels and their subsequent sandstone dominated infill sequences. It was found that the channel evolution and facies distribution are related to spatiotemporal changes in flow characteristics of the palaeo-Mediterranean Outflow Water. The recognized channel facies distribution correlates well with previously established bedform stability diagrams. Erosion and upper-stage flow regime bedforms are associated with the most vigorous bottom currents, generally related to its core. Laterally, following the decrease in flow velocity towards the adjacent drift, bedforms comprise dunes, lower-stage plane bedforms and more heterolithic facies. Similar facies changes are also observed down-channel, related to a decrease in flow velocities resulting from turbulent mixing of water masses, associated decreases in density gradients and the subsequent deceleration due to gravity. Results of this work have been used to propose a three-dimensional facies model for channelized sandy contourites. This study contributes to understanding contourite systems, thus benefitting oceanographic and climatic reconstructions as well as aiding the predictability of contourite channel systems for industry geoscience applications.This project was funded by the Joint Industry project supported by Total, BP, ENI, ExxonMobil, Wintershall DEA and TGS, executed in the framework of ‘The Drifters Research Group’ at Royal Holloway University of London (RHUL). The research contribution of O. Miguez-Salas was funded through a pre-doctoral grant from the Ministerio de Educacion, Cultura y Deporte (Gobierno España).Peer reviewe